Re: N. (T.)
ORB File No: 7620
Hearing held on: Monday, May 11, 2026
Place of hearing: St. Joseph’s Healthcare Hamilton, West 5th Campus 100 West 5th Street, Hamilton, Ontario
Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. S. Clapp Members: Dr. J. Kis Dr. G. Nexhipi Ms. N. Nathanson Mr. S. Doherty
Parties Appearing:
Accused: N. (T.) Counsel: Ms. M. Addie
The person in charge of hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Ms. J. McKenzie
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.
Pursuant to s. 672.501(1) of the Criminal Code, the Ontario Review Board prohibits the publication, broadcasting, or other transmission of any information that could identify a victim in this matter or a witness who is under 18 years of age.
REASONS FOR DISPOSITION
(Dated June 4, 2026)
Introduction:
On October 15, 2019, N. (T.) was found unfit to stand trial on charges of sexual assault and sexual interference with a person under sixteen, contrary to the Criminal Code.
Mr. N. (T.) is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated May 22, 2025, whereby he was detained at the Syl Apps Youth Centre (“Syl Apps”) awaiting transfer to St. Joseph’s Healthcare Hamilton, West 5th Campus. Mr. N. (T.) was transferred to the Forensic Psychiatry Program at St. Joseph’s Healthcare Hamilton, West 5th Campus (“SJHCH” or the “hospital”) on August 6, 2025. He has privileges up to and including living within the catchment area of the hospital in 24-hour per day supervised accommodation approved by the person in charge. He is also required to refrain from contact or communication with children under the age of 14 years unless he is in the presence of his mother.
On May 11, 2026, a panel of the Board convened at SJHCH to review Mr. N. (T.)’s fitness to stand trial and his Disposition pursuant to sections 672.48(1) and 672.81(1) of the Criminal Code. Mr. N. (T.) attended the hearing with his counsel, Ms. Addie. Mr. N. (T.)’s mother, N. (C.) attended the hearing by telephone.
The Hospital Report dated May 4, 2026, was marked as Exhibit 1. In addition to the documentary evidence, Mr. N. (T.)’s attending psychiatrist, Dr. Y. Naidoo, gave evidence.
The issues to be determined at the hearing were whether Mr. N. (T.) continues to be unfit to stand trial in accordance with section 2 of the Criminal Code, and if so, what is the necessary and appropriate Disposition taking into account the factors set out in section 672.54 of the Criminal Code.
The Hospital Report indicated that the last prima facie hearing was held on October 8, 2025, and Ms. McKenzie advised that the next one is scheduled for September 16, 2026.
Positions of the Parties:
At the outset of the hearing, the parties were asked for their initial without prejudice positions. On behalf of the hospital, Mr. O’Brien took the position that Mr. N. (T.) remains unfit to stand trial and a continuation of the existing Detention Order with some changes is the necessary and appropriate Disposition. Specifically, all references to Syl Apps should be removed, seven day passes for the purpose of discharge planning should be added, and a change in the geographic area for community living were suggested.
Ms. McKenzie supported the position of the hospital on behalf of the Attorney General. Ms. Addie conceded the issue of significant threat, and also supported the position of the hospital.
Findings:
- For the reasons that follow, the panel found that Mr. N. (T.) remains unfit to stand trial and that the necessary and appropriate Disposition, which is also the least onerous and least restrictive in the circumstances, is a continuation of a Detention Order. In addition to accepting the parties’ recommended changes to the Disposition, the panel removed the indirectly supervised privileges on hospital grounds and in the community, and added a provision allowing Mr. N. (T.) to be accompanied by a person designated by the person in charge (not just staff or an approved person). The panel also qualified the seven day passes for discharge planning to 24-hour per day supervised accommodation.
Alleged Index Offences:
- The circumstances of the alleged index offences are set out at page 3 of the Hospital Report, and can be summarized as follows. Mr. N. (T.) was 14 years old in 2019 when it is alleged that he tried to insert his penis into a 4-year-old girl’s anus. Mr. N. (T.) was subsequently alleged to have been found in a 5-year-old girl’s bed with his pants down, touching the girl’s vagina with his hand and penis.
Background:
- Mr. N. (T.)’s personal history is outlined in the Hospital Report in detail and will only be summarized here. Mr. N. (T.) is currently 20 years old. Concerns were raised regarding his developmental milestones from an early age. He was diagnosed with Autism Spectrum Disorder (ASD) at age 3 and attended school until grade eight. Mr. N. (T.)’s father ceased contact with Mr. N. (T.) and his mother when Mr. N. (T.) was an infant as a result of difficulties adjusting to the care needs of his son. A diagnosis of Intellectual Disability was made in 2012 when Mr. N. (T.) was seven years old. A psychoeducational report concluded that his overall cognitive abilities and adaptive skills were in the “much below average range” and his receptive language and expressive language skills were severely delayed.
Criminal History:
- Mr. N. (T.) has no prior criminal history.
