Re: Nathaniel Gooding
ORB File No: 8007
Hearing held on: Tuesday, May 19, 2026
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Banks
Members: The Hon. B. Allen
Dr. G. Eayrs
Dr. M. Mamak
Ms. B. Naegele
Parties Appearing:
Accused: Nathaniel Gooding
Counsel: Mr. D. Embry
The person in charge of hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Ms. L. Earle
REASONS FOR DISPOSITION
(Dated June 18, 2026)
Introduction
Mr. Nathaniel Gooding was charged with aggravated assault, contrary to the Criminal Code and was found not criminally responsible on account of mental disorder on November 19, 2021.
Pursuant to s. 672.81(1) of the Criminal Code a panel of the Ontario Review Board (“the Board”) was convened on May 19, 2026, at the Centre for Addiction and Mental Health (“CAMH” or “the Hospital”). Mr. Gooding’s mother attended the hearing.
Mr. Gooding’s existing disposition dated May 12, 2025, orders that Mr. Gooding be detained at the Forensic Service of CAMH with privileges up to and including living in the community in approved accommodation.
Pursuant to the criteria set out in s. 672.54 of the Criminal Code, the issues to be decided at this hearing are whether Mr. Gooding continues to meet the test for significant threat to the safety of the public and, if so, a determination on the least onerous and least restrictive disposition in the circumstances including any conditions to be attached to that disposition.
At the start of the hearing the parties provided the Board with their respective positions regarding significant threat and disposition. The parties took a joint position that Mr. Gooding remains a significant threat to public safety and that the appropriate disposition is detention at the Forensic Service at CAMH with privileges up to and including residing in the community in approved accommodation.
Disposition
- For reasons set out below the Board determines pursuant to s. 672.54 of the Criminal Code that Mr. Gooding continues to pose a significant threat to public safety and that the necessary and appropriate, least onerous and least restrictive disposition, is that Mr. Gooding remain detained at the Forensic Service of CAMH with privileges extending to and including residing in the community in supervised accommodation.
The Evidence
- A Hospital Report co-authored by Dr. Deep Jaiswal and dated April 19, 2026, was filed as an exhibit. It contains a description of Mr. Gooding’s personal and psychiatric backgrounds which need not be repeated here in detail.
Diagnoses
- Mr. Gooding’s diagnoses are schizophrenia and cannabis use disorder, in sustained remission, within a controlled setting.
Substance Use
- Mr. Gooding reported that he started smoking cannabis at age 16 and used between one to three grams daily although he indicated he would also abstain for weeks at a time. The evidence is that Mr. Gooding drank a significant amount of alcohol during the months leading up to the index offence and his mother indicated that he began drinking hard liquor frequently in September 2020. The evidence suggests that Mr. Gooding has been a heavy cannabis user but he claims he stopped in the summer of 2020.
Criminal History
- Mr. Gooding does not have a criminal record before the index offences although the police were called to the family home on some occasions for his involvement in domestic disputes.
Index Offences
- The index offences as summarized from pages 8 and 9 of the Hospital Report are as follows:
On November 22, 2020, Ms. Gooding was lying in her bed when she saw Mr. Gooding had swung the door open and stood masked at the doorway with a butcher knife in his hand. Mr. Gooding uttered, “God told me you have to die.” He attacked Ms. Gooding in her back and hands as she attempted to ward off the attack. Ms. Gooding uttered to her son, “You’re sick, you need help.” As the attack continued, Mr. Gooding said to Ms. Gooding, “You are sick, you need to go to sleep.” Mr. Gooding tried to suffocate Ms. Gooding with the bedding and with a plastic bag which he could not get over her head. Mr. Gooding then put his fingers in his mother’s mouth and she bit down hard. Mr. Gooding said, “Mom, God told me to do this cause you’re sick.” Ms. Gooding let her body go limp and kept telling her son that she loved him. Mr. Gooding’s demeanour changed. He said, “Oh my God, I have to go.” Ms. Gooding asked her son to call 911. He did so and left the area of the home in his mother’s vehicle. He was not home when police first arrived.
Personal and Psychiatric Backgrounds
Before the Current Reporting Year
Mr. Gooding is 29 years of age, born in Toronto, and raised by a single mother along with a half-sister. He graduated from high school and attended college for one semester but did not complete the program.
