Re Gregory Cane, 2026 CanLII 34253

Re: Gregory Cane

ORB File No: 8467

Hearing held on: Friday, March 6, 2026

Place of Hearing: Southwest Centre for Forensic Mental Health Care, 401 Sunset Drive, St. Thomas

Pursuant to: Section 672.81 (1) of the Criminal Code

Before:

Alternate Chairperson: Ms. T. Mann

Members: Dr. R. Chandrasena

Dr. A. Kerry

Mr. E. Siebenmorgen

Ms. B. Little (via videoconference)

Parties Appearing:

Accused: Gregory Cane

Counsel: Ms. N. Circelli

The person in charge of hospital: Counsel: Ms. J. Zamprogna

Attorney-General of Ontario: Counsel: Mr. J. Huber

AMENDED REASONS FOR DISPOSITION

(Dated April 13, 2026)

Please see underlined change to original reasons made April 23, 2026.

Introduction

1. On December 18, 2023, Mr. Gregory Cane was found not criminally responsible on account of mental disorder (“NCR”), on a charge of manslaughter, contrary to the Criminal Code. Mr. Cane was most recently subject to a Disposition of the Ontario Review Board (“ORB” or “the Board”) dated March 21, 2025 pursuant to which he was ordered detained at the Southwest Centre for Forensic Mental Health Care, St. Joseph's Health Care London (“Southwest” or “the Hospital”), subject to a variety of terms and conditions, including privileges that provide for indirectly supervised passes into Elgin and Middlesex Counties, as well as 72-hour accompanied passes into the same area, up to six times annually.

2. On Friday, March 6, 2026, a panel of the Board convened in person at the Hospital to conduct the annual review of Mr. Cane’s Disposition. The issues for determination were whether Mr. Cane represented a significant threat to the safety of the public within the meaning of s. 672.5401 of the Criminal Code and, if so, what was the necessary and appropriate Disposition having regard to the criteria in s. 672.54 of the Code.

3. Mr. Cane was present and represented throughout the hearing by his counsel, Ms. Circelli. Mr. Cane’s parents and several members of his unit treatment team also attended.

4. The documentary evidence at the hearing consisted of the Hospital Report, dated January 20, 2026 (Exhibit 1). The panel also heard oral evidence from Dr. D. Curry, a postgraduate resident working under the supervision of Dr. J. Quinn, Mr. Cane’s attending psychiatrist. Dr. Quinn also attended the hearing.

5. The hearing proceeded on the basis of a joint submission. At the outset, counsel for all parties agreed that Mr. Cane represented a significant threat to public safety and that the necessary and appropriate Disposition was a Detention Order. The parties jointly proposed the following changes and additions to the previous Disposition:

• increasing the maximum number of 72-hour accompanied passes from six to eight times per year in Elgin and Middlesex Counties, and permitting Mr. Cane to have indirectly supervised time within those passes with an approved itinerary;
• adding seven-day passes, up to four times per year in Elgin and Middlesex Counties;
• adding a privilege permitting Mr. Cane to live in the community in approved supervised accommodation; and
• requiring Mr. Cane to report to the person in charge of the Hospital, or designate, not less than four times monthly while living in the community.

6. For the following Reasons, the panel found that Mr. Cane represents a significant threat to the safety of the public. The necessary and appropriate Disposition in the circumstances is a continuation of the existing Detention Order, amended in accordance with the parties’ joint recommendation as described in the previous paragraph.

The Index Offence

7. The circumstances of the index offence are contained within an agreed statement of facts, from the proceedings at court on December 18, 2023. That agreed statement is helpfully contained within the Hospital Report and includes a summary of the evidence that linked Mr. Cane to the offence. The following essential facts are extracted from the agreed statement:

"The accused in this case is Gregory Cane (38). The victim in this case is Stephen Hutchinson (66). The victim and the accused were friends. On January 31, 2022, the victim was home with his common-law [spouse] Debra McKay at their residence at 12 Springbank Dr in the City of London. Debra left the house at 10:09 am to go to the gym. The victim remained at home and began to make his breakfast. At 10:16 am, a black Chevrolet Cruze plated ARVF114 attended 12 Springbank Drive and parked in the driveway. A lone male is seen exiting the vehicle. This vehicle is registered to the accused.

