Ontario Review Board
Re: Trey Thomas
ORB File No. 7475
Hearing Date: March 3, 2026
Hearing Location: St. Joseph’s Healthcare Hamilton, West 5th Campus
Pursuant to: Section 672.81(1) of the Criminal Code of Canada;
Before:
Alternate Chairperson: Mr. R. Bigelow
Members: Dr. K. Hand Dr. T. Stirpe Ms. M. McKinnon Mr. K. McKenna
Parties Appearing:
Accused: Trey Thomas Counsel: Mr. A. Rai
The Person in charge of Hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Ms. J. McKenzie
REASONS FOR DISPOSITION
(Dated March 25, 2026)
Introduction
Mr. Thomas was found not criminally responsible (NCR) on December 21, 2018, for the Criminal Code offence of assault with a weapon.
He is currently subject to a detention order under a Disposition dated March 26, 2025, with privileges that extend to living in the community of Southern Ontario in accommodation approved by the person in charge.
A panel of the Ontario Review Board (the panel) convened this annual hearing on March 3, 2026, at St. Joseph’s Healthcare Hamilton, West 5th Campus (St. Joseph’s or the Hospital) to review the current Disposition pursuant to s. 672.81(1) of the Criminal Code of Canada.
Mr. Thomas receives a monthly income from the Seminole Tribe in Florida. Two personnel from this Tribe attended the hearing by videoconferencing.
At the commencement of the hearing, the Hospital recommended a continuation of the current Disposition with no changes to the terms and conditions. Crown Counsel and counsel for Mr. Thomas supported this recommendation.
After considering the evidence, the panel also concluded that Mr. Thomas remains a significant threat to the safety of the public, and that a continuation of last year’s Disposition with the same terms and conditions was necessary and appropriate.
Index Offence
- The following is a synopsis of the facts pertaining to the index offence.
The Index Offence occurred on August 11, 2018. Mr. Thomas attended the home of his sister and her boyfriend (Janet Thomas and Jordan Hill), and asked for his passport. He was told they did not have his passport. Mr. Thomas became upset he went outside and grabbed a shovel which he used to strike Ms. Thomas’ vehicle numerous times. Mr. Thomas then swung the shovel at Jordon Hill and Brody Thomas who were attempting to take the shovel away from him. The police arrived and arrested Mr. Thomas. The police report indicates that in the six weeks prior to the index offence they received 15 mental health related calls concerning Mr. Thomas.
Hospital Report dated February 25, 2026
The Hospital Report dated February 25, 2026, was prepared for this hearing and contains a detailed review of Mr. Thomas’ personal and mental health history.
Mr. Thomas is diagnosed with Schizophrenia and Substance Use Disorder (in remission).
Mr. Thomas’ mother was originally from Florida and part of the Seminole Tribe. His father was a member of the Six Nations. When Mr. Thomas was 9 years of age his mother returned to Florida. She died in a motor vehicle accident in 2015. In October 2017, his father committed suicide.
Prior to the index offence, Mr. Thomas lived with his sister Janet. She advised that her brother started to become withdrawn at the age of 15, and that she began to notice psychotic symptoms at the age of 17 following the death of their father. He completed High School but has no work history.
He has had numerous admissions to the hospital for psychiatric care prior to the NCR finding. In January 2018, he attempted suicide and was observed to be responding to command hallucinations. In April 2018, he was hospitalized after telling police that he had abused children and that he was considering suicide. He was further hospitalized in August 2018, after telling police that he had thoughts of harming his sister. Mr. Thomas was described as acutely psychotic and hearing voices when he was admitted to St. Joseph’s on September 5, 2018. During the time of these admissions, Mr. Thomas was not taking his medication and was consuming marijuana. The hospital notes prior to the index offence refer to Mr. Thomas as being psychotic, having no insight into his condition, and responding to internal stimuli.
At the time of his admission to St. Joseph’s in September 2018, Mr. Thomas continued to express that he was a child molester, and would not accept that these thoughts were delusions. Clozapine was introduced to his medication regimen which resulted in noticeable improvements. The auditory hallucinations, however, continued and were at times severe. The hospital reports indicate that Mr. Thomas lacked the motivation to engage in meaningful activities.
Following the NCR finding on December 21, 2018, Mr. Thomas remained an inpatient at St. Joseph’s until March 8, 2021, when he was discharged to live in the community at a home operated by the Canadian Mental Health Association. He was readmitted to the hospital on March 16, 2021, after advising the housing staff of suicidal thoughts. The Hospital concluded that Mr. Thomas required housing that provided closer supervision and monitoring. It was apparent that there was no structure to his day, he was likely not taking his medication, and he complained of feeling lonely.
