Re: Dinesh Balachandiran
ORB File No: 8528
Hearing held on: Wednesday, November 12, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences 700 Gordon Street, Whitby
Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Silver Members: Dr. S. Lessard Dr. T. Stirpe Ms. C. Murray Ms. B. Naegele
Parties Appearing:
Accused: Dinesh Balachandiran Counsel: M. R.W. Browne (via Zoom)
The person in charge of hospital: Representative: Dr. J. Pytyck
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DISPOSITION
(Dated November 24, 2025)
Introduction
[1]. On April 3, 2024, Mr. Dinesh Balachandiran was found unfit to stand trial on account of mental disorder on Criminal Code of Canada (“Criminal Code”) charges of sexual assault and assault.
[2]. Mr. Balachandiran is currently subject to a Disposition of the Ontario Review Board (“the panel” or “the Board”), dated November 1, 2024, detaining him within the Forensic Services of the Ontario Shores Centre for Mental Health Sciences (“Ontario Shores” or “the hospital”) until such time as he can be detained within the Dual Diagnosis Service at Ontario Shores, and, once transferred, to be detained within the Dual diagnosis Service of Ontario Shores. The outer limit of privileges is to live in the community in DSO-affiliated accommodation approved by the person in charge.
[3]. On November 12, 2025, the Board convened a hearing at Ontario Shores to conduct the annual review of the current Disposition. In accordance with s. 672.48(1) of the Criminal Code, the Board must determine if Mr. Balachandiran remains unfit as of the date of the hearing within the meaning of s. 2 of the Criminal Code. If he remains unfit, the necessary and appropriate Disposition to manage that risk must be determined, bearing in mind the criteria set out in s. 672.54 of the Criminal Code.
[4]. Mr. Balachandiran was present at the hearing and was represented by counsel, Mr. Russell Browne, throughout. Mr. Browne attended via Zoom technology.
[5]. A Tamil interpreter was present to provide translation should Mr. Balachandiran require the same. The alternate chairperson, Ms. Silver, canvassed Mr. Balachandiran’s need for simultaneous translation. Mr. Browne advised the Board that there is no way of knowing whether Mr. Balachandiran requires translation to Tamil as he is mute and largely non-communicative. Dr. Pytyck opined that Mr. Balachandiran does not require translation services. At the alternate chairperson’s request, the interpreter asked Mr. Balachandiran, in Tamil, if he would like the translator to translate English to Tamil for him at the hearing. Mr. Balachandiran did not respond or indicate in any way whether he wanted English translated to Tamil during the hearing. Mr. Browne was content for the hearing to proceed in English as there were no contested issues to be heard. As such, and there being no objections, the Board proceeded in English only.
[6]. Evidence at the hearing included a Hospital Report dated November 4, 2025 (the "Hospital Report"), which was entered as Exhibit 1, and the viva voce evidence of Dr. Jennifer Pytyck.
[7]. For the reasons set out below and based on the evidence before us, the Board concludes that Mr. Balachandiran remains unfit to stand trial, likely permanently. The Board finds that the necessary and appropriate Disposition is a continuation of the existing Detention Order with the addition of privileges permitting Mr. Balachandiran to enter the community within 150 kilometres of Ontario Shores, indirectly supervised for up to 12 hours. Additionally, paragraph 1 of the Disposition is amended ordering that Mr. Balachandiran be detained with the Forensic Service of Ontario Shores or within the Dual Diagnosis Service of Ontario Shores.
