Re: Andre Knight
ORB File No: 7866
Hearing held on: Wednesday, January 22, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. M. Labrosse
Members: Dr. R. Buckingham
Dr. W. Loza
Ms. L. Banks
Mr. W. Apted
Parties Appearing:
Accused: Andre Knight
Counsel: Mr. K. Vakili
The person in charge of hospital: Representative: Dr. P. Darby
Attorney General of Ontario: Counsel: Ms. D. Silver
REASONS FOR DISPOSITION
(Dated March 19, 2025)
Introduction
On February 11, 2021, Mr. Andre Knight was found not criminally responsible on account of mental disorder on a charge of attempted murder, contrary to the Criminal Code of Canada.
Mr. Knight is currently subject to an Ontario Review Board Disposition dated August 21, 2023, which detains him at the General Forensic Unit of the Centre for Addiction and Mental Health, Toronto (“CAMH”) with permission to live in the community of the Greater Toronto Area in accommodation approved by the person in charge.
On January 22, 2025, the Ontario Review Board convened a hearing at CAMH to review Mr. Knight’s Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Knight was present at his hearing and represented by counsel, Mr. K. Vakili. A Hospital Report dated August 12, 2024, was entered as Exhibit 1 for the hearing. The matter had previously been scheduled for a hearing on August 30, 2024, and was adjourned on that date for reasons that have not been provided to this Panel.
The issues for the hearing are whether Mr. Knight continues to pose a significant threat to the safety of the public and, if so, to determine the necessary and appropriate disposition having regard to the factors enunciated at s. 672.54 of the Criminal Code.
For the reasons set out below, the Board finds that Mr. Knight continues to pose a significant threat to the safety of the public, but that the risk can now be managed with a conditional discharge, the terms of which shall be set out at the end of the Analysis and Conclusion section of these Reasons.
Index Offence
- The circumstances of the index offence are extracted from last year's Reasons for Disposition as follows:
“On September 12, 2020, the accused was in the residence with the victim, who was sleeping in her bedroom, at approximately 3:08 p.m. The accused placed his right leg and body weight on top of the victim in an attempt to prevent her from escaping, waking up the victim. The accused then stated that "I have to kill you... you have to die" and pulled her hair in an attempt to expose her neck. The victim grabbed the knife, sustaining lacerations to her hand in the process. The victim then suggested that the accused kill the neighbours instead, in an attempt to distract him. The accused agreed and got up and left the residence with the victim and began walking down the hall. The victim quickly went to the neighbour's apartment next door and secured herself inside.
The accused then walked out to the park, talking to the 911 call taker, where he was arrested by Police at 3:41 p.m. for Utter Threats Cause Death. The accused was read rights to counsel and cautioned all to which he indicated he understood."
Background History
The details of Mr. Knight’s personal, legal and psychiatric history are set out in detail in the Hospital Report, filed for this hearing. Briefly summarized, Mr. Knight, who is currently 39 years of age, was raised in Mississauga, Ontario primarily by his mother and stepfather. He did not do well in school and has a limited employment history of mostly odd jobs.
Mr. Knight has no criminal history predating the index offence.
At the time of the index offence, Mr. Knight was residing in an apartment in Toronto with his mother, the victim of the index offence. He was unemployed and financially supported by ODSP.
Mr. Knight has a long psychiatric history and has had many admissions to hospital for mental health treatment. These are set out in detail in the Hospital Report and reportedly started as far back as 2006 and continued until Mr. Knight’s last admission to hospital in 2016. He last saw a doctor six months before the commission of the index offence.
Mr. Knight’s current diagnosis is schizophrenia.
Evidence at the Hearing
The hospital's evidence was presented through its report dated August 12, 2024, entered as Exhibit 1 at the hearing and through the oral testimony of Dr. P. Darby, who attended the hearing virtually. That evidence is summarized below.
Dr. Darby has been Mr. Knight’s attending psychiatrist since he moved into the community 18 months ago following his discharge from hospital. Mr. Knight was discharged to the community on June 6, 2023 and has been residing in SHIP housing, which is a large community agency in Brampton.
According to Dr. Darby, Mr. Knight has had a very good first year in the community. He has maintained his stability, and there have been no reported concerns with his behaviour. Mr. Knight gets along well with his treatment team including Dr. Darby and his Forensic Outpatient case worker, Ms. Steadman. He also reportedly gets on well with the co-residents in his group home.
Mr. Knight maintains close relationships with his family and spends time with them including overnights at the family home during the Christmas Holidays which reportedly went very well.
Mr. Knight has expressed remorse about the harm that he caused to his mother, who was the victim of the index offence. The relationship appears to have survived and continues to be very positive and supportive for Mr. Knight.
With respect to treatment, Mr. Knight has been compliant with his long-acting injectable antipsychotic medication which he receives once every three months. There are no reported side effects, nor does he complain about taking his medication. With respect to psychosocial programming, Mr. Knight has completed a CBT program and reportedly participated actively in the group sessions.
With respect to insight, Dr. Darby believes that Mr. Knight still has some difficulty connecting the index offence to the symptoms of his mental illness but that overall, he is engaged in treatment and understands that he continues to need to take medication in the long term.