Psychiatric History:
The Hospital Report included a discussion of the initial fitness assessment for Mr. N. (T.), as well as his history since coming under the jurisdiction of the Board and will not be repeated here. In brief, Mr. N. (T.)’s diagnoses of ASD and Intellectual Disability were confirmed (there was some discussion of a diagnosis of Schizophrenia, but this was ultimately not supported). Mr. N. (T.) was detained at Syl Apps from 2019 until his transfer to SJHCH in August 2025.
While at Syl Apps, Mr. N. (T.) experienced auditory hallucinations (some of which were command in nature), engaged in property damage, and demonstrated dysregulated and aggressive behaviours, as well as some sexualized behaviours. Physical restraints were required at times. It was noted that Mr. N. (T.) was “easily overwhelmed.” Mr. N. (T.) was treated with antipsychotic medication, and extensive efforts were made to connect Mr. N. (T.) with community agencies for resources and funding (many of which were unsuccessful).
Mr. N. (T.) obtained his high school diploma while at Syl Apps, and participated in programs in the community (at The Hub) when his funding allowed. He is extremely attached to his mother.
Fitness coaching was provided at Syl Apps and Mr. N. (T.) was consistently found unfit to stand trial. It was noted that Mr. N. (T.) had a superficial cognitive understanding of his charges and the court proceedings, but significant limitations with respect to appreciation of the process, including the nature and object of the proceedings were noted. The following excerpt is taken from Dr. Jeremy Butler’s clinical impressions and recommendations prior to the transfer to SJHCH (at page 13):
“I have found Mr. N. (T.), across examinations, to understand his charges but (at best) to have a recited understanding of the roles of court officers and procedure. His lawyer "helps me". The judge "helps people." At individual times he became stuck trying to remember what the Crown does or what the outcomes of his case could involve. Even when given time or calm reassurance his frustration can quickly overwhelm.
He does understand the importance of telling the truth in court. His ability to engage in the process is quite transactional without understanding of what the process means and simply focused on what happens. The ORB hearing has been a source of considerable stress throughout this year as his understanding of the previous outcome has been challenging for him-with a near-constant refrain of "I don't know what's happening with my case." I believe that that comment and his inability to internalize the explanations of an abstract process are consistent and seemingly unlikely to change.
In my psychiatric opinion, he remains unfit to stand trial. After five years of attempted reinforcement and education, given the limited internalization demonstrated, I do not expect that his fitness will be restored through treatment.”
The treatment team at Syl Apps was unable to locate a community residence that would accept Mr. N. (T.) as he requires specialized supervised accommodation. Mr. N. (T.) was placed on a waiting list for transfer to SJHCH when he turned 18 years old.
Mr. N. (T.) is treated as “marginally capable” to consent to psychiatric treatment. He is incapable of managing his property and the Public Guardian and Trustee began managing Mr. N. (T.)’s finances in October 2025.
Evidence at the Hearing:
The Hospital Report stated that Mr. N. (T.) had a “variable and challenging year.” Due to Mr. N. (T.)’s neurodevelopmental disorder, clinical progress has been limited. His insight remains limited, and he has struggled with emotion and behaviour regulation throughout the reporting year, requiring periods of seclusion. He also had several incidents of self-harm over the past year. He is compliant with medication and has engaged well with recreational activities and appears to enjoy community outings (he is always escorted 1:1 by staff). Mr. N. (T.) has not demonstrated any inappropriate sexual behaviour since his admission to SJHCH, although it was noted that this remains a risk that requires close monitoring.
Mr. N. (T.) is independent in basic activities of daily living but requires prompting to attend to his hygiene, meals, and completion of daily routines. He has been utilizing community passes escorted by staff to his mother’s home without any concerns. Mr. N. (T.)’s mother has not yet become an Approved Person.
Behaviour Therapy has been a part of in Mr. N. (T.)’s care since his transfer from Syl Apps and a Behaviour Support Plan is currently being developed for the prevention of challenging behaviours.
The Hospital Report stated that Social Work has had numerous contacts with the Halton Developmental Services Ontario (DSO) in relation to their ability to support Mr. N. (T.) in the Hamilton area with housing and access to funding. Mr. N. (T.) was placed on wait lists for housing through DSO in the Hamilton, Oakville, Burlington, and Niagara areas. All housing options would have 24-hour support and supervision available. In December 2025, Mr. N. (T.) was considered an urgent status for housing with DSO due to currently being in hospital and not in the most appropriate environment for his disability. However, it was noted that housing wait lists can be several years long even with an urgent status.
The Hospital Report stated the following about fitness to stand trial (at page 25):
“With respect to Fitness to Stand Trial, Mr. N. (T.) was unable to state the various individuals in the court room or to acknowledge his charges stating “I don’t know”. He appeared unable to understand his pleas stating “I’m not sure”. When provided teaching regarding available pleas, he initially was able to recall the information, then was unable to connect the concept of pleas to his charges. He was unable to understand or repeat the definition of an oath, nor could he understand the consequences of lying under oath in a court room. He was unable to appreciate the potential consequence of his charges. Furthermore, as a result of his difficulty tolerating stress, he would likely be unable to communicate effectively with counsel. Overall, Mr. N. (T.) remained Unfit to Stand Trial in my opinion.”
