Re: Rick Duc Lao
ORB File No: 7072
Hearing held on: Thursday, May 14, 2026
Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. J. Weinstein
Members: Dr. R.D. Chandrasena Dr. P.N. Wright Mr. E. Siebenmorgen (by Zoom) Ms. B. Little
Parties Appearing:
Rick Duc Lao Counsel: Ms. K. Bhamra
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Ms. A. Dalrymple
REASONS FOR DISPOSITION
(Dated June 8, 2026)
Introduction:
On December 14, 2016, Mr. Rick Duc Lao was found not criminally responsible on account of mental disorder, on a charge of criminal harassment, contrary to the Criminal Code of Canada ("Criminal Code").
Mr. Lao is subject to a disposition of the Ontario Review Board (the "Board"), dated March 20, 2025, which orders that he be detained at the Southwest Centre for Forensic Mental Health Care, St. Joseph's Health Care London ("Southwest").
On May 14, 2026, the Board convened a hearing at Southwest to conduct the annual review of the current disposition.
Mr. Lao was present at the hearing and was represented by his counsel, Ms. Bhamra.
A Hospital Report, dated January 13, 2026 (the "Hospital Report"), was entered as Exhibit 1.
The issues at this hearing were whether Mr. Lao is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code, and, if so, what disposition is necessary and appropriate in the circumstances, bearing in mind the factors set out in s. 672.54 of the Criminal Code.
For the reasons set out below and based on the expert evidence and opinions before it, the Board concluded that Mr. Lao continues to pose a significant threat to the safety of the public. The Board ordered that the necessary and appropriate disposition in the circumstances is a continuation of the existing detention order.
Current Psychiatric Diagnoses:
- Schizophrenia Substance Use Disorder Antisocial Personality Disorder Traumatic Brain Injury
Index Offence:
- The circumstances giving rise to the Index Offence are extracted from last year's Board reasons, as follows (with redactions and edits to conceal any identifying information):
"On August 17, 2016, at approximately 10:30 p.m., the parents of 2 children (14 years and 10 years of age) were in Ivey Park. During this time, the children were on their cell phones catching fictional Pokémon characters and walking approximately 5 metres ahead of their parents. The parents' attention were drawn to a male, later identified as the accused, who was quickly approaching from behind them. The parents observed the male to be clenching his fists and walking purposefully toward them. As a result, the parents became frightened of the male and sped up their pace to catch up with the children.
The accused walked past the parents, catching up to the children, and stopped directly in front of them. The father called out, asking the accused if he had a problem, at which time mother pulled the accused's arm to get him away from their children. The accused pulled out of mothers' grip, which caused her to yell to her children to run, as it was her belief that the male intended to cause harm to them. The children began to run away as the accused gave chase directly behind them. The mother was able to grab hold of the accused in an attempt to stop him; however, the accused continued to chase after the children, dragging her behind him for approximately 30 metres.
At one point, eldest child was able to loop around and get behind his parents; however, his younger sister was still running away from the accused, who was then specifically chasing after her. The youngest child made a left turn in the park, and the accused followed, making the same left turn. The mother began to call out to other witnesses, asking for help and for someone to call 911. Several calls were made to the London Police regarding this matter. The accused ceased his chase and sat down while witnesses provided updates to 911 over the phone."
- Mr. Lao's history and background are outlined in the Hospital Report and were accurately summarized in last year's reasons:
"Mr. Lao was born in Kitchener and moved to Sarnia with his mother and then-stepfather when he was 8 years old. Mr. Lao has a younger half-brother. Mr. Lao was placed into care when he was 15 years old. He was in care for approximately four months. Mr. Lao left school during Grade 9. He has been supported by ODSP since he was 18 years old. Mr. Lao is single. He has a child born in 2008 and another in 2014, as a result of two different relationships.
Mr. Lao reported using cannabis and alcohol when he was 14 years old. When he was 15 years old, he began to use crystal methamphetamine. He also has a history of using psilocybin, cocaine, and ecstasy. Prior to the Index Offence, Mr. Lao had a criminal history commencing in 2004, including convictions as an adult for robbery and aggravated assault.
