Ontario Review Board
Re: Chelsea Eileen Kemp
ORB File No: 8623
Hearing held on: Monday, January 27, 2025
Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas
Pursuant to: Sections 672.47(1) and 672.48(1) of the Criminal Code
Before: Alternate Chairperson: Ms. T. Mann Members: Dr. A.D. Jones Dr. S. Wiseman Ms. K. Tomaszewski Ms. C. Plyley
Parties Appearing: Accused: Chelsea E. Kemp Counsel: Mr. C.P. Dobson
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Mr. D. Rows
REASONS FOR DISPOSITION
(Dated March 31, 2025)
Introduction
On September 13, 2025, the accused, Chelsea Kemp, was found unfit to stand trial on account of mental disorder on Criminal Code of Canada charges of two counts of assault, fail to comply with probation order and resist arrest, all arising in connection with a series of events occurring on May 12, 2024. The matter of a Disposition was deferred to the Ontario Review Board (“the ORB” or “the Board”).
On January 27, 2025, the ORB convened a hearing at the Southwest Centre for Forensic Mental Health Care (“the Southwest Centre” or “the Hospital”) to review the issue of whether Ms. Kemp continued to be unfit to stand trial and, if so, determine the necessary and appropriate Disposition to manage her care over the coming year. Ms. Kemp was present at the hearing and represented by her lawyer, Mr. C. Dobson.
Positions of the Parties
- At the outset of the hearing, the parties were canvassed as to their respective without prejudice recommendations to the Board. All parties were joined in recommending that Ms. Kemp be found unfit to stand trial. Further, Ms. Zamprogna for the Hospital and Mr. Rows for the Attorney General were joined in recommending that Ms. Kemp be subject to a detention disposition upon the terms and conditions set out in an Updated Hospital Report dated January 17, 2025. Mr. Dobson concurred with the recommendation that Ms. Kemp be found unfit to stand trial but could not speak to the necessary and appropriate disposition. All parties maintained their initial recommendations in submissions.
Alleged Index Offences
- The following synopsis of the alleged index offences is taken from pages 2 to 4 of the Hospital Report dated November 21, 2024, which was made an exhibit at the hearing:
“The following information is from the Crown Brief Synopsis dated May 12, 2024.
The accused in this matter is Chelsea Kemp (Age: 30 Yrs.)
On February 20, 2024, the accused, Chelsea KEMP, was convicted of Public Disturbance and Resist Peace Officer in the Ontario Court of Justice in Stratford, Ontario. The accused was subsequently placed on probation for a period of 18 months. As per his [her] probation order, the accused is to abide by the conditions to keep the peace and be of good behavior.
Start Date: 2024-02-20
End Date: 2024-02-21
The accused is bound by the statutory condition to keep the peace and be of good behavior.
On Sunday May 12, 2024, both victims in this matter Claudette VERDON and Angela HARPER were sitting out of 62 Cawston in the parking lot. The accused walked on to the property yelling and swearing at seemingly no one. The accused is trespassed from the property so HARPER said to her as she walked towards them “You're not allowed to be here.” The accused continued to yell and entered the front entryway of 62 Cawston. HARPER entered as well and told the accused “Chelsea you can't be here.” The accused turned towards HARPER and began punching her multiple times with her right hand, making contact with her left cheek and chin. HARPER raised her right arm to attempt to block the assaults, the accused continued to throw punches hitting HARPER in the upper right arm and face until VERDON opened the door to see what the commotion was. The accused then turned and punched VERDON on the left side of the face also hitting her upper right arm.
The accused then walked off their property and continued North bound down Forman Avenue still yelling and screaming.
The accused was located by the police on Huron Street. The accused was told she was under arrest and to put her hands behind her back. The accused actively resisted by walking running away from the officer West bound on Huron. A second officer was required to affect the arrest where the accused continued to actively pull away from the officers.
The accused was read her rights to counsel and caution to which she understood and was provided the opportunity to speak with duty counsel and was held for bail.”
