Re: Kiritharan Kannathasan
ORB File No: 7636
Hearing held on: Tuesday, March 11, 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. S. Clapp
Members: Dr. R. Sheppard Dr. S. Lessard Mr. D. Sandor Mr. J. Cyr
Parties Appearing:
Accused: Kiritharan Kannathasan Counsel: Mr. V. Zenobio
The person in charge of hospital: Representative: Ms. A. Feldstein
Attorney General of Ontario: Counsel: Mr. M. Yousuf
REASONS FOR DISPOSITION
(Dated April 30, 2025)
Introduction:
On November 14, 2019, Kiritharan Kannathasan was found not criminally responsible on account of mental disorder (“NCR”) on charges of assault with a weapon, and aggravated assault, contrary to the Criminal Code. He is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated March 22, 2024, whereby he is discharged from the Centre for Addiction and Mental Health (“CAMH” or the “hospital”) subject to a number of conditions, including that he abstain from substances and refrain from possessing weapons.
On March 11, 2025, a panel of the Board convened at CAMH to conduct Mr. Kannathasan’s annual review pursuant to section 672.81(1) of the Criminal Code. Mr. Kannathasan attended the hearing and was represented by counsel.
The Hospital Report dated February 22, 2025, was marked as Exhibit 1. In addition to the documentary evidence, Mr. Kannathasan’s attending psychiatrist, Dr. R. McMaster, gave evidence.
The issues to be decided at the hearing were whether Mr. Kannathasan continues to meet the test of posing a significant threat to the safety of the public and if so, what is the necessary and appropriate Disposition, bearing in mind the four factors in section 672.54 of the Criminal Code.
Position of the Parties:
All parties were asked for their initial without prejudice positions at the outset of the hearing. Ms. Feldstein stated that the hospital’s position was that Mr. Kannathasan continued to represent a significant threat, and recommended a continuation of the existing Conditional Discharge, but with the removal of the conditions related to abstention from substances and drug screening. Mr. Yousuf agreed with a continuation of the Conditional Discharge but reserved his position on removal of the conditions related to substance use. Mr. Zenobio agreed with the position of the hospital.
Following the hearing of the evidence, Mr. Yousuf supported the hospital’s position on behalf of the Attorney General. There was, therefore, a joint submission before the panel.
Findings:
- For the reasons that follow, the panel found that Mr. Kannathasan continues to pose a significant threat to the safety of the public, and concluded that the necessary and appropriate Disposition is a continuation of the existing Conditional Discharge, with removal of the conditions requiring that Mr. Kannathasan abstain from the use of substances and submit samples of his urine and/or breath.
Index Offences:
- The circumstances of the index offences are outlined in the Hospital Report (at page 6) as follows:
“Aggravated Assault and Assault with a Weapon – November 2018
According to the Peel Regional Police Services Synopsis, Ms. Thanaluxmy Kannathasan and her husband Mr. Permashandran Veluppilai resided together at 3 Knightsbridge Road, Unit #2712 in Brampton. She had one adult son named Kiritharan Kannathasan (22 years old) from a previous marriage who also resided with them. All parties resided at the address for approximately three years. Police had dealt with the family for previous domestic related incidents.
On November 25, 2018, at approximately 7:30 pm, all three parties were present in the residence. Mr. Kannathasan was acting strange, and the victims became concerned for his mental state. As his mother was preparing to bring him to the hospital, he armed himself with two knives, and proceeded to stab her once in her stomach and once on the right of her neck. He also cut his father in his stomach area. The cut was minor and did not require any medical attention. A blood trail was located down the building stairwell to the 15th floor, across to the other stairwell and down to the main floor lobby. At 7:34 pm, police attended 3 Knightsbridge Road, and located Mr. Kannathasan in the parking lot and arrested him. He was informed about his rights to counsel and cautioned, all of which he understood. He was transported to 21 Division Peel Regional Police pending a bail hearing. His mother was transported by ambulance to Sunnybrook Hospital where she required surgery to her stomach. Her injuries were considered serious but not life threatening. The cut to her neck was minor. Mr. Kannathasan sustained a minor cut to his left little finger and did not require medical attention. Alcohol or drugs were not considered to be a factor.
When assessed in 2019 and asked about the index offence, Mr. Kannathasan initially referenced stacking papers and burning them. When reminded about stabbing his mother, he was able to discuss the incident. At the time of the index offence, he was hearing voices telling him to stab his family. He stated that he was taking medications, “the needle” at the time, and was not using cannabis or other substances. He reported he “had no choice” but to stab his mother. He explained that he was “in control,” though he felt “pissed off.” In reflecting on his actions, he reported, “I feel sad.”