Given the fact that Mr. Knight has made good progress in the last year and a half since he was discharged to the community, the hospital is recommending a conditional discharge.
In response to questions posed to him by counsel for the Attorney General, Ms. Silver, Dr. Darby responded as follows:
a. He confirmed that, at last year’s ORB hearing. the treatment team believed that a conditional discharge was premature as Mr. Knight had been living in the community for only six months.
b. With respect to 1:1 counseling, Dr. Darby and the treatment team believe that Mr. Knight no longer needs it at this time. The treatment team is looking for other programs for him, now that the CBT program has concluded, and that will likely be a program that deals with symptom management.
c. There is no evidence that Mr. Knight has experienced any positive symptoms of schizophrenia since being discharged, nor have there been any reports of such symptoms since Mr. Knight’s NCR finding.
d. Dr. Darby confirmed that Mr. Knight has progressed very well through the ORB system. In his opinion, if Mr. Knight was to experience any decompensation of his illness, he would likely voluntarily attend hospital. The provisions of the Mental Health Act would also likely be sufficient to admit him.
In response to questions posed to him by counsel for Mr. Knight, Mr. Vakili, Dr. Darby agreed that though Mr. Knight is stable in the community, is accepting of treatment and also looking for employment, he still needs to develop greater insight into the symptoms of his mental illness and the risk of aggression. Dr. Darby further confirmed that Mr. Knight has experienced decompensations in the past even while treated, and has also been good at masking symptoms of his illness when he is experiencing them. According to Dr. Darby, Mr. Knight needs to demonstrate stability for a longer period of time and to demonstrate an enduring commitment to continuing treatment in the non-forensic system. It is on that basis that Mr. Knight still poses a significant threat to the safety to the safety of the public in the opinion of Dr. Darby.
In response to questions posed to him by members of the panel Dr. Darby was not aware of whether Mr. Knight's driver’s license had been suspended because of his illness. He is aware from other patient cases that if a driver’s license is suspended for a long enough period of time, the person has to go through the process and apply for a driver’s license and submit to a driving test in order to regain their driver’s license.
The hospital’s risk assessment is found at pages 28 and 29 of the Hospital Report and specifically under the heading Re-offence Scenario. The report summarizes as follows:
“In risk assessment, one of the best predictors of future violence is a patient’s history of violence.
If Mr. Knight were to reoffend, it would likely be in the context of substance use and/or medication non-compliance. Substance use, even in the context of medication compliance would likely lead to re-emergence of psychotic symptoms. This would then lead to falling away from services and further non-compliance with treatment and supervision. Noncompliance with medication would also lead to worsening of psychotic symptoms. In either circumstance, Mr. Knight would become increasingly unwell, with delusions and impulsivity, and would be at a heightened risk of acting out violently towards others.
- No other evidence was presented.
Submission of the Parties
- The Board was presented with a joint submission of all parties that Mr. Knight continues to meet the threshold for significant threat to the safety of the public but that the risk can now be adequately managed with a conditional discharge including a residence term that Mr. Knight be required to reside at 11 Henderson Avenue in Brampton, which is the address of his current SHIP housing.
Analysis and Conclusion
Having considered all of the evidence tendered at the hearing, and the joint submission of the parties, the Board finds that Mr. Knight continues to pose a significant threat to the safety of the public as set out in s. 672.5401 of the Criminal Code of Canada and as further defined by the Supreme Court of Canada in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.
Mr. Knight has a long history of mental illness, dating back to 2006. He is diagnosed with schizophrenia, and prior to the index offence, his compliance with treatment appears to have been largely due to the efforts of his mother to make appointments and ensure his compliance. The index offence was a violent attack with a knife against his mother while Mr. Knight was psychotically decompensated.
Mr. Knight has had a very good response to treatment. He has been stable since shortly after the index offence. He is progressing well in his rehabilitation and has developed good therapeutic relationships with the members of his treatment team. He is engaged in treatment.
Mr. Knight was discharged to a SHIP group home over18 months ago and there have been no reported issues with his behaviour, and he gets along well with co-residents in his group home. He has good support from his family, including his mother.
Dr. Darby believes that Mr. Knight needs to develop further insight into the symptoms of his illness and his risk of violence. He is open to participating in further programs, as recommended by his treatment team. Dr. Darby believes that Mr. Knight would likely cooperate with a request for admission, and if not, the provisions of the Mental Health Act would be sufficient to bring him back to hospital.
We agree with the joint submission of the parties that a conditional discharge is the necessary and appropriate, and the least onerous and least restrictive disposition to manage the risk that Mr. Knight poses at this time. In coming to our decision, we have considered the factors as set out in s. 672.54 of the Criminal Code, namely the protection of the public, which is the paramount consideration, the mental condition of the accused, his reintegration into society and his other needs.
The conditional discharge shall include the following terms and conditions:
i. that Mr. Knight reside at 11 Henderson Avenue in Brampton;
ii. that he be required to report to the hospital not less than once every two weeks;
iii. that he abstain from the non-medical use of alcohol and drugs, and that he submit for random screens; and
iv. the disposition shall continue to include a weapons prohibition.
DATED this 19th day of March, 2025, at the City of Toronto, in the Region of Toronto.
Ms. M. Labrosse
Alternate Chairperson
Office of the Registrar
Ontario Review Board