The victim and accused got into a confrontation in the driveway near the rear of the house closest to the detached garage. During this altercation the accused stabs the victim at least ten times between the chest, neck and back of the victim. Two of the stab wounds pierced the victim's heart and another the neck of the victim. The victim collapsed in the driveway due to his injuries. A knife was left at the scene.

The accused then left the residence in his vehicle at 10:20 am. The victim remained lying in the driveway, suffering from his injuries, until he was found at 11:40 am when Debra returned home from the gym. London Police, Paramedics and London Fire were all called to attend the scene.

The victim was transported to Victoria Hospital with life-threatening injuries. At 12:18 pm, the victim was pronounced deceased by Dr. Parry.

At 10:50 pm, D/C Robertson attended the residence of the accused and conducted a door knock. Of note, the Chevrolet Cruze belonging to the accused was in the driveway. The accused answered the door and was arrested for Murder. He was provided with his Rights to Counsel and Caution which he understood. Police noted an odour of alcohol on the accused. He was transported to the London Police Headquarters Detention Unit at 11:21 pm by Sgt O'Brien.

Police interviewed multiple witnesses to determine if there was any apparent motive for the murder. Witnesses that were interviewed included the family, friends and neighbours of victim, as well as the accused family, co-workers, and friends. The police could not determine any credible motive for the actions of the accused. Nothing was found on the accused or victim's cell phone extraction to suggest any pre-existing argument or tension between the two. The accused family members confirmed that the accused had pre-existing mental health issues that had been generally managed and non-violent. A cell phone extraction from the accused cell phone revealed text messages in January 2022 from the accused complaining of vertigo and paranoia, further indicating he had not been taking his medication and that he was discussing the risks of being psychotic with family.

Self-Report of the Index Offence

8. Mr. Cane reported the thoughts, beliefs, and hallucinations that he experienced in the period prior to and on the day of the index offences. His account to Dr. P. Klassen, who prepared a criminal responsibility assessment, is reproduced in the Hospital Report. The following is extracted from that account:

“Mr. Cane stated that Scott [sic – Stephen] Hutchinson was his "best friend," and he typically saw Mr. Hutchinson approximately weekly. There was reportedly no conflict between them. Mr. Cane stated that Mr. Hutchinson "talks to me now," but Mr. Cane remarked that he is not sure that Mr. Hutchinson is dead (and later opined that Mr. Hutchinson is, in fact, alive).

Mr. Cane stated that the experience of voices came and went from October 2021. He stated that at times, the voices would tell him to kill a friend or friends, and certain referential experiences tended to corroborate the perceived legitimacy of the voices' instructions, though he tried to "block it out." He reported that he also heard voices of family members telling him to "do it!" which he felt meant to kill. He stated that he was not sure where the voices emanated from, indeed stated that he continued to hear them though "I am not as convinced" of the veracity of the voices as he was while he was with Dr. Ramshaw, at which point he thought that it was "the system." Mr. Cane stated that he was told to kill his friend. Thus, he did "what I was supposed to do." He stated that he came home after and drank beer (but stated that he had not consumed alcohol prior). He recalled feeling "maybe I got fooled", when his parents were tearful about the murder. He was not sure why it was Steve Hutchinson who was wanted dead.

I asked Mr. Cane why he would obey the commands, and he responded that he heard, "do this or your brother has to watch you die." He also stated that he was worried if he did not obey, that he would be hospitalized for "life," given "poison," and killed. He felt that they would "let me go," as he was "supposed" to commit the act.

More specifically, Mr. Cane stated that on the day in question, the thoughts "were getting stronger." He stated that he asked the voices that he heard how he was to commit the act, and he was told: "with a knife." He recalled being told, "Go now; he's home now." Thus, Mr. Cane drove to Mr. Hutchinson's home. I asked Mr. Cane if he had been close to acting on these thoughts previously and he stated that he had been. He recalled that some voices also told him, "don't". In response to the presented questions, Mr. Cane stated that he did not talk to Mr. Hutchinson, upon his arrival. He recalled Mr. Hutchinson asking why.

When Mr. Cane was asked about the reported "system," he stated that the identity of "the system" is not clear to him; he is not sure who is behind that, though he believes that it continues. When asked, he stated he was unsure why this should involve Mr. Hutchinson. He reported, at various times, "the system" taking over his motor activities, including work at Loblaws and at the material time. He speculated that the system may be either the government, or the mafia.”