Background:
Mr. Kannathasan’s personal background and history are set out in detail in the Hospital Report and will not be repeated here. Briefly summarized, Mr. Kannathasan is a 29-year-old single man who was born in Sri Lanka and came to Canada at age 11. Prior to coming to Canada, he lived with his maternal grandparents. There was little contact with his father due to concerns related to alcohol and physical abuse.
Mr. Kannathasan’s mother remarried, and Mr. Kannathasan lived with his mother and stepfather. He started smoking cannabis in grade 10 and did not complete high school (he was reportedly two credits short of obtaining his high school diploma). Mr. Kannathasan worked in a few jobs but lost them due to heavy cannabis use. He described himself as “homeless and smoking weed.” He is supported by the Ontario Disability Support Program.
Mr. Kannathasan has one sister who has schizophrenia. He is not in contact with her. At the time of the index offences he was living in Brampton with his mother and stepfather, who were the victims of the index offences.
Criminal History:
- The Hospital Report stated that Mr. Kannathasan had convictions for assault, mischief, and utter threats in January 2016, as a result of a physical assault against his mother. There were also convictions for failure to comply with probation. The Hospital Report also stated that Mr. Kannathasan’s family members contacted police on a number of occasions between 2015 and 2016 due to concerns about physical violence, threats of harm, and damage to property.
Psychiatric History:
The Hospital Report includes Mr. Kannathasan’s psychiatric history commencing when he first started to experience symptoms of psychosis and was diagnosed with schizophrenia around the age of 18 or 19. He had multiple admissions to Brampton Civic Hospital between 2016 and 2018 where he presented with bizarre behaviours, delusions, (such as believing that his parents were not his real parents), and command hallucinations about harming his mother. His diagnosis was consistently schizophrenia, with his decompensations typically occurring in the context of medication noncompliance and cannabis use. During an admission in October 2018, Mr. Kannathasan was found incapable of consenting to treatment and was placed on a community treatment order.
Following his arrest for the index offences, Mr. Kannathasan was in custody at the Toronto South Detention Centre and Maplehurst Correctional Complex. During this time, he was treated with antipsychotic medication, but he continued to experience auditory hallucinations, grandiose beliefs, and somatic delusions. Clozapine was proposed but he did not want to change his medication.
Following the NCR finding, Mr. Kannathasan was admitted to CAMH. He was detained on a general unit and had ongoing auditory hallucinations. He also did not believe that his family was his real family. Mr. Kannathasan was deemed capable of consenting to treatment and eventually agreed to trial Clozapine in March 2020. This resulted in most of his positive psychotic symptoms subsiding, and his insight into his illness and the index offences was described as fair.
Mr. Kannathasan was discharged to TRHP2 housing (Transitional Rehabilitation Housing Program 2) on July 13, 2021. He needed some increased support while he transitioned to community living but then settled into the daily routines of the residence well. Mr. Kannathasan began self-administering his antipsychotic medication in November 2022 and obtained part-time employment in February 2023 as a cleaner.
Mr. Kannathasan received a Conditional Discharge in February 2023. He continued to do well at TRHP2 housing and did not display any overt psychotic symptoms. He independently managed his medications and appointments, was compliant with rules, progressed with his activities of daily living, and had no critical incidents or substance use. His insight improved as well.
The Hospital Report stated that Mr. Kannathasan’s diagnoses are Schizophrenia and Cannabis Use Disorder, in remission.
Evidence at the Hearing:
The Hospital Report stated that Mr. Kannathasan had another excellent reporting period. He moved to an independent apartment through Forensic Supportive Housing (FSH) on May 12, 2024, and has done well since that transition. His mental state remained stable, he maintained a good rapport with his treatment team, he adhered to his medication, and his insight into his diagnosis and the need for medication continue to improve. There were no concerns regarding substance use, with random urine drug screens consistently negative. His long-acting injection of antipsychotic medication was decreased, and ultimately discontinued this year, in order to reduce overall side-effect burden. Mr. Kannathasan continued to work two to four hours per week as a cleaner and also participated in group activities.
The Hospital Report included results from the Dundrum 3 & 4 which was completed in February 2025. It included the following under the recovery domain of insight (at page 24):
“Insight – staff judged that while he appreciates the need for treatment and his legal obligations, where he noted he had a relapse prevention plan, staff were not certain of his ability at this time to have a fulsome understanding of warning sign, triggers, and management strategies in the event of a relapse.”