Following the index offence, during the reporting year from 2021 to 2022, he exhibited some positive developments but some negative behaviours as well.
Mr. Gooding was transferred from TSDC (Toronto South Detention Centre) to CAMH on December 6, 2021. At that time Mr. Gooding was not experiencing any active psychotic symptoms. He reported an “okay” mood, denied suicidal or violent ideation and stated that he was compliant with medications in jail. He enjoyed the continuous support of his mother in his hospital care. There was one incident of violence against a co-patient in December 2021 which resulted in him being placed in locked seclusion for two days.
In 2022, Mr. Gooding displayed some insight into his mental illness and medications. On February 16, 2022, he acknowledged that he had been diagnosed with schizophrenia and disclosed that auditory hallucinations and paranoia were symptoms of his illness. He acknowledged that his medications would play a significant role in maintaining his stability and was agreeable to continuing his antipsychotic medications.
There were further positive developments during the reporting year 2022 to 2023. Mr. Gooding was transferred from a secure forensic assessment unit to a general forensic unit on April 13, 2022. For the entire duration of that period Mr. Gooding remained in that unit without any transfers for behavioural incidents or mental health decompensations. There were no violent incidents or AWOL attempts. All of his urine drug screenings were negative and he completed substance relapse prevention programming on the general forensic unit.
While Mr. Gooding was compliant with his medications during that year, he showed a lack of insight into the importance of the medication to his mental stability. He expressed the view that he felt fully recovered and believed that the only way to see what would happen off medications would be a trial off all medications.
In answer to questions about the index offence Mr. Gooding stated that it was a difficult subject for him because he was out of character when he offended. When asked directly about what motivated his conduct Mr. Gooding stated that he thought stress and depression were factors but also conceded he may have had symptoms of psychosis. Mr. Gooding tended to minimize his past which indicated to the treatment team a lack of understanding of the severity of the index offence.
Mr. Gooding succeeded in attaining level 7 passes which involve indirectly supervised passes in the community. His pass levels increased steadily without any reductions or incidents. Mr. Gooding regularly participated in and completed CAMH recreational and therapeutic programs and used opportunities to participate in special events and community outings.
Things changed adversely at a point during the 2023 to 2024 reporting year.
The Hospital Report indicates that Mr. Gooding had troubling episodes involving a return of psychotic symptoms, multiple episodes of violence and aggression with co-patients, staff and co-employees at his workplace.
Mr. Gooding exhibited increasing irritability toward co-patients and staff. He accused co-patients of disrespecting him and his mother and of searching his room. He engaged in physical altercations and yelling with co-patients on several occasions. Mr. Gooding was also found to have a box cutter in his room, thought to be a tool in his employment, and he was warned it was considered to be a weapon. The clinical team suggested he attend an anger management program, a suggestion he did not accept. Mr. Gooding was transferred to another general forensic unit.
Mr. Gooding displayed limited insight into his mental illness maintaining there was nothing wrong with him and that other patients were trying to sabotage him. He denied symptoms such as hallucinations and delusions, though there was evidence of paranoia and irritability leading to interpersonal conflicts.
In September 2023, a Code White was called when Mr. Gooding approached a co-patient who was watching television and started punching and kicking him, the co-patient returning punches. A nurse intervened and got punched in the wrist trying to separate them. Staff had to pull Mr. Gooding off the co-patient. Security arrived on the unit and Mr. Gooding was escorted to seclusion. There was no evidence of substance use and Mr. Gooding showed no remorse, saying he had done nothing wrong.
On October 5, 2023, Mr. Gooding was transferred from a general forensic unit to a secure forensic assessment unit. It was decided that Mr. Gooding should remain on the secure forensic unit in view of his many conflicts with staff and other patients and because of his absconding from the unit. Mr. Gooding showed a lack of insight into his behaviour and need for medications. He denied feeling paranoid and declined a recommended change to his medications.
Mr. Gooding was allowed level 1 escorted passes on November 13, 2023, and he showed some progress by being engaged in groups on the unit. The clinical team re-connected him with his individual therapist for culturally adapted cognitive based therapy.
On November 24, 2023, the Board convened a hearing to review the significant increase in restrictions on Mr. Gooding’s liberty beginning on October 5, 2023, and continuing at the time of the hearing. The Board found the restriction was necessary and appropriate and the least onerous and least restrictive measure in Mr. Gooding’s circumstances.