Current Psychiatric Diagnoses
[8]. Autism Spectrum Disorder (severe); and
Intellectual Disability (severe)
Position of the Parties
[9]. At the commencement of the hearing, the parties were canvassed for their positions. On behalf of the hospital, Dr. Pytyck, took the position that Mr. Balachandiran remains unfit to stand trial as of the date of this hearing, likely permanently so, and that he represents a significant risk of harm to the public. She submitted that the necessary and appropriate disposition is a continuation of the existing Detention Order Disposition with the addition of a clause permitting Mr. Balachandiran to enter the community within 150 kilometres of Ontario Shores, indirectly supervised. Dr. Pytyck explained that the addition of this clause would allow the care teams associated with Passport funding, Developmental Services Ontario (“DSO”), or Springboard to pick Mr. Balachandiran up for programming and attend such programming with him. Dr. Pytyck noted that Mr. Balachandiran would always be supervised and accompanied.
[10]. Counsel for the Attorney General of Ontario, Ms. MacDonald, supported the hospital’s position in its entirety.
[11]. Counsel for Mr. Balachandiran, Mr. Browne, took no position as he was unable to obtain instructions.
Alleged Index Offences
[12]. According to the police synopses, on March 8, 2024, a woman was sitting in the front passenger seat of a parked car with her door open when Mr. Balachandiran ran up to the car, grabbed the woman’s crotch over her clothing, and ran away.
[13]. On March 11, 2024, Mr. Balachandiran ran up to a woman who had just stepped out of her car and “attempted to attack her” but she kicked him away.
Background and History
[14]. The Hospital Report contains detailed information regarding Mr. Balachandiran’s background and history, the entirety of which need not be repeated here in detail. In brief, Mr. Balachandiran is 33 years old. Until his arrest he lived in an apartment in Scarborough with his parents and younger brother. The primary language in the family home was Tamil.
[15]. Mr. Balachandiran was diagnosed with autism spectrum disorder at the age of four. He was later diagnosed with an intellectual disability. He has been described as non-verbal, but he sometimes uses individual words. Mr. Balachandiran can follow some simple verbal directions and can use some hand gestures to communicate.
[16]. Mr. Balachandiran has a long history of behavioural difficulties. He has had no prior psychiatric hospitalizations, but his worsening aggressive and violent behaviours led his parents to seek help for him in emergency rooms. He has destroyed furniture and walls in the home and assaulted his parents. He has had some agitation and aggression towards his younger brother. He required 24-hour supervision with all his activities of daily living. He engaged in challenging behaviours such as screaming, environmental and physical aggression, self-injury, Pica (eating non-food items), inappropriate sexual behaviour (stripping clothing / attempting to remove a female’s clothing), wandering, and emotional outbursts.
[17]. Mr. Balachandiran had no criminal record prior to the alleged offences. The Hospital Report mentions that he had been arrested but not charged in relation to an assault on a female in 2021.
[18]. Mr. Balachandiran is supported financially by the Ontario Disability Support Program (“ODSP”), DSO, and the Passport Program through the Ontario Autism Program (“OAP”).
[19]. Mr. Balachandiran’s father serves as his substitute decision maker (“SDM”) for treatment decisions.
[20]. After his initial hearing, Mr. Balachandiran remained on the Forensic Transitional Unit (“FTU”) until his transfer to the Dual Diagnosis Services (“DDS”) on April 11, 2025. He was then transferred back to the general FTU on July 2, 2025, and remains an inpatient there at this time.
[21]. During his three-month stay at DDS, Mr. Balachandiran showed “remarkable adaptability” to the structured routine of the unit. Despite being non-verbal, he thrived with consistent daily schedules, clear routines, and predictable structure on the DDS. Regardless of the behaviours Mr. Balachandiran engaged in, his planned activities continued without threat of cancellation or punishment. This approach was based on the clinical assessment that Mr. Balachandiran did not demonstrate an understanding of cause-and-effect consequences. Therefore, punishment-based interventions would not be therapeutically beneficial or instructive.
[22]. The DDS treatment team relied on non-pharmacological interventions as the primary approach to behavioural management. PRN medications were not ordered while Mr. Balachandiran was residing on DDS because, being non-verbal and unable to communicate his internal state, he could not communicate if he was experiencing distress that would warrant PRN medications. He also could not communicate whether PRN medications had been effective.
