Re: T. (E.), 2026 CanLII 39762

Ontario Review Board

Re: T. (E.)

ORB File No: 6721

Hearing held on: Thursday, April 9, 2026

Place of hearing: Ontario Shores Centre for Mental Health Sciences 700 Gordon Street, Whitby

Pursuant to: Sections 672.81(1) and 672.81(2.1) of the Criminal Code

Before:

Alternate Chairperson: Mr. J. Weinstein

Members: Dr. K. Hand Dr. M. Kalia Hon. A. Sosna Mr. J. Cyr

Parties Appearing:

Accused: T. (E.) Counsel: Ms. J. Boissonneault

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

Attorney General of Ontario: Counsel: Ms. N. MacDonald

*Pursuant to section 110(1) of the Youth Criminal Justice Act, no person shall publish the name of the accused, or any other information, if such publication would identify the accused as a person who was dealt with as a young person under the Youth Criminal Justice Act or the former Young Offenders Act.

REASONS FOR DECISION AND DISPOSITION

(Dated April 30, 2026)

Introduction

1. On March 23, 2015, Mr. T. (E.) was found not criminally responsible on account of mental disorder, on charges of careless use of firearm, pointing a firearm, and assaulting a police officer, all contrary to the Criminal Code of Canada (“Criminal Code”).

2. Mr. T. (E.) is subject to the terms of a Disposition of the Ontario Review Board (the “Board”) dated April 30, 2025, which ordered that he be detained within the General Forensic Service at Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”).

3. Pursuant to s. 672.56(2) of the Criminal Code, Ontario Shores notified the Board, by letter dated February 19, 2026, that Mr. T. (E.) ’s liberty had been restricted: Mr. T. (E.) had been residing on the General Forensic Community Reintegration Unit (“FCRU”). He was transferred to the Secure Forensic Assessment Rehabilitation Unit (“FARU”), following recurrent substance use and ongoing rule violations related to his plan of care. He was then transferred to the Secure Forensic Assessment Unit (“FAU) on March 7, 2026.

4. On April 9, 2026, the Board convened a hearing at Ontario Shores to conduct the annual review of the current Disposition and to conduct a Restriction of Liberty (“ROL”) hearing.

5. Mr. T. (E.) was present at the hearing and was represented by his counsel, Ms. J. Boissonneault.

6. A Hospital Report, dated March 13, 2026 (the “Hospital Report”), was entered as Exhibit 1.

7. When a hospital significantly restricts the liberty of an accused for more than seven days, it has an obligation, under s. 672.56(2)(b) of the Criminal Code, to provide notice to the Board as soon as possible. Under s. 672.81(2.1), the Board is then required to convene an ROL hearing to review the hospital’s decision, also as soon as is practical. Since Mr. T. (E.) ’s annual hearing was scheduled for April 9, 2026, it was agreed that his annual review and the ROL would happen concurrently.

8. For the ROL, the issues at this hearing were:

a) whether the decision made by the person in charge to significantly increase the restriction of liberty on Mr. T. (E.) was warranted and necessary, as well as the least onerous, and least restrictive, option in the circumstances, at the time of its onset, on February 16, 2026; and

b) whether it continues to be so.

9. For the annual review, the issues at this hearing were:

a) whether Mr. T. (E.) continues to post a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code; and

b) if so, what is the necessary and appropriate Disposition in the circumstances, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.

10. For the reasons set out below and based on the expert evidence and opinions before it, the Board concluded that the initial Restriction of Liberty was warranted, necessary and appropriate, as is the ongoing Restriction of Liberty. The Board found that these restrictions were necessary for public safety, and they represented the least onerous, and least restrictive, interventions available.

11. For the reasons set out below and based on the evidence before us, the Board concluded that Mr. T. (E.) continues to pose a significant threat to the safety of the public. The Board found that the necessary and appropriate Disposition in the circumstances is a Detention Order within the Forensic Service of Ontario Shores. The Board agreed to order an updated Gladue Report and to add a clause permitting Mr. T. (E.) to attend an Indigenous residential treatment centre within the Province of Ontario, approved by the person in charge.

Position of the Parties

12. Counsel for the hospital submitted that both the initial, and the ongoing, restrictions of liberty were warranted, necessary and appropriate. Counsel for the Attorney General agreed with the hospital’s submission.

13. Counsel for Mr. T. (E.) took the position that neither the initial, nor the ongoing, restrictions of liberty were warranted, necessary or appropriate for public safety.