Background Information

9. Mr. Cane’s personal/family, substance use, and prior psychiatric histories are detailed in the Hospital Report, which is in evidence and need not be thoroughly summarized here for the purpose of these Reasons. A very useful summary of this information was, however, prepared in the Reasons for Disposition following his initial post-NCR disposition hearing in 2024, and was reproduced as follows in last year’s Reasons for Disposition, dated April 14, 2025:

“Mr. Cane did not have a criminal record prior to the index offence.

Mr. Cane’s prior history is set out in extensive detail in the reports of Dr. Ramshaw, Dr. Klassen and Dr. Quinn, and will not be repeated in these Reasons. Between 2007 and 2012, Mr. Cane had a number of contacts with the Centre for Addiction and Mental Health (“CAMH”) in Toronto. He was admitted for several weeks in January 2007. Following his discharge Mr. Cane was followed in the Community Outpatient Program. The diagnosis was major depressive disorder with psychotic features. Mr. Cane had further contact with the London Health Sciences Centre (“LHSC”) starting in 2013. In early January 2014, he was admitted to the hospital under the Mental Health Act (“MHA”) for approximately three weeks. His discharge diagnosis was “psychosis not otherwise specified.” Mr. Cane’s care was then transferred to St. Joseph's Healthcare where he was again followed in the community until his last contact with the team on January 19, 2022. Mr. Cane’s last evaluation by a psychiatrist was October of 2021. The diagnosis at that time was “major depressive disorder with residual anxiety symptoms.”

As set out in the Hospital Report, Mr. Cane has a long history of substance use and abuse commencing at the age of 12. His substance of choice was alcohol and he reported having experienced “lots” of blackouts. He acknowledged that alcohol had interfered with his work. Mr. Cane also acknowledged using “lots” of cannabis commencing at age 14.

As above, Mr. Cane's personal history is set out in detail in the reports which were filed as exhibits. Mr. Cane's parents reside together. He acknowledges having a good relationship with both of them. He has two siblings, a younger and an older brother and describes a good relationship with both of them. Mr. Cane graduated from high school and attended Georgian College where he took Golf Course Management for three years.

He completed that program of study and then attended the University of Toronto in General Arts but did not complete his first year. Most of Mr. Cane’s work history involves working at golf courses either in maintenance or as an assistant professional in the shop. While working together at a golf course Mr. Cane became friends with the deceased, Mr. Hutchinson. They remained in contact after Mr. Cane left the course. In 2017, Mr. Cane began working at Loblaws where he remained until his arrest. Mr. Cane has never married nor lived in a common-law relationship.”

10. The foregoing overview provides a chronological backdrop from which to extract the main themes of Mr. Cane’s symptoms and their longstanding nature, especially his paranoid thoughts and delusions. His first admission occurred in January 2007, when his parents brought him to the Centre for Addiction and Mental Health (CAMH) for passive suicidal ideation due to frustration secondary to paranoid delusions. He remained paranoid and guarded during this, was not forthcoming with the treatment team about his paranoid beliefs, and at one point, barred his family from visiting him in the hospital due to paranoia about them. Nevertheless, from a behavioural standpoint, no violence or significant agitation was reported. After his discharge, Mr. Cane was followed by the CAMH first episode psychosis outpatient psychiatry clinic in Peel until 2009. There were concerns about cannabis and alcohol misuse, his medications were adjusted, and there remained no reports of aggression or agitation.

11. Mr. Cane reported that he did not trust others and believed that people were trying to mess up his mind, or worse. He came to the CAMH Emergency Department on his own in February 2012. He believed that he was being targeted and tracked. He reported inconsistent adherence to his antipsychotic medication. He was diagnosed with substance-induced psychosis and referred to addiction services at Credit Valley (currently Trillium Health Partners). Later in 2012, he moved from Mississauga, where he had grown up, to London, as he wanted the experiences that he was having to end. He worked at a golf course there and eventually began to experience the hearing of voices. In his words, while he had moved to London in an attempt to get away from his problems, after he got there, “it happened again” (his fears about what others were doing to him). He was assessed at the outpatient Psychiatry Urgent Consultation Clinic at London Health Sciences (LHSC) in December 2013, reporting that others were talking about him and that he had been nonadherent with his medications for years.

