Re: Rohinie Bisesar
ORB File No: 7449
Hearing held on: Thursday, May 1, 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. Finley Members: Dr. P.E. Cook Dr. H. Moulden Mr. B. Garrow Mr. S. Duffy
Parties Appearing: Accused: Rohinie Bisesar Counsel: Mr. M. Bornfreund The person in charge of hospital: Representative: Dr. T. Wilkie Attorney General of Ontario: Counsel: Mr. M. Feindel
REASONS FOR DISPOSITION OF THE MAJORITY
(Ms. C. Finley, Dr. H. Moulden, Mr. B. Garrow, Mr. S. Duffy)
(Dated June 10, 2025)
Introduction
1On November 6, 2018, Rohinie Bisesar was found not criminally responsible (“NCR”) on account of mental disorder on a charge of murder, contrary to the Criminal Code, (the “Code”).
2Ms. Bisesar is conditionally discharged under terms of a Disposition dated May 17, 2024.
3On May 1, 2025, the Board convened a hearing, pursuant to s. 672.81(1) of the Code to conduct the annual review of the current Disposition. Ms. Bisesar was present at the hearing and represented by counsel.
4The issues before the Board are whether Ms. Bisesar continues to pose a significant risk to the safety of the public, and if so, what is the necessary and appropriate disposition to manage that risk having regard to the criteria set out in s. 672. 54 of the Code.
5The parties jointly submitted that there be no change to Ms. Bisesar’s current Disposition. The issue of significant threat was not contested.
6For the reasons that follow the Board, Dr. Cook dissenting, finds that Ms. Bisesar continues to pose a significant threat to the safety of the public and that her care should continue on the same terms as her current Disposition.
Evidentiary Record
7Dr. Wilkie co-authored the Hospital Report dated, April 9, 2025, Exhibit 1, and testified on behalf of the hospital. A document entitled R.B. Performance Report dated March 31, 2025, and a letter from Fitness for Mental Health dated August 4, 2024, were adduced on Ms. Bisesar’s behalf and marked as Exhibits 2 and 3, respectively.1 No further evidence was adduced at the hearing.
Background
8Ms. Bisesar’s personal and psychiatric history, including the details of her mental disorder and treatment since being found NCR, are described in detail in the Hospital Report. Briefly, Ms. Bisesar is 50 years of age, single, with no dependents. She was discharged to the community in October 2021, and lives independently in her own apartment. She is unemployed and financially supported by Ontario Disability Support Program (ODSP). She volunteers 2-3 hours weekly with Fitness for Mental Health, (“FMH”), performing a variety of tasks including assisting with research, coordinating partnerships and preparing submissions for grant proposals. Ms. Bisesar is capable of consenting to psychiatric treatment and management of her financial affairs. She is followed by the Expanded FOPS team under the care of Dr. Wilkie.
9Ms. Bisesar’s current diagnosis is Schizophrenia. As noted in the Hospital Report, she remains on two antipsychotic medications comprising of a long-acting depot medication administered monthly and an oral medication, ingested daily. On this regime, her psychotic symptoms remain in full remission.
10The circumstances surrounding the index offence are excerpted from the Hospital Report, as follows:
“On Friday December 11th 2015 at approximately 2:55 PM, the victim was in the Shoppers Drug Mart located at 66 Wellington Street West, in the City of Toronto. The victim was on a break from work, and attended this location to do some shopping. The accused entered the store carrying a small kitchen knife concealed by both of her hands, and walked through the store and directly towards the location of the victim. The victim was on her cell phone speaking to a friend, and began browsing some nail polishes on the merchandise display shelf. The accused approached the victim and without provocation or any interaction, stabbed the victim in the upper chest with the concealed knife. The victim stumbled backwards and walked towards the pharmacy, where she asked for help and collapsed.
The accused turned around and began walking back towards the entrance she used to enter the store, discarding the knife in a small make-up display case in the middle of the aisle. The accused walked out of the store and used the underground PATH system to flee the area.
The victim received first aid assistance from staff at the pharmacy until Toronto Paramedic Services attended and transported the victim to St. Michaels Hospital. The victim was rushed into trauma surgery where she was treated for a single stab wound to her upper left chest, which penetrated her heart. The victim was stabilized, however, her condition remains critical and recovery from her injuries is still unknown.
The accused was subsequently identified through video surveillance from the scene. On Tuesday December 15th, 2016 the accused was located at 3692 St. Clair Avenue East in the City of Toronto. The accused was arrested, read her Rights under the Charter, and transported to 52 Division, where was charged accordingly and held for a bail hearing”.