14. Counsels for the hospital and for the Attorney General submitted that the continuation of the existing Detention Order, with the amendment that Mr. T. (E.) now be detained at the Forensic Service of Ontario Shores, was the necessary and appropriate Disposition.

15. Counsel for Mr. T. (E.) submitted that her client no longer posed a significant threat to the safety of the public and that he should be absolutely discharged. In the alternative, should this Board find that the threshold for significant threat has been made, Mr. T. (E.) was seeking a Conditional Discharge. Should the Board find that a Conditional Discharge was not the necessary and appropriate Disposition in the circumstances, her client was requesting the following changes to the current Detention Order:

a) That he be detained at the Forensic Service of Ontario Shores

b) That a new Gladue Report be ordered (the previous Gladue Report was done in 2022)

c) That he be given the permission to attend an Indigenous residential treatment centre within the Province of Ontario, approved by the person in charge

16. At the conclusion of the hearing, counsel for the hospital and Attorney General agreed to the amendments to the Detention Disposition recommended by counsel for Mr. T. (E.) . Counsel for Mr. T. (E.) maintained her initial position.

Current Psychiatric Diagnoses

17. Schizophrenia

Cannabis Use Disorder, severe

(ADHD), predominantly inattentive presentation, mild to moderate

Specific Learning Disorders, with impairments in mathematics and reading

Index Offences

18. The circumstance giving rise to the Index Offences are extracted from last year's Board Reasons as follows (with redactions of identifying information):

“The accused in this matter is T. (E.) of Curve Lake First Nation. He resides with his parents on the First Nation. Currently attending school off of the community. He has a history of drug use; however, he has since quit using due to the effects of possible mental illness and was assessed as part of this investigation on the 10th of October 2014.

On October 9th, 2014 T. (D.) called the Curve Lake detachment reporting having problems with her son. T. (E.) stated that her son was in his bedroom freaking out and that she wished for assistance in calming him down.

Police attended the residence at the address indicated. Upon exiting the police vehicle, Constable Redsky could hear a male party state "Fuck you pigs" and immediately began to fire what was thought to be a handgun. Constable Redsky positioned himself behind the homeowner's vehicle, which was parked in the driveway, and saw the male party at his bedroom window holding what appeared to be a handgun. The male party closed his window and could be heard yelling and trashing his bedroom. Constable Redsky was not struck by any of the projectiles which he heard to land on the driveway area.

Constable Redsky continued to update the Communications Centre and cleared the residence as family members were still in the home. The Constable attempted to speak with the male party at his bedroom door; however, he continuously struck the door with an unknown item causing major damage to the door. As a result, the Constable removed himself from the residence and waited for assisting units to arrive. Once all units arrived, the male party was spoken to and agreed to walk. to the hallway area of the residence. A subsequent arrest was made without incident.

Constable Redsky entered the bedroom in question with members of the Ontario Provincial Police and observed the room to be damaged as broken furniture was on the floor throughout, holes in the wall, clothing all over the place and three knives stuck in the walls in three different areas. Police found a silver hand held air pistol with a black handle next to the bed on the floor and a shotgun was also located in the closet area. Both items were proven safe and seized. As a result of the concerns from his mother for possible drugs and mental illness, the male party was transported to hospital in Peterborough for an assessment and he was committed to be held for 72 hours.

On October 10th, 2014, as a result of information that the male party had been released, Constable Redsky located the male party at a youth drop in Centre in Peterborough. Arrest was made with the male party's mother present. Rights to counsel and caution were attempted; however, the subject did not respond. Constable Redsky observed the male party to nod his head up and down when asked if he wished for his mother to contact a lawyer. Mother stated that she would contact a lawyer.”

Reasons for Restriction of Liberty

19. The Hospital Report sets out the reasons for Mr. T. (E.) ’s transfer to the FARU on February 16, 2026, as follows:

“Mr. T. (E.) was transferred to the Secure Forensic Unit (FARU) on February 16, 2026. This was due to increased risk related to drug use and contraband on FCRU, including the presence of fentanyl found in products that had been brought onto the unit and were in Mr. T. (E.) ’s possession prior to his transfer. The potential for the presence of fentanyl on the unit to cause harm to either Mr. T. (E.), his co-patients, or staff, was deemed to be significant. In addition to this, concerns about his continued use and access to substances whilst on a General Unit were amplified by his refusal to comply with his antipsychotic medication, increasing the likelihood of his decompensating, and associated increased risk of violence.”

