Re: Ivy Jorda
ORB File No: 7644
Hearing held on: Tuesday, March 25, 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. L. Banks
Members: Dr. P. Prendergast Dr. L. O. Lightfoot Ms. M. Labrosse Mr. A. Bouvier
Parties Appearing:
Accused: Ivy Jorda Counsel: Mr. N. Xynnis (by video-conference)
The person in charge of hospital: Representative: Ms. S. Zelaya
Attorney General of Ontario: Counsel: Ms. S. Burton
REASONS FOR DISPOSITION
(Dated May 6, 2025)
Introduction:
On November 26, 2019, Ms. Ivy Jorda was found not criminally responsible by reason of mental disorder (“NCR”) on five charges of assault and one charge of uttering threat to cause death or bodily harm, all contrary to the Criminal Code of Canada (“Criminal Code”). Pursuant to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated April 24, 2024, Ms. Jorda was ordered discharged subject to a variety. Of conditions, including that she reside at a specified address and that she report to the person in charge of the Centre for Addiction and Mental Health (“CAMH” or the “hospital”) not less than once per week, or as required.
On March 25, 2025, a panel of the Ontario Review Board (“ORB” or the “Board”) convened at CAMH for the annual review of Ms. Jorda’s Disposition pursuant to s. 672.81(1) of the Criminal Code. Ms. Jorda was present at the hearing and was represented by her counsel, Mr. Xynnis, who appeared by video-conference.
The issues to be determined at this time was whether Ms. Jorda meets the threshold of significant threat and, if so, the necessary and appropriate Disposition in the circumstances to manage that risk having regard to the criteria set out in s. 672.54 of the Criminal Code.
For the reasons set out below, the Board finds that Ms. Jorda no longer represents a significant threat to the safety of the public and accordingly, she must be absolutely discharged.
Initial Positions:
At the outset of the hearing the parties were canvassed as to their initial positions. Counsel for the hospital indicated the hospital was recommending an Absolute Discharge.
Counsel for the Attorney General supported the hospital’s recommendation.
Mr. Xynnis indicated he was supportive of an Absolute Discharge.
All parties maintained their joint recommendation to the Board in closing submissions.
Index Offences:
- The details of the index offences are set out in the Hospital Report to the ORB dated March 10, 2025 (the “Hospital Report”) and are summarized in last year’s Reasons for Disposition, as follows:
“The assaults took place on dates between October 2016 and January 2018. There were at least four occasions when Ms. Jorda assaulted female victims. Also, she uttered a death threat to an employee at a MacDondald’s restaurant. All of the victims were strangers to Ms. Jorda.”
Personal History:
Ms. Jorda’s personal background and history are set out in detail in the Hospital Report which was entered as an exhibit at the hearing and need not be repeated at length here. Briefly summarized, she is a 45-year-old woman who was born in the Philippines. She was adopted by relatives and then moved to Canada with her adoptive family when she was a teenager. Ms. Jorda is the youngest in a sibline of five. Her parents are now deceased.
Ms. Jorda attended elementary and secondary school in the Philippines. She attended Parkdale Collegiate Institute in Toronto, Canada. She reported dropping out after Grade 10 due to substance use issues.
Before her arrest, Ms. Jorda lived with her partner, Mr. McLaine, in Toronto. She had been residing with him on and off for a number of years. She indicated that they moved around a lot and noted that she would sometimes leave his residence and reside on the street or in shelters.
Ms. Jorda has 6 children, all of whom have been removed from her care by the Children's Aid Society (“CAS”). She has regular contact with her three adult children. Her other children are quite young and have been adopted by other families. Her only daughter recently moved to the United States to be with her husband. Ms. Jorda has been granted 2 visits yearly with her youngest kids (J.1 & J.2) who were adopted into the same family. Ms. Jorda has a boy named J.3 who she believes was likely adopted by a different family.
Ms. Jorda has had a number of employment positions in low-labour forms of work. She has not been employed for some time and has been financially supported through ODSP for many years.
Ms. Jorda has a diagnosis of Hepatitis C and is followed at the liver clinic at Toronto Western Hospital but has not consistently attended appointments. She also has a history of prolonged QT Syndrome which can occur from certain psychiatric and psychotic medications and disrupts the natural heart rhythm.
