Ontario Review Board
Re: Bohdan I. Kudelya
ORB File No: 6052
Hearing held on: Wednesday, April 9, 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. C. Fromstein Members: Dr. L.E. Cappe Dr. C. Young Hon. C. Nelson Ms. B. Naegele
Parties Appearing: Accused: Bohdan I. Kudelya Counsel: Mr. W. Jaksa
The Person in charge of Hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Ms. V. Culp
REASONS FOR DISPOSITION
(Dated June 3, 2025)
Introduction
On February 1, 2012, Bohdan I. Kudelya was found not criminally responsible on account of mental disorder on the charge of assault, contrary to the Criminal Code of Canada.
Pursuant to s. 672.81(1) of the Criminal Code, a panel of the Ontario Review Board (the Board) was convened on April 9, 2025 at the Centre for Addiction and Mental Health (CAMH or the Hospital) to review Mr. Kudelya’s existing disposition as to his risk to public safety and disposition.
Mr. Kudelya’s existing disposition, dated May 15, 2024, orders that he be detained at the forensic service of the CAMH with privileges up to the ability to live in the community in supervised accommodations approved by the Hospital.
Ms. Warner represented the hospital; Ms. Culp, the Crown, and Mr. Jaksa represented Mr. Kudelya. Mr. Kudelya’s mother was present at the hearing.
Initial Positions
- At the start of the hearing, the parties provided the Board with their initial positions. All three parties: the hospital, Crown, and Mr. Kudelya’s counsel, indicated that they were supporting a Detention Order as requested by the hospital. Mr. Jaksa said that the matter would proceed as “almost a joint submission” but that he would request a small change in that he was asking that Mr. Kudelya’s 72-hour pass privilege be extended to seven days to allow international travel (accompanied by his mother).
Index Offence
- A summary of the index offence is as follows:
Mr. Kudelya and the victim of the index offence lived next door to each other in Toronto. On November 26, 2011, the accused banged on the victim’s apartment door. When the victim answered the door, the accused barged in and punched the victim in the face and said, “You fucking Jew.” He tried to punch the victim again. The accused fled when the victim’s wife said she was calling the police. The accused was apprehended under the Mental Health Act and arrested in the hospital where he was assessed.
Background
Before the index offence, Mr. Kudelya had had some encounters with the criminal justice system. In 2003 he was charged with robbery and theft. Due to his young age the charges were stayed. He has no pre-index offence criminal convictions.
Mr. Kudelya’s current diagnoses are schizophrenia and substance use disorder (in sustained remission in a controlled environment).
By way of his general background, Mr. Kudelya is 36-years-of-age and was born in Ukraine, immigrating to Canada with his mother at age 10. He is not married and has no dependants. He had a variety of jobs but has not been able to maintain employment because of his mental illness. Ms. Kudelya has a close and supportive relationship with her son. She is the substitute decision-maker and an approved person by the Hospital.
The Hospital Report indicates that Mr. Kudelya began using illicit substances in high school and began to use substances and alcohol to excess in college.
Mr. Kudelya’s mother stated that she first observed her son exhibiting unusual behaviour in 2005 at age 17. He was argumentative and hostile towards her. His first formal psychiatric admission was in 2008, which was followed by many subsequent hospital admissions. Many were related to the use of cannabis and crack/cocaine which led to deterioration in his mental state and an escalation in verbal and physical aggression. He also failed to comply with his treatment while in the community.
As noted earlier, the index offence occurred in November, 2011. Following the NCR finding on February 1, 2012, Mr. Kudelya was admitted to CAMH where he remained until June, 2015 when he was discharged to live in supportive housing. Use of cannabis, medication tampering and unwillingness to engage in structured activities were factors in his re-admissions to CAMH in November, 2016 and in early January 2019 after a discharge to community housing in 2017. In 2019 Mr. Kudelya admitted to using cannabis for months when in the community.
Mr. Kudelya remained in CAMH through the period from April, 2019 to April, 2020. He demonstrated periods of progress and decline through this period. He continued to test positive for cannabis and admitted to having cannabis in his room and to smoking on the unit. He displayed cognitive rigidity, delusional thoughts about satellites, anxious preoccupation and functional impairment due to his residual psychotic symptoms. He derived some benefit with his antipsychotic medicine, clozapine, optimized. Mr. Kudelya achieved overnight visits with his mother and indirectly supervised privileges on the grounds. However, he abused a pass for a long weekend visit to a cottage and a pass for a visit with his mother by using cannabis.