Course Since Last Disposition

20. Mr. T. (E.) ’s course since his last Disposition is set out in detail in the Hospital Report. The following extracted paragraphs are relevant to this hearing:

“Mr. T. (E.) has been non-compliant with antipsychotic medication since January 2026, thus his capacity continues to be regularly assessed.

Following Mr. T. (E.) ’s most recent Ontario Review Board hearing, he remained an inpatient on the General Forensic Transitional Unit (FTU).

Whilst on FTU, Mr. T. (E.) remained difficult to engage, had very poor sleep hygiene, neglected his personal hygiene, and was dismissive during interactions with the treatment team. Mr. T. (E.) ’s persistent substance use, unit policy violations and contraband possession resulted in the need to adjust his behavioral plan multiple times. Mr. T. (E.) was supported by Behavior Therapy however their engagement was ultimately terminated in June 2025.

Mr. T. (E.) was also frequently testing positive for cannabis, which likely contributed to his lack of motivation to attend programming or engage with the treatment team. Ultimately, Mr. T. (E.) was transferred to the General Forensic Community Reintegration Unit (FCRU) on August 14, 2025, due to a therapeutic impasse with the clinical team, and the hope that a fresh start with a new team could allow for an improved therapeutic relationship and perhaps the reengagement of behavioural services.

Following Mr. T. (E.) ’s transfer to the FCRU, he tested positive for THC on numerous occasions.

Mr. T. (E.) tested negative for THC between October 30, 2025, and December 20, 2025, the longest sustained period of abstinence from substances since his transfer.

Mr. T. (E.) began consistently testing positive again for THC in late December and early January.

Mr. T. (E.) continued to have consistently positive urine drug screens for THC after this point, despite his indirectly supervised privileges having been cancelled. He was found to be smoking cannabis on the unit and was receiving substances from co-patients who had off unit privileges. On numerous occasions, room searches revealed contraband such as fruit or cups that had been fashioned into drug paraphernalia, as well as pieces of tinfoil often containing the residue of substances. He was caught attempting to pass a substance to a co-patient concealed in a nicotine inhaler, and he was also found to have tampered with his urine on a number of occasions, either by placing toothpaste in the urine sample, or attempting to provide a clean urine that he had obtained from another patient.

Mr. T. (E.) had two major incidents on FARU which ended up necessitating his transfer to the Secure Forensic Assessment Unit (FAU), specifically the high observation Psychiatric Intensive Care Unit (PICU) on March 7, 2026. Mr. T. (E.) instigated two physical altercations (which were reviewed on camera for their accuracy) with two different male co-peers. The first altercation occurred on February 24, 2026, when Mr. T. (E.) lunged at a male peer, which in turn prompted retaliation towards Mr. T. (E.). As a result, Mr. T. (E.) suffered a head injury, requiring transfer to hospital and 10 staples to his head.

The second physical altercation occurred on March 6, 2026, after Mr. T. (E.) was observed engaging in a conversation with another male peer. Mr. T. (E.) was noted to reach out his hand to this co-peer as if to shake it. When this co-peer reached out his hand, Mr. T. (E.) punched him in the stomach and kicked him in the leg without provocation.”

The panel notes that the facts surrounding the above 2 incidents were disputed at the hearing and these two incidents were not relied upon in arriving at the necessary and appropriate Disposition.

Evidence at the Hearing

(Excluding Evidence with Respect to Gladue and Indigenous Programming Available)

21. The Board had available to it the evidence and the documents forming the Record, the Exhibits and oral evidence from Dr. Harrigan. Dr. Harrigan co-authored the Hospital report and testified as follows:

a) Mr. T. (E.) was transferred to the FAU, on March 7, 2026. This transfer was due to a period of medication noncompliance and observed clinical deterioration. Upon arrival at FAU, he was initially placed in the Psychiatric Intensive Care Unit (“PICU”) for close observation.

b) Prior to January 2026, Mr. T. (E.) had been on Abilify Maintena 400 mg, a monthly long-acting injectable (“LAI”) medication. From January 2026 onward, Mr. T. (E.) refused further LAI medication.

c) In mid-March, Mr. T. (E.) reported sleep difficulties, racing thoughts and vivid dreams to Dr. Alioglou, the FAU psychiatrist. Mr. T. (E.) was started on olanzapine, 10 mg PO PRN, which he later agreed was helpful. Since late March, Mr. T. (E.) has been consistently adherent with his olanzapine, 20 mg nightly.

d) As of his most recent assessment, Mr. T. (E.) remains capable to consent to treatment and continues to decline LAI medication.

