Re: James Alston
ORB File No: 7937
Hearing held on: Monday, April 20, 2026
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. M.D. Segal
Members: Dr. T. Verny Dr. S. Wiseman Ms. A. Israel Mr. S. Doherty
Parties Appearing:
Accused: James Alston Counsel: Ms. M. Addie
The person in charge of hospital: Counsel: Mr. K. Dow
Attorney General of Ontario: Counsel: Ms. K. Kirec
REASONS FOR DISPOSITION
(Dated June 3, 2026)
Introduction
James Alston, age 44, was on August 24, 2011, found not criminally responsible on charges of assault with a weapon, and aggravated assault, contrary to the Criminal Code. On April 20, 2026, Mr. Alston, who is subject to a Detention Order with privileges up to and including living in the community in accommodation approved by the person in charge, appeared at the Centre for Addiction and Mental Health (the “hospital”) before the Ontario Review Board (the “Board”) for his annual hearing.
The Board had before it a Hospital Report dated March 20, 2026, as Exhibit 1.
In preliminary positions the hospital supported by Crown counsel endorsed the current Disposition. Ms. M. Addie, for the patient, conceded that significant risk was present and endorsed a joint position. By the conclusion of the hearing, the Board agreed with the joint submission.
Mr. Alston was born in Montreal. His family moved to Stouffville when he was four. When he was 16 his parents divorced. Mr. Alston has two siblings. Mr. Alston was in the military from 2006 to 2013. He receives disability benefits from Veterans Affairs. He worked as a trainer. He is currently unattached. He has two sons but is not in contact with them. Mr. Alston had some criminal involvement with the courts in 2017 to 2019. His first contact with psychiatric services occurred in 2020. His diagnosis is schizophrenia.
Index Offences
- The details of the index offences are excerpted from last year’s Reasons for Disposition, as follows:
“On Monday, January 11, 2021, police responded to an assault in progress in the area of Bellefair Avenue and Norway Avenue in the City of Toronto. Information received was that a male was assaulting and chasing individuals in the area.
Mr. Alston began to follow Victim #1 southbound on the east side of Bellefair Avenue carrying a hammer. Victim #1 then turned eastbound on Norway Avenue and continued to walk on the north side of Norway Avenue. He continued to follow the victim. He then closed the gap on the victim on Norway Avenue. He then attempted to assault Victim #1 with the hammer (Charge #1) (Charge #2). Witnesses in the area intervened and Mr. Alston dropped the hammer briefly and then picked it up again and continued to walk away from Victim #1 turning westbound on Norway Avenue and then northbound on Bellfair Avenue.
Mr. Alston then walked northbound on Bellefair Avenue and approached Victim #2. Victim #2 was doing work on a porch with his head down in an extremely vulnerable position. He approached Victim #2 from behind and struck him with the hammer several times in the back of the skull (Charge #3) (Charge #4).
Police arrived on scene and located the accused on Bellefair Avenue and placed him under arrest. The accused was then transported to 55 Station where he was identified by way of fingerprints.”
Evidence at Hearing
Dr. S-K Liu, the patient’s psychiatrist, testified. Dr. Liu reported that Mr. Alston is doing well. He is going into the community by himself.
Dr. Liu indicated that when Mr. Alston was transferred to a secure unit in November 2024, he arrived in poor shape. He was not taking his medication, and his behaviour was poor. Passes were out of the question. Mr. Alston was contesting incapacity and appealed a finding of incapacity resulting in an inability to treat.
Mr. Alston was extremely paranoid. He would stay up all night and was antagonizing other patrons. There were physical engagements with co-patients.
Eventually Mr. Alston agreed to treatment. Last September an antipsychotic was begun. Mr. Alston responded dramatically. There were marked improvements in a few days. The patient’s agitation completely disappeared. After feeling isolated and secluded he began to integrate with others.
During recovery Mr. Alston’s insight blossomed. Mr. Alston could remember all of his inappropriate behaviours and was apologetic. Mr. Alston’s insight and mental state both improved dramatically.
Mr. Alston is on a long -acting injection. There were side effects as Mr. Alston could not stay put and his sleep was difficult. The issue was discussed with Mr. Alston. Small dosing changes were made but ultimately the decision was that the benefits of the current medication outweighed the side effects. Mr. Alston’s sister is his substitute decision maker who works closely with her brother.
There have been some improvements over the last few months regarding the side effects. No changes are currently anticipated in the medication.
In Dr. Liu’s view the significant threat analysis in the Hospital Report remains valid.
The current plan is to move Mr. Alston up the privilege ladder.
In Dr. Liu’s view community living is a tricky matter. The last time Mr. Alston was discharged he was not on medication. Mr. Alston was stable for a year but then fell apart.
Mr. Alston is very functional. He will be ready for community living in the next year. Continuing to build up rapport with the forensic team will be a focus.
Dr. Liu, who oversaw the Dual Diagnosis Program at the hospital for five years, does not believe Mr. Alston is a candidate for admission. There is no intellectual disability.
Mr. Alston’s presentation is not typical. He is now symptom free. Mr. Alston is very open with the forensic team. If he were unwell, he would be unlikely to engage with the team.
In closing submissions Ms. Addie spoke about her client’s sincere remorse and excellent insight. Remorse speaks to insight as well. Her client appreciates he wasted a year. Mr. Alston is committed to taking his medication.
Mr. Alston goes out into the community for specific activities. He likes to go to the park to work out. He takes physiotherapy. He has aspirations of going back to school. He very much enjoys going to the gym.
Analysis
- The Mr. Alston who appeared before the Board is very far removed from the individual who was psychotic and paranoid a year ago. Mr. Alston presented as healthy, affable, and positive. While significant threat is present, the trajectory is currently very promising. The current Disposition balances Mr. Alston’s needs and the protection of the public. We wish Mr. Alston well in the upcoming year.
DATED this 3^rd^ day of June, 2026, at the City of Toronto, in the Region of Toronto.
Mr. M.D. Segal
Alternate Chairperson
Office of the Registrar
Ontario Review Board