Substance Use History:
Ms. Jorda has an extensive and well documented history of crack cocaine and crystal methamphetamine use. She also has a history of abusing alcohol, marijuana and LSD. She first used cocaine and crystal methamphetamine in high school and last used before her last arrest. She used approximately weekly. She panhandled, engaged in prostitution and theft, and used her ODSP money to fund her addiction.
The Hospital Report indicates that she sought help from Narcotics Anonymous and Cocaine Users Anonymous among other group programs. Her longest length of abstinence from drug use was one-and-a-half years, and this occurred approximately six years ago. The Hospital Report also indicates that historically substance use has increased the risk of a re-emergence of psychotic symptoms and destabilization in her mental state.
Legal History:
- Ms. Jorda has an extensive criminal record beginning in 1998 and includes convictions for assault, assault with a weapon, uttering threats and failing to comply with court orders.
Psychiatric History:
Ms. Jorda has a significant psychiatric history of Schizophrenia. Her first hospital admission resulting from a drug-induced psychosis took place in 2000. Since that time, Ms. Jorda has had at least 13 admissions to hospital, not including emergency room visits. The majority of these have been under the auspices of court-ordered treatment orders. Her presentation during these admissions has been characterized by disorganized and aggressive behaviours, and paranoid, grandiose and bizarre delusions. Ms. Jorda has a documented history of aggression towards both family members and strangers when unwell.
Ms. Jorda typically responds well to medications but unfortunately, she has a history of not following through with treatment recommendations upon release from hospital. Her history of poor medication compliance and her use of substances has often led to rapid relapses of her psychotic illness.
Current Diagnoses:
- Ms. Jorda's current diagnoses are:
Schizophrenia; and
Stimulant Use Disorder, in sustained remission in a controlled environment.
Evidence at the Hearing:
Dr. M. Kravtsenyuk, Ms. Jorda’s out-patient psychiatrist testified at the hearing to supplement the documentary evidence before the Board. She endorsed the contents of the Hospital Report and advised there were no updates.
Ms. Jorda continues to be assessed as capable to consent to treatment for her psychiatric illness. She currently receives a daily oral dose of the antipsychotic medication, Aripiprazole, which she reliably self-administers. There have been no changes to her medication over the past year nor have there been any fluctuations in her mental stability. The doctor advised that Ms. Jorda has consistently demonstrated compliance with her medications and her illness has been in a state of remission for years.
Ms. Jorda’s mental state has remained stable over the year in review and she has not presented with any overt mood or psychotic symptoms. She has consistently denied experiencing delusions or hallucinations and she has not been observed responding to internal stimuli. She has also denied suicidal or violent ideation.
Ms. Jorda was originally discharged to Margaret Frazer housing in the community on August 16, 2021. This is a transitional housing program and their agency provides a continuum of housing options to women living with mental illness. In May 2023, Ms. Jorda transitioned to an independent/shared apartment through Margaret Frazer Housing. She has three female co-residents with whom she shares this accommodation and to date, she has interacted well with her co-tenants. She resides at 50 Barrington Avenue in Toronto. This residence has staff support available typically weekly but such support can be accessed more frequently, on an as-needed basis. At the present time, Ms. Jorda has not expressed any plan to relocate from her current housing.
Ms. Jorda has not required any hospital readmissions over the year in review. In fact, she has not shown any signs of deterioration in her mental state since her discharge to the community in 2021. She has remained compliant with the terms of her ORB Conditional Discharge Disposition. There have been no incidents of concern over the past reporting year.
Ms. Jorda is supported in the community by the Forensics Out-patient Services (“FOPS”) team. Her care has been overseen by Dr. Kravtsenyuk since August 2023. She is also supported in the community by her case manager, Ms. E. Moreau, with weekly reporting arrangements (a combination of phone calls, home visits and clinic visits).
All random urine drug screens (“UDS”) conducted over the year in review have been negative for the presence of alcohol and intoxicants and have verified the presence of her medication at therapeutic levels. This has been the case for many years.
In terms of insight, Ms. Jorda acknowledges suffering from a major mental illness and demonstrates an understanding of the importance of her medication and managing her symptoms. She also expresses insight into the importance of remaining abstinent from alcohol and substances of abuse.
The Hospital Report indicates that Ms. Jorda has continued to be engaged in substance use programming. She attended Narcotics Anonymous (“NA”) several times per week and now acts in a leadership capacity. She keeps in regular contact with her NA sponsor and she intends to continue with the NA program even in the event of an Absolute Discharge.
