Background
Gurjas K. Singh was found not criminally responsible (NCR) by reason of mental disorder on charges including attempted murder arising from a 2017 incident in which she stabbed a stranger in a parking lot while experiencing paranoid delusions. Her current diagnoses are schizoaffective disorder (bipolar type), severe cannabis use disorder in early remission, and mild cocaine use disorder. She was detained at Ontario Shores Centre for Mental Health Sciences under a detention order with community living privileges.
After two years as an in-patient, Ms. Singh moved to an independent subsidized apartment in February 2024. During the reporting year she showed no overt signs of psychosis, though she experienced anxiety and depression and was briefly readmitted voluntarily for seven days. She was compliant with her antipsychotic medication but failed several drug screens and was not fully forthcoming about her drug use. She also discontinued antidepressant and anti-anxiety medications without notifying her treatment team, though the team did not recommend resuming them as she appeared to be managing well.
At her annual review, Ms. Singh sought a conditional discharge, proposing a suite of safeguards: a “Young clause” (requiring her to attend hospital for assessment and to admit herself on request, with judicial enforcement available under s. 672.93 of the Criminal Code for any breach), a treatment compliance clause, and continued abstinence, drug-testing, and weapons-prohibition conditions. The Ontario Review Board nonetheless continued the detention order, finding that without it she would likely disengage from treatment, become medication non-adherent, increase substance use, and thereby return to a state of psychosis that previously led to violence.
The Court’s Holding
The Court of Appeal (Miller, Paciocco, and Wilson JJ.A.) allowed the appeal and remitted the matter to the Review Board for reconsideration. The court held that the Board failed to meaningfully consider whether the conditional discharge proposed by Ms. Singh — anchored by a Young clause and treatment compliance condition — could practically and effectively manage the public safety risk she posed. Under the court’s prior decisions in Collins (Re), 2018 ONCA 563, and Ahmadzai (Re), 2020 ONCA 169, where a conditional discharge has an air of reality it must be genuinely considered, and the Board’s reasons did not meet that standard.
Applying the framework articulated in Ramos (Re), 2025 ONCA 820, the court identified two questions the Board was required to address: (1) whether the evidence and treatment history supported the conclusion that Ms. Singh would not voluntarily attend for treatment if her condition deteriorated; and (2) whether the compulsory mechanisms she proposed — including judicial enforcement of readmission under s. 672.93(2) of the Criminal Code — would be inadequate to protect the public. The Board addressed neither question with sufficient depth, and in particular failed to assess the likely timeline and nature of any clinical decompensation and whether a Young clause could be enforced on a timeline adequate to protect the public.
The court also accepted fresh evidence from the Crown that Ms. Singh had been involuntarily admitted to hospital after the Board’s decision, an admission upheld at a restriction of liberties hearing in February 2026. Because the record contained no explanation of the circumstances, treatment received, or implications of that admission for the conditional discharge question, remittal was especially warranted so the Board could consider the matter on a complete evidentiary record.
Key Takeaways
- Where a conditional discharge proposal has an air of reality, the Review Board must engage meaningfully with whether the proposed conditions — including a Young clause and treatment compliance obligation — can adequately protect public safety; a general assertion that detention is necessary is insufficient.
- The Board must specifically assess the nature and likely timeline of an NCR accused’s potential decompensation and whether judicial enforcement of a Young clause under s. 672.93(2) of the Criminal Code can operate on a timeline that safeguards the public.
- An NCR accused’s history of compliance with antipsychotic medication, stable housing, and regular engagement with a treatment team are relevant factors weighing in favour of considering a conditional discharge, even where some non-compliance (such as drug use) exists.
- Significant new clinical events occurring after a Board decision — such as an involuntary hospitalization — must be considered on remittal and can independently justify sending a matter back for a fresh hearing.
Why It Matters
This decision reinforces and extends the line of Ontario Court of Appeal authority requiring Review Boards to rigorously and specifically evaluate conditional discharge proposals made by NCR accused, rather than defaulting to detention whenever risk is not eliminated. By demanding that Boards engage with the mechanics of Young clause enforcement — including decompensation timelines and the adequacy of judicial readmission orders — the court tightens the analytical standard boards must apply and ensures that liberty is curtailed only to the extent genuinely necessary.
For practitioners, the case confirms that a well-constructed conditional discharge proposal, backed by an NCR accused’s track record of medication compliance and community stability, can and should receive rigorous Board consideration even where the accused has not been perfect. It also signals that fresh clinical developments arising between a Board decision and an appeal will be taken seriously by the Court of Appeal in assessing the appropriateness of remittal.