Connor Kennedy (Re), 2025 CanLII 33818

Re: Connor Kennedy

ORB File No: 7184

Hearing held on: Thursday March 27, 2025

Place of hearing: Southwest Centre for Forensic Mental Health Care (Via Zoom Video Conference)

Pursuant to: Section 672.81(2.1) of the Criminal Code

Before: Alternate Chairperson: Mr. J. Goldenberg Members: Dr. R. Kunjukrishnan Dr. H. Moulden Mr. D. D’Intino Ms. B. Little

Parties Appearing: Accused: Connor Kennedy Counsel: Ms. C. Whillier The person in charge of hospital: Counsel: Ms. J. Zamprogna Attorney General of Ontario: Counsel: Ms. K. Dalrymple

REASONS FOR DECISION

(Dated April 17, 2025)

Introduction

1Connor Kennedy was found not criminally responsible on July 26, 2017, of the offences of possession of a weapon for a dangerous purpose, possession of break-in instruments, and breaking and entering with intent to commit an indictable offence, all contrary to the Criminal Code of Canada (The Code).

2Mr. Kennedy is currently subject to a disposition of the Ontario Review Board, (the “Board”) dated November 19, 2024, detaining him at the Southwest Centre for Forensic Mental Health Care, St. Joseph's Health Care London, and he is subject to conditions inter alia at the discretion of the Person in Charge, and with privileges up to and including to live in the community in a supervised accommodation approved by the Person in Charge.

3By letter dated December 13, 2024, the Person in Charge of the Hospital advised the Ontario Review Board that Mr. Kennedy had requested a readmission to Hospital on November 29, 2024.

4Prior to the ROL hearing, the Board received an ROL Report authored by Dr. Ajay Prakash.

5A panel of the Ontario Review Board convened this Restriction of Liberty hearing, pursuant to Section 672.81(2.1) of the Criminal Code of Canada, on March 27, 2025, to consider if the significant increase in the restriction of Mr. Kennedy‘s liberty, which started on November 29, 2024 and continued as of the date of the hearing, was necessary and appropriate and the least onerous and least restrictive option available to the Hospital to manage his risk in all the circumstances.

Position of the Parties:

6At the commencement of the hearing the parties were requested to provide their initial without prejudice positions with respect to the issues before the Board.

7On behalf of the Hospital, Ms. Zamprogna submitted that the Restriction of Liberty was necessary and appropriate in the circumstances and remains so.

8Counsel for the Attorney General supported the hospital position.

9Counsel for Mr. Kennedy agreed that the initial ROL was warranted but that the ongoing ROL was no longer necessary.

Conclusion

10For the reasons that follow, the panel found that both the initial and ongoing restrictions of Mr. Walker’s liberty were and remain necessary and appropriate in the circumstances, and represents the least onerous and least restrictive course of action available to the hospital to manage the increased risk presented by Mr. Kennedy.

Index Offence(s)

11The index offenses occurred on My 24, 2017. The following details are excerpted from the most recent hospital report:

It was noted on May 24, 2017, at approximately 3:00 a.m., Sarnia Police Service were dispatched to the city of Sarnia in regards to an attempt break and enter. Someone was attempting to get into the complainant's residence.

Upon arrival, officers heard a noise around the north side of the residence. Upon turning the corner, it was noted that Mr. Kennedy was attempting to break into a basement window. When Mr. Kennedy stood up, he had a knife in his right hand with a blade approximately 8 to 10 inches in length. In his left hand, he had another knife with a blade approximately 3 to 4 inches in length.

It was noted that a constable immediately drew his firearm, commanding Mr. Kennedy to drop the knife. At that time, Mr. Kennedy squatted down and untied the knives from his wrists as they were fastened to them by shoelaces. Mr. Kennedy put the knives down and listened to the commands and was arrested at the time. It was noted that the officers observed Mr. Kennedy having a screwdriver in his possession that he had been using as a break-in instrument.

It was noted that when read his rights, Mr. Kennedy asked to speak to his lawyer, Jamie Guggisberg.

It was noted that a witness advised that Mr. Kennedy had gained entry through a unit on Milton Street. An officer attended the unit where he found that the bathroom cabinet had been pushed over, where it appeared that Mr. Kennedy had gained entry through the window. Once in that apartment, Mr. Kennedy threw two glass pitchers down a flight of stairs to smash them. Mr. Kennedy was then advised of the additional charge of break enter and commit mischief.