- On May 13, 2024, Ms. Kemp was admitted to the Elgin Middlesex Detention Centre (EMDC). On June 6, 2024, an assessment order was made to assess her fitness to stand trial and she was found unfit to stand trial for the first time on June 27, 2024. On June 27, 2024, a treatment order was made effective as of July 2, 2024, for 60 days to provide treatment and to once again assess Ms. Kemp’s fitness to stand trial. Accordingly, Ms. Kemp was admitted to assessment unit A3 at the Southwest Centre on July 2, 2024. On September 13, 2024, Ms. Kemp returned to court and was found unfit to stand trial. The warrant of committal ordered her to remain at the Southwest Centre pending an initial hearing by the Ontario Review Board. This is that hearing.
Background
The Hospital Report provides a great deal of information concerning Ms. Kemp’s personal, developmental and mental health history, details of the alleged index offences, and her course following her admission to Hospital on September 13, 2024. Given that the Hospital Report was made an exhibit in this hearing, it is not necessary to reproduce in detail the information contained within it in these Reasons.
Of note, however, is the information before the panel that Ms. Kemp was born with neurological damage. At age seven, she was diagnosed with a seizure disorder as a result of which she has been taking medication throughout her life. Reportedly, Ms. Kemp presented with behavioural problems from her mid-to-late adolescent years.
Developmentally, Ms. Kemp has a history of Global Developmental Delay. At one point, she was able to communicate effectively, directing her care and treatment and self-advocating, but her functional abilities have declined over the last five years, most markedly within the last three.
During her school years, Ms. Kemp required special education support. The Hospital Report does not indicate the level of education she was able to attain.
In the year 2000, an MRI revealed a number of abnormalities in the structure of her brain. An EEG conducted in 2012 reinforced the diagnosis made in 2000 of focal seizures with secondary generalization. Over the years, Ms. Kemp has been treated for her seizures with various anticonvulsants. She has demonstrated poor adherence to her medication regimen.
The Hospital Report relates that in August 2008, at around 15 years of age, Ms. Kemp was taken into Children Aid’s Society (CAS) care. She had several placements due to her behaviour which was characterized as violent and defiant. Records indicate that she was admitted to Southlake Regional Hospital for a psychiatric crisis assessment. In 2009, she required a specialized group home being Hatts Off. Due to her aggressive behaviour, she required 1:1 support for sixteen hours each day. Ms. Kemp’s needs exceeded her parents’ and stepfather’s ability to meet them and she became a crown ward of the CAS in 2009.
In July 2009, a psychological assessment conducted by Dr. Olga Henderson found that Ms. Kemp had sub-average functioning in most areas. In July 2012, when she was 18, another psychological assessment was conducted. The results indicated that delays were evident in language processing and social-emotional functioning. Ms. Kemp’s overall level of cognitive functioning measured by her Full Scale I.Q. fell in the Extremely Low range at 1st percentile.
The assessment further indicated that:
The cognitive profile which emerges indicates that Chelsea [Ms. Kemp] has modest learning potential. Significant delays are seen in all areas of language processing. Chelsea's word knowledge is well below that of most age peers. She has limited ability to engage in abstract verbal reasoning. Her general background knowledge is quite weak. She misses a great deal of information that is presented to her through verbal means. She is extremely limited in her ability to draw inferences or make generalizations from verbal information.
Both psychological assessments – in 2009 and 2012 – indicated that her scores were consistent with a diagnosis of a mild intellectual disability.
Ms. Kemp’s adult psychiatric history consists of multiple encounters with mental health professionals, including attendances to Grand River Hospital, the Emergency Department of the Centre for Addiction and Mental Health (CAMH), Stratford General Hospital and London Health Sciences Centre (Victoria Hospital Campus). Common themes giving rise to her emergency room attendances and brief hospitalizations included problems with mood (suicidality), substance use (including alcohol, cocaine, cannabis, amphetamines, methamphetamine and benzodiazepines). She very often became agitated and violent, and required physical and chemical restraint to control her aggression. Her behaviour was bizarre and disorganized, and at times her speech was incomprehensible. Diagnoses included substance-induced mood disorder, substance-induced psychotic disorder, and Schizophrenia. The record reveals a significant history of failure to adhere to treatment and follow-up. On several occasions she discharged herself early from hospital or eloped.
Over the years, Ms. Kemp’s care involved placement in group home settings and more recently a “foster model” of care. Ms. Kemp spent most of her life in group homes. Historical assessments indicate that Ms. Kemp had higher support needs and required a 24-hour supervised group home setting with behavioural supports.