Ms. Jorda also attends the Relapse Prevention group (either in person or online) through the Oasis Addiction Recovery Society. Ms. Jorda has also continued to attend a weekly Substance Relapse Prevention group at CAMH. She has stated that she understands that in the past she has become aggressive and violent and has engaged in criminal behaviour when using substances. The doctor stated that Ms. Jorda seeks out appropriate programming as she finds these supports of assistance to her. The doctor testified that she expects that this will not change for Ms. Jorda in the context of her receiving an Absolute Discharge.
In the summer of 2024, Ms. Jorda had UDS results that were positive for opioids. She denied any opioid use or consumption of prescription pain medications and was clearly upset over the unexpected UDS results. It appeared likely that the results were related to her consumption of poppy seed bagels and there have been no further positive UDS results since that time. There were no observable changes in her mental status at that time. Ms. Jorda continues to express her internal motivation to remain abstinent of substances of abuse. According to the doctor, Ms. Jorda has quite good insight into the potentially deleterious impact of substance use on her mental health.
Over the year in review, Ms. Jorda has been an active and appropriate participant in a wide variety of therapeutic programs and recreational activities available to her through the FOPS team and her housing provider. Of particular note, she was engaged in volunteer orientation at the Toronto Humane Society and she also started a job at CMHA as a cleaner working some shifts. During the year, Ms. Jorda began attending a Filipino Baptist church service on Sundays. She is also well-engaged in recreational fitness programs at Trinity Bellwood Park community centre, including dancing, gym and volleyball.
In August 2024, Ms. Jorda got accepted for OSAP and for the hairdressing course at Avola college of Esthetics which started in September 2024 and was a full-time program. Due to demands in practical assignments at school, she decided to end that educational pursuit due to the physical discomfort she experienced as a result of a neuromuscular condition. The doctor advised that there are other vocational pursuits that Ms. Jorda is likely to explore going forward bearing in mind her medical challenges.
In January 2025, Ms. Jorda got a tutor through Parkdale Project Read and began attending "Skills Group" through Recovery Reimagined, a recovery group for women, through Michael Garron Hospital.
Over the past year, Ms. Jorda’s insight into the likelihood that she was the victim of an on-line scam improved and she no longer sends money to the perpetrator of that scam. The Hospital Report indicates that “While she remains vulnerable in her relationship choices, she is open to feedback and therapeutic support to help guide her decision-making.”
Ms. Jorda maintains regular contact with her brother and sister and considers them important supports. She also has contact with her three adult children. Her family supports are important to her.
Ms. Jorda has a very positive rapport with her family doctor, Dr. Yavorska, and Ms. Jorda appropriately seeks out her physician’s support when necessary. Her family doctor is associated with Parkdale Community Health.
According to the Risk Assessment contained in the Hospital Report, “…her treatment team opines that, within the context of an absolute discharge, Ms. Jorda would likely sustain medication compliance and engagement with professional and personal supports that would help her to cope with emerging stressors and destabilizers, and to strengthen enhanced coping skills. Ms. Jorda has been actively engaged with her treatment team, and fully compliant with medication and reporting for over the years. She demonstrated sustained substance abstinence. She participated actively in numerous relapse prevention groups for an extended period. She expressed good insight into her diagnosis, need for ongoing treatment, need for abstinence, and potential for violence if she were to discontinue medication. In recognition of these factors, the treatment team is of the opinion that Ms. Jorda no longer meets the criteria of significant threat to the safety of the public, as defined in Winko.”
The doctor described Ms. Jorda’s recovery as “consistent and fulsome” while under the Board’s jurisdiction. Her stability in the community has been noted for years. Dr. Kravtsenyuk commented that Ms. Jorda is capable to independently manage her mental health needs and she appropriately reaches out for mental health supports as needed.
In terms of transitioning Ms. Jorda to non-forensic care providers, the doctor testified that in the team’s opinion, Ms. Jorda does not currently require any regular psychiatric follow up. Her family doctor is able to prescribe her current Abilify antipsychotic medication. In Dr. Kravtsenyuk’s opinion, Ms. Jorda’s family doctor at Parkdale Community Health is aware of her mental health history and her connection to CAMH and the ORB. Dr. Kravtsenyuk stated that Ms. Jorda’s care will be bridged by the current FOPS treatment team until her care is formally transferred to her family doctor or, if warranted, an appropriate civil mental health agency. Dr. Kravtsenyuk undertook to engage in discussions with Ms. Jorda’s family physician in the near future should an Absolute Discharge be ordered by the Board. The doctor underscored the fact that Ms. Jorda has been stable in the community for years and is optimally treated on monotherapy with an oral medication which has resulted in the full remission of her illness.