In August 2021, Mr. Thomas was accepted into a welding program at Mohawk College. He did not complete the necessary paperwork or pursue the program. The Hospital Report indicates that this is an example of his lack of motivation and reluctance to engage in activities or programming.
In January 2023, Mr. Thomas was discharged from the hospital to reside in the community at Emmaus Place. This facility is operated by the Good Shepherd and has 24 hours per day supervision. The staff at Emmaus Place indicated that Mr. Thomas missed scheduled appointments, and would not approach staff for his medication as he was directed to do. He attended some recreational programs but required significant encouragement. The staff described Mr. Thomas as being mentally stable but his mood fluctuated. He preferred to sleep in late, and as a consequence, missed his morning medication on many occasions. The missed medication was not his antipsychotic medication.
Mr. Thomas has been readmitted to the hospital on numerous occasions since his discharge to Emmaus Place in January 2023.
On April 18, 2023, he was readmitted after experiencing suicidal ideation.
He was admitted at his request on October 25, 2023, for suicidal thoughts.
On September 15, 2023, he was readmitted after advising staff that he was feeling lonely and unwell.
On October 25, 2023, he was readmitted for a similar reason and stated to staff that he felt safer in the hospital.
He was readmitted on February 1, 2024 for passive suicidal ideation.
On April 5, 2024, he was readmitted after disclosing significant suicidal plans to his outpatient team. He has remained in the hospital since that time.
Mr. Thomas does not have a criminal record.
He has reported to staff that social withdrawal, isolation, and increased sleep indicate that he is decompensating. These symptoms are often precipitated by feelings of loneliness or boredom.
Mr. Thomas would often report to staff that the auditory hallucinations he had experienced in the past were now fine. However, he is not typically forthcoming with information concerning these hallucinations, so it has been difficult for the treatment team to assess the frequency and intensity of the hallucinations.
The staff at Emmaus Place indicated that they were providing more extensive support for Mr. Thomas than they provided to the other tenants. They were meeting with him twice weekly for scheduled appointments, they were performing nightly telephone check-ins, and they were observing Mr. Thomas take his medication. Following his readmission to hospital in April 2024, Emmaus Place advised the Hospital that they were terminating his tenancy. This was a result of his numerous readmissions, and the staff view that he was not making any progress.
On October 15, 2024, Mr. Thomas attempted suicide by cutting his left forearm. He was placed on 1:1 constant observation from October 15 to October 23. His affect appeared sad at the time. He refused to discuss the incident with staff.
The Hospital Report indicates that this past year Mr. Thomas has reported auditory hallucinations in the form of “noise in the background.” He claims that they are generally well managed and controlled. However, on January 27, 2025, Mr. Thomas informed his social worker that he withholds information from staff, including perceptual disturbances that he experiences. This information is withheld so as to not lose his privileges.
He continues to present with low mood, and his conversation with staff is typically superficial and flat. When questioned about his mood, he responds by stating that he doesn’t want to talk about it. He has periodically, with hesitation, reported suicidal ideation which is mostly passive in nature.
Mr. Thomas consistently adheres to the unit rules and utilizes therapeutic passes appropriately. His urine drug screens have all been negative for alcohol and substances. With prompting from staff, he has been compliant with his medication.
Mr. Thomas has been engaged on a weekly basis with the social worker to develop his DBT skills to manage his fluctuating mood and passive suicidal ideation. With encouragement, he tries to use the skills he has learned to assist him with coping with his fluctuating mood and the passive suicidal ideation. He does not engage openly with staff and requires a significant amount of support.
Mr. Thomas expresses interest in employment or furthering his education, but has difficulty following through on these plans. He has minimal contact with his siblings.
The social worker has been in communication with the Seminole Tribe in Florida to determine if funding is available to obtain the services of a support worker who could assist Mr. Thomas when he is discharged to live in the community. The Seminole Tribe has been very involved with Mr. Thomas since the end of 2024. In March 2025, he became involved with their Financial Guardianship Program. The Tribe is able to financially support his health-related costs. Mr. Thomas has met with the Tribe’s Guardianship Supervisors virtually on several occasions to discuss his current status and future goals.
There were two incidents this past year that were noted in the Hospital Report. On January 23, 2025, Mr. Thomas was found to have concealed a razor cartridge. He admitted to being triggered to remove the razor by something he heard on television. Mr. Thomas was moved to a room closer to the care desk on October 6, 2025, as a result of low mood and thoughts of suicide. He was closely monitored and kept from accessing items with which he could harm himself. Mr. Thomas used a key to scratch the word ‘death’ on the floor outside the unit.