[23]. When Mr. Balachandiran was transferred back to FTU in July 2025 he began to destabilize significantly despite the FTU treatment team’s efforts to maintain continuity with Mr. Balachandiran’s established activities and routines. A consultation between the FTU and DDS teams resulted in the development of a care plan based on the successful strategies used during Mr. Balachandiran’s DDS placement. Since implementing the care plan, Mr. Balachandiran has demonstrated significant improvement and stability on FTU, including no incidents of aggression.
[24]. Mr. Balachandiran is currently under consideration for specialized housing through DSO. Mr. Balachandiran’s father has expressed a preference for permanent housing to be chosen over temporary housing.
[25]. The Hospital Report notes that Mr. Balachandiran remains unfit to stand trial due to his intellectual disability and inability to engage in meaningful conversation, including matters related to fitness. The Hospital Report notes that Mr. Balachandiran is likely permanently unfit to stand trial given the “immutable nature” of his underlying mental disorder.
Oral Evidence
[26]. In her oral evidence, Dr. Jennifer Pytyck testified at the hearing as follows.
[27]. Dr. Pytyck has been Mr. Balachandiran’s attending psychiatrist since his admission in May 2024 with the exception of April to July 2025 when Mr. Balachandiran was transferred to DDS for optimization of his behavioral plan and medications.
[28]. Mr. Balachandiran is largely mute. He occasionally repeats one or two English words spoken by staff, but he does not use verbal language to communicate in a meaningful way.
[29]. Dr. Pytyck testified that Mr. Balachandiran is not able to meaningfully communicate or meaningfully participate in legal proceedings. It is not likely that his cognitive capacity will ever reach the threshold for fitness to stand trial even if his verbal communication improves.
[30]. The treatment team has tried to help Mr. Balachandiran with verbal communication using a Picture Exchange Communication (PEC) board. Mr. Balachandiran finds using the PEC board difficult and demonstrates behavioural dysregulation when attempts are made to use it. He has been unable to return to his speech language pathologist (“SLP”) in the community due to his aggression. The treatment team is currently attempting to find another SLP for him.
[31]. Mr. Balachandiran demonstrated significant periods of behavioural instability this reporting year including physical and environmental aggression. Mr. Balachandiran’s behaviours stabilized while he was living in DDS. He then experienced a period of decompensation when he returned to FTU in July 2025. As of the time of this hearing, his behaviours have stabilized.
[32]. Mr. Balachandiran requires a high level of oversight and supervision. Since July 2025, he has largely required one-to-one supervision by nursing staff in addition to other staff who engage him in activities.
[33]. The mainstay of Mr. Balachandiran’s treatment is the behavioural plan. Medications are not a primary component of his treatment.
[34]. Mr. Balachandiran has no insight into his past behaviours. He is very vulnerable and decompensates behaviourally with stress and small changes in his environment. His behaviour is subject to change very quickly. As a result, Mr. Balachandiran needs to be in a setting where staff can quickly adapt his behavioural plan.
[35]. The treatment team is working with Springboard and DSO to try to find housing with specialized programming suitable for Mr. Balachandiran’s special needs. A Detention Order is clearly needed until appropriate housing can be found for him. The hospital requires the ability to readmit Mr. Balachandiran quickly, if necessary. A Conditional Discharge is not on the horizon for Mr. Balachandiran.
[36]. Dr. Pytyck testified that, based on a review of Mr. Balachandiran’s history, he has never been able to engage in meaningful communication verbally or non-verbally.
[37]. Dr. Pytyck stated that it is necessary for the Disposition to have a clause, such as the current clause 1, to keep open the possibility of Mr. Balachandiran attending twelve-week DDS programs.
Analysis and Conclusions
Fitness
[38]. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board finds that Mr. Balachandiran is unfit to stand trial, based on the guidance as set out in R v Bharwani, 2025 SCC 26.
