Ontario Review Board
Re: Ian Stirling
ORB File No: 3533
Hearing held on: Wednesday, April 15, 2026
Place of hearing: Southwest Centre for Forensic Mental Health Care St. Thomas, ON
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. S. Kert
Members: Dr. S. Simpson Dr. S. Wiseman Ms. K. Tomaszewski Ms. C. Plyley
Parties Appearing:
Accused: Ian Sterling Counsel: Ms. C. Francis (via Zoom)
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Mr. J. Huber
REASONS FOR DISPOSITION
(Dated May 25, 2026)
Overview
On April 8, 2002, Ian Sterling was found not criminally responsible on account of mental disorder (NCR) on a charge of break and enter with intent. Mr. Sterling was charged with that offence on November 16, 2001, after he and three other men attended at a female victim's residence with the intention of entering it and threatening or harming the victim. While on the porch of the residence, one of the men (not Mr. Stirling) cut a screen with an unknown object, reached through and began pounding on the inner window, breaking it. At the same time, the police attended at the residence. Mr. Stirling and the other men ran from the scene and were apprehended shortly after.
Mr. Sterling is currently subject to an Ontario Review Board disposition detaining him at the Southwest Centre for Forensic Mental Health Care (Southwest Centre or the Hospital), with privileges extending to living in the community of Elgin County in accommodation approved by the person in charge.
On April 15, 2026, this panel of the Review Board convened at the Southwest Centre to hold a hearing and review that disposition. Mr. Sterling attended in person. At the time of the hearing, he continued to reside on a rehabilitation unit at the Hospital. His lawyer, Ms. Francis, participated via Zoom.
The issues to be decided at this hearing are whether Mr. Sterling continues to pose a significant threat to the safety of the public and, if so, what is the necessary and appropriate disposition, considering the four factors in s. 672.54 of the Criminal Code.
The hearing proceeded based on a joint submission in respect of both issues. None of the parties contested a finding of significant threat, and the parties submitted that the current detention disposition should continue, without changes. We agree. These are our reasons.
Background
Mr. Sterling is 48 years old. He has spent half his life under the jurisdiction of the Review Board. His current diagnoses are listed in the hospital report as: schizoaffective disorder, bipolar type, multiple episodes, in full remission; ADHD; stimulant, alcohol and cocaine use disorders, in sustained remission in a controlled environment; antisocial, histrionic, and borderline personality disorders; and intellectual disability.
Mr. Stirling's early years were difficult. He was diagnosed with ADHD at age five and was prescribed medication at age nine. His highly unpredictable behaviour, including assaults on his mother and sister, led to his placement in a residential treatment centre from ages 8 to13. At 13, the Children's Aid Society placed him in a group home. During his seven months there, he was arrested for the first time. When he returned to live with his parents, he regularly threatened to kill his sister. His high school years were marked by heavy drug use which, in the years that followed, expanded to include cocaine, marijuana, PCP, ecstasy, LSD, crystal methamphetamine and heroin.
Mr. Stirling has a criminal history with multiple convictions dating from 1992, and as a youth spent time in and out of secure and open custody. He also had several psychiatric admissions to the Chatham-Kent Health Alliance between February 1993 and June 2001. During those admissions, he was given numerous and various diagnoses. Over the years he experienced symptoms of paranoia, auditory hallucinations and delusional ideation associated with his mental illness.
Except for two relatively brief periods, after the finding of NCR in 2002, Mr. Stirling was detained at Waypoint (originally Oak Ridge) for 20 years. He was transferred to Ontario Shores in July 2011 and returned to Waypoint at his own request in May 2012. On August 13, 2014, while at Waypoint, Mr. Stirling threw a cup of boiling water at a female staff's face. In April 2015, he was convicted of assault causing bodily harm in respect of his actions and sentenced to six months in jail, having been found criminally responsible for that offence. He was transferred to the St. Lawrence Treatment Centre to serve his sentence and returned to Waypoint in August 2015.
For many years Mr. Stirling's tenure at Oak Ridge/Waypoint was marked by significant instability, behavioural difficulties, aggression and some sexual preoccupation. Periods of seclusion were routine in almost every reporting year. His attitude toward compliance with medication fluctuated.