On December 26, 2023, Mr. Gooding was again placed in seclusion after an assault on a co-patient. He continued to refuse an increase in his medication doses. He was released from seclusion on December 29, 2023. After Mr. Gooding’s level 1 pass had been withdrawn because of his conduct on October 5th, it was reinstated on January 9, 2024. The pass was again revoked and reinstated on March 4, 2024.
During 2023 and 2024, Mr. Gooding showed no insight into his illness, medications or the seriousness of the index offence. He repeatedly denied paranoid symptoms and his diagnosis. He said he only took medication because he was required to. Mr. Gooding denied the medication’s role in any improvement in his symptoms. When asked about the index offence he attributed his actions to “family dynamics.” He denied the need for oversight by the Board and the Hospital.
During the early part of the reporting year May 2024 to 2025, Mr. Gooding resided on a secure forensic unit. In September 2024, he was transferred to a general forensic unit. Except for two episodes of breakthrough psychotic symptoms, overall, Mr. Gooding maintained clinical stability during the reporting year.
Factors in Mr. Gooding’s favour were: he remained capable of consenting to treatment and maintained adherence to the same; his urine analyses revealed abstinence from substances; he maintained phone contact with his mother on an almost daily basis; and he acknowledged being unwell. Somewhat detracting from this progress was his reported belief that “other patients tried to sabotage his situation.” He did not recognize that his beliefs were delusional and did not accept that paranoia led him to believe his mother was evil and that this was an aspect of mental illness.
The Current Reporting Year – April 2025 to May 2026
Mr. Gooding remained in a general forensic unit during the current reporting year. At the start of this period Mr. Gooding was clinically stable. His urine screens indicated abstinence from substances. Of concern was that his antipsychotic medication caused him to experience a resting tremor of his hands. In September 2025, the dose of olanzapine was gradually eliminated and replaced with a long-acting, injectable antipsychotic medication, paliperidone, when, after nine days, Mr. Gooding began experiencing clinical instability, expressing the belief that the team was being hostile toward him. Later that month his treatment was augmented with olanzapine at 5 mg at night.
On September 19, 2025, Mr. Gooding absconded while on a community pass for a group outing with staff and co-patients. He exited a streetcar and ran into the neighbourhood where he had gotten off the streetcar. A staff member followed him and after ten minutes he returned to the vicinity of the unit staff. Police were called and he waited with the unit staff until police arrived to escort them back to the Hospital. When questioned about the event, Mr. Gooding said he felt “stressed out” and “reiterated that staff” were “holding him back.” Subsequently Mr. Gooding’s passes were reduced to escorted passes on Hospital grounds and were gradually increased in line with his level of clinical stability.
After completing pass training, escorted passes to the community were approved on December 15, 2025. Mr. Gooding began utilizing escorted passes to the community and at the time of the Hospital Report he had progressed to indirectly supervised passes to the community.
Mr. Gooding again requested a change from long-acting injectable paliperidone to aripiprazole and after discussions with the team about risk to his mental status he agreed to remaining on paliperidone.
Mr. Gooding intermittently experienced transient changes in his presentation during the remainder of the reporting year such as being observed smiling/responding to internal stimuli. He had a few incidents of irritability as well. But he subsequently returned to states of clinical stability.
There were other areas of progress. Mr. Gooding continued to receive support from his mother who maintained regular contact with him and visited him when she was able to. Regarding housing, as Mr. Gooding progressed up the pass ladder and recently maintained clinical stability, the general forensic team anticipated applying for semi-supportive/supervised housing programs. Mr. Gooding’s insights were limited and tentative in regard to the index offence, his need for medication and the detrimental effect of cannabis.
The Hospital Report at pages 24 and 25 addresses factors affecting the risk to re-offend:
In the absence of ORB involvement, Mr. Gooding is likely to discontinue treatment, get exposed to stressors, and fall away from supports. In this context, he is likely to experience a mental state decompensation and the same is likely to go undetected in the early stages of decompensation. Additionally, when unwell, he is likely to return to cannabis use. In the context of mental state decompensation, he is likely to incorporate individuals in his proximity in his psychotic experience and engage in violent behaviours towards them. Consequently, the threshold for significant threat to public safety is met in his case on balance.