12. A month later, in January 2014, Mr. Cane presented himself, with his brother, at the LHSC Emergency Department. He was certified under the Mental Health Act (MHA) and remained hospitalized for approximately a month. He described being confused with lapses in his memory, was unable to make decisions, and endorsed recent stressors of being laid off work. During his admission, he was anxious, vague in his description of symptoms, believed that others could read his thoughts, and at times appeared unable to speak. He demonstrated moderate to severe cognitive impairment. Nevertheless, he demonstrated no aggression or agitation.

13. Mr. Cane presented with similar symptoms following his admission to the Southwest Centre and was watchful and guarded on his unit. He was noted to have thought blocking and, at times, difficulty engaging in conversation. His mood was stable, but he often appeared agitated and anxious. He was often observed rapidly pacing the unit hallways. He was observed almost daily appearing to be preoccupied, and the treatment team reported witnessing him yelling out random words in what seemed a response to internal stimuli.

14. During Mr. Cane’s initial occupational therapy living skills assessment following the NCR verdict, he reported previous difficulty with his Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs) while experiencing symptoms of his mental illness, such as anxiety, paranoia and being under the control of a “system.” During his first year under the Board’s authority, he continued to experience residual symptoms such as paranoia, auditory hallucinations, delusions, anxiety, and obsessive thinking. He continued to hold delusional beliefs about a larger power, which he referred to as "the system". He continued to believe that “the system” had control over his surroundings and put thoughts into his head. He continued to hold the belief that this system may also be controlling other people and allowing them to talk to him. Mr. Cane expressed an underlying fear that if he told certain staff about his symptoms, “the system” would get angry at him and something bad would happen.

15. Mr. Cane’s participation in group programming, such as recreational activities, was somewhat limited during his initial reporting period. He generally limited his contact with peers and preferred programs that were smaller sized as he was fearful of others finding out about his index offence and was fearful of their judgment. Despite this, he was able to form and maintain some friendships on the unit.

16. During his initial reporting period, Mr. Cane actively worked at expanding his coping strategies through participation in various psycho-therapeutic group programs, including Dialectical Behavioural Therapy (DBT), Distress Tolerance, and Cognitive Behavioural Therapy for psychosis (CBT-p). Beginning in June 2024, he also engaged in psychotherapy for treatment of his anxiety and trauma, the latter related to the index offence that resulted in the loss of his friend.

Evidence for the Current Reporting Year and at the Hearing

17. Mr. Cane’s diagnoses are listed in the Hospital Report as follows:

• Schizophrenia;
• Alcohol and Cannabis Use Disorders in sustained remission in a controlled environment; and
• Cluster “C” personality traits (obsessive-compulsive, avoidant).

18. Mr. Cane continued to reside on a treatment unit, under the care of Dr. A. Malka, for the first portion of the current reporting period. He moved to a rehabilitation readiness unit in early July 2025, at which time he was transferred to Dr. Quinn’s care.

19. Mr. Cane reported that his anxiety improved after venlafaxine was added to his medications in February 2025. This medication was effective in reducing his obsessive thoughts and compulsive behaviours, though some residual symptoms persisted. Mr. Cane stated that he was no longer overthinking as frequently and had significantly reduced his pacing behaviours. Additionally, he noted increased flexibility in his routines, such as sitting in different seats in the day room without distress, whereas previously he would only sit in one specific seat. However, he continued to engage in a highly structured coffee routine and weighed himself daily. The team recommended limiting weigh-ins to once per week, as his preoccupation with weight was consuming his thoughts. Mr. Cane agreed to this adjustment and later confirmed adherence, though expressed frustration at being unable to check his weight more frequently. Mr. Cane acknowledged that anxiety remained an ongoing concern throughout the review period.

20. Despite generally coping well with his residual symptoms, by mid-July, Mr. Cane expressed a desire to eliminate them entirely. As a result, his olanzapine was increased on July 15, 2025, and resulted in reduced referential and paranoid thoughts, though occasional brief paranoid ideas persisted (e.g., concerns about poisoning). He was able to challenge these thoughts promptly with skills learned in CBT for psychosis such as weighing evidence and checking if his thoughts were factual. However, in early August 2025, he reported increased stress related to reintegration into the community, coinciding with the re-emergence of an auditory hallucination, a male voice urging him to “fight to get out.” He maintained his insight, denied intentions of acting on the voice, and agreed to inform staff if he felt at risk of losing control. At his request, his olanzapine dosage was further increased.

