Re: Dylan Hill
ORB File No: 8523
Hearing held on: Tuesday, May 12, 2026
Place of hearing: St. Joseph’s Healthcare Hamilton, West 5th Campus 100 West 5th Street, Hamilton, Ontario
Pursuant to: Section 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: Dylan Hill Counsel: Mr. A. Confente
The person in charge of hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Mr. B. Adsett
REASONS FOR DISPOSITION
(Dated June 4, 2026)
Introduction:
On March 20, 2024, Dylan Hill was found not criminally responsible on account of mental disorder (“NCR”) on charges of flight from a peace officer and dangerous operation of a motor vehicle, contrary to the Criminal Code. Mr. Hill is currently subject to a Disposition of the Ontario Review Board (“ORB” or “Board”) dated May 29, 2025 whereby he is detained at the Forensic Psychiatry Program of St. Joseph’s Healthcare Hamilton, West 5th Campus (“SJHCH” or “the Hospital”) with privileges up to and including community living within Southwestern Ontario in accommodation approved by the person in charge. He is subject to a driving prohibition, and is also required to abstain from substance use and refrain from possessing weapons.
On May 12, 2026, a panel of the Board convened at SJHCH to conduct Mr. Hill’s annual review pursuant to section 672.81(1) of the Criminal Code. Mr. Hill was present and represented by his counsel, Mr. Confente. Mr. Hill’s father was also present.
The Hospital Report dated April 14, 2026, was marked as Exhibit 1. In addition to the documentary evidence, the panel heard oral evidence from Dr. S. Baldeo, Mr. Hill’s attending psychiatrist.
The issues to be decided at the hearing were whether Mr. Hill continues to meet the test of posing a significant threat to the safety of the public as set out in section 672.5401 of the Criminal Code, and if so, what is the necessary and appropriate Disposition, taking into account the four factors set out in section 672.54 of the Criminal Code.
Positions of the Parties:
At the outset of the hearing, the parties were invited to provide their initial without prejudice positions. All parties agreed that Mr. Hill represents a significant threat to the safety of the public and that the necessary and appropriate Disposition was a Detention Order containing the same terms and conditions as the current Disposition. The parties maintained their joint position at the conclusion of the evidence.
Mr. Confente advised that his client’s position regarding a Gladue Report remained the same as last year, for the same reasons (this issue was discussed in detail in last year’s Reasons for Disposition). Specifically, he did not want to go through the invasive and potentially traumatic process that is required for the preparation of such a report.
Findings:
- For the reasons that follow, the panel found that Mr. Hill continues to pose a significant threat to public safety. The panel concluded that the necessary and appropriate Disposition, which is also the least onerous and least restrictive in the circumstances, is a continuation of the existing Detention Order.
Index Offences:
- The index offences occurred on October 15, 2020, when Mr. Hill was 23 years old. The circumstances surrounding the index offences are outlined at pages 2-5 of the Hospital Report, and were summarized in last year’s Reasons for Disposition as follows:
On October 15 of 2020, a food delivery courier left his vehicle running while picking up an order from a restaurant in Dunnville, Ontario. Mr. Hill stole the vehicle. The driver’s cellphone was in it permitting the vehicle to be tracked. Police officers were dispatched and tried a rolling block at a ramp to a major highway near Oakville. An unmarked vehicle stopped to block Mr. Hill who deliberately drove into the police vehicle inflicting damage to it and pushing it about five meters. Mr. Hill then accelerated onto the Queen Elizabeth Highway without stopping. A second rolling block by vehicles with lights and sirens was attempted in Mississauga but Mr. Hill again successfully eluded the police. The police pursuit was stopped, however, Mr. Hill continued to be tracked in Toronto and York Region. Stop sticks were used but Mr. Hill avoided them. Eventually Mr. Hill ran out of gas in York Region and was arrested.
Background:
The Hospital Report outlines Mr. Hill’s personal history and background in detail and will only be summarized here. Mr. Hill turned 29 years old on the day of the hearing. He is single, with no children. Mr. Hill was born in Brantford, Ontario near the Six Nations Reserve. He identifies as Haudenosaunee, Mohawk and Wolf Clan. He used to go to church and attend the Longhouse. He described a happy childhood, with supportive parents.
Mr. Hill’s parents separated when he was 10 years old, and his mother remarried when he was a teenager. Mr. Hill has a younger brother and a maternal half-sister. He reported that his family moved a lot while he was growing up. Due to these frequent moves, he changed schools multiple times. He generally enjoyed school, got along well with his teachers, and had a good group of friends. Mr. Hill reported taking four classes at Six Nations Polytechnic following his high school graduation, but did not complete additional courses due to a lack of funding.