Mr. Thomas is capable to manage his finances including the income from the Seminole Tribe. He is also capable of independently managing daily activities such as grooming, basic meal preparation, and utilizing public transit.
Mr. Thomas struggles with engaging in community-based activities without the presence of staff. He typically restricts his participation to structured forensic programming because of increased anxiety and limited coping skills in a social setting. This is a concern when considering Mr. Thomas living independently in the community.
Mr. Thomas is not currently on a housing waitlist. He is able to afford market rent for an apartment when living in the community becomes an available option.
Dr. Prat Testimony
Dr. Prat is the treating psychiatrist for Mr. Thomas, and he testified at this hearing.
He stated that Mr. Thomas has made some improvement this past year. He has been better engaged with certain programming, and has been working towards greater independence.
Dr. Prat advised the hearing that last week Mr. Thomas expressed a feeling of hopelessness. Dr. Prat reiterated that Mr. Thomas struggles with coping with these mood fluctuations, and that he struggles with social anxiety. It is very important, according to Dr. Prat, that regulating Mr. Thomas’ emotions be achieved.
Dr. Prat identified Mr. Thomas having relationships with other people as being very beneficial to his emotional health, but that developing such relationships is very difficult for him.
Regarding significant threat to the safety of the public, Dr. Prat believes Mr. Thomas remains a significant threat, and generally, referred to limited insight into his illness and the need for treatment, his emotional fragility and the very real risk of relapse.
Dr. Prat also referred to Mr. Thomas’ reluctance to inform the staff when his mood is low or he is experiencing psychotic symptoms as an issue that needs improvement.
Dr. Prat confirmed with counsel for Mr. Thomas that Mr. Thomas is treatment capable, he has been compliant with his medication, he has not consumed substances including alcohol, and that there have been no suicide attempts since January 2025.
Regarding housing in the community, Dr. Prat testified that at the present time Mr. Thomas requires housing that provides support. If Mr. Thomas’ condition improves, supportive housing may become less important. He is able to function independently, but does not believe the support provided by the Forensic Outpatient Program alone is currently sufficient. Dr. Prat stressed that Mr. Thomas would benefit from having friends in the community with whom he could interact to address the mood fluctuations.
Submissions
At the conclusion of the evidence, the parties continued to recommend a continuation of the detention order with the same terms that are in last year’s Disposition.
The Hospital referred to Mr. Thomas continuing to experience the same issues that have existed for many years, and that any progress has been slow. Crown Counsel agreed with the comments from the Hospital, and counsel for Mr. Thomas referred to medication compliance, negative drug screens, and his regular engagement with the Seminole Tribe as being encouraging.
Analysis
After considering the evidence, the panel accepts that there is ample evidence to support a conclusion that Mr. Thomas remains a significant threat to public safety. This includes a significant threat to his own safety.
There continues to be a prevalence of fluctuating moods and suicidal ideation, although usually passive. He commonly experiences despondency, a sense of loneliness, and boredom. It has been difficult for Mr. Thomas to progress because he also suffers from social anxiety, and prefers to engage in social activities only when hospital staff are present.
Mr. Thomas has difficulty coping with his fluctuating emotional state, and the evidence is clear that ensuring mental health stability relies not only medication, but also on well-managed emotional regulation. The emotional regulation is somewhat compromised by the social anxiety.
It is the evidence that if Mr. Thomas were not under the care of the forensic program and compelled to follow various rules, he would not be able to manage his emotions and very likely discontinue treatment. His condition would deteriorate, his despondency would become more intense, and there would be a reemergence of intense psychotic symptoms. This would create a significant risk to public safety.
There is also a significant risk to Mr. Thomas personally. He has a persistent history of suicidal ideation, and has on a few occasions attempted suicide. As recently as October 6, 2025, the Hospital had to move Mr. Thomas’ room closer to the care desk so he could be closely monitored after expressing to the staff serious suicidal thoughts. In his present condition it would be inappropriate for Mr. Thomas to live independently. The risk of harm to the public and to himself could not be properly managed with independent housing at this time.
It does appear, however, that having a person regularly engage with Mr. Thomas by frequently visiting his home and monitoring his mental and emotional health could help to manage his emotional dysregulation and anxiety, and potentially satisfy the Hospital that his risk can be managed living in the community. It may not be necessary for this person to be a member of the forensic team according to Dr. Prat. This appears to be an avenue the Hospital may explore.
Continuing the terms and conditions in last year’s Disposition is appropriate.
Dated this 25th day of March 2026, at the City of Toronto, in the Toronto Region.
Kevin McKenna Legal Member
Office of the Registrar Ontario Review Board