Mr. Lao's first contact with psychiatric services was in 2007, when he was 19 years old. His first hospital admission was in 2008. Mr. Lao had several subsequent admissions to hospital in the London area, with the last admission prior to the Index Offence being in 2016."
Course Since Last Disposition:
- Mr. Lao's course since his last disposition is set out in detail in the Hospital Report. The following extracted paragraphs are relevant to this hearing:
"Mr. Lao began the reporting period on the Forensic Rehabilitation Unit (B1) under the care of Dr. Arun Prakash, Forensic Psychiatrist, as well as the Forensic Outreach Treatment Team. As outlined in last year's report, he had been on a leave of absence (LOA) to a group home in Port Bruce since January 9, 2024. Also noted, Mr. Lao had various brief admissions to hospital, with the last one reported on December 31, 2024, for cannabis use and alcohol consumption. He returned to the home on January 7, 2025. During this reporting period, he had three more brief admissions. On February 3, he was readmitted as a result of substance use that led to decompensation and returned to the home on April 8. On May 27, he was readmitted for using cannabis, methamphetamine, cocaine, and crack. His care was transferred to Dr. Amir Rezaei Ardani, Forensic Psychiatrist, and the Forensic Rehabilitation Treatment Team (B1) on June 12, 2025. On August 18, he began an LOA to the home from Monday to Friday and returned to the hospital on weekends for monitoring. On September 11, he engaged in substance use (cannabis and methamphetamine) and was again returned to hospital and started on Nabilone, a medication to help with cravings for cannabis. On October 27, he returned to the home and, while on the LOA, used methamphetamine, causing him to decompensate, and he was readmitted to hospital on November 4 with no return to community living, requiring a longer period of stabilization. As Nabilone was not helpful in managing his cravings, the inpatient team referred him to a community-based addiction group, Alcoholics Anonymous, which he reported enjoying. However, on January 8, 2026, he absconded while attending a community program and engaged in crystal methamphetamine use. He was returned to hospital by police the same day.
Throughout the reporting period, Mr. Lao experienced persistent auditory hallucinations, often appearing preoccupied and responding to unseen stimuli (e.g., laughing out loud or gesturing with his hands), which required prompting to remain focused. His hallucinations are not known to be commanding; rather, he hears various voices, some known to him and some not. He believes in the reality of the voices. At times, he demonstrated suspiciousness and paranoia. For instance, he believed that people in the community were going to steal his money. During periods of decompensation, specifically when engaging in substance use, his psychotic symptoms were more pronounced."
Position of the Parties:
Counsel for the hospital, counsel for the Attorney General, and counsel for Mr. Lao advised that this was a joint submission. All adopted the hospital's recommendation that the existing detention order continue, subject to one small change to add the word “delegate” to expand the categories of persons who may accompany Mr. Lao for his community passes.
For the purposes of this hearing, counsel for Mr. Lao advised that significant threat was not in dispute.
Evidence at the Hearing:
- The Board had before it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Ardani and Mr. Lao. Dr. Ardani testified as follows:
a) He was Mr. Lao's most responsible physician until February 2026.
b) Mr. Lao's primary diagnosis remains schizophrenia, which continues to be the dominant factor shaping his behaviour.
c) Although Mr. Lao has a historical diagnosis of antisocial personality disorder, no antisocial traits were observed this reporting year, and Mr. Lao’s behaviour was instead driven by psychosis and substance-related cravings.
d) Mr. Lao has no meaningful insight into his psychotic illness.
e) Mr. Lao interprets his hallucinations as spiritual experiences and does not recognize any early signs of decompensation, which can occur within hours.
f) Mr. Lao has not responded to multiple trials of antipsychotic medications currently available in Canada. As a result of these unsuccessful trials, he was transferred in February 2026 to a new psychiatrist to begin a trial of amisulpride, a medication imported through Health Canada's Special Access Program. The current dose of amisulpride is 100 mg twice daily. The treatment plan is to increase the dose gradually to the recommended therapeutic level.
g) Early notes from the treatment team indicate small improvements in Mr. Lao’s ability to complete activities of daily living without prompting.
h) All attempts to treat Mr. Lao’s cannabis cravings have failed. Trials of nabilone and topiramate were unsuccessful and, in fact, increased Mr. Lao’s cravings.