Dr. Deep Jaiswal’s Oral Evidence
Dr. Deep Jaiswal, a co-author of the Hospital Report dated April 19, 2026, testified at the hearing. He has been involved with Mr. Gooding’s care since September 30, 2024, when he was transferred to the general forensic unit. There were no transfers to another unit over the current reporting year.
In terms of updates to the Hospital Report, Dr. Jaiswal advised that an application was submitted for supervised housing in Peel Region but it was not accepted. He explained there was a “call out” by the outpatient team to notify the inpatient team of available vacancies. The doctor indicated that applications will be submitted to three further 24/7 supervised housing accommodations that provide medication monitoring, being on Eglinton Ave. W., King St. W. and Oakwood Ave., all situated in Toronto. The deadline for applications is May 25, 2026.
In answer to a query about how long it might take for Mr. Gooding to obtain housing Dr. Jaiswal indicated that if the application is accepted it could take about one month once ODSP support and primary care are in place.
In response to a query about Mr. Gooding’s current medications, the doctor advised that he is being treated with a long-acting injection that is augmented by a nightly oral dose of olanzapine at 5 mg.
Dr. Jaiswal explained that Mr. Gooding was experiencing ongoing hand tremors while receiving the long-acting injections. To ameliorate his experience of the side effects, the team reduced the dose of olanzapine. That medication was eventually discontinued but early signs of decompensation were later observed. Dr Jaiswal stated that it was decided that olanzapine at 5 mg nightly would be re-introduced to manage his breakthrough symptoms. Dr. Jaiswal testified that the plan is to monitor the medication and indicated that the frequency of the long-acting injection administration may have to be increased to every 11 weeks (instead of every 12 weeks) if signs of decompensation appear. As the doctor pointed out, the challenge going forward remains to achieve medication optimization.
Dr. Jaiswal testified about Mr. Gooding’s preference to switch from injectable paliperidone to aripiprazole and he explained the decompenation risk involved with a change to aripiprazole. Mr. Gooding is treatment capable and he accepted the advice of the doctor. Dr. Jaiswal stated that despite the changes in medications Mr. Gooding has remained medication compliant.
Dr. Jaiswal was also asked about Mr. Gooding’s September 19, 2025, absconding incident. He advised that before the AWOL incident Mr. Gooding had been using level 8 indirectly supervised passes. But following the AWOL incident Mr. Gooding’s passes were downgraded to escorted passes on Hospital grounds. Over the reporting year, Mr. Gooding had progressed to level 7 indirectly supervised passes into the community for recreational purposes. As of May 1, 2026, he was approved for level 8 indirectly supervised passes into the community. While Dr. Jaiswal acknowledged the brittleness of Mr. Gooding’s mental status, he pointed out that since the absconding incident there have been no further problems or incidents.
In terms of a future housing choice Dr. Jaiswal pointed out that it is particularly important that the administration of his oral olanzapine be supervised at his residence and his mental state be closely monitored by staff at the residence. To Mr. Gooding’s favour he has not refused medication in the current reporting year and there has been no evidence of substance misuse.
Dr. Jaiswal was asked about Mr. Gooding’s vocational goals going forward. The doctor indicated that Mr. Gooding is interested in construction and seeks to obtain certification for employment in that area.
The doctor testified that Mr. Gooding’s risk factors include: his non-compliance with his prescribed medications; the possibility of his relapse to alcohol and/or drugs; and his experience of stressors when he transitions to community living. The doctor advised that Mr. Gooding’s psychotic illness is now in remission. However, Mr. Gooding’s clinical stability has not been sustained for a prolonged period. Nor has his stability been tested while he has had liberal indirectly supervised community access.
The Parties’ Closing Submissions
The parties were in agreement that Mr. Gooding continues to be a significant threat to public safety and that the necessary and appropriate disposition to mitigate danger to the public, that is the least onerous and least restrictive in the circumstances, is a detention order.
The parties maintained their joint position that the existing conditions should continue except, as alluded to earlier, the differing views as to whether the accommodation in the housing condition should be specified “as approved” by the Hospital or specified as “supervised.” As noted earlier the Hospital saw approved accommodation as sufficient on the view that supervised housing would fall under the general rubric of approved housing but was not averse to the condition requiring supervised housing.