e) On April 3, staff found a partially unsmoked joint and burnt matchstick in his room. Mr. T. (E.) refused a urine sample. He later claimed that he had discovered cannabis in a jacket pocket that had been transferred with him and that he had decided to use it because he didn’t believe that another urine test would be ordered soon. Several patients reported that Mr. T. (E.) had shared cannabis with them, which caused him, and them, to lose off-unit privileges.

f) Mr. T. (E.) continues to meet individually with the Concurrent Disorders Counsellor and his psychologist.

g) Mr. T. (E.) is historically sensitive to interpersonal stress, especially when unwell.

h) Mr. T. (E.) ’s medication non-adherence, combined with cannabis use, increases his risk of psychotic decompensation, including paranoia, hallucinations, irritability and disorganization.

i) Past episodes of decompensation (e.g., 2022, 2023) required restraints and seclusion, and it took months to stabilize Mr. T. (E.).

j) Given Mr. T. (E.) ’s history, and the low dose of his medication, he would likely engage in the following behaviours if he were granted an Absolute Discharge: leave hospital immediately; stop all antipsychotic medications; resume heavy cannabis use; and discontinue contact with psychiatric services. These behaviours would cause him to decompensate quickly and experience psychosis-driven symptoms, creating a very high risk of violence towards members of the public.

k) The hospital is recommending detention within the “Forensic Service” versus the currently specified “General Forensic Unit” (“GFU”), as doing so provides the flexibility to move him back to a GFU when clinically appropriate. On a GFU, Mr. T. (E.) would have access to broader programming and activities, both those related to his culture and others that would support general engagement and recovery.

l) The treatment team has long-standing concerns about Mr. T. (E.) ’s ability to acquire substances, even in secure settings. In the past, he has obtained substances containing fentanyl, which posed a risk to himself and others. Sharing substances without knowing their contents is considered dangerous and de-stabilizing for Mr. T. (E.) and for other patients.

m) Mr. T. (E.) ’s engagement in treatment and planning is variable. He can be collaborative at times and ambivalent at others.

n) Mr. T. (E.) has poor insight into how cannabis use negatively affects his motivation and treatment participation.

o) The plan for the coming year includes continued individual therapy (for concurrent disorders), structured activities to support motivation, and ongoing efforts to engage him collaboratively in treatment.

p) Mr. T. (E.) ’s insight into his major mental illness is “developing” at best. He is uncertain whether he has schizophrenia, and he does not accept that he requires ongoing antipsychotic medication treatment.

q) A Conditional Discharge would not provide adequate public safety protection. Mr. T. (E.) would likely engage in similar behaviours to those predicted under an Absolute Discharge: non-adherence to his medication regimen; failure to return to hospital if unwell; and discontinuation of treatment contact.

22. In response to questions from counsel for the Attorney General, Dr. Harrigan testified:

a) Mr. T. (E.) ’s ongoing restriction of liberty remains necessary for the following reasons: he stopped his antipsychotic medication; he lacks insight into his illness and substance use; he rapidly decompensates without treatment; his current dose of olanzapine is low; and he remains ambivalent about treatment.

b) Cannabis use is a significant risk factor, as it worsens his mental stability, and increases his risk.

c) Mr. T. (E.) ’s refusal to take his LAI medication was a major factor in his clinical deterioration and his increased risk to public safety.

d) The hospital requires authority to monitor medication adherence, mental stability and abstinence.

e) Mr. T. (E.) must be stabilized on appropriate medication before any transfer to a less secure forensic unit could be considered.

23. In response to questions from counsel for Mr. T. (E.) , Dr. Harrigan testified:

a) The social worker spoke with Mr. T. (E.) ’s family. His mother mentioned that his aunt had a bedroom available for Mr. T. (E.) , at Curve Lake. Dr. Harrigan agreed that this fact establishes that housing does exist, but it does not mitigate her clinical risk concerns.

b) Prior to his transfer to the FARU, Mr. T. (E.) had not exhibited any physical aggression. He had shown verbal irritability, and staff had experienced discomfort enforcing the rules. Mr. T. (E.) ’s conduct supported the clinical opinion that his emerging instability was tied to his medication refusal and stressors. This behaviour, in conjunction with his use of cannabis, made a transfer to the FARU necessary and appropriate.

c) Mr. T. (E.) meets regularly with a psychologist and attends concurrent disorders counselling sessions. He can engage in 1:1 programming, but these psychotherapy programs do not address the broader risk factors that still require him to be on a Secure Forensic Unit (‘SFU”).