As of August 2024, Ms. Kemp had been under the care of group home provider “Hatts Off” for 10 years, during which period of time she had moved between Stratford, Kitchener, and Hamilton. Currently, her tenure within the Hatts Off program remains in place, pending the outcome of her current involvement in the forensic system.
Mention is made in the Hospital Report of Ms. Kemp’s previous involvement with Regional Support Associates. She consistently refused recommended supports, including psychiatric care and programs offered through Community Living.
For several years her symptoms of Schizophrenia have worsened alongside increasing legal troubles, vulnerability, negative peer connections, substance abuse and suspected involvement in sex for drugs. Ms. Kemp’s drug use has led to erratic behaviour including staying awake four or five days at a time followed by crashes. Ms. Kemp’s relationships with intimate partners have been both physically and verbally abusive. Caregivers have expressed increasing fear for her life due to her behaviours, lifestyle, drug use and comorbid brain issues.
In terms of her legal history, Ms. Kemp has an extensive history of involvement with the legal system between 2015 and 2024. Her convictions occupy fully three and a half pages of the Hospital Report and are set out at pp 4-7. Convictions include multiple counts of assault, mischief under, break and enter with intent, possession of property obtained by crime under $5000, assault with a weapon, cause disturbance and resist arrest. Notably, there are many convictions for failure to comply with probation orders, recognizances, and failure to appear for court. She is currently subject to several mandatory and discretionary weapons prohibitions, the most recent of which was made on December 16, 2019, for 10 years.
Financially, Ms. Kemp receives support from the Canada Pension Plan and the Ontario Disability Support Program. Her personal supports are very limited.
Diagnoses
- Ms. Kemp is currently diagnosed with the following conditions:
(a) Severe Intellectual Disability (b) Polysubstance Use Disorder (methamphetamine, cocaine and cannabis), in early remissions within a controlled environment; (c) Unspecified Schizophrenia Spectrum and Other Psychotic Disorder.
- As noted above, Ms. Kemp has a seizure disorder impacting her functioning which is being evaluated. Ms. Kemp suffers from migraine headaches without aura. She tested positive for Hepatitis C which is reflective of her ongoing struggle with substance abuse (via injection) and associated health complications.
Course Subsequent to the Alleged Index Offences
During her admission to the Elgin Middlesex Detention Centre from May 13, 2024 to July 2, 2024, Ms. Kemp presented with significant psychiatric concerns. She was reluctant to engage in conversation and guarded in providing information. She was often observed pacing, displaying bizarre behaviour and exhibiting disorganized incoherent speech. This made it difficult to assess her thought content.
Upon admission to the Southwest Centre on July 2, 2024, Ms. Kemp was agitated and placed in seclusion. Despite treatment with injectable antipsychotic medication, Ms. Kemp exhibited psychotic symptoms, including delusional and suspicious thought content, disorganized thinking and bizarre behaviours throughout her admission. She showed limited improvement with treatment and her unpredictable behaviour and irritability persisted. On a number of occasions, it was necessary to seclude her to manage her unpredictable and aggressive behaviour and severe agitation.
Regrettably, her fitness to stand trial did not improve. Ms. Kemp was unable to express an understanding of her legal situation. She could not identify the participants in court proceedings nor their roles and was similarly unable to demonstrate an understanding of the charges against her.
Following being found unfit to stand trial on September 13, 2024, Ms. Kemp was returned to the Southwest Centre (assessment unit A3) under the psychiatric care of Dr. S. Jafarzadehfadaki, who is supervised by Dr. Ajay Prakash.
During her time on the Hospital’s assessment unit, Ms. Kemp’s mental status and behaviour remained labile, unpredictable and aggressive. Her difficulties with communication as well as her cognitive and psychological limitations caused her presentation to fluctuate significantly. She often displayed severe agitation and dysregulation, resulting in almost daily scoring on the Aggressive Index Scale. During periods of agitation and dysregulation, she often postured in a threatening manner. At times she was redirectable but for the most part it was necessary to remove her to a different, less stimulating environment in order to manage her agitated and dysregulated behaviour. Ms. Kemp was physically assaultive, striking staff with her fists and attempting to bite staff. She also threatened a peer and was often secluded to manage her aggressive behaviours. When escalated, she was often resistive to redirection.