Diagnosis

12Mr. Kennedy has been diagnosed with Schizophrenia, Substance Abuse Disorder (in early remission), and Antisocial Personality Disorder.

The ROL Report

13Mr. Kennedy was subject to a Detention Order since his last annual hearing on November 19, 2024, which detained at the Southwest Centre for Forensic Mental Health Care in St. Thomas, Ontario. On October 1, 2024, he began a Leave of Absence (LOA), residing in a 24/7 group home in Port Bruce, ON. After demonstrating mental status stability, he was discharged to the Forensic Outreach Team in the care of Dr. Ajay Prakash.

14Mr. Kennedy was assessed on November 20, 2024, and reportedly demonstrated a stable mental status. He denied any thoughts of paranoia or hallucinations. He presented with a euthymic mood and was cooperative and forthcoming with his treatment team. Of note, he remained not optimally treated while his treatment team continued to encourage him to initiate the start of clozapine. However, he was not compliant with receiving routine bloodwork, so the medication was not started.

15On November 29, 2024, Mr. Kennedy reported to his treatment team that he was experiencing psychotic symptoms (delusions) and that he did not feel safe living in his group home. He voiced that he was being raped in his sleep by his roommate (of note, his roommate is an elderly frail man). He further shared that a sticky substance was found on his anus and inferred that he must have been assaulted. When his treatment team attended to him in person on the same day, Mr. Kennedy voiced feeling afraid living in the community and would rather live in hospital. His treatment team opined that his delusions around his roommate were consistent with his long-standing delusional themes around sexual assault.

16It was also opined that his presentation of delusions was likely in the context of inadequate antipsychotic treatment. It was also reported that he was nonadherent with lithium since, at least, mid-November 2024. He was encouraged to take clozapine numerous times in the past reporting year and self-reportedly agreed that he was not optimally treated at his latest board hearing held on November 7, 2024.

17Mr. Kennedy’s treatment team decided to re-admit him to hospital on this same day (November 29, 2024) both at his request and due to other factors, which included: a history of absconding (AWOL), substance use (and recent self-report of alcohol two weeks prior to his delusional thoughts), noncompliance with medication and violence. Furthermore, there was a record of an assault (threatening a peer) while he was living at the Port Bruce Manor in early 2022.

18Mr. Kennedy was admitted to the Forensic Readiness Unit (A1) in the care of Dr. Jason Quinn.

19Of note, Mr. Kennedy had multiple admissions to hospital over the past two years, including: October 2022 for substance use and noncompliance with medication and abscondment; April 2023 for substance use, noncompliance with medication and abscondment; January 2024 for substance use; and, June 25, 2024, for noncompliance with medication.

20On December 23, 2024, inpatient staff reported that Mr. Kennedy did not sleep well the night before and his thoughts appeared pre-occupied and hewas responding to unseen stimuli. It was also reported that he appeared irritable. As a result of his presentation and his refusal to initiate recommended antipsychotic medication (clozapine), he was denied a pass to visit his aunt’s home on this day. He reported that he did not care about his aunt and just wanted to go outside to have a cigarette. He was asked to remain on the unit until he could be further assessed by his attending physician. He then became argumentative and proceeded to demonstrate signs of heightened aggression, evidenced by pounding his fists on the windows of the nursing station, eyes wide open, shuffling, raising fists, and rapid speech. He was reportedly yelling at the nursing staff, "I don't want an injection" or any other medications. He then proceeded to push an inpatient staff member, who was entering the unit hallway, by placing his hands on the staff’s chest and pushing the staff backwards.

21He then threatened, two more times, to hit this same staff member. He was then placed in seclusion and initially agreed to take a PRN, however, he later refused. When his behaviours were discussed with the treatment team, he made statements suggesting that he was assaulted and that he should phone the police and charge staff. He further voiced that he was not having delusions prior to his admission and that he was actually raped, repeatedly, at night by his roommate. He also voiced that if he started taking clozapine, he would be more likely to be raped by roommates and others because it is a "date rape drug."

22On January 3, 2025, Mr. Kennedy’s dose of olanzapine was increased (from 10 to 20mg).