24. In response to questions from the panel, Dr. Harrigan testified:

a) There is no air of reality to a Conditional Discharge.

b) It is important that Ontario Shores retain the authority to approve housing for Mr. T. (E.) to monitor his mental stability and to ensure his adherence to his medication regimen and abstention from substances. Any one of these factors individually could cause Mr. T. (E.) ’s mental state to decompensate, causing him to become a threat to public safety.

c) Under a Conditional, or Absolute, Discharge, the risk of harm is great. It is not speculative, it is real. The harm that Mr. T. (E.) would cause is real, foreseeable, and substantial, and it would pose a significant risk of serious physical, or psychological, harm to members of the public.

d) Should Mr. T. (E.) get a Conditional, or Absolute, Discharge, he would not return to hospital voluntarily. It is her opinion that the Mental Health Act (“MHA”) cannot be employed proactively and could not be used quickly enough to protect public safety and prevent Mr. T. (E.) from committing aggressive acts.

e) The reasons for the initial restriction of liberty were that Mr. T. (E.) tested positive for cannabis on numerous occasions, despite not having privileges, tampered with his urine samples, and offered substances to other patients. In addition, Mr. T. (E.) has refused his antipsychotic medication and had demonstrated poor insight into both his major mental illness and the negative impact that his cannabis use has on his mental state. This lack of insight represents a real risk to the safety of the public. At one point, Mr. T. (E.) was using, and offering to co-patients, substances that he did not realize were adulterated with fentanyl, a drug that poses a serious, significant threat to his own health and theirs.

f) For the reasons she has previously stated, and for the following reasons the hospital had no other alternative other than to transfer Mr. T. (E.) to the FAU, even if he had not been involved in any assaults:

i. Mr. T. (E.) ’s insight into his cannabis use and his major mental illness continues to be lacking.

ii. Mr. T. (E.) is still not optimally treated. When he is not taking his antipsychotic medication, it takes him several months to decompensate, and he needs to be closely monitored so that he does not pose a danger to others. This type of supervision can only be done on a SFU.

iii. Unfortunately, substances are readily available on a GFU, and until Mr. T. (E.) develops better insight into his need to abstain from substances, and as long as he remains sub-optimally treated, it is important that he remain on a SFU.

g) In summary, both optimization of his medication regimen and significantly improved insight into the adverse effects of substances have to be shown before she would recommend any transfer back to a GFU.

h) Mr. T. (E.) is on a low dose of olanzapine, which he just started recently. It is her opinion that he would need a higher dose of olanzapine to maintain his mental stability and that these are still early days.

i) Mr. T. (E.) does not demonstrate any global cognitive deficits. She would describe him as a bright and capable individual.

j) When asked about Mr. T. (E.) ’s selective agreement to engage in programming, and whether his presentation reflects lack of insight or resistance, she described it as primarily driven by ambivalence.

k) There is no clear evidence of an underlying personality component contributing to Mr. T. (E.) ’s presentation.

l) Should Mr. T. (E.) feel that he is not getting adequate cultural programming at Ontario Shores, the treatment team would consent to transfer him to Thunder Bay Regional Mental Health Centre, upon his request.

25. No other evidence was called.

Evidence at the Hearing

(Gladue Report: Summary of Cultural and Indigenous Programming)

26. The Board had available to it the Hospital Report marked as an exhibit and oral evidence from Dr. Harrigan.

27. According to the Hospital Report and Dr. Harrigan, Mr. T. (E.) consistently attended Indigenous cultural programming, both on the unit and in the community, with staff support, while he was on the GFU. His presentation during these activities was notably positive. In fact, the Hospital Report states that: “Mr. T. (E.) ’s behaviour and attitude was markedly different during these activities… He was calm, cooperative, respectful, and engaged.” Activities included the following:

a) Fire groups / Men’s Circles

b) Traditional Teaching sessions (e.g., Thunder Beings)

c) Big Drum Socials

d) Pow Wows (including his home Pow Wow at Curve Lake)

e) Sweat lodge ceremonies

f) Drum circles at the Friendship Centre in Peterborough

28. Mr. T. (E.) co-facilitated an Indigenous group through Recovery College. He also engaged in smudging activities, horticultural Individual Work Placement, a Land Back Speaker event at Durham Community Health Centre, Traditional Men’s Learning Circle, and Indigenous Heritage Celebration. He also shared cultural knowledge with peers and helped plan Indigenous programming within the hospital.

