Ontario Review Board
Re: Athena Paul Kosy
ORB File No: 6099
Hearing held on: Friday March 21, 2025
Place of Hearing: North Bay Regional Health Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. R. Bigelow
Members: Dr. A. Jones
Dr. T. Stirpe
Hon. E. Kruzick
Ms. K. Brisson
Parties Appearing:
Accused: Athena Paul Kosy
Counsel: Mr. C. Bracken
The Person in Charge Counsel: Mr. P. Trenker
Attorney-General of Ontario: Counsel: Mr. P. Lambert-Belanger
REASONS FOR DISPOSITION (Dated April 9, 2025)
Introduction
On April 12, 2012, Athena Paul Kosy was found not criminally responsible on account of mental disorder on charges of possession of a weapon for a dangerous purpose and fail to comply with a probation order contrary to the Criminal Code. Ms. Paul Kosy is subject to a disposition of the Ontario Review Board (the Board) dated April 2, 2024, ordering her discharge on conditions.
On Friday, March 21, 2025, the Board convened a hearing at the North Bay Regional Health Centre (the Hospital) to review Ms. Paul Kosy`s disposition pursuant to section 672.81(1) of the Criminal Code. Ms. Paul Kosy was present and represented by counsel, Mr. Bracken. The issues to be determined at the hearing were whether Ms. Paul Kosy continued to constitute a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and, if so, what was the necessary and appropriate disposition that was also the least onerous and least restrictive taking into account the factors set out in 672.54 of the Criminal Code.
Initial Positions of the Parties
At the commencement of the hearing the parties were requested to provide their initial without prejudice positions with respect to the issues before the Board. Counsel for the Hospital advised that the position of the Hospital was that Ms. Paul Kosy continued to represent a significant threat to the safety of the public and that the necessary and appropriate disposition was a detention order with the same terms and conditions as the current order save and except for the removal of condition 2(h) requiring her to accept treatment on her consent pursuant to section 672.55 of the Criminal Code.
Counsel for the Attorney General supported the Hospital recommendation. Counsel for Ms. Paul Kosy also supported the Hospital position.
Evidence at the hearing
- The evidence at the hearing consisted of the Hospital Report dated February 15, 2025, and the oral evidence of Dr. Kolawole, Ms. Paul Kosy’s treating psychiatrist.
Findings:
- For the Reasons that follow, the Board finds that Ms. Paul Kosy continues to represent a significant threat to the safety of the public and that the necessary and appropriate disposition is a continuation of the current discharge on conditions with the only change being the removal of condition 2(h) requiring her to accept treatment on her consent pursuant to section 672.55 of the Criminal Code.
Index Offences:
- The circumstances surrounding the index offence as summarized in last year’s Reasons for Disposition:
In summary, on February 23rd, 2012, Ms. Paul-Kosy was in a public hotel in Sudbury. She became involved in a verbal altercation with a bartender and in the course of that paced about the bar holding a knife. The knife had a 3-inch blade. A patron took the knife away from her. She was subsequently arrested. At the time, she was bound by a probation order dated September 7th , 2011, which included a condition that she keep the peace and be of good behavior.
Background Information Regarding the Accused:
- Ms. Paul Kosy is a 34-year-old First Nations woman who grew up in Sudbury. She has six siblings, and her mother passed away in 2008. She has one son with whom she maintains a relationship while he is being raised by her paternal grandparents. She left school in grade 9 although since her hospitalization under the Board’s jurisdiction she has completed high school. She has no formal employment background.
Legal History:
- Ms. Paul Kosy has a criminal record commencing in 2007 in the Youth Court which includes convictions for criminal harassment, assault, possession of a controlled substance, communicate for the purpose of prostitution, break and enter and numerous convictions for breaching court orders. Subsequent to the index offences she was convicted of assaulting a hospital staff member in 2016 and has a history of incidents of aggressive behaviour while under the jurisdiction of the Board.
Substance Use History
- Ms. Paul Kosy has a long history of illicit drug use including crack cocaine, intravenous cocaine, cannabis, narcotics and alcohol and has admitted to prostituting herself to gain money for her drug use.