The victim later died in hospital.
11As noted in the Hospital Report, Ms. Bisesar has a psychiatric history of treatment for delusional disorder, and chronic paranoid schizophrenia, predating the index offence. Ms. Bisesar was suffering from significant symptoms of psychosis at the time of the index offence. She had a history of poor compliance and declined treatment with antipsychotic medication. Notably, she did not disclose that she had been experiencing command auditory hallucinations until after the index offense.
12Dr. Wilkie became Ms. Bisesar’s treating psychiatrist in October 2021, coincident with her discharge to the community. Ms. Lingsher assumed the role of Forensic Outpatient Services case manager at that time. Ms. Bisesar was granted a conditional discharge in May 2023.
Course Since Last Annual Review
13Ms. Bisesar’s mental state remained stable throughout the year with no overt affective or psychotic symptoms. There were no changes to her psychiatric medication regime. She took her oral medication independently. She described herself as being in a “steady-state” regarding her mental health. Dr. Wilkie expressed that Ms. Bisesar is highly motivated to maintain her well-being.
14Ms. Bisesar attended numerous recreational outings organized by FOPS recreational therapist throughout the year. She practised yoga and attended a community gym. As noted in the Hospital Report, she also completed the Enhanced Illness Management and Recovery Course and began a Forensic Systems group.
15Ms. Bisesar also completed a course in equity trading and sales and continued work on a derivatives course. In May 2024, she began volunteering with FMH. She also planned to register for the Charted Financial Analyst exam.2
16Dr. Wilkie confirmed that during the early part of the review period Ms. Bisesar met with her case manager, Ms. Lingsher, weekly and emailed her daily to advise that she had taken her oral medication. Over the course of the year this evolved to meeting her case manager every three weeks with no email contact regarding her daily medication use. She met with Dr. Wilkie approximately every four to six weeks.
17Notably, despite the reduction in the frequency of formal meetings with FOPS staff, Ms. Bisesar’s communication and interaction with staff remained high. Ms. Bisesar attended FOPS regularly to attend therapeutic programs or to communicate more informally with the team. She regularly emailed her case manager or other outpatient team members for clarification of information during sessions, or to provide information she felt was relevant to her care.
18Dr. Wilkie said that the next step in the process of reintegrating Ms. Bisesar into society involves gradually decreasing the intensity of her current supervision and support, and then connecting her with a non-forensic mental health services team in the community. Currently, Ms. Bisesar is highly engaged with FOPS, even though the required reporting decreased in frequency. The FOPS service is very responsive to Ms. Bisesar’s needs, so there is a high level of ongoing engagement. Dr. Wilkie noted that the availability and responsivity of a community based mental health service will be significantly lower.
19The issue underlying the risks Ms. Bisesar presents is whether she will be able to maintain her stability without the current level of support and engagement she is currently accessing. There remains a degree of uncertainty that has yet to be resolved. Thus, considerable care must be taken to ensure that she is matched up with a non-forensic team that has the capacity to accommodate her needs, in order to mitigate the risk of a setback due to the inevitable reduction in the level of mental health support that will be available to her in the community.
20The transition from forensic to community based care is a stressful process. At present, when Ms. Bisesar’s stress level increases, FOPS provides a lot of support. Therefore, monitoring Ms. Bisesar’s response to working with the civil team and their capacity to be responsive to her needs is a critical piece in managing the risks during the transition phase.
21Ms. Bisesar’s long-term goal is to obtain full-time employment. As noted in the Hospital Report, she has already encountered challenges to her employability based on the notoriety of the index offense and the stigma attached to her mental health issues. Informally, she now uses a different name in her interactions with the general public. She has indicated that if she was not under the jurisdiction of the Board she would consider a legal name change.
22At the moment, Ms. Bisesar is less preoccupied with seeking employment, having obtained the volunteer position with FMH and continuing to pursue further education to enhance her skill set. Dr. Wilkie is satisfied that Ms. Bisesar makes rational decisions to modulate her stress in looking for employment. However, if she obtained full-time employment, monitoring her stress level would be critical for managing her dynamic risks, involving judgment and decision making.
23In Dr. Wilkie’s opinion, while Ms. Bisesar currently demonstrates stability in her mental state, she remains a significant threat, considering in context, the high level of supervision, engagement and support she depends on daily to maintain her stability. Absent that level of professional support, there is a risk, albeit low, of imminent or future violence.