29. Mr. T. (E.) also had access to Indigenous food options, smudging supplies and ceremonies.

30. Mr. T. (E.) had available, and used, the following Indigenous programming while he was on other secure units (FAU & FARU): weekly smudging ceremonies, visits from the Indigenous peer support worker/Recovery College Worker and access to cultural events even when privileges are restricted.

31. An Indigenous specific program does exist on the FAU, but it is limited.

32. Mr. T. (E.) is still able to attend smudging ceremonies on Fridays while on the FAU. He also received a visit from the Indigenous peer support worker – Recovery College worker on at least one occasion, to engage in drumming.

33. Indigenous programming for Mr. T. (E.) is prioritized. The hospital acknowledges that Indigenous programming is integral to his identity and improves his behaviour. The hospital has attempted to facilitate his attendance at Indigenous programming, whether or not he can access indirectly supervised privileges.

a) While the SFUs restrict movement and programming options, Mr. T. (E.) has been able to participate in smudging ceremonies, drumming sessions with peer support, and cultural engagement in hospital, even during periods of privilege suspension.

b) Despite efforts to accommodate him, the SFU cannot provide the full range of Indigenous programs available on GFUs. The FAU is not a rehabilitation unit, and as such does not have the staffing to be available off unit for prolonged periods of time.

c) Mr. T. (E.) uses his opportunities to engage in programming available to him while on an SFU, and this engagement has a clearly documented positive effect on his behaviour and wellbeing.

Analysis and Conclusions With Respect to Gladue Focused Issues

34. It is clear from all the programs that Mr. T. (E.) has been able to participate in that Ontario Shores has done all it can to engage him with culturally appropriate supports. It is acknowledged that he does not have as many supports while on FAU, a Secure Forensic Unit. Because of this reduction, the Hospital wants to transfer Mr. T. (E.) back to a General Forensic Unit, as soon as it is safe to do so. The fact that such a move is judged to be inadvisable at this time because Mr. T. (E.) poses a risk to public safety, does not represent a failure to abide by Gladue principles. See Summers (Re) 2024 ONCA 772.

35. The hospital was agreeable to ordering an updated Gladue Report, to investigate additional recommendations and new programs that would continue to support Mr. T. (E.) ’s cultural needs. The Board agrees with submissions from counsel for the hospital that the mere fact that the Gladue Report was completed in 2022 does not necessarily justify the need for an update. However, in this circumstance, as it is on consent of all the parties, the Board agreed to order a new Gladue Report.

36. The Board has no difficulty concluding that the hospital understands that Mr. T. (E.) ’s Indigenous identity is a core protective factor and is integral to his positive self-identity. Mr. T. (E.) ’s connection to his culture is one of the few domains in which he demonstrates consistent motivation, leadership and prosocial behaviour. Mr. T. (E.) ’s cultural activities give him a sense of belonging, a prosocial role and a structured, and meaningful, routine, all of which are essential for his long-term rehabilitation. Mr. T. (E.) has expressed interest in an Indigenous-focused residential treatment centre. Both the hospital and the Attorney General indicate support for exploring this option. Such a placement would: address his substance use; support cultural healing; provide structure and supervision; reinforce protective factors; and reduce reliance on secure forensic settings. This approach aligns with Gladue principles, which emphasize culturally relevant, community-based alternatives where feasible.

37. The Board is fully aware of its obligations, and those of Ontario Shores, pursuant to the existing jurisprudence and including R v Sim (2005) CanLII 37586 (ON CA), 2005 CanLII 37586 (ON CA), 78 O.R. (3d) 183 (CA).

Analysis and Conclusions

38. Having heard and considered the entirety of the evidence, as well as submissions from the parties, the Board finds that Mr. T. (E.) poses a significant threat to the safety of the public.

39. In Winko, the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Harrigan, in addition to the documentary evidence before us.

40. Mr. T. (E.) 's risk for future violence, as assessed using the HCR-20V3 tool, is influenced by several historical, clinical, and risk management factors. Historically, he has experienced difficulties with violence, employment, relationships, substance use, major mental disorder, and treatment/supervision response. The latter four challenges are particularly relevant to his risk for future violence. ​ His prior violent incidents have often occurred in the context of psychotic symptoms, exacerbated or triggered by cannabis use, and interpersonal conflicts have been a precipitant for aggression.

41. Clinically, Mr. T. (E.) has shown recent problems with insight and treatment/supervision response, and partial difficulties with symptoms of major mental disorder, violent ideation/intent, and instability. He has limited insight into his mental health and the impact of his symptoms on his risk for violence. He has voiced uncertainty about his diagnosis, refused medication, and continued cannabis use despite being educated about its negative effects on his mental state. His low mood and depressive symptoms contribute to his substance use and limit his engagement in therapeutic programming.