i) Mr. Lao's cognitive impairment arising from his schizophrenia prevents him from engaging meaningfully in addiction programs such as AA.
j) There is no medication currently available that can safely reduce Mr. Lao’s cravings.
k) All of Mr. Lao’s readmissions this year were triggered by substance use, including cannabis and crystal methamphetamine. Substance use consistently worsens Mr. Lao’s mental status and was a factor in the Index Offence.
l) Mr. Lao is aware that substance use is a breach of his Disposition, but he continues to use substances because he seeks the euphoria or spiritual experiences they produce.
m) Mr. Lao's HCR-20 risk rating is moderate to high even in hospital and would be higher under a less restrictive disposition. His HCR-20 risk rating has increased during this reporting period, as compared with last year, due to his repeated relapses, frustration with treatment, and a statement suggesting potential violence. Mr. Lao has stated that he would repeat the Index Offence behaviour if he experienced the same hallucinations again.
n) Mr. Lao is currently enjoying level 3 privileges, allowing full access within the hospital, and the treatment team is currently considering granting level 4 privileges (grounds access).
o) Mr. Lao successfully completed a 72-hour pass to visit with his mother in December of 2025.
p) Mr. Lao’s previous group home placements were cancelled after repeated failed leaves of absence, and any future placement must provide supervision of Mr. Lao’s mental state, medication adherence, and abstinence.
q) Community integration is not realistic until the treatment team is able to manage the active symptoms of his schizophrenia and improve his insight.
Counsel for the Attorney General had no questions.
In response to questions from counsel for Mr. Lao, Dr. Ardani testified:
a) Mr. Lao has struggled with substance use for many years and continues to believe that cannabis helps with his mood, stress and anxiety, although his explanations are inconsistent.
b) Mr. Lao also believes that crystal methamphetamine enhances his spiritual experiences.
c) In response to questions about whether medical cannabis could be used as a harm-reduction strategy, he explained that this had already been attempted through Nabilone, which contains a psychoactive component of cannabis. This trial failed because it increased Mr. Lao's desire to use street cannabis.
d) No alternative cannabinoid medication is likely to help because Mr. Lao seeks the euphoric effects of THC.
e) Complete abstinence is the only safe approach given Mr. Lao’s lack of insight and active psychosis. Mr. Lao is in the pre-contemplative stage of addiction treatment and does not believe abstinence is necessary. Accordingly, psychological or pharmacological craving management strategies are ineffective until Mr. Lao’s insight improves.
f) Mr. Lao is not yet ready to return to a group home. He is not permitted to return to his previous group home. It is too early to predict when community integration might occur, as this depends on Mr. Lao's response to his new medication regimen and his ability to remain abstinent.
- In response to questions from the panel, Dr. Ardani testified:
a) There is no need for an external pharmacological opinion. Mr. Lao suffers from a treatment-resistant form of schizophrenia, and this diagnosis has been confirmed since 2007 by various psychiatrists. The challenge is not diagnostic uncertainty but the lack of response to available medications.
b) The diagnosis of traumatic brain injury is based solely on Mr. Lao’s self-report of being hit by a car. There are no medical records confirming the injury or its severity, and no neuropsychological assessment has been completed. Such an assessment would only be appropriate once Mr. Lao’s psychosis is better controlled.
c) Mr. Lao's impulsive behaviour continues, including blurting out inappropriate statements and pretending to have a gun. Dr. Ardani attributes this behaviour to Mr. Lao's cravings and psychosis rather than to antisocial traits.
d) Mr. Lao is currently receiving 100 mg of amisulpride twice daily which is a very low early stage dose. The maximum therapeutic dose is approximately 1200 mg per day and meaningful clinical benefit emerges only after the dose is optimized and maintained for several weeks.
e) The decision to switch Mr. Lao from an injectable antipsychotic to oral medication was made to reduce distress that Mr. Lao experiences with his fear of needles. Mr. Lao is adherent with his oral medications as he is in a supervised setting.
f) Mr. Lao’s ability to engage in psychotherapy, addiction treatment, and community reintegration will depend heavily on whether the trial with amisulpride is successful in reducing his positive symptoms and improving his insight.
This completed the evidence of Dr. Ardani.