Psychiatric History
Ms. Paul Kosy‘s first admission to hospital with respect to mental health related issues was in January 2008 when she was brought to the emergency room of the Sudbury Regional Hospital by police after her brother had reported that his sister was “out of control” yelling and had a knife. Upon admission she admitted to hearing voices with both positive and negative command hallucinations. After several weeks she was discharged against medical advice with a diagnosis of schizophrenia, disorganized type and marijuana abuse.
Ms. Paul Kosy was admitted to hospital with respect to mental health related issues a further six times prior to the index offences.
A Community Treatment Order was issued in 2010. However, her psychiatrist and the Sudbury ACT-2 team were unable to maintain her in a stable psychiatric condition in the community because they were seldom able to locate her.
Current Diagnosis
- Ms. Paul Kosy’s current diagnoses are:
Schizophrenia
Substance Use Disorder (cocaine, marijuana, opiates), in Full Remission in a Controlled Environment;
Borderline Personality Disorder
Other Specified Anxiety Disorder
Evidence of Dr. Kolawole
Dr. Kolawole indicated that he had been Ms. Paul Kosy’s treating psychiatrist since November 2024. He noted that she was residing in a CMHA group home, and that this residence was potentially a permanent home for her.
Dr. Kolawole stated that Ms. Paul Kosy had some issues with respect to her mental health over the reporting year and had returned to hospital voluntarily for a brief period of time. She had been introduced to the Sudbury ACT-2 team and that the team would continue support for her if she was granted an absolute discharge. He advised that the treatment team was recommending the removal of the treatment clause from her disposition to test her ability to follow through on treatment without the legal requirement.
In response to questions from counsel for the Attorney General, Dr. Kolawole indicated that Ms. Paul Kosy was provided her medication by group home staff when at her residence but needed some additional support to ensure she adhered to her medications particularly when visiting her father. On a few occasions she had missed medication while at her father’s, but she contacted the treatment team for support when that happened. Treatment for her borderline personality disorder would be CBT (Cognitive Behavioural Therapy) with intensive case management. The treatment team’s plan for the upcoming year was to encourage her to be more engaged with theACT-2 team.
Analysis and Conclusion, Significant Threat:
Although the issue of significant threat was not contested at the hearing, the Board nevertheless makes an independent finding that Ms. Paul Kosy does represent a significant threat to the safety of the public. She suffers from a major mental illness, schizophrenia, as well as having a diagnoses of borderline personality disorder, substance abuse disorder (in remission in a controlled environment) and other specified anxiety disorder. When unwell she experiences emotionally charged persecutory and somatic delusions, emotional instability, disorganized thought form and distractibility, visual perceptual disturbances, periodic depression and suicidal ideation, and command type auditory hallucinations.
Ms. Paul Kosy has a history of aggressive behaviour including convictions for assault, assault causing bodily harm and assault peace officer and has engaged in threatening, aggressive and assaultive behaviour while in hospital. Although she is currently abstinent from substance use, she has a significant history of substance abuse beginning in early adolescence. She has not engaged in any aggressive behaviour over the reporting year but has had issues with respect to her emotional stability in the community requiring significant support from the treatment team including one brief readmission to hospital.
Ms. Paul Kosy has just begun to establish a relationship with the SudburyACT-2 team but has yet to meet with the psychiatrist associated with the team. Absent the structure and support provided by the Hospital outpatient treatment team, there is a significant likelihood that Ms. Paul Kosy would have difficulty adhering to her medication regime and return to the use of substances resulting in a return of the symptoms of her illness and a serious increase in risk to members of the public.
Analysis and Conclusion, Necessary and Appropriate Disposition:
The Board finds that the evidence also amply supports the joint submission that the necessary and appropriate disposition is a continuation of the current disposition with the only changes being the removal of the requirement to accept treatment on her consent pursuant to section 672.55 of the Criminal Code. Ms. Paul Kosy has been residing in the community since the spring of 2022 without displaying any aggressive behaviour or significant symptoms of her major mental illness. Her risk has been well managed under the terms of her current disposition and the Board finds that a continuation of that disposition is necessary to manage risk. However, given adherence to treatment requiring consent to accept treatment is no longer necessary.
The Board encourages Ms. Paul Kosy to work with the Sudbury ACT-2 Team and achieve the necessary level of support to transition to the civil mental health system.
DATED this 9th day of April 2025, at the City of Toronto, in the Toronto Region.
Robert Bigelow
Alternate Chairperson
Office of the Registrar
Ontario Review Board