42. In terms of risk management, Mr. T. (E.) is likely to experience future problems with treatment/supervision response and stress/coping, with partial evidence of potential issues with professional services and plans, living situation, and personal support. His ongoing contravention of his Disposition, including substance use and medication nonadherence, poses significant challenges to risk management. His susceptibility to stress and limited coping strategies further increase his risk of violence.

43. Mr. T. (E.) ’s significant threat arises from the interaction of the following factors: predictable medication non-adherence; predictable heavy cannabis use; rapid and severe psychotic relapse as a result of the above; a history of dangerous behaviour when psychotic; poor insight across all domains; and an inability to self-manage illness in the community. Together, these factors create a substantial likelihood of serious violence if not in a supervised, structured environment. Dr. Harrigan testified that the risk of violence and harm to members of the public is real, foreseeable, substantial, and not speculative, with a significant risk of serious physical harm. Mr. T. (E.) would not return voluntarily to the hospital if he were to decompensate nor would he stay in hospital. The MHA could not be used to return him to hospital. Mr. T. (E.) ’s lack of insight into his need for medication and into the risk that substances pose to him creates a real risk to the safety of the public.

44. In light of the Board’s finding that Mr. T. (E.) poses a significant threat to the safety of the public, it must determine the appropriate Disposition.

45. The doctor’s evidence is that a Conditional Discharge has no air of reality for the same reasons that an Absolute Discharge is not appropriate. In particular, the hospital needs to retain the authority to approve Mr. T. (E.) ’s housing to ensure public safety, as it is essential to oversee his medication adherence, ensure his continued absence from substances, and monitor his mental stability. The MHA would not be sufficient to protect public safety, as it would not allow the hospital and treatment team to respond quickly enough, should Mr. T. (E.) return to using substances. The MHA is more proactive than reactive.

46. The MHA sets different thresholds for risk on admission to hospital, and for ongoing hospital detention, than does Part XX.1 of the Criminal Code, which is explicit that public safety is a paramount consideration.

47. In particular, the Board relies on the following extracted paragraphs from the Hospital Report:

“Potential Re-offence Scenario of Future Violence: A potential re-offence scenario for Mr. T. (E.) would likely stem from cannabis use (and/or other substances) and/or medication nonadherence precipitating psychotic symptoms such as paranoia and disorganization. In such a scenario, concurrent experience of psychosocial stress or interpersonal conflict is likely to contribute to mental destabilization. Symptoms of particular concern would be the emergence of persecutory beliefs or paranoia about specific others. In light of Mr. T. (E.) ’s history, it appears likely that potential victims would include those with whom he is engaged in interpersonal conflict, or those attempting to intervene when Mr. T. (E.) is in a dysregulated state. The violence is likely to take the form of threats of harm, but may escalate to physical violence (i.e., breaking items, use of weapons, punching) should he feel increasingly unsafe.

Clinical Assessment of Risk

The following remain areas of clinical concern for Mr. T. (E.):

• Mr. T. (E.) is very difficult to engage in terms of developing realistic goals for his recovery and progress through the forensic program.

• Whilst an inpatient on the General Forensic Unit (FTU), Mr. T. (E.) spent the majority of his time in his room playing video games and not adhering to his behavioural plan. This resulted in his being transferred to a different General Forensic Unit (FCRU) to determine whether a new clinical team could create a more robust therapeutic alliance with him and re-assess his behavioural plan. Unfortunately, his limited engagement and motivation remained generally unchanged whilst on FCRU.

• Whilst on both General Forensic Units, and even with prolonged periods of time by which he did not have access to indirectly supervised privileges, Mr. T. (E.) was able to acquire substances from other patients and consume them on the unit, resulting in numerous positive urine drug screens for cannabis.

• Mr. T. (E.) also engaged in other deceptive behaviours related to substance use, such as fashioning “bongs” from fruit and Styrofoam cups, concealing contraband in his room and on his person, tampering with his urine samples or attempting to substitute “clean urine” for his own, and attempting to covertly exchange substances with other co-patients on the unit.

• Prior to his transfer from FCRU to FARU, it was determined that Mr. T. (E.) had possession of substances on the unit which tested positive for fentanyl. This had the potential to result in serious physical harm to either Mr. T. (E.), or to an unsuspecting co-patient or staff member who inadvertently had contact with this substance.