Mr. Hill has worked at several jobs with family members, including as a mechanic, in construction, and as a traffic guide. Most recently, he worked for his stepfather’s tobacco company, but he was asked to leave this job because he used cannabis while at work. He has been unemployed since then and is supported by the Ontario Disability Support Program (ODSP).
The Hospital Report indicated that Mr. Hill experienced a number of very serious and traumatic events in his life, such as his aunt’s death and a fatal car accident.
Mr. Hill reported spending most of his childhood living on the Six Nations reserve. He described engaging in his culture during this period, wherein he attended pow wows with his family, learned about the Creator, participated in community gardening, learned the Mohawk and Cayuga languages, and attended various other ceremonies and rituals.
Mr. Hill has a significant history of substance use commencing when he was a teenager. He started drinking alcohol at age 15 and using cannabis at age 16. He described drinking alcohol to excess, and blacking out. He reduced his alcohol use in his early twenties; however, his cannabis use increased to smoking almost daily. He reported frequent cannabis use around the time of the index offences.
Mr. Hill reported that he used other substances occasionally (including cocaine, psilocybin (“magic mushrooms”), and fentanyl). His healthcare records showed that he met the criteria for Opiate Use Disorder in August of 2023, and was prescribed methadone treatment.
Criminal History:
Mr. Hill had no criminal record prior to the index offences. However, he was charged with sexual assault and sexual interference involving a 12-year-old boy in a playground while he was under the influence of alcohol. The incident occurred on October 13, 2020, two days before the index offences. New details about these offences came to light during this reporting year. The charges resolved with a guilty plea to simple assault on October 19, 2023, and Mr. Hill received a one-day jail sentence plus a three-year probation term. The Probation Order requires (among other things) that Mr. Hill is not to attend any daycare, public swimming pool, elementary school, secondary school or public park unless in the direct company of a parent. Mr. Hill is also required to “attend and actively participate in all assessment, counseling or rehabilitation programs as directed by the probation officer and complete them to the satisfaction of the probation officer including but not limited to psychiatric or psychological issues and sexual deviance.” Mr. Hill’s Probation Officer is satisfied that the Forensic Psychiatry Program is addressing the psychiatric and psychological issues, and Mr. Hill’s treatment team is now working to satisfy the requirement for assessment and intervention for sexual deviance. Mr. Hill is also prohibited from possessing any weapons for 10 years.
During the reporting period, the treatment team also became aware of a series of assault related charges that were apparently laid on January 24, 2024. Mr. Hill was served with an Undertaking by Six Nations Police requiring him to attend court in September 2025. The Undertaking included a no contact order with Mr. Hill’s mother and cousin. The parties advised the panel that these charges were laid on January 24, 2024; however, they were all withdrawn on May 8, 2026.
Psychiatric History:
Last year’s Reasons for Disposition clearly outline Mr. Hill’s psychiatric history in detail and will only be summarized here. Mr. Hill’s first psychiatric contact began with a referral by Six Nations Police to Six Nations Mental Health Services in July of 2019. It was noted that Mr. Hill had seen traumatic events over the last few years that had affected him mentally, and he tended to see things that were not real. In August 2019, Mr. Hill’s father reported that his son had been violent with him, was frequently agitated, and his thoughts appeared confused. Mr. Hill was using marijuana daily, drank frequently, and had a history of cocaine use.
Mr. Hill was treated by Dr. Kathryn Macdonald of the Six Nations Health Services’ Mental Health and Addiction Team for the rest of 2019 and into 2020 prior to the index offences. In a report from October 2020, Dr. Macdonald stated that Mr. Hill’s medication compliance was irregular and that he appeared to be developing schizophrenia. She wrote about ongoing but unsuccessful attempts to contact him for regular appointments, noting that his living situation was transient and that he would go missing for long periods of time, with family unable to find or contact him.
Dr. Macdonald also noted that Mr. Hill was seen in the ER at Brantford General Hospital, St. Joseph’s Hamilton, and West Haldimand on eleven occasions since March 2020, but despite evidence that he was unwell, he was not admitted.
Following the index offences, Mr. Hill was admitted to Oakville Trafalgar Memorial Hospital while in custody. He presented as paranoid and disorganized. He was transferred to SJHCH and then ultimately discharged to Six Nations Health Service in November 2020. He was prescribed psychiatric medications and his mother was named as his substitute decision-maker (“SDM”). Mr. Hill lived in the community from 2020 up until the NCR finding in 2024.