In the fall of 2019, Mr. Stirling began treatment with clozapine and showed improvement. By September 2021, his treatment team was reporting positive effects from his adherence with medication — he had not been physically assaultive over the year, his insight into the benefits of and compliance with medication had improved and his engagement with his caregivers was better. However, Mr. Stirling continued to misuse substances even in the highly secure setting at Waypoint. His attending psychiatrist also advised that despite the best efforts of staff to motivate him, Mr. Stirling did not wish to change his situation, preferring to remain at Waypoint for another year.
At his annual Review Board hearing in 2022, the Waypoint treatment team reported that Mr. Stirling had achieved a level of stability not previously seen. This was likely due to his increased adherence to treatment and the fact that he was largely abstinent from substances. The team supported Mr. Stirling’s transfer to the Southwest Centre, noting that although historically he had expressed ambivalence about leaving Waypoint (and may have engaged in self-sabotage to ensure that did not occur), he was expressing a desire to move forward.
The Review Board agreed with the transfer recommendation, and on November 7, 2022, Mr. Stirling was transferred to the Southwest Centre. He has remained an inpatient since that time. Following his transfer he did not engage in violent or threatening behaviour, but his long-standing issues with rule breaking behaviours continued. He had a history of buying, selling and trading with peers at Waypoint, with similar behaviours at the Southwest Centre. He tested positive for methamphetamines in March 2023 and January 2024.
A psychological assessment focused on Mr. Stirling’s cognitive abilities and personality was conducted from July 2023 to January 2024. It concluded that his general cognitive abilities were in the borderline range, and that his personality profile was complex as he endorsed several clinically significant traits of histrionic, obsessive-compulsive, narcissistic, borderline and antisocial personality.
Course Since the Last Hearing
At Mr. Stirling’s last annual hearing (in April 2025), the Board received evidence that over the prior year Mr. Stirling had ongoing issues with impulsive and attention seeking behaviours, rule breaking behaviours, and lack of motivation. In August 2024, he tested positive for methamphetamines. But there were also some positive developments. Dr. Mokhber, who had been his psychiatrist since his admission, reported that Mr. Stirling had been a more active participant in occupational therapy groups and his participation in leisure programs increased. He was also attending every two weeks for psychological treatment and was engaged in the sessions. Dr. Mokhber described that Mr. Stirling was open to working towards living in the community, and she was hopeful that he would be in a position to move to a rehabilitation unit in the coming year.
The evidence at the current hearing consisted of an updated hospital report and the oral testimony of Dr. Curry, a psychiatric resident under the supervision of Dr. Quinn (who also testified briefly). Dr. Quinn took over care of Mr. Sterling in July 2025, when he was transferred from a treatment unit to a rehabilitation unit.
While he remained on the treatment unit, Mr. Stirling attended what the hospital report describes as “the minimum number of required groups” to access off-unit privileges. However the report also indicates that while he required occasional prompting to attend, he “participated sufficiently once groups began.” By the spring of 2025, he had achieved level 3 privileges, which allowed him unlimited in-hospital indirectly supervised access.
Since his transfer to the rehabilitation unit, Mr. Stirling’s engagement in programming has been variable. The hospital report indicates that he attended AA “most weeks,” and that he previously completed concurrent disorders programming. He periodically engaged in treatment sessions with the psychology service, focused on developing insight into his personality functioning and sense of self, as well as behavioural activation, but missed several sessions due to forgetfulness. Between September and December 2025, he was enrolled in the Action Based Cognitive Remediation (ABC-R) group to improve his performance in several cognitive domains. He was offered 13 sessions, and ultimately attended 11.
Given his long history of substance abuse, Mr. Stirling is required to submit weekly samples for toxicology testing. On September 10, 2025, after staff observed that he was more disinhibited and dishevelled than his usual baseline, Mr. Stirling’s urine screen returned positive for morphine. His privileges were suspended for 24 hours. In late fall, he continued to report opioid cravings. After discussions with the team, he agreed to start treatment with suboxone in November 2025. He has since reported that the medication is effective in reducing his cravings.