23On January 7, 2025, Mr. Kennedy voiced that he is in hospital voluntarily and should be able to “check-out” and return back to his previous group home. His inpatient team explained that despite him returning to the hospital independently, he is not in hospital voluntarily, and that he was admitted under his detention order for various reasons (outlined above). During this conversation, he demonstrated a lack of insight into his mental illness symptoms, by denying that he was experiencing an increase in paranoid or delusional thinking. He expressed some insight into the need to refrain from illicit substance use and discussed the difficulty of relapsing if substances are around him. His demeanor was calm and cooperative during this interaction.

24On January 13, 2025, Mr. Kennedy was transferred to the Forensic treatment team (B2) due to his ongoing delusions, instability, and need for more intensive treatment. He is now in the care of Dr. Naghmeh Mokhber.

25On January 17, 2025, Mr. Kennedy’s dose of olanzapine was increased again (from 20 to 30mg).

26On January 21, 2025, Mr. Kennedy’s inpatient team reported that his mental status appeared fragile, irritable, and suspicious, presenting with various symptoms of paranoia. He required increasing prompting and education to take his morning medications. He then thought one of the nursing staff on the unit was following him and proceeded to say bizarre comments towards staff like "where's my baby" and "you know what I'm talking about.”

27On January 27, 2025, Mr. Kennedy approached an inpatient staff member and asked to see the doctor as he would like to have an ultrasound completed. He then stated, "I am having pain on my back, all over my spine, most of the day. Also, my stomach is bloating, it’s getting bigger day by day. Also, I don't have my lower rib on the right side, its missing. I hear voices, never mind, leave it. I want to talk to doctor." He was asked to elaborate on the voices; however, he refused to elaborate and denied experiencing any hallucinations. He was offered a PRN but refused. An abdominal assessment was completed with no concerns reported.

28On January 28, 2025, Mr. Kennedy agreed to start on clozapine (12.5mg) as the treatment team and Mr. Kennedy were not seeing much benefit with the increases of olanzapine. His dose of clozapine increased every couple of days and is now at 175mg. His dose of olanzapine decreased several times with the addition of clozapine and is now at 12.5mg, with the plan to further reduce it until it is discontinued.

29On February 1, 2025, Mr. Kennedy reported that he felt “stuck”. He voiced that he was upset because the only peers who seem capable of socializing with him are peers who are also offering him drugs. He denied any substance use and his toxicology screens have returned negative since his hospital admission. He endorsed that his auditory hallucinations were less frequent and more positive, likely because of the addition of clozapine. There have been no overt side effects since starting on clozapine. His paramount concern regarding clozapine was that he believes he may be “allergic” to it. He shared that one night after taking clozapine he felt “tingles all over and like the skin on [his] legs was being stretched” and also stated, “I felt like I was going to die”. This belief only occurred one night, other nights he did not voice having such side effects. The treatment team will continue to monitor and assess during his trial with clozapine.

30On February 4, 2025, Mr. Kennedy denied any ongoing concerns with taking clozapine. He denied tachycardia, chest pain, or flu-like symptoms. He endorsed minor orthostasis, which he remarked had improved. He expressed that he would prefer not to have his vitals taken pre and post clozapine administration. He was amenable to self-monitoring for tachycardia, chest pain, and orthostasis. He expressed some uncertainty around whether his auditory hallucinations have diminished since the initiation of clozapine, demonstrating limited insight into his treatment and mental illness. He shared that the voices are less frequent and bothersome, and their content is more positive (sometimes even funny). He reported that he is no longer concerned about nursing staff performing night checks (as this was an issue in the past). With that said, his treatment team considers his current presentation an improvement since his olanzapine was increased and clozapine was initiated.

31On February 7, 2025, Mr. Kennedy was reported stable aside from some frustration he expressed about not being able to return to his previous group home. His inpatient team has worked with him to arrange storage of his belongings.

Evidence at the Hearing

32Dr. Prakash testified at the hearing on behalf of the Hospital and adopted the contents of the ROL Report.

33Dr Prakash is not currently Mr. Kennedy’s Attending Psychiatrist but was during his time in the community.

34Dr. Prakash testified that Mr. Kennedy remains in the Hospital pending the availability of a suitable community placement. This admission has been different than any previous admission for Mr. Kennedy. He has finally agreed to start Clozapine, despite resisting this medication for years.

35His medication is not optimized, and he is currently receiving a 275mg dose of Clozapine. His psychotic symptoms have improved greatly, and while they persist, they are less frequent and less intensive.

