Re: Sean Carter
ORB File No: 6815
Hearing held on: Tuesday, April 14, 2026
Place of hearing: Centre for Addiction and Mental Health Via Zoom Videoconference
Pursuant to: Section 672.81(2.1) of the Criminal Code
Before: Alternate Chairperson: Mr. D. Sandor Members: Dr. P. Prendergast Dr. G. Nexhipi Ms. M. den Haan Mr. A. Mete
Parties Appearing: Accused: Sean Carter Counsel: Mr. A. Pollard
The person in charge of hospital: Counsel: Ms. S. Rosales Zelaya Attorney General of Ontario: Counsel: Mr. D. Brandes
REASONS FOR DECISION
(Dated May 27, 2026)
Introduction
[1]. On August 27, 2015, Mr. Carter was found not criminally responsible on account of mental disorder on charges of attempted murder and aggravated assault, contrary to the provisions of the Criminal Code of Canada. He is currently subject to a disposition of the Ontario Review Board, dated January 27, 2026, detaining him at the Forensic Service of the Centre for Addiction and Mental Health, Toronto (hereinafter referred to as "the Hospital").
[2]. On February 27, 2026, the Hospital forwarded a Notice of Restriction of Liberty concerning Mr. Carter to the Ontario Review Board advising that he had been admitted on an inpatient basis and had remained detained since that time. Accordingly, a panel of the Ontario Review Board convened a hearing on April 14, 2026, to review that restriction pursuant to section 672.81(2.1) of the Criminal Code.
[3]. Mr. Carter was represented at the hearing by his lawyer, Mr. Pollard. Mr. Pollard confirmed that he had reviewed the matter with his client, was fully instructed, and that Mr. Carter had chosen not to attend. An order was made that the hearing proceed in Mr. Carter's absence pursuant to section 672.5(10) of the Criminal Code.
[4]. The record for the hearing included the Notice of Hearing, the Notice of Restriction of Liberty mentioned above, the Board's response to that Notice, the most recent Disposition, the Reasons for that Disposition, and a Hospital Report authored in January 2026. On the consent of all parties a Restriction of Liberties Report, dated April 7, 2026, was entered into evidence as Exhibit 1.
[5]. The parties were canvassed for their positions. All agreed that the significant increase in restriction of Mr. Carter's liberty was justified and necessary and represented the least onerous and least restrictive option available to the Hospital from its initiation on February 19, 2026, to March 10, 2026, when he was discharged. This joint position was maintained through to the end of the hearing.
[6]. For the following reasons, the Board agrees with the joint submission.
Background
[7]. By way of background, Mr. Carter stabbed a 19-year-old student in the head with a knife on December 26, 2013, while waiting at the bus stop. The victim was a stranger to Mr. Carter, and the attack was unpredictable. Mr. Carter has a long history of struggle with major mental illness that includes auditory hallucinations and aggressivity. He is 42 years old, has a history of substance use and has been described as being "floridly psychotic" over the course of several periods since 2011. His major mental illness has factored into several violent offences including one where he suddenly punched two elderly individuals in the head, believing they were stealing his blood. His criminal record includes six assault convictions (two causing bodily harm, three with a weapon) and several weapons charges involving firearms. He is currently diagnosed with schizophrenia, cannabis use disorder, and antisocial personality traits.
[8]. At Mr. Carter's most recent annual review, the panel concluded that he continued to represent a significant threat to the safety of the public. This finding was driven by his major mental illness, his non-adherence to medication and other treatments in the absence of external controls and structures, and the antisocial traits he manifests that are aggravated by substance use and by the active symptoms of his psychosis. He had been unreliable when reporting, showed persistent lack of insight into his diagnosis, symptoms and reoffence risk and had little insight into the impact substances would have on his major mental illness if he returned to the use of cannabis. He was vulnerable to psycho-social stressors that included being worried about his mother's declining health and his finances.
[9]. Exhibit 1 explains that, following his annual review, Mr. Carter tested positive for cannabis. By mid-February 2026, he was testing consistently positive for this substance and his compliance with community supervision began deteriorating. His behaviour became increasingly intimidating and aggressive towards supports, including his psychiatrist. Owing to the change in his presentation, the Hospital issued a Form 49 for Mr. Carter's admission into the Hospital. He was located by police at his residence and brought to the Hospital where he remained from February 19, 2026, to March 10, 2026.
