Re: Jude Kanikkai
ORB File No: 6927
Hearing held on: Wednesday, April 30, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Finley Members: Dr. P.E. Cook Dr. H. Moulden Mr. B. Garrow Mr. S. Duffy
Parties Appearing:
Accused: Jude Kanikkai Counsel: Mr. J. Halberstadt
The person in charge of hospital: Counsel: Mr. K. Dow
Attorney General of Ontario: Counsel: Ms. K. Kirec
REASONS FOR DISPOSITION
(Dated June 10, 2025)
Introduction
[1]. On March 16, 2016, Jude Kanikkai was found unfit to stand trial on charges of repeatedly communicating directly or indirectly with person, and assaulting a peace officer, all contrary to the Criminal Code, (the “Code”).
[2]. Mr. Kanikkai is currently subject to a Disposition of the Ontario Review Board, (the “Board”) dated, May 22, 2024, detaining him at the Forensic Service of the Centre for Addiction and Mental Health (“CAMH” and/or the “hospital”) with discretionary privileges up to and including living in the community in 24 hour a day supervised accommodation approved by the person in charge.
[3]. On April 30, 2025, the Board convened a hearing pursuant to s. 672.48(1) and s. 671.81(1) of the Code to review Mr. Kanikkai’s Disposition. Mr. Kanikkai was present and represented by counsel.
[4]. The issues before the Board are whether Mr. Kanikkai remains unfit to stand trial, and if so, what is the necessary and appropriate disposition to manage that his risk to the public having regard to the criteria set out in s. 672. 54 of the Code.
[5]. At the commencement of the hearing, the parties present jointly submitted that Mr. Kanikkai remains unfit to stand trial and that there should be no change to his current Disposition.
[6]. For the reasons that follow the Board finds that Mr. Kanikkai remains unfit to stand trial and that there be no change to his current Disposition.
Evidentiary Record
[7]. Dr. Igoumenou co-authored the Hospital Report dated April 7, 2025, Exhibit 1, and testified on behalf of the hospital. No other evidence was adduced at the hearing.
Background
[8]. Mr. Kanikkai’s personal and psychiatric history, including the details of his mental disorder and treatment since being found unfit to stand trial are described in detail in the Hospital Report. Briefly, Mr. Kanikkai is 51 years of age, married with one adult son. He has been living in the community since April 2021. He currently resides at Shepherd Lodge, in 24 hour supervised long term care housing. He is financially supported by the Ontario Disability Support Program.
[9]. Mr. Kanikkai is seen monthly by his forensic outpatient case manager, and Dr. Igoumenou, who became his treating psychiatrist in January 2025. He is incapable of making either treatment or financial decisions. Mr. Kanikkai’s wife, the primary victim of the index offence provides substitute consent for treatment. The Public Guardian and Trustee is his substitute decision maker with respect to financial affairs.
[10]. Mr. Kanikkai’s current diagnoses include psychotic disorder due to a medical condition (temporal lobe epilepsy), alcohol use disorder, in remission in a controlled environment, and major neurocognitive disorder, secondary to multiple etiologies (alcohol use, seizure disorder and query traumatic brain injury).
[11]. The index offences occurred over a four-month period in 2015, from June through October. The primary victim was Mr. Kanikkai’s spouse, from whom he was separated and whom he repeatedly harassed by attending at her home, often in an intoxicated state.
Course Since Last Annual Review
[12]. As noted, Mr. Kanikkai continues to reside in a locked, high support nursing home. He has only limited ability to care for himself. All of his physical and mental health care, including administering his medication, is managed by staff. There is no psychiatrist on staff, but he is seen by Dr. Barsky, a geriatric psychiatrist who visits the home periodically.