Concern over Mr. Hill’s condition continued from December 2020 to February 2021, with reports of being disorganized and acting oddly. In June 2021, Mr. Hill was admitted to Brantford General Hospital due to medication noncompliance and after he had threatened his father with a bat. He was restarted on his psychiatric medications and was to follow up with Dr. Macdonald.
In July 2021, Mr. Hill assaulted his mother. She kicked him out of the house and his father became his SDM.
Mr. Hill was admitted to the Acute Mental Health unit at SJHCH from November 5 to 18, 2021. Collateral information from his father indicated that while Mr. Hill was originally taking his prescribed medication, he failed to follow up with Dr. Macdonald as directed, stopped taking his medication, and his mental state deteriorated. On the day prior to his admission, he attempted to hit his father for no clear reason. The next morning, his father found him in his bedroom holding a butcher knife to his wrist and threatening to kill himself. Following this admission, Mr. Hill was discharged on a Community Treatment Order (“CTO”), to be followed by Dr. MacDonald.
Mr. Hill did quite well and took his prescribed medications pursuant to the CTO; however commencing around August 2022 there were concerns about Mr. Hill’s housing environment (living with his father and grandmother), his worsening engagement, and medication noncompliance.
Mr. Hill had admissions to hospital in December 2023 and early 2024 as a result of threatening and assaultive behaviors. His CTO had expired in August of 2023, he had not received his long-acting injectable antipsychotic medication since then, and his mental condition had deteriorated. He was restarted on psychiatric medications.
At the time of Mr. Hill’s initial ORB hearing in 2024, he was an inpatient at the Schizophrenia Unit at SJHCH. He was transferred to the Forensic Psychiatry Program on May 6, 2024. During his first year under the jurisdiction of the Board, Mr. Hill’s mental status was stable, he was medication compliant, and abstinent from substances.
The Hospital Report stated Mr. Hill’s diagnoses as Schizophrenia and Polysubstance Use Disorder, partial remission. He is capable to consent to treatment and manage his finances.
Evidence at the Hearing:
The Hospital Report stated that Mr. Hill’s mental status remained relatively stable over the reporting year. Although his insight is described as poor, Mr. Hill has been adherent with his long-acting injectable antipsychotic medication and generally engages with the treatment team. There were no instances of agitation, aggression, or threatening behaviour. All urine drug screens have been negative and Mr. Hill is proud of himself for maintaining sobriety.
A Community Living Skills Assessment was conducted in June 2025, and it was recommended that Mr. Hill reside in a supervised/supported setting with access to supports for instrumental activities of daily living.
This reporting year, Mr. Hill’s father moved to a two-bedroom apartment near the hospital. Mr. Hill attends his father’s home daily (where he usually plays video games) in addition to having two 24-hour passes a week to the residence. Mr. Hill’s father has demonstrated a commitment to learning about the Forensic Mental Health System and has been working collaboratively with the treatment team. Mr. Hill’s father’s residence has been viewed by Social Work and approved for community living accommodation.
The Hospital Report stated that it is the intention of the treatment team to gradually transition Mr. Hill towards discharge to his father’s home. Mr. Hill has begun to meet with the Forensic Outpatient Team and is becoming accustomed to the increased obligations that come with being an outpatient. To date, Mr. Hill has been doing well and is receptive to education about the importance of maintaining his appointments with the outpatient team.
Mr. Hill began to engage with an Addiction Worker with the Concurrent Disorder Capacity Building Team in March 2026. The plan is to gradually shift Mr. Hill to a community-based substance abuse program.
Mr. Hill has some concerning medical conditions. An abdominal ultrasound showed severe fatty infiltration of the liver with severe hepatomegaly. It also noted cholelithiasis with a non-mobile stone in the gallbladder neck. Mr. Hill has gained a considerable amount of weight since his admission. He met with a dietician, was started on Metformin, and was referred to (and discharged from) a Bariatric Clinic. His dose of Olanzapine was also decreased.
The Hospital Report stated the following about continuing areas of concern (at page 26):
“There are ongoing physical health concerns related to weight gain and hygiene. Mr. Hill has gained a significant amount of weight and continues to be educated on long-term risks including Type 2 Diabetes, fatty liver disease, and their associated complications…He is encouraged to make behavioural and dietary changes including walking to his father’s apartment which is nearby the hospital as opposed to taking a taxi. His hygiene has been an ongoing issue and education as well as strategies have been provided to encourage daily showering, appropriate laundry techniques, and skin care.”