[10]. Exhibit 1 explains that Mr. Carter was cooperative with readmission procedures and settled into the emergency department well. While he continued to minimize and to deny cannabis use, he apologized for his earlier behaviours. Even so, his mental state continued to present concerning changes from his baseline. He was highly preoccupied with his need to use cannabis. He expressed grandiosity concerning his status in Jamaican society. He spoke about how he had "blessed himself" with his "powers" and expressed concerns that someone was spitting in his water on the unit. He attributed negative symptoms to voodoo being performed on him and was involved in a physical altercation with another patient on February 26, 2026, on the unit.
[11]. By March 2, 2026, Mr. Carter appeared to return to his longitudinal baseline. He was no longer preoccupied with his powers or with voodoo and was able to express improved judgment concerning relapse prevention and his need to abstain from the use of cannabis. While he still craved that substance, he no longer saw it as necessary for his functioning. He was discharged on March 10, 2026.
[12]. Dr. H. Meng is Mr. Carter's treating psychiatrist. She explained that the restriction of Mr. Carter's liberty formed part of a recurring pattern seen as efforts are made to introduce him into the community. She explained that invariably, that process leads to changes in his mental state and disposition. She advised that Mr. Carter's underreporting of cannabis use when in the community is a significant concern. She detailed the significant supports and monitoring provided by Mr. Carter's treatment team, commenting positively on Mr. Carter's level of attendance and engagement in contingency reward programs that incentivize abstinence from the use of substances. Mr. Carter reports twice weekly. He works well with his CMHA case manager who is also his housing provider. While Mr. Carter still has poor insight into the risk posed to the public by his use of cannabis, that lack of insight is mitigated by his desire to increase his likelihood of winning lottery prizes associated with the contingency reward program, which seems to be a promising pilot project developed at the Hospital.
Submissions, Analysis, and Conclusion
[13]. As mentioned, at the end of the hearing the parties renewed their submissions as set out at the beginning of the hearing. All agreed that the evidence supported the conclusion that Mr. Carter had experienced a restriction of his liberty and that the restriction from February 19, 2026, to March 10, 2026, was justified, necessary, and represented the least onerous and least restrictive course available to the Hospital throughout that period.
[14]. The panel agrees. There is no doubt that Mr. Carter experienced a restriction of his liberty when brought to the Hospital on a Form 49 and detained there for a period in excess of seven days. Mr. Carter's liberty norm shifted from living in the community, with all of its associated privileges, to being under the strict supervision provided in a hospital setting.
[15]. It is also clear that the restriction was justified and necessary. While the Hospital had evidence of Mr. Carter's use of cannabis, and while this had formed part of a cycle of decompensation associated with his transitioning to community living in the past, the Hospital did not issue the Form 49 until such a time as Mr. Carter began manifesting aggressivity to supports including his psychiatrist. That aggressivity, accompanied by decreasing reliability in reporting and sustained use of cannabis informed the Hospital's decision to restrict Mr. Carter's liberty. It is notable that, while in the Hospital, Mr. Carter continued to manifest grandiosity and aggressivity, together with decreased insight into the decompensatory impact of cannabis on his major mental illness.
[16]. The Board is satisfied that the Hospital employed the least onerous and least restrictive measure available to it when returning Mr. Carter to the Hospital. Mr. Carter's history of violence when using substances that cause decompensation is concerning. It includes random acts of severe violence to unsuspecting individuals in the community. Mr. Carter was not reporting to the Hospital as required and when he did report to the Hospital, he minimized his substance use and showed aggressivity towards his psychiatrist. Mr. Carter's decompensation was in a state of rapid decline. No other option suitable to the assurance of public safety was available to the Hospital on February 19, 2026.
[17]. Mr. Carter's state in the Hospital carried the concerns associated with the restriction of his liberty through to March 10, 2026. Mr. Carter was hospitalized until the primary symptoms of his psychosis were brought to his baseline, following which he was promptly transitioned to the liberty norm that he enjoyed prior to February 19, 2026.
[18]. As a result, the Board concludes that while Mr. Carter experienced a restriction of his liberty from February 19, 2026, to March 10, 2026, that restriction was justified, necessary, and represented the least onerous and least restrictive option available to the Hospital.
[19]. The Board thanks all who assisted in today's hearing and encourages Mr. Carter in his abstinence from the use of cannabis and in his engagement with the CMHA, his treatment team, and the programming offered to him by the Hospital.
DATED this 27th day of May, 2026, at the City of Toronto, in the Toronto Region.
Mr. D. Sandor Alternate Chairperson
Office of the Registrar Ontario Review Board