The Crown submitted that the housing condition should specifically state “supervised” accommodation because of the particular requirement that Mr. Gooding’s medication should be monitored.
Mr. Gooding’s counsel agreed with the Hospital’s initial position submitting that Hospital approved accommodation is sufficient to manage Mr. Gooding’s risk and his housing should not be restricted to “supervised” housing, especially if Mr. Gooding’s situation improves over the next year.
The Board’s Conclusions
Based on the evidence before us the Board unanimously accepts the conclusions of the Hospital Report, authored by Dr. Deep Jaiswal, that Mr. Gooding remains a significant threat to public safety within the criteria outlined in Winko v. British Columbia, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625, and as defined in s. 672.5401 of the Criminal Code.
The Board accepts that the least onerous and least restrictive disposition that is appropriate in the circumstances is an order detaining Mr. Gooding at the Forensic Service at CAMH. The Board agrees that the existing conditions of his disposition should continue except that paragraph 2(d), which provides accommodation “approved by the person in charge” should be amended to “supervised” accommodation “approved by the person in charge.”
The Board relies on the following evidence.
The Board finds concerning the vacillations in Mr. Gooding’s stability over the years, continuing to the present, which we find pose a potential risk to public safety. There have been many ups and downs in his clinical presentation as the clinical team makes efforts to find the appropriate optimization of his medication.
There was a notable change from Mr. Gooding’s more favourable presentation in the reporting year 2021 to 2022 to less favourable at times in 2023 and 2024. The Board is concerned that, while in 2022, Mr. Gooding shown some clinical stability, his risk factors increased in 2023. In January 2024, Mr. Gooding, unprovoked, physically assaulted a co-patient on the unit and began disagreeing with his diagnosis and the importance of Board and Hospital oversight. He engaged in numerous conflicts with co-patients and staff and in public. Mr. Gooding displayed a lack of insight into his mental illness and was non-compliant with medication to the point that he lost his level 1 privileges.
During the first half of 2025 to 2026, his psychotic and aggressive behaviours began to subside. He abstained from substance use and consented to and was compliant with the changes in his medication. However, in September 2025, while efforts were being made to optimize his medication, Mr. Gooding experienced a decline in clinical stability to the extent of a return to displays of hostility toward staff and co-patients on the unit. Most troubling to community safety was an incident that occurred in September 2025, while Mr. Gooding was on an indirectly supervised group community pass, when he absconded into a neighbourhood for ten minutes and had to be returned to the Hospital by police.
Mr. Gooding’s clinical stability has not been sustained for prolonged periods and has not yet been sufficiently tested while on liberal indirectly supervised community access. The Board finds in the circumstances that a detention disposition order is necessary to allow the Hospital to regularly monitor Mr. Gooding’s stability in the community and approve housing that has facility to supervise the administration of his oral medication. Medication adherence is a critical component to risk management. During the current reporting year, Mr. Gooding has shown some progress, as by March 2026, he returned to a state of clinical stability, remaining adherent to his medications and maintaining independence in his activities of daily living.
Against this backdrop of some progress in Mr. Gooding’s circumstances the clinical team is attempting to find suitable accommodation in the community. Compliance with augmenting oral medication is critical to Mr. Gooding’s stability and capacity to safely reside outside the Hospital. Efforts to optimize medication may be ongoing as Mr. Gooding’s treatment team closely monitors him for any changes in his clinical presentation. Staff supervision over the administration of his oral medications together with close monitoring of his clinical presentation is critical to his risk management.
In conclusion the Board gives full support to the plan for community living recommended by the Hospital. We recognize the contribution to Mr. Gooding’s success that the housing plan will offer. As well, continued abstention from cannabis use is critical to the maintenance of his mental stability. The Board offers Mr. Gooding our praise for the long and difficult road he has travelled to reach a point that living in the community is on the near horizon.
For the reasons set out the Board finds, pursuant to s. 672.54 of the Criminal Code, that Mr. Gooding remains a significant threat to public safety and that the appropriate and necessary disposition is an order detaining Mr. Gooding at the Forensic Service at CAMH with privileges as set out in the existing disposition except making a change in the housing condition from approved accommodation to supervised accommodation approved by the person in charge.
DATED this 18th day of June, 2026, at the City of Toronto, in the Toronto Region.
The Hon. B. Allen
Legal Member
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Office of the Registrar
Ontario Review Board