• Despite providing intensive individual concurrent disorders and psychological programming and support, Mr. T. (E.) remained pre-contemplative in terms of his use of cannabis.

• Mr. T. (E.) engaged in disrespectful and verbally abusive behaviour towards nursing staff when attempts were made to remind him of unit rules and regulations, especially when housed on the less structured and staffed General Units.

• Mr. T. (E.) refused to take his antipsychotic injection, abilify maintenna, as of January 2026, despite significant concerns raised with him in relation to the serious likelihood of his decompensation and increased risk of aggression towards others.

• As of the writing of this report, Mr. T. (E.) remains non-compliant with antipsychotic medications, either oral or injectable.

In Mr. T. (E.) ’s favour:

• Mr. T. (E.) continues to maintain deep connections with his indigenous heritage and greatly enjoys attending various cultural events, both within hospital and in the community.

• Whilst using accompanied privileges to attend cultural events, he has not been suspected of trying to acquire substances.

• Mr. T. (E.) participated in, and even led, the cultural workshop related to fashioning dream catchers. He received significant positive feedback from the group facilitator for his leadership skills.

• At times, during 1:1 interviews, Mr. T. (E.) was able to demonstrate some insight into his apparent stagnation within the forensic system and expressed a desire to change his oppositional behaviour in order to make steps forward towards eventual discharge into the community.

48. The Board agrees that a Restriction of Liberty has taken place, pursuant to the decision of the Ontario Court of Appeal in R vs MLC (2010 ONCA 843), as well as in Regina vs Campbell (2018 ONCA 140). The Board has also concluded, based on the evidence before us, that the hospital’s decision to significantly restrict Mr. T. (E.) ’s liberty, by transferring him to the FARU on February 16, 2026, and his ongoing restriction, were warranted and necessary. In particular, the Board relies on the following extracted paragraphs from the Hospital Report:

“With regards to the restriction of liberty, which occurred on February 16, 2026, when Mr. T. (E.) was transferred from FCRU (a General Forensic Unit) to FARU (a Secure Forensic Unit), the team is of the opinion that this was necessary and appropriate due to a number of factors, including: numerous positive urine drugs screens for cannabis despite limited to no access to his own privileges; evidence that Mr. T. (E.) was smoking cannabis on the unit which also created a fire hazard; his receiving drugs from, and trading drugs with, his co-patients on the General Unit; his creation of drug paraphernalia on the unit using fruit and Styrofoam cups; his attempting to falsify urine drug screens by using other patients’ urine or by putting toothpaste into his urine sample; his bringing substances onto the unit that tested positive for fentanyl, endangering himself, staff, and co-patients; his non-compliance with his antipsychotic depot medication beginning in January 2026, which exacerbated concern related to decompensation in the context of ongoing substance use; and his lack of motivation to engage in any risk relevant programming that would allow him to progress to using indirectly supervised privileges.

The clinical team is also of the unanimous opinion that the ongoing restriction of liberty remains necessary and appropriate due to the following factors: ... his ongoing lack of insight into how interpersonal stressors and non-compliance with antipsychotic medication very likely contributed to his transfer back to a Secure unit ...; and his ongoing pre-contemplative nature with regards to cannabis use.”

49. The Board had extensive and conflicting evidence with respect to the two physical assaults that occurred on the FAU. Counsel for the hospital relied on video evidence and counsel for Mr. T. (E.) relied on numerous hospital notes. This panel does not feel that it is necessary to resolve this issue. The doctor’s uncontroverted evidence was that Mr. T. (E.) ’s ongoing detention on the FAU was necessary, whether he was the instigator, or the victim, of these assaults, and this Board agrees. The evidence shows that, even in a highly secure forensic environment, Mr. T. (E.) continues to exhibit the following behaviours: using and sharing substances; engaging in covert, rule-violating behaviour; declining essential antipsychotic treatment; demonstrating fluctuating insight and early psychotic symptoms; and failing to maintain or demonstrate stability or safety without intensive supervision. These factors – independent of the two physical altercations – justify the clinical team’s conclusion that the ongoing restriction of liberty remains necessary and appropriate to manage risk and support stabilization.

50. In consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. T. (E.) , his reintegration into society and his other needs, the necessary and appropriate Disposition is a Detention Order detaining him at the Forensic Service at Ontario Shores, with the amendments recommended by counsel for Mr. T. (E.) and as agreed to by all the parties.

DATED this 30^th day of April 2026, at the City of Toronto, in the Region of Toronto.

Mr. J. Weinstein Alternate Chairperson Office of the Registrar Ontario Review Board