Dr. Baldeo testified that he has been Mr. Hill’s attending psychiatrist since July 2024. He stated that a slow and gradual transition to the community is being undertaken due to ongoing concerns, which include Mr. Hill’s fluctuating insight into his diagnosis and need for medication, and his physical health concerns. Mr. Hill’s ability to stay abstinent from substances in the community also needs to be tested. Dr. Baldeo added that there have been some occasions where Mr. Hill has not followed the directions or instructions of the treatment team.
Dr. Baldeo stated that he will continue on as Mr. Hill’s out-patient psychiatrist.
Dr. Baldeo testified that Mr. Hill continues to meet the significant threat threshold based on his psychiatric diagnosis, criminal history, substance use history, and ongoing fluctuating insight. He opined that absent the supervision of the Board, Mr. Hill would likely stop taking his medications over time, use substances, and his mental condition would deteriorate within days to weeks. This would increase his risk of criminal behaviour significantly.
In response to questions, Dr. Baldeo confirmed his understanding that Mr. Hill had abused opiates extensively and had been diagnosed with Opiate Use Disorder; however, Mr. Hill was transitioned off of methadone treatment approximately one year ago.
When asked about the plan to discharge Mr. Hill to his father’s residence, Dr. Baldeo stated that this option had only presented itself this year when Mr. Hill’s father moved to the area. Before this, Mr. Hill wanted to be transitioned to a trailer on his mother’s property. Mr. Hill has also been placed on housing waitlists, but they are lengthy. Although the Hospital Report stated that Mr. Hill’s father had an historical opiate addiction and some difficulties with the law, Dr. Baldeo stated that Mr. Hill’s father has been educated and is working well with the team. There had been a recent meeting with the treatment team, Mr. Hill, and Mr. Hill’s father regarding expectations for the year ahead. Dr. Baldeo did not know why Mr. Hill’s father is not an approved person.
Dr. Baldeo was also asked how the recommendation of the Community Living Skills Assessment that Mr. Hill reside in a supervised and supported setting related to living with his father. Dr. Baldeo stated that Mr. Hill’s father appears able to meet Mr. Hill’s needs; however, if assistance is required further supports can be provided. Alternatively, if the housing situation with his father does not work out, the treatment team can bring Mr. Hill back to the hospital by virtue of the recommended Detention Order.
In response to a question from Mr. Confente, Dr. Baldeo agreed that Mr. Hill has been attending two programs with the Canadian Mental Health Association (“CMHA”) in the community.
Dr. Baldeo was also asked if he had any concerns about the fact that Mr. Hill had not been forthcoming about his outstanding criminal charges. Dr. Baldeo acknowledged this concern, but also stated that Mr. Hill’s low cognitive functioning and limited memory may have played a role. He had no reason to believe that Mr. Hill was not being forthcoming about other things or that he was intentionally withholding information or being manipulative.
In response to questions from the panel about Mr. Hill’s significant weight gain and serious comorbid medical conditions, Dr. Baldeo stated that he would consider changes to Mr. Hill’s antipsychotic medication (specifically from Olanzapine to Abilify), as well as other potential options such as a GLP-1 medication.
Analysis and Conclusions:
The panel accepted the parties’ joint position and found independently that Mr. Hill represents a significant threat to the safety of the public. Mr. Hill suffers from a major mental illness, as well as Polysubstance Use Disorder. The index offences were very serious, and could have caused significantly more harm than they did. Mr. Hill continued to engage in criminal behaviours following the index offences when living in the community, but prior to the NCR finding. All of this occurred despite efforts by health care professionals, including Dr. Macdonald at Six Nations Health Services, to treat his illness (including the use of CTOs).
While Mr. Hill has remained compliant with medication and abstinent from substances since coming under the jurisdiction of the Board, his insight into his diagnoses, need for treatment, and substance use remains poor. Absent an ORB Disposition, it is likely that Mr. Hill would disengage from treatment, use substances, and experience a deterioration in his mental condition. This would lead to harm to the public, as has happened in the past.
The panel agreed with the parties’ joint submission that the necessary and appropriate Disposition is a continuation of the existing Detention Order. Mr. Hill has made good progress this year and a gradual transition to this father’s home has been started. There are a number of outstanding concerns, both with respect to Mr. Hill’s mental illnesses, as well as his physical health, that will need to be monitored closely. While it is hoped that Mr. Hill and his father can manage living together, Mr. Hill does require significant support and supervision, and this will have to be tested. This makes a Detention Order crucial at this time, as Mr. Hill can brought back to the hospital if there are unexpected difficulties.
The panel wishes Mr. Hill success with his transition to the community and hopes that he continues on this positive trajectory.
DATED this 4th day of June 2026, at the City of Toronto, in the Toronto Region.
Ms. S. Clapp Alternate Chair
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Office of the Registrar Ontario Review Board