- While Mr. Kannathasan has progressed well in the last few years, the treatment team remain of the view that Mr. Kannathasan remains a significant threat to the safety of the public. The following statement is taken from the “Composite Assessment of Risk” on page 27:
“Mr. Kannathasan has experienced several decompensations related to non-compliance with medication. Further, he has also experienced deterioration of his mental state due to substance use. Re-emergence of symptoms, including paranoid delusions and auditory hallucinations, has led to multiple admissions to psychiatric hospitals, where he was sometimes brought by police for disturbing conduct while ill. His historical poor understanding of his illness has been in part responsible for his history of non-compliance with treatment leading to decompensation in his mental state. Further, absent clozapine and while receiving other antipsychotic medications, he presented with active psychotic symptoms with resultant behavioural disturbance and aggression. This appears to have been the situation at the time of the index offence. Based upon the combination of his history of violence and the fluctuation in his mental illness, Mr. Kannathasan continues to represent a significant threat to the safety of the public.”
The treatment team recommended that a continuation of the Conditional Discharge is necessary and appropriate this year. Mr. Kannathasan indicated that he would reside in approved housing, return to the hospital if requested by his clinical team, or voluntarily present to hospital in the event that he began to experience psychotic symptoms. The team was of the opinion that the Mental Health Act would be sufficient to manage the risk to the public.
Given Mr. Kannathasan’s abstention from substance use over many years, the team also recommended the removal of the conditions related to abstention from substance use and submitting samples of urine and/or breath for the purpose of analyzing whether he had ingested any substances.
The Hospital Report also stated that the team plans to connect Mr. Kannathasan to a non-forensic team.
Dr. McMaster testified that Mr. Kannathasan had a very good year and reiterated that he had a successful transition to an independent apartment, worked well with the treatment team, and is adherent to his medication. He added that Mr. Kannathasan is prosocial and seeks out help when needed.
Dr. McMaster was asked about the rationale for the removal of the conditions related to substance use. He testified that Mr. Kannathasan has abstained from substance use since June 2018, and he has had fulsome discussions with him about this issue. Dr. McMaster stated that Mr. Kannathasan is aware of his diagnosis of Cannabis Use Disorder and has internalized the effect that cannabis has on his mental state. He has not used despite many opportunities to do so when unsupervised and being in his own apartment now. Dr. McMaster testified that Mr. Kannathasan is internally motivated not to use (as opposed to being motivated by his Disposition) and therefore it is unnecessary to have these conditions in his Disposition.
Dr. McMaster testified that Mr. Kannathasan still requires support and follow-up in the community in light of the fairly recent removal of the long-acting injectable medication, his move to new housing, and his history of being violent when unwell. Dr. McMaster stated that he wants to see Mr. Kannathasan transition to a non-forensic team, maintain abstinence, and develop further independence, before an absolute discharge would be recommended.
Analysis and Conclusion:
Based on the Hospital Report and the evidence of Dr. McMaster, the panel found that Mr. Kannathasan continues to represent a significant threat to the safety of the public. The panel was satisfied that absent ORB involvement, Mr. Kannathasan would likely fall away from treatment and supervision, experience stressors, and resume cannabis use. This would likely lead to an exacerbation of psychotic symptoms associated with his schizophrenia, resulting in aggressive and violent behaviours towards members of his family, as happened at the time of the index offences. The panel also considered that prior to the index offences, Mr. Kannathasan had a history of multiple hospitalizations following non-compliance with medication in the community.
The panel accepted the joint submission that a continuation of the existing Conditional Discharge Disposition, with the removal of the conditions related to substance use, was necessary and appropriate, as well as the least onerous and least restrictive Disposition for Mr. Kannathasan at this time. Mr. Kannathasan has made good progress through the ORB system in the last few years, and some significant changes were made during this past year. He moved to an independent apartment and his long-acting injectable antipsychotic medication was discontinued. It is still relatively early days since these changes, and the evidence demonstrated that Mr. Kannathasan still requires some support in the community to maintain his independence. He could also develop some increased insight into triggers and warning signs of a relapse.
Removal of the provisions related to abstention from substance use and testing for substances is reasonable in light of Mr. Kannathasan’s continued abstinence for many years. He has not engaged in substance use despite living in the community and having access to substances. Cannabis use was a significant contributing factor to the deterioration of Mr. Kannathasan’s mental state in the past. Mr. Kannathasan’s internal motivation to remain abstinent will be tested by removal of these provisions in his Disposition and will inform the team going forward about his risk.
We echo Dr. McMaster’s comment that Mr. Kannathasan is on a very good trajectory and encourage him to continue on this path in the coming year.
DATED this 30th day of April 2025, at the City of Toronto, in the Toronto Region.
Ms. S. Clapp Alternate Chairperson
__________________ Office of the Registrar Ontario Review Board