[13]. Mr. Kanikkai had a relatively uneventful year, with no readmissions to hospital. His mental health remained stable and there were no incidents of aggression or violence. However, he continues to suffer from symptoms of psychosis, notably auditory hallucinations. He has no knowledge of the illnesses he is diagnosed with, nor does he recognize his symptoms or understand why he takes medication. Dr. Igoumenou confirmed that the etiology of Mr. Kanikkai’s psychosis is most likely temporal lobe epilepsy, a form of epilepsy that is known to cause psychosis and mimic schizophrenia.
[14]. Mr. Kanikkai takes his medication as directed, and did not use alcohol or drugs over the reporting period. Although Mr. Kanikkai is encouraged to participate in activities offered through Shepherd Lodge he declines to involve himself.
[15]. Mr. Kanikkai spends most weekends with his wife and their son at their home. Mr. Kanikkai’s wife is a health care professional and administers his medication when he is there. All his visits have gone well. Mr. Kanikkai’s Disposition provides the privilege of travelling internationally, when accompanied by an approved person. The purpose of the passes is to permit Mr. Kanikkai accompanied by his wife, who is an approved person, to travel to Sri Lanka, but due to financial constraints they have been unable to do so.
Fitness
[16]. Dr. Igoumenou has met with Mr. Kanikkai on four occasions to assess his fitness for trial and ensure that his medications are adequate, since becoming his treating psychiatrist. On each occasion, and most recently when she assessed his fitness in March, Dr. Igoumenou concluded that Mr. Kanikkai remains unfit to stand trial. Dr. Igoumenou confirmed that despite having a rudimentary understanding of the nature and object of court proceedings, and the potential outcomes, Mr. Kanikkai remains unfit from a psychiatric perspective to stand trial given his very significant cognitive impairment which renders him unable to retain and use the information he would require to instruct counsel to present a defence on his behalf. Moreover, Dr. Igoumenou is of the opinion that given the irreversible nature of his cognitive impairment, Mr. Kanikkai is likely permanently unfit.
[17]. Counsel for the Attorney General informed the panel that the charges against Mr. Kanikkai remain outstanding and that sufficient evidence can be adduced to put Mr. Kanikkai on trial.
[18]. Dr. Igoumenou confirmed that Mr. Kanikkai is at low risk for violent reoffending under his current Disposition, while he remains in his current high support supervised housing. However, the risks he presents become higher if he is discharged to independent housing without that level of support and supervision.
[19]. Dr. Igoumenou does not know whether Mr. Kanikkai’s ability to remain at Shepherd Lodge is dependent on maintaining his status under the Board. She agreed that Mr. Kanikkai is incapable of making housing decisions. However, it is unclear who has that authority.
[20]. There is a risk that without a detention order Mr. Kanikkai would leave Shepherd Lodge, or try to do so in order to move into his wife’s home. Mrs. Kanikkai works full time and is unable to provide the supervision and treatment her husband requires in order to maintain his mental stability.
[21]. Dr. Igoumenou also confirmed that Mr. Kanikkai can continue to be managed safely in the community in his current high support supervised housing under his current Disposition.
[22]. The plan for the upcoming year is to attempt to engage Mr. Kanikkai in activities and test him in social situations. The team will also attempt to identify a civil outpatient psychiatrist who may be willing to take on Mr. Kanikkai’s care.
Analysis and Conclusions
[23]. Having considered all of the evidence and the joint submission presented by the parties the Board finds that Mr. Kanikkai remains unfit to stand trial. In the circumstances, we also find that there should be no change to the current Disposition. We agree with Dr. Igoumenou’s conclusion that given the irreversible nature of nature of Mr. Kanikkai’s cognitive he is likely permanently unfit.
[24]. In coming to this conclusion, the Board has considered its responsibility pursuant to s. 672.54 of the Code to make a disposition that is necessary and appropriate in the circumstances, taking in to account the safety of the public, which is the paramount consideration, the mental condition of the accused, his reintegration into society, and his other needs.
DATED this 10th day of June, 2025, at the City of Toronto, in the Region of Toronto.
Mr. B. Garrow Legal Member
__________________ Office of the Registrar Ontario Review Board