36When Mr. Kennedy was first admitted to the Hospital, he was under the care of Dr. Quinn on the Rehab Unit (A1) and has since been transferred to the Treatment Unit (B2).

37Mr. Kennedy has level 3 privileges at this time, which allows him to spend virtually the entire day off unit but within the Hospital, returning only for meals and medications. He is in the early stages of being tested outside the hospital grounds and in the community.

38Dr. Prakash explained that there is no firm timeline for a transfer to the Rehab Unit, but when that occurs, Mr. Kennedy’s privileges will increase, and he will be tested further with respect to his addictions and his medication treatment. From there, housing options will be looked at.

39Dr. Prakash further articulated that patients are afforded the same privileges on each unit. When a patient attains level 5 or 6 privileges, that’s when they would normally move down to the rehab unit. Mr. Kennedy is on the verge of being moved to the Rehab Unit but has some treatment goals to attain before that transfer will occur.

40In response to questions from Counsel for the Attorney General, Dr. Prakash stated that the timeline for Mr. Kennedy’s transfer to the Rehab unit is more a matter of months, than days or weeks.

41In response to questions from Ms. Whillier, Dr. Prakash confirmed his belief that Mr. Kennedy wishes to return to Port Bruce upon discharge and that he felt they would be happy to have him back.

42Dr. Prakash further testified that among the reasons that Mr. Kennedy has not been transferred to the Rehab unit were because his Clozapine dosage has not been stabilized, and because other treatment goals such attending substance abuse programming and staying away from substances are still being assessed.

43Dr. Prakash confirmed that Mr. Kennedy’s Clozapine levels could be optimized on the Rehab Unit and at Port Bruce as well.

44In response to questions from the Panel, much was made about the lack of Campbell Letter being issued when Mr. Kennedy was transferred from his “home unit” of B2 back to the Treatment Unit A1, as well as the distinction between the privilege levels on A1 and B2.

45The Panel felt that a Campbell Letter should have been issued when this transfer from B2 to A1 took place, while the Hospital felt that there was little utility in doing so, as the available privilege levels on both are the same.

46Dr. Prakash was quite adamant that the highest tier of privileges, Level 7, were attainable on both the Rehab and Treatment Units, but that few patients achieve privilege Level 6 or higher because by then, they are transferred to the Rehab Unit. In this sense, Dr. Prakash felt there was not a ROL because the transfer from A1 to B2 did not result in a lower privilege level for Mr. Kennedy, nor does it restrict his attainable privileges.

Analysis and Conclusion

47The evidence provided by the Hospital supports Mr. Kennedy’s readmission to Hospital and his ongoing Restriction of Liberty.

48Mr. Kennedy’s readmission to Hospital was at his request but coincided with a reoccurrence of delusions of being sexually assaulted at his group home which was believed to be caused by inadequate antipsychotic treatment. Furthermore, it was believed that he was non-compliant with his Lithium as well.

49Mr. Kennedy has a history of medication non-compliance, absconding, substance use (which purportedly occurred two weeks prior to his readmission) and a history of violent behaviour. These factors have resulted in multiple readmissions to the Hospital over the past two years.

50In December of 2024, staff noticed that Mr. Kennedy was not sleeping well, was preoccupied with internal stimuli, irritable and refusing to initiate Clozapine. He became argumentative and evidenced acts of aggression and continued to endorse delusional beliefs.

51In this context, the Panel finds that the readmission in November of 2024, transferring him from the Rehab Unit to the Treatment Unit and the Hospital’s caution in both gradually increasing Mr. Kennedy’s privileges and awaiting further progress before transferring him back to the Rehab Unit, was and remains prudent.

52In considering the totality of the evidence presented at the hearing, including the information contained in the Hospital Report, the positions of the parties and the testimony of Dr. Prakash, the Panel finds that the both the initial Restriction and ongoing Restriction of Mr. Kennedy’s Liberty was and remains both necessary and appropriate, and that the least onerous and least restrictive option was utilized by the hospital to manage the risks posed by Mr. Kennedy in consideration of the totality of the circumstances.

53In the future, should a patient be transferred from one unit to another, the Panel recommends that the Hospital issue a Campbell Letter, even if it is of the opinion that there are no changes to the patient’s “liberty norm”.