21. By mid-August 2025, again attributed to the stress of community integration, Mr. Cane experienced an increase in symptoms, including a belief that the victim was still alive and heightened ideas of connection, such as linking wildfires that he saw on TV to the victim’s last name and a past fire at Mr. Cane’s favourite golf course. Increased pacing, which was a previous marker of unwellness, was also observed. Given the seriousness of his index offence and persistent symptoms, clozapine was recommended as the optimal treatment. Mr. Cane eventually consented and clozapine was initiated on August 13, 2025. Its dosage was gradually titrated to the dose mentioned in the Hospital Report.

22. Dr. Curry explained that there is room to further titrate the clozapine dose upward, but so far, Mr. Cane has not been amenable to this. Mr. Cane is capable of consenting to his psychiatric treatment and has been adherent to his medication while in hospital, but Dr. Curry noted that there were times in his history when he had been non-adherent. Mr. Cane experiences hallucinations that, among other things, instruct him not to take his medication. Dr. Curry confirmed, in response to a question from Ms. Circelli, that the last period of known non-adherence was sometime in 2021 (the year before the index offence in January of 2022).

23. Dr. Curry stated that Mr. Cane has benefited from CBT for psychosis to help “bat away” some of his residual symptoms and the skill he has learned have been effective except when he is stressed. Stress remains the biggest single factor affecting his mental condition. He is at his most vulnerable time when stressed, as it is in these circumstances when he is less able to recognize signs of his decompensation and less likely, especially when experiencing delusions, to be forthcoming about his symptoms. In response to a question from Ms. Circelli, Dr. Curry explained that Mr. Cane can become more guarded at times in response to command hallucinations that direct him to do things and not to do things. Dr. Curry stated that the summer of 2025 was the last time that Mr. Cane reported experiencing command hallucinations, and that more recently, he has been better able to manage his referential and persecutory delusions.

24. Dr. Curry agreed with Ms. Circelli’s suggestion that the index offence was for Mr. Cane an “outlier” from the standpoint of his history. He had no prior history of violent behaviour. Rather, the behaviour was a function of hallucinations that developed in response to stress.

25. A major theme of Mr. Cane’s course in the Hospital has been his primary source of stress, which stems from his index offence and associated feelings of shame and guilt. He expressed concern about what to say when encountering old friends and has engaged in role-playing exercises to practice these interactions. He described some fear of negative interactions with others if he were to divert conversation away from the index offence when asked about it. He expressed concern about being judged by his former peers if they were to find out about the index offence.

26. After being granted indirectly supervised passes in August 2025, Mr. Cane initially participated in programs that appealed to him, such as cooking groups, and registered with addiction services. However, over time, he began to avoid community activities, and his use of community passes became increasingly limited. This was seen by his treatment team as representing a significant barrier in Mr. Cane’s progress toward community living. At the hearing, Dr. Curry supplemented this information from the Hospital Report by stating that Mr. Cane has more recently been able to tolerate increased indirectly supervised community privileges and has been using such passes three to four times weekly.

27. Mr. Cane is reported to possess partial insight into his illness and developing need for treatment. He has expressed an intention to remain adherent to his medication. His insight into his risk for violence is described as partial. He appears to understand the circumstances of the index offence but continues to express disbelief that he could commit it. Discounting his future risk, he has stated that he “wouldn’t listen” to voices if they commanded him to commit acts of violence in the future. Dr. Curry agreed with Ms. Circelli’s suggestion at the hearing that Mr. Cane’s experience of remorse over the index offence demonstrates a level of insight and understanding, and that the situation would be more troubling if he showed no such remorse.

28. The Hospital Report for the current reporting period states that Mr. Cane has not attributed any responsibility for his past violent behaviour to substance use, though he stated his intention to abstain from substances indefinitely. He completed the Concurrent Disorders program and initiated individual counseling sessions with Thames Valley Addictions Services. He began attending in-person sessions in January 2026. Notably, however, during the previous reporting period, the Hospital Report states (p. 27) that when discussing the index offence, Mr. Cane acknowledged that mental illness and substance use were indeed contributing factors.