Throughout 2021 Mr. Kudelya continued to be vulnerable to substance relapse. Structured programming and a high level of controls were seen as critical to his transition to community living. The Hospital Report indicates that in 2020, Mr. Kudelya continued to be an inpatient in a forensic general unit and remained generally mentally stable with ongoing residual symptoms of anxiety and delusional thought. Mr. Kudelya continued to have indirect supervision on the grounds and in the community. At times he was in breach by smoking on the grounds and selling cigarettes on the unit. He displayed superficial insight into his mental illness and risk factors for violence. Mr. Kudelya began to be consistently involved in hospital programming but his participation was seen as superficial.
At the beginning of the March, 2022 to March, 2023 reporting year, Mr. Kudelya remained under the care of CAMH. He continued to have fixed delusions about satellites sending messages to people’s minds which caused him anxiety. He was able to acknowledge that those thoughts were delusional. He continued to show little insight into his mental illness and need for treatment. He would deny using substances until he was confronted at which point he would admit it. He began working a few shifts a week at an LCBO in July, 2022.
On December 1, 2022 Mr. Kudelya was discharged from inpatient care to a group home at 96 Dowling Ave. which is 24-hour supervised, high-support permanent housing. He indicated that he enjoyed his residence. He denied mood disturbances, psychotic symptoms and mind control thoughts. The Hospital Report indicates that on assessment by the CAMH forensic outpatient program team, Mr. Kudelya was not thought disordered and gave appropriate answers to lines of inquiry and questions. He was pleasant and cooperative in interactions with the treatment team.
Mr. Kudelya’s urine drug tests were not positive for any substances throughout the reporting period. He stated that he understood the importance of abstaining from substances and the effects they have on his mental health. There was, however, concern during this period about a co-patient’s report that he was selling cigarettes on the unit. Mr. Kudelya attended programs but had to be encouraged and prompted to do so.
Evidence at the Hearing
The evidence at the hearing was provided by Dr. D. Jaiswal, who took over the role of Mr. Kudelya’s treating psychiatrist over a year ago. In addition, the Board had the Hospital Report dated April 9, 2025, which was made Exhibit 1.
Mr. Kudelya continues to reside in 24/7 supervised high support permanent housing on Dowling Avenue. The major issue this year was that Mr. Kudelya and his mother continued to request reductions in Mr. Kudelya’s psychotropic medications. They often cited episodes of generalized pressure and fatigue. Mr. Kudelya remains capable of consenting to treatment.
The difficulty is that when Mr. Kudelya’s dosages of both clozapine and valproic acid are reduced, there are breakthrough episodes of psychosis apparent. These are transient but present nonetheless. Mr. Kudelya and his mother, however, report that he feels physically better and they continue to request reductions in dosage.
The plan, to which Mr. Kudelya and his mother have agreed, is to have Mr. Kudelya come to the hospital and remain there while further reductions in medications take place. The team will be able to monitor his stability over some weeks or longer. If he remains stable he will return to his residence on Dowling.
Dr. Jaiswal advised that he consulted with Dr. McMaster, another psychiatrist, who is aware of the case, about the feasibility of the reduction of medication. Dr. McMaster noted that at the time of initiating valproic acid, Mr. Kudelya’s clozapine levels were sub-therapeutic and, therefore, it is likely that any improvement in psychosis was related to clozapine. Dr. McMaster opined that given Mr. Kudelya’s high support setting, a slow titration of valproic acid could be done.
There has already been a small tapering of valproic acid, so far without consequences. Clozapine reduction in the hospital setting will be closely monitored as the team is concerned about breakthroughs in psychotic symptoms. These symptoms include Mr. Kudelya’s feeling that he is controlling people and thinking that he was a revolutionary fighter.
Other than some transient breakthrough symptoms, Mr. Kudelya has had a good year. His housing has been stable and the housing staff have raised no concerns.
Mr. Kudelya’s physical health continues to be monitored through the Neurosurgery Department at Toronto Western Hospital which monitors him for a neurological lesion. The most recent imaging evidence is a tiny lesion which is stable.
Dr. Jaiswal testified that a Detention Order is still necessary and appropriate because Mr. Kudelya suffers from treatment resistant schizophrenia. A Detention Order is necessary, especially while he is monitored, as his clozapine reduction takes place. Dr. Jaiswal is certain that Mr. Kudelya will attend the hospital voluntarily but states that if Mr. Kudelya decides to leave in the middle of his treatment, he is likely to experience mental instability. Under these circumstances, the provisions of the Mental Health Act will not be sufficient to manage his risk.