[39]. Mr. Balachandiran’s thought content is largely inaccessible due to his challenges with verbal communication and due to his moderate to severe intellectual disability.
[40]. The panel accepted Dr. Pytyck’s opinion that Mr. Balachandiran’s underlying mental disorder, renders him unable to engage in any meaningful conversation, including conversations about fitness to stand trial. He would be unable to meaningfully participate in a trial.
[41]. Mr. Balachandiran has never been able to meaningfully communicate verbally or non-verbally. The Board accepts Dr. Pytyck’s evidence that Mr. Balachandiran is likely permanently unfit to stand trial.
Significant Threat
[42]. The Board finds that Mr. Balachandiran continues to represent a significant threat to the safety of the public.
[43]. Mr. Balachandiran’s year has been riddled with periods of behavioural destabilization. The behavioural plan developed is complex and has contributed to the recent stabilization of Mr. Balachandiran’s behaviours. However, he requires a very high level of engagement by staff across multiple disciplines to maintain this stability. During times of behavioural destabilization, Mr. Balachandiran demonstrates environmental and physical aggression that has the potential to cause serious physical and psychological harm to those around him, including his care team.
[44]. In making the determination that Mr. Balachandiran continues to represent a significant threat, the Board relies on the clinical assessment of risk extracted from the Hospital Report as follows:
“Clinically, there has been clear evidence for recent problems with instability, symptoms of major mental disorder, insight, and treatment or supervision response. Mr. Balachandiran demonstrated some periods of improvement in his behaviour over the past reporting year, particularly when he was briefly transferred to the Dual Diagnosis Service (DDS) for further assessment and stabilization; however, he quickly regressed following his transfer back to the Forensic Transitional Unit (FTU), likely due to the significant change in the environment, the milieu, and the level of structure and support. He has more recently demonstrated improved behavioural stability, but requires a very high level of engagement by staff from multiple disciplines in order to maintain this presentation. During periods of behavioural destabilization, Mr. Balachandiran continues to present with physical and environmental aggression that has the potential to cause substantive psychological or physical harm to individuals in his vicinity, including care providers.”
Necessary and Appropriate Disposition
[45]. Having found Mr. Balachandiran unfit to stand trial, the Board must make a Disposition that is necessary and appropriate, considering the criteria delineated in s. 672.54 of the Criminal Code.
[46]. The Hospital Report notes that Mr. Balachandiran will require a highly specialized group home environment when he is ready to be discharged from hospital. Once Mr. Balachandiran is discharged from hospital to a group home specializing in developmental disorders and/or dual diagnoses, the hospital will require the ability to readmit Mr. Balachandiran immediately if his behaviour deteriorates.
[47]. Given Mr. Balachandiran’s risk of aggression, the Board accepts Dr. Pytyck’s evidence that a Conditional Discharge is not on the horizon for Mr. Balachandiran.
[48]. The hospital has recommended that Mr. Balachandiran be permitted to receive indirect supervised from specialized staff who are not affiliated with Ontario Shores, allowing him to attend specialized off-site programming. The panel recognizes that such programming is necessary for Mr. Balachandiran’s progress and accepts Dr. Pytyck’s evidence that Mr. Balachandiran will be supervised and accompanied at all times. Therefore, the recommended addition to the Disposition is approved.
[49]. The panel notes that there is a joint submission regarding unfitness and the Disposition. The Board had no difficulty concluding that the necessary and appropriate Disposition is as recommended jointly by all parties.
[50]. In consideration of the criteria set out in s. 672.54 of the Criminal Code and based on the documentary and viva voce evidence, the Board unanimously agrees that the least onerous and least restrictive disposition is continuation of the Detention Disposition with the addition of a privilege permitting Mr. Balachandiran to access the community within 150 kilometres of Ontario Shores, indirectly supervised.
DATED this 24th day of November 2025, at the City of Toronto, in the Region of Toronto.
Ms. C. Murray Legal Member
Office of the Registrar Ontario Review Board