No further evidence was called by the parties.
Analysis and Conclusion:
The Board is unanimous in finding that Ms. Jorda no longer meets the threshold of posing a significant threat to the safety of the public. We note that this position was not contested by any of the parties. In coming to this conclusion, we have relied upon the documentary evidence and the expert testimony of Dr. Kravtsenyuk, particularly regarding Ms. Jorda's course over the past several reporting years. As well, the panel carefully considered the decision of the Supreme Court in Winko v. British Columbia. In that case, the Court identified a significant risk as a "real risk of physical or psychological harm to members of the public that is serious in the sense of going beyond the merely trivial or annoying. The conduct giving rise to the harm must be criminal in nature". There must be a positive finding by the Board of a significant risk to the safety of the public to engage the provisions of the Criminal Code and to support restrictions on an NCR accused’s liberty. Something else, for example, uncertainty, cannot suffice. If the Board cannot resolve the question of whether or not the NCR accused constitutes a significant threat to public safety, it must grant the accused an Absolute Discharge.
In Winko, the Supreme Court also outlined that in coming to a conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence including the circumstances of the original offence, the past and expected course of the accused's treatment, the present state of the NCR accused's medical condition and the NCR accused's own plans for the future, the support services existing for the NCR accused in the community and, perhaps most importantly, the recommendations provided by experts who have examined the NCR accused.
The evidence before us outlined the sustained progress that Ms. Jorda has continued to make over the past several years. She has been residing successfully in the community since 2021 with no hospital readmissions. She has successfully resided in stable independent housing and there have been no reported incidents of concern since her discharge.
Ms. Jorda has not engaged in any violence or assaultive behaviour. Ms. Jorda attends all of her scheduled appointments with the FOPS team without issue.
To her credit, Ms. Jorda is insightful regarding the symptoms of her illness, its early warning signs, and the importance of medication compliance in perpetuity. Ms. Jorda is internally motivated not to fall back into psychiatric illness and realizes that she must remain compliant with her treatment and abstinent of substances of abuse in order to avert a recurrence of her illness.
The symptoms of her mental illness have been in sustained and complete remission for many years. Ms. Jorda remains compliant under her own consent as she is assessed as treatment capable. She does not present with any overt symptoms of psychosis or mood disturbance.
Ms. Jorda’s UDS results have all returned negative for substances of abuse except as indicated above in paragraph 32 of these Reasons. She has engaged appropriately with her treatment team and has been an active participant in recommended programming. She has complied with all of the terms in her ORB Disposition. These are all indicators of her positive trajectory in terms of full community re-integration.
Ms. Jorda’s follow-up will likely be transferred to her existing family physician at Parkdale Community Health with whom she enjoys a positive rapport. To her credit, Ms. Jorda expresses an understanding of the importance of, as well as a commitment to, remaining engaged with professional care givers and she has actively sought out mental health and addiction support care providers, as required. According to Dr. Kravtsenyuk, the FOPS team will liaise with the team at Parkdale Community Health and transfer care to that office. Until that transfer of care has occurred, the FOPS team will bridge care.
Dr. Kravtsenyuk is confident that Ms. Jorda’s risk will be sufficiently mitigated by many protective factors. These include: her well-developed insight, her adherence to her prescribed medication, her engagement in a variety of pro-social community endeavours, stable housing, and her network of family members who are positive social supports. Given these many protective factors, the Board concurs with the recommendation of the treatment team and agrees that Ms. Jorda’s risk can be sufficiently managed in the community absent an order of the ORB.
In view of the foregoing, this Board finds that Ms. Jorda no longer meets the threshold of significant risk to the safety of the public and we order that she be absolutely discharged. The Board congratulates Ms. Jorda, her family members, Dr. Kravtsenyuk and the treatment team and wishes Ms. Jorda continued success in the future.
In making this Disposition, the Board has reviewed the provisions of s. 672.54 of the Criminal Code and has carefully considered the need to protect the public from dangerous persons, the mental condition of Ms. Jorda, her reintegration into society and her other needs.
DATED this 6th day of May, 2025, at the City of Toronto, in the Region of Toronto.
Ms. L. Banks Alternate Chairperson
__________________ Office of the Registrar Ontario Review Board