- Mr. Lao testified as follows:
a) He has previously been prescribed marijuana-based medication. He wondered why, for other individuals who receive methadone and Suboxone to assist with cessation, a similar option is not available to him.
b) He believes it is not realistic for him to abstain entirely from cannabis, although he believes it is realistic for him to avoid crystal methamphetamine and other drugs.
c) Cannabis helps him remain calm and manage his stress and he needs something to keep him calm.
d) He has been on psychiatric medication since childhood. He felt that the cumulative effect of these medications has been negative for him.
e) His primary concern is obtaining something that will help manage his stress more effectively.
No other evidence was called.
Analysis and Conclusions:
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the joint submission: Mr. Lao remains a significant threat to the safety of the public.
In Winko, the Supreme Court outlined that, in determining whether there is a significant threat, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support available for the NCR accused in the community; and, most importantly, the recommendations provided by experts who examined the NCR accused. In reaching its conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Ardani, in addition to the documentary evidence before it.
Mr. Lao continues to have limited insight into his mental illness. He is able to name his diagnosis, however, he does not agree with the diagnosis of schizophrenia.
Mr. Lao’s insight into his need for treatment remains underdeveloped. He does not believe it is necessary for him to take medication, nor does he think it is effective. Mr. Lao does not recognize that substance use or failure to take medication could result in decompensation of his mental illness, rendering him a significant threat to the safety of the public.
Mr. Lao’s protective factors are largely external; he is under the supervision of the Ontario Review Board: he is required to live in a supervised environment; and he is currently receiving 24/7 professional care.
In particular, the Board relies on the following paragraphs extracted from the Hospital Report, both in relation to the threshold “significant threat” issue and as to why a Detention Order is necessary and appropriate:
“Integration Judgement - HCR-20 and SAPROF.
Overall, if Mr. Lao were to be managed under a detention order, even in hospital, his risk for violence would be moderate to high. If he were to be managed under a less restrictive disposition, his risk for violence would be high.
Re-Offence Scenario
Absent Forensic supervision and support, Mr. Lao would likely be without an adequate living accommodation and resort to living in a shelter or on the streets. He would not be able to obtain professional supports independently or in a timely manner. These circumstances would heighten his stress. Due to the lack of insight, he would not take his medications and would return to substance use. His symptoms, including auditory hallucinations and paranoia, which are currently active, would further exacerbate, causing significant instability and decompensation, leading to an increased risk of violence, similar to the events around the time of the index offence.
Overall Clinical Assessment of Risk
It is the opinion of the treatment team that Mr. Lao continues to pose a risk of serious physical or psychological harm to members of the public. The following evidence supports this opinion:
Mr. Lao remains impacted by active symptoms of his psychotic mental illness. He continued to experience both positive and negative symptoms of his illness throughout the reporting year. These symptoms elevate his violence risk, especially when engaged in substance use, which was present this year;
Mr. Lao continued to use substances causing decompensation and instability which required multiple admissions to hospital throughout the reporting year. He was eventually readmitted to hospital for a longer period. While in hospital, he absconded and relapsed on substances while also threatening to break into cars and steal money;
Mr. Lao’s level of insight into his mental illnesses, need for treatment, substance use disorder and violence risk remains underdeveloped;
Mr. Lao has expressed violent ideas this reporting period;
Mr. Lao has presented with disregard for rules and expectations;
Mr. Lao’s protective factors from risk are externally driven and his personal supports are limited; and
Mr. Lao has no professional mental health supports aside from his current Forensic supports. He would not be able to obtain such supports independently.
An alternative disposition was not considered. Mr. Lao’s mental stability and overall risk remained a concern throughout the entire reporting period. He continued to engage in substance use, lacking insight into how these behaviours exacerbate his mental illness and violence risk. When community living is considered in the future, he will most likely require a supervised setting to which the hospital will need to approve. He will also require a Warrant of Committal to ensure that prompt intervention is maintained, protecting the public’s safety, as demonstrated throughout the current reporting period.”
- In consideration of all the evidence, submissions of the parties and the criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Lao, his reintegration into society and his other needs, the necessary and appropriate Disposition is to continue with a Detention Order.
DATED this 8th day of June 2026, at the City of Toronto, in the Region of Toronto.
Mr. J. Weinstein Alternate Chairperson Office of the Registrar Ontario Review Board