Since her admission to hospital, the treatment team has seen modest improvement in her ability to settle but Ms. Kemp remains quick to anger. Her aggressive behaviours are triggered by her perceived needs not being met or when boundaries are set by staff. Ms. Kemp initiates interaction with staff when she has needs or requests but does not enjoy being prompted to engage, despite appearing to like having staff and peers around her. She has limited ability to concentrate; her ability to forward plan and problem solve is severely limited, and she quickly dysregulates when faced with an obstacle. Her ability to care for herself is limited, and she quickly becomes challenging verbally and at times physically assaultive when she feels her needs are not being met in a timely way. She has a tendency to ask staff to do things that she is capable of doing on her own. She has poor interpersonal boundaries and engages in disinhibited behaviour or intrudes into the personal space of others without being aware that she has done so.
Overall, it has been difficult to assess Ms. Kemp’s thoughts and insight into her mental health, treatment, and risk of violence due to her speech difficulties, cognitive limitations and limited attention span. More generally, Ms. Kemp is unaware of the reasons for her admission to the Southwest Centre. The treatment team’s efforts to increase her insight into this issue have been unsuccessful to date.
Ms. Kemp is not capable of making treatment decisions relating to her mental health, nor is she capable of making financial decisions. Her substitute decision maker for both treatment and finances is the Office of the Public Guardian and Trustee (PGT).
With support, Ms. Kemp is amenable to taking her medications. Although adjustments to her medication regimen have been made, her medication has yet to be optimized. Following her admission, Ms. Kemp experienced a number of physical health issues including significant dental pain in response to which she had a number of teeth removed under general anesthetic. Efforts to assist her in managing excessive saliva production were met with aggression and required seclusion.
On October 19, 2024, Ms. Kemp experienced five consecutive focal seizures. Despite receiving anti-convulsive medication, by the next day, her level of consciousness had decompensated to the point that she was only responsive to painful stimuli. She was admitted to a local hospital and then transferred to the neurology unit of University Hospital in London. An ECG showed “epileptiform abnormalities” which were suggestive of a very strong tendency towards seizures. This prompted changes to her anticonvulsive medication regimen. Ms. Kemp returned to the Southwest Centre on October 25, 2024. She will be followed by a neurologist for ongoing care and consultation regarding treatment options. Ms. Kemp also started treatment for Hepatitis C. A referral to endocrinology is pending due to concerns around her thyroid, menstrual cycle and diabetes.
While in hospital, Ms. Kemp has had extensive involvement with occupational therapy in an effort to obtain a comprehensive understanding of her complex presentation and to inform potential care needs. It was determined that Ms. Kemp requires a high degree of assistance for almost all aspects of daily living. Her lack of independence was largely attributable to intrinsic factors related to her cognition, affective/emotional and communication limitations. Recommendations for care include that treatment plans be trauma-informed, compassionate, consider her cognitive limitation and seek to build therapeutic rapport. Due to her cognitive and communication issues, it is recommended that information be provided to her in a variety of ways (verbal, simple written, and visual including pictures and timers). Input from a behavioural analyst has been sought and is in its initial stages of completion.
Due to the practice of the Hospital that there be no indirectly supervised access within the Hospital or the community until after an ORB Disposition is in place, Ms. Kemp has been accompanied by staff off the unit, with no reported concerns.
Ms. Kemp’s primary personal support consists of her stepfather, John Segarajasinghe, who lives in Belleville, Ontario. In terms of community-based professional supports, Ms. Kemp’s former community workers from Developmental Services Ontario (Chris Morley) and Hatts Off (Chris Riel) remain available to her currently.
The treatment team is in the initial stages of exploring the various funding options to which Ms. Kemp may have access, including DSO, Hatts Off and CAS. Apparently, external funding may be available for community living, personal needs and personal support workers.
Future plans include continuing to optimize Ms. Kemp’s medication, providing psychoeducational programming aimed at substance use treatment and improving, to the extent possible, her insight into her index offences, diagnoses and need for medication. Referrals to psychology will be made to further assess her adaptive, executive and cognitive functioning. Her physical health needs will continue to be monitored. She will be provided with 1:1 staff support. Efforts will be made to liaise with external agencies to determine funding streams and opportunities that might be available to assist Ms. Kemp in her rehabilitation.