29. In his oral evidence, Dr. Curry stated that substance use would be detrimental to Mr. Cane’s mental health. He stated that Mr. Cane has used substances as a mechanism for coping with stress in the past, so any use of substances in the future would give an indication that he is under stress. In response to a question from Ms. Circelli, Dr. Curry agreed that from the recitation of the facts of the index offence, there was no substance use at the time, but it did occur afterward.

30. Mr. Cane enjoys the support of his family, especially that of his parents and two brothers. His parents and one brother are approved persons. Mr. Cane has utilized overnight passes with his parents without incident, and has had day passes with his brother, including restaurant visits and, on several occasions, golfing outings. Dr. Curry confirmed that there have been no overnight visits with Mr. Cane’s brother.

31. Dr. Curry addressed the Hospital’s recommendation for a community living privilege that would require supervised accommodation. The treatment team is recommending that Mr. Cane reside at a 24/7 supervised group home. While Mr. Cane desires to live independently in an apartment in a building owned by his brother, Dr. Curry stated that he would prefer to have Mr. Cane “walk before we run”. Mr. Cane had a tour of the proposed group home earlier during the week of the hearing, and according to Dr. Curry, this visit went well. Dr. Curry referred to and adopted the Clinical Risk Summary and Re-Offence Scenario set out in the Hospital Report. He emphasized that without adequate supervision and support in his living environment, the increased stress that Mr. Cane experiences in relation to community reintegration would lead to a re-emergence of his symptoms.

32. In Dr. Curry’s opinion, the Hospital’s ability to approve Mr. Cane’s accommodation is critical to his wellness. In response to a panel member’s question, he reiterated his opinion that the accommodation needs to be supervised at some level. In Dr. Curry’s opinion, Mr. Cane could realistically be living in the community within the coming reporting period. More data from Mr. Cane’s use of his community passes is necessary prior to further vocational testing, which would lead to a referral to the proposed group home or other supervised home. In Dr. Curry’s words, the treatment team wishes to see “how sturdy the ground is” in relation to Mr. Cane’s use of community passes, initially for recreational purposes.

33. Ms. Circelli addressed the issue of Mr. Cane’s limited use of community passes. Dr. Curry agreed with her suggestion that Mr. Cane’s physical hip and back pain, described in the Hospital Report, likely contributed to this. Dr. Curry updated the parties and the panel by advising that in the weeks preceding the hearing, his pain has experienced significant resolution.

34. With respect to Mr. Cane’s obsessive-compulsive behaviours, Dr. Curry advised that over the year, the anxiety that was associated with this behaviour subsided, and accordingly so have the behaviours themselves.

35. Dr. Curry was questioned further by panel members concerning Mr. Cane’s issues around avoidance, guilt, and shame over the index offence. He said that Mr. Cane’s paranoia is also “on the table” in regard to this. He advised that Mr. Cane has reached out to close friends from before the incident and not heard back from them. Mr. Cane is experiences the index offence as a barrier in at least three ways:

(i) through grieving the loss of his friend, the victim;

(ii) through his personal remorse; and

(iii) through his avoidance issues.

36. A suggestion was made that Mr. Cane may benefit from “role-play” help along with some “scripts” to use to help him with interactions when a subject such as the index offence arises. Dr. Curry stated that some of this work has been already done, but the treatment team could look into this even more.

37. Dr. Curry advised that the treatment team has also been working closely with Mr. Cane’s family members around their understanding of mental illness and the index offence. They are provided with psychoeducation around Schizophrenia and its symptoms. They have engaged well and are willing to work with the team. This work has resulted in some “loosening” in terms of Mr. Cane’s ability to interact with his family.

38. Dr. Curry also confirmed that Mr. Cane’s family members are amenable to the Hospital’s recommendation around extending Mr. Cane’s community passes.

39. Panel members questioned Dr. Curry about the absence, from the re-offence scenario in the Hospital Report, of any discussion of the role, if any, of substance use or medication nonadherence in relation to risk. Dr. Curry clarified that in his opinion, both matters are indeed relevant to Mr. Cane’s risk. As Mr. Cane is on both clozapine and a long-acting injectable antipsychotic medication, there would be some protective effect from the latter medication if he were to discontinue the clozapine. Even so, Dr. Curry opined that Mr. Cane would likely experience decompensation within days to weeks, or even more quickly. He is prescribed a near maximum dose of his long-acting medication, yet still experiences intermittent symptoms.