In answering questions from Ms. Culp, Dr. Jaiswal stated that Mr. Kudelya last experienced a psychotic breakthrough about three weeks ago. He believed he was influencing the president of the United States. This episode was transient. Dr. Jaiswal is of the opinion that the psychotic symptoms may be the result of Mr. Kudelya not being optimally treated with clozapine, but he is not altogether certain. He expressed concern about breakthrough symptoms if and when clozapine is reduced. If Mr. Kudelya decompensates, ECT might be an alternative. This can be done while Mr. Kudelya is an outpatient. A Detention Order will enable the team to manage Mr. Kudelya’s risks in a hospital setting. As far as insight is concerned, Dr. Jaiswal testified that Mr. Kudelya recognizes that he experiences psychosis and knows that clozapine is helpful. Dr. Jaiswal’s expressed concern is the degree to which Mr. Kudelya may be forthcoming about breakthrough symptoms.
In answering a question from Mr. Jaksa about passes, Dr. Jaiswal said that he is not opposed to granting the privileges of up to seven-day passes but that the hospital has to approve a travel and safety plan.
In answer to a panel member’s question, Dr. Jaiswal said that clozapine is given daily but the hospital would have to approve a plan involving medication needs if Mr. Kudelya were to travel. Dr. Jaiswal also stated that he would expect rapid decompensation if Mr. Kudelya stopped his medication.
In answer to another question from a panel member, Dr. Jaiswal stated that Mr. Kudelya has not undertaken any international travel yet but that he has no concerns. The only caveat is that Mr. Kudelya and his mother would likely have to endorse a new dosage of clozapine after titrating of the medication. Dr. Jaiswal, also in answer to a panel member’s question, stated that, in his opinion, a conditional discharge would not mitigate risk. There is simply too much uncertainty about dose restrictions. The Mental Health Act would not likely minimize risk if Mr. Kudelya were to rapidly decompensate and by then it would be too late to rely on its provisions.
No further evidence was called.
Submissions
- Each party maintained their initial position with respect to the issue of significant threat and the disposition of a Detention Order. As a result, they were in agreement that Mr. Kudelya still represents a significant threat to the safety of the public. The submissions themselves centered around Mr. Jaksa’s request for a further travel privilege of up to four weeks for international travel.
Conclusion
Even though the parties proceeded by way of a joint submission with respect to the issue of significant threat in the disposition of a Detention Order with conditions, it is up to the Board to independently assess the evidence and come to its own conclusion. Having done so, the Board accepts the joint submission with respect to both the issue of significant threat and the disposition being that of a Detention Order with the same conditions as last year’s Disposition.
Mr. Kudelya remains a significant threat to the safety of the public within the criteria set out in Winko and as defined in s. 672.5401 of the Criminal Code.
We accept the uncontradicted evidence of Dr. Jaiswal, that without the oversight of the Board and the continued involvement of Forensic Outpatient Services, Mr. Kudelya would refuse treatment, become noncompliant with his medication, put his housing at risk and engage in violent behaviour that poses a real threat to the safety of the public. Mr. Kudelya suffers from treatment resistant schizophrenia and needs to be on an antipsychotic medication and continues to suffer from breakthrough psychosis. He has requested that the hospital reduce his dosages of clozapine. Given these facts, the Board finds that he presents a significant risk to the safety of the public.
Though not argued, the Board also finds that a conditional discharge would be an inadequate disposition at this time. The Mental Health Act would be of limited usefulness given the evidence that if Mr. Kudelya were to decompensate he would do so rapidly. The hospital must also be able to maintain his upcoming admission until such time as it is deemed safe to discharge him back into the community.
Although Mr. Jaksa submitted that last year’s Disposition be modified to enable Mr. Kudelya to travel internationally (with his mother) for up to four weeks, the Board agrees with the submission of the hospital that this privilege cannot be ordered at this time, as the Board heard no evidence on the issue. No plan was presented. Mr. Kudelya has not travelled internationally even though allowed to do so. Last year’s Disposition states, in paragraph 2(g) that Mr. Kudelya has the right to request a travel pass for up to three weeks; that privilege shall remain.
As well, Mr. Jaksa requested that Mr. Kudelya be granted a seven-day travel pass to allow him to travel to the family cottage in Muskoka. The hospital submitted that this extension is unnecessary given the privileges of paragraph 2(g) of the Disposition which would allow for the inclusion of this kind of travel. The Board agrees with the hospital.
In conclusion, last year’s Disposition will continue with no changes. The Board has made the least onerous and restrictive Disposition that is necessary and appropriate to mitigate risk to public safety. Mr. Kudelya has had a positive year and the Board wishes him continued success.
DATED this 3^rd^ day of June, 2025, at the City of Toronto, in the Toronto Region.
Hon. C. Nelson
Legal Member
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Office of the Registrar
Ontario Review Board