Evidence at the Hearing
The Board had available to it information contained in the hearing documents which provided relevant information from the Court, including the warrant of committal, Ms. Kemp’s CPIC and local police record, as well as the Hospital Report dated November 21, 2024, and a supplemental Hospital Report dated January 17, 2025. The Board also had the benefit of oral evidence from Ms. Kemp’s (former) attending forensic psychiatrist, Dr. Ajay Prakash. Dr. Prakash endorsed the information contained in the Hospital Report and its update and provided the Board with an overview of Ms. Kemp’s progress and fielded questions from the parties and the Board.
Dr. Prakash advised that on December 18, 2024, Ms. Kemp was moved from the A3 assessment unit to a treatment unit (A2) and is currently under the care of Dr. A. Malka. Ms. Kemp managed the transfer to a new unit fairly well and there have been no seclusions or code whites since then. Dr. Prakash said that there is now a behaviour plan in place which provides direction to her and staff for management of her more challenging behaviours. Between nursing, allied health and Developmental Services of Ontario (DSO) staff, Ms. Kemp is being provided with 1:1 supervision on the unit, which is going well. Currently, her needs are being met in hospital. Next steps include assessing her suitability to exercise privileges. Privileges will only be implemented in a slow and cautious manner. Ms. Kemp will be offered substance abuse programming in a very modified way, broken down into simple steps.
Dr. Prakash maintained that Ms. Kemp continues to be unfit to stand trial and that the necessary and appropriate disposition is that of a detention disposition with privileges up to and including living in the community of Southwestern or Southern Ontario in 24/7 supervised accommodation approved by the person in charge. This would meet the twin goals of finding Ms. Kemp an appropriately supervised and supportive setting in which to live, one that meets her complex needs and where she has the best chance of living successfully in the community (which has not been the case to date) and the subsidiary goal of discharging her from a forensic hospital setting which is not designed to meet her cluster of diagnoses.
Dr. Prakash was unable to estimate a timeframe within which Ms. Kemp might be eligible for discharge from the Hospital to the community for several reasons, including first needing to ascertain the appropriate type of group home setting to meet her needs and then navigating the admission process and likely waitlists. Dr. Prakash cautioned that the search might prove daunting given the intense level of support necessary to meet Ms. Kemp’s complex presentation.
As for Ms. Kemp’s fitness to stand trial, Dr. Prakash advised that he assessed her fitness the morning of the hearing and determined it had not changed significantly from the assessment set out in the Hospital Report. She remains unable to participate meaningfully in interviews regarding fitness or to identify the charges against her. She cannot describe the potential outcomes or courses of action available to her. She cannot make decisions as to the proper conduct of her case. While she may be able to communicate with counsel from time to time, she is unable to do so in a consistent manner. While her level of fitness may fluctuate somewhat from day to day, she is not able to participate meaningfully in the court process overall. Dr. Prakash felt that Ms. Kemp was likely permanently unfit.
In response to questions from the representative for the Attorney General, Dr. Prakash confirmed that Ms. Kemp’s substantial criminal record coincided with times she was living in various group home settings, but he was unable to say whether and to what extent she was able to successfully navigate the criminal justice system. The doctor did not doubt that Ms. Kemp had a level of familiarity with the system but maintained his opinion that she was currently unfit to stand trial.
Dr. Prakash also spoke to the difficulty of ascertaining whether Ms. Kemp’s symptoms and behaviours were consistent with an undifferentiated schizophreniform disorder or a psychotic disorder linked to substance use or even bipolar disorder. Dr. Prakash is reasonably confident that Ms. Kemp is likely suffering from a primary mental health condition that benefits from treatment with antipsychotic medication, given the attenuation of the more overt symptoms of psychosis and paranoia observed by staff since her admission to the Hospital and treatment with antipsychotic medication.
Mr. Rows for the Attorney General had no questions of Dr. Prakash.