Dr. Naidoo testified that he had been Mr. N. (T.)’s attending psychiatrist for four months. He explained that the adult setting at SJHCH is different from what Mr. N. (T.) experienced at Syl Apps, and the behavioural therapists and treatment team have been working to understand his needs and manage his behaviours in order to reduce the risk of violence.
Dr. Naidoo stated that Mr. N. (T.) has complex needs and his medications have been adjusted to manage his impulsive and aggressive behaviours in the context of his ASD. There has been a good response lately with some improvement in behaviours, but there has been fluctuation overall. Dr. Naidoo acknowledged that the hospital is not the optimal place for Mr. N. (T.), but stated that they are doing their best in the circumstances.
Dr. Naidoo stated that Mr. N. (T.)’s fitness to stand trial has not changed. While Mr. N. (T.) is able to repeat back information, he is not able to apply the information to himself or understand it in a meaningful way. His ability to instruct counsel is impaired and he is not able to tolerate difficult conversations or communicate with counsel. Dr. Naidoo has not worked with Mr. N. (T.) long enough to conclude that he is permanently unfit.
Dr. Naidoo stated his opinion that Mr. N. (T.) represents a significant threat to the safety of the public if he is not subject to the jurisdiction of the Board. Mr. N. (T.) requires significant support for medication adherence, day-to day structure, way-finding, and to manage stress. Without these supports, Mr. N. (T.) would rapidly exhibit problems with mood regulation, anxiety, anger, and impulsive outbursts. Dr. Naidoo noted that this has occurred even within the secure setting of the hospital, and testified that it would be “impossible” to manage Mr. N. (T.)’s risk without an ORB Disposition at the current time.
In response to questions from Ms. Addie, Dr. Naidoo stated that he would explore what could be done to enable Mr. N. (T.) to engage with peers of the same maturity level (as opposed to his own biological age). Dr. Naidoo believed that he could consult his child/adolescent and dual diagnosis colleagues about this. Dr. Naidoo also stated that the treatment team was considering the best way to use Mr. N. (T.)’s Passport funding, and would also explore further potential DSO services in the coming year.
In response to questions from the panel, Dr. Naidoo stated that indirectly supervised privileges on hospital grounds and into the community were not realistic for Mr. N. (T.), at least over the coming year; however, Dr. Naidoo understood that indirectly supervised privileges were required for a person other than hospital staff or an approved person (for example a DSO worker) to take Mr. N. (T.) out of the unit or hospital. Upon further questioning, Dr. Naidoo agreed that inclusion of “a person designated by the person in charge” in the accompanied privileges clause in the Disposition would allow for this.
Analysis and Conclusions:
Based on the Hospital Report and the evidence of Dr. Naidoo, the panel concluded that Mr. N. (T.) remains unfit to stand trial when considering section 2 of the Criminal Code and the relevant case law. It was clear from the evidence that while Mr. N. (T.) may have a superficial understanding of his charges or the court process, as a result of his diagnoses and cognitive difficulties, he is unable to apply the information to his own situation or engage meaningfully with his lawyer or the proceedings. He is not able to communicate meaningfully with his counsel or make reality-based decisions regarding his case in the meaning of R. v. Bharwani, 2025 SCC 26.
The panel also found that absent the supervision and support afforded by an ORB Disposition, Mr. N. (T.) would disengage from treatment, and his dysregulated, impulsive, aggressive, and sexualized behaviors would likely return quickly.
Taking into account the safety of the public, including consideration of the seriousness of the alleged index offences, the panel agreed with the joint recommendation that a Detention Order with the proposed changes by the hospital was appropriate. This included the addition of a clause allowing for seven day passes for discharge planning (specifically to 24-hour per day supervised accommodation), and expansion of the geographic area to Southern Ontario for community living. This will provide more options for DSO housing for Mr. N. (T.).
Although Ms. Addie advocated for the panel to leave the indirectly supervised privileges in Mr. N. (T.)’s mother Disposition, so as not to “tie the hands” of the treatment team, the panel decided that there was no air of reality to Mr. N. (T.) using indirectly supervised privileges on hospital grounds or into the community. He is currently escorted 1:1 at all times off the unit, including when visiting his mother’s home.
Having said that, the panel wanted to ensure that any person or worker that was not staff or an approved person could spend time with Mr. N. (T.) and take him off the unit or hospital grounds if appropriate. We were satisfied that adding the “person designated by the person in charge” language in the accompanied privileges clauses in the Disposition would serve this purpose and allow the hospital to ensure that the safety of the public is protected. This position was supported by both Dr. Naidoo and Mr. O’Brien who stated that this would serve the expected purpose.
DATED this 4th day of June 2026, at the City of Toronto, in the Toronto Region.
Ms. S. Clapp Alternate Chair
Office of the Registrar Ontario Review Board