40. No further evidence was led following that of Dr. Curry.

Analysis and Conclusions

41. Dealing first with the matter of “significant threat”, the panel is satisfied that Mr. Cane represents a significant threat to the safety of the public. Notably, all parties agreed on this issue. Mr. Cane suffers from a serious mental illness, the symptoms of which have impacted his life for many years. Notably, he moved from his home area of Mississauga to London in a failed attempt to get away from what he perceived as the source of his problems. Those symptoms have included paranoid delusions which have impaired his relationships, specifically his ability to trust others.

42. In addition, Mr. Cane’s illness manifests itself in the form of auditory hallucinations of a commanding nature. In response to those command hallucinations, he committed a serious act of violence, with a weapon, that had fatal consequences. The victim was a known acquaintance who was indeed described as a friend.

43. Mr. Cane has no criminal history and no history of any form of aggressive behaviour. Indeed, as the psychiatric history reviewed earlier in these Reasons indicates, even when he was actively psychotic during earlier psychiatric admissions, he was never aggressive or agitated. However, from his self-report, Mr. Cane’s command hallucinations began in late 2021, at a time when he was nonadherent to previously prescribed medication. Those hallucinations were active during the most recent reporting period and are related to increased stress upon Mr. Cane (most recently, stress associated with efforts at community reintegration). This prompted the initiation of clozapine. While no hallucinations have been reported since clozapine treatment began in August 2025, this medication is a recent part of Mr. Cane’s treatment regimen. He continues to experience other active symptoms of his illness and his medication is not yet considered optimized.

44. While Mr. Cane is currently relatively stable, apart from his ongoing symptoms, it is clear that his stability is a function of his adherence to his main antipsychotic medication, which is administered orally with his consent, and the support and supervision that he has received in the structured environment of the Hospital.

45. It is of concern that the efforts being undertaken to facilitate Mr. Cane’s reintegration into the community, and indeed the prospect of the achievement of that goal, are themselves current contributors to the kind of stress that exacerbates Mr. Cane’s symptoms. His treatment team is sensitive to this and is taking a gradual and measured approach to this process. This is a critical time in Mr. Cane’s rehabilitation. It is evident that without the oversight of a forensic mental health facility and its staff, Mr. Cane would pose a real risk of experiencing a serious decompensation of his illness and engage in serious conduct, of a criminal nature, that is likely to result in serious (indeed catastrophic) physical or psychological harm.

46. The panel adopts, in making this finding, the list of risk factors in the Clinical Summary of Risk in the Hospital Report and finds itself in agreement with the risk scenario in that Report, which states:

“Absent forensic supervision and support, Mr. Cane would experience significant stress. He would likely choose to live somewhere with inadequate supervision and support, such as an independent apartment, or with family. He would not be forthcoming with symptoms, as in the past. His stress would exacerbate his psychotic symptoms, which include command hallucinations and delusions of reference. As in the index offence, he would be at significant risk of responding to such symptoms with violence.”

47. Turning to the matter of disposition, the panel agrees with the parties’ joint position that the necessary and appropriate Disposition continues to be a Detention Order. There is no air of reality to a Conditional Discharge at this juncture, and no party suggested that this could be an appropriate Disposition.

48. The panel is satisfied on the evidence that Mr. Cane may be ready to live in the community in some form of supervised accommodation during the next reporting period, and that the expanded list of privileges recommended jointly by the parties can support Mr. Cane’s move toward community living in a manner that protects the public while supporting his mental health and wellbeing and addressing his other needs. Mr. Cane enjoys the support of his parents and brothers, and a good therapeutic rapport with his treatment team. The panel is satisfied that a Detention Order, with the terms and conditions proposed by the parties, constitutes the least onerous and least restrictive Disposition that addresses the statutory factors as they apply to Mr. Cane’s particular circumstances.

49. In concluding these Reasons, the panel wishes to commend Mr. Cane on his work with his treatment team to date. He has done well in overcoming significant challenges. We encourage him to continue working collaboratively with his team and his family, who provides him with good support. We particularly encourage Mr. Cane to continue to work with his treatment team as they seek to support both him and his family members in their understanding of the symptoms of his illness.

DATED this 13^th day of April 2026, at the City of Toronto, in the Toronto Region.

Eric Siebenmorgen

Legal Member

____________________________

Office of the Registrar

Ontario Review Board