Mr. Dobson in his questions explored the suitability of the Crest Centre as a possible placement for Ms. Kemp. Dr. Prakash was familiar with this organization and said it has a history of working well with dual diagnosis clients such as Ms. Kemp and has highly supervised units which might be appropriate in the circumstances. Dr. Prakash outlined some steps that Ms. Kemp could take to optimize the likelihood of her achieving greater liberty, including cooperating with her treatment team, following direction, abiding by her treatment plan and being patient with staff when her needs are not able to be immediately met.
Analysis and Conclusions
Fitness to Stand Trial
The legal framework for assessing fitness to stand trial has been most recently addressed by the Court of Appeal in R. v. Bharwani, 2023 ONCA 203. The Court emphasized the need for meaningful participation in proceedings for an individual to be fit for trial. At para. 167 of the judgment the Court emphasized the need for a nuanced, contextual assessment of an accused’s abilities to conduct a defense or to instruct counsel to do so. The purpose of applying the criteria set out in s. 2 of the Criminal Code of Canada is to ensure that an accused can be meaningfully present and meaningfully participate at their trial. This includes, among other things, that an accused must have a reality-based understanding of the nature, object and possible consequences of the proceedings as well as the ability to make decisions and intelligibly communicate them to counsel or the court. In this regard, an accused need not have the analytical capacity to make decisions in their own best interests.
For the reasons set out below, in considering the legal test, and based on the expert evidence and opinions before it, the Board has no hesitation in finding that Ms. Kemp is unfit to stand trial. The Board accepts uncontroverted evidence of Dr. Prakash, and the evidence set out in the Hospital Report, that Ms. Kemp’s intellectual disabilities and impaired cognitive functioning preclude her from having even a rudimentary understanding of the nature, object and possible consequences of the charges against her, the identity and role of the various participants in the court proceeding or to consistently communicate with counsel in such a way as to meaningfully assist in conducting her own defense or to participate in court proceedings. Although not germane in the context of an initial hearing before the Board, Ms. Kemp is likely permanently unfit to stand trial.
Necessary and Appropriate Disposition
As for the necessary and appropriate disposition, the Board finds that despite treatment with psychiatric medication and residing in a highly structured and supportive setting, Ms. Kemp engages in impulsive and aggressive behaviours that are challenging to manage and which present a risk of harm to others. In this regard, the Board relies upon the integrated risk assessment set out at p. 26 of the Hospital Report dated November 21, 2024 which concludes that Ms. Kemp presents a high risk of violent reoffending over the next reporting year even under a detention disposition. She is in need of significant support to manage her medication, treatment and follow-up. Treatment, including substance abuse treatment, will need to be tailored to her specific needs. She is unable to live independently and would be best placed in a 24/7 supervised setting appropriate to her needs. Ms. Kemp’s history of involvement in the criminal justice system, addiction and vulnerability to exploitation speaks eloquently to the inability of prior placements to meet her complex needs, and her risk to others and herself. Ms. Kemp is in need of a high degree of support, supervision and care which can best be provided under the auspices of a detention disposition allowing her to live in Southwestern or Southern Ontario in 24/7 supervised accommodation approved by the person in charge. This will allow the Hospital to conduct a search for an appropriate non-forensic setting and to place her there should an opportunity arise over the coming year.
Ms. Kemp’s indirectly supervised privileges should be limited to within the hospital only. Other access to hospital and grounds and the communities of Southwestern and Southern Ontario shall be accompanied by staff, or a person or delegate approved by the person in charge. This will permit approved non-hospital staff, such as group home staff, to accompany her outside the hospital in appropriate circumstances. Her history with the criminal justice system and her untreated substance use disorder inform the need for her to abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant, submit samples of urine or breath to permit monitoring of this term and to refrain from possessing weapons and the like. When living in the community, Ms. Kemp shall be required to report to the person in charge not less than four times per month. These privileges, taken together, are consistent with maximizing Ms. Kemp’s liberty interests while keeping herself and others safe.
The Board wishes Ms. Kemp well in the coming year.
In arriving at our Disposition, the Board has considered the paramount factor of the safety of the public, Ms. Kemp’s community reintegration, her mental condition and her other needs, all as required by s. 672.54 of the Criminal Code.
DATED this 31st day of March 2025, at the City of Toronto, in the Region of Toronto.
Ms. T. Mann Alternate Chairperson Office of the Registrar Ontario Review Board