By the time of this hearing, Mr. Stirling held level 6 privileges, allowing him daily indirect access in the hospital and on the grounds. He can also access the community with staff or an approved person. He has taken part in supervised community outings for activities such as shopping, community orientation, and introduction to CMHA programs and recreational activities, and there were no behavioural issues during these outings. Mr. Stirling’s father is now an approved person, and Mr. Stirling is permitted three-hour passes with his dad, who is considered to be a prosocial and supportive resource for his son. His father generally visits monthly and maintains regular phone contact.
In response to questions regarding the concurrent use of multiple medications — Mr. Stirling is currently prescribed and compliant with two antipsychotics, two mood stabilizers and an antidepressant medication — and the opportunity to address risk through a change in his treatment regimen, Dr. Curry and Dr. Quinn advised that Mr. Stirling had come to the unit on these medications. The team had received information about being careful around changing his medications, but there is some room for cautious review.
Analysis and Conclusion
Having heard and considered all of the evidence, we find that the threshold test for significant threat is met, and that the current detention disposition remains necessary and appropriate in the circumstances.
Mr. Stirling has a long history of behavioural problems with numerous admissions to hospital and a criminal record that includes assaultive behaviour, even in hospital following the finding of NCR. His violence has involved various victims (family members, co-patients, staff) and has been both reactive in nature (when his immediate needs were not met) and planned and deliberate (as a form of retaliation). He has diagnoses of antisocial, histrionic and borderline personality disorders, including a history of being deceitful, antagonistic, manipulative, labile and impulsive. His PCL-R scores have consistently been in the 30-32 range (out of 40), indicative of significant psychopathic traits. He has a long-standing problem with substance abuse, and his misuse of substances often led to destabilization of his mental state (including this clinical year), and in the past has increased his risk for violence.
As described by Dr. Curry, in the last few years Mr. Stirling’s problematic behaviours have been more in the nature of low-risk nuisance behaviours. This is obviously a very significant improvement for Mr. Stirling, as is his ability to successfully utilize greater levels of privileges this past year. It is also clear that in order to maintain and improve upon these gains, Mr. Stirling will continue to require a high level of structure, supervision and staff support. Without significant oversight by a forensic mental health team, Mr. Stirling is at real risk of falling away from treatment (as occurred in the past) and of returning to substance use, both of which would inevitably lead to a rapid decompensation in his mental state and significantly increase his risk for violence.
The current detention disposition provides the level of supervision and support that Mr. Stirling continues to require, but also allows him greater opportunities for community reintegration. The primary challenge for the treatment team over the next year will continue to be finding a way to overcome Mr. Stirling’s lack of engagement in programming, his avoidance behaviour and his resistance to and/or fear of moving forward and out of the forensic system.
This is not new for Mr. Stirling who, as stated in the hospital report, has a long history of institutionalization. For years he was ambivalent about leaving Waypoint because it felt like home to him. He is comfortable in the forensic system (where he has spent the last 24 years) and at the Southwest Centre. Despite his statements about wanting to learn independent living skills and transition to a group home in the community, there are very real concerns that at times he is self-sabotaging to avoid progressing toward those goals. His move to the rehabilitation unit, where the focus is on transitioning patients to the community, has probably exacerbated some of these issues.
Dr. Curry testified that the treatment team has found it difficult to find what will motivate Mr. Stirling to use more of the opportunities available to him outside of the Hospital, so that he can eventually transition to a life outside the forensic system. They are working to address his anxiety through community orientation (so that Mr. Stirling becomes more familiar with the community near the Hospital and with services available to him in that community) and have encouraged him to attend and participate in social activities that he enjoys outside of the Hospital. They are also attempting to engage Mr. Stirling with a behaviour therapist who can assist him in developing the skills necessary to gradually reintegrate into the community. We encourage the treatment team to continue these efforts and share the hope that Mr. Stirling will continue to work with the team to move forward.
Taking into consideration public safety (which is paramount), as well as Mr. Stirling’s mental condition, reintegration into society and other needs, we find that the necessary and appropriate disposition is one continuing to detain him at the Southwest Center with privileges and prohibitions as set out in the current disposition.
DATED this 25th day of May, 2026, at the City of Toronto, in the Region of Toronto.
Ms. S. Kert Alternate Chairperson
Office of the Registrar Ontario Review Board