24The Hospital Report describes the circumstances that may give rise to Ms. Bisesar re-offending in the context of her clinical risk factors, as follows:
“If Ms. Bisesar were to re-offend, it would occur in the context of untreated symptoms of psychosis. It is unlikely that Ms. Bisesar will become non-compliant with anti-psychotic medication as long as she is treated with a long-acting intramuscular antipsychotic, and under the care of a treatment team. Ms. Bisesar has shown significant motivation for rehabilitation and has acknowledged the need for ongoing medication treatment as a key pillar to her recovery. Ms. Bisesar would be at greatest risk for medication non-compliance if she was treated exclusively with oral antipsychotic medication, or if she was not under professional care. This would likely transpire in the context of significant psychosocial stressors such as a failure to obtain employment, financial difficulties, family stressors and unstable relationships. If Ms. Bisesar stopped taking antipsychotic medication her symptoms of psychosis would likely return. Early signs of decompensation would include poor hygiene, social withdrawal, inability to follow-up with therapeutic appointments, appearing distracted and distant. If Ms. Bisesar remained untreated for a prolonged period of time her symptoms would likely become as severe as they were at the time of the index offence, placing Ms. Bisesar at moderate-high risk of violence.”
25The clinical team’s recommendation for a continuation of Ms. Bisesar’s current Disposition is set out in the Hospital Report as follows:
“The clinical team is of the opinion that a Conditional Discharge remains the necessary and appropriate, least onerous and least restrictive, disposition to manage Ms. Bisesar’s risk at this time. She continues to manage well in the community, with a high level of support from the treatment team. Although the formal frequency of her contacts with FOP have decreased, she continues to reach out to the FOP team regularly and has a very high need for structure. It is the opinion of the team that the next phase of her reintegration is continuing to decrease the intensity of her current supports through FOP and then to initiate engagement with a nonforensic team. She has no plans to move from her current residence, and her housing is stable.”
Analysis and Conclusions
26Having considered all of the evidence and the joint submission presented by the parties, the Board finds that Ms. Bisesar continues to pose a significant threat to the safety of the public and that her care should continue on the same terms as her current Disposition.
27Ms. Bisesar is to be commended for the progress she has made and her efforts to reintegrate into society. We fully endorse the treatment team’s plan for the next phase of her reintegration. We trust that Ms. Bisesar will respond well to engaging with a non-forensic team, as she continues to develop the confidence necessary to demonstrate her ability to manage her mental health risk successfully on her own in the context of an absolute discharge.
28In coming to these conclusions, 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.
REASONS FOR DISPOSITION OF THE MINORITY
(Dr. P.E. Cook)
29Winko vs British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625 – If the NCR accused does not pose a significant threat to the safety of the public, then an absolute discharge must be ordered. To be a significant threat to the safety of the public, the threat must be (1) more than speculative in nature and must be supported by the evidence; (2) significant, in the sense of there being real risk of physical or psychological harm to individuals in the community and in the sense that this potential harm must be serious; and (3) the conduct creating the harm must be criminal in nature.
30The Index Offence is most serious, first degree murder. At the time of the offence, Ms. Bisesar was acutely psychotic and her conduct was driven by command hallucinations. Since treatment with antipsychotic medications has been initiated, the psychotic symptoms have completely remitted. She has very good insight into the nature of her mental illness and a life-long need for treatment with antipsychotic medication. She is compliant with her medication regime. There is no history of substance use or abuse.
31Ms. Bisesar has been living independently in the community for over three years. She has been taking her medications independently, without supervision for a year now.
32She is independent with self-care and spends much of her time seeking employment. It is unfortunate that she has experienced stigma related to her criminal history and potential employers.
33Since discharge to the community, Ms. Bisesar has been followed by the Outpatient Forensic Team of CAMH. Not only has she complied with all of the formal reporting requirements and other terms of her disposition, she maintains close “informal” contact with the treatment team by email and phone.
34Dr. Wilkie, her outpatient psychiatrist, in her evidence, indicates that the transition to a non-forensic outpatient service is the next step to recommending an Absolute Discharge. Dr. Wilkie also gave evidence that should an absolute discharge be granted, that the Forensic Outpatient Team would continue to follow and bridge her community Ms. Bisesar’s care until she is matched with the appropriate community supports within the civil mental health system.
35In my analysis of Ms. Bisesar’s risk to public safety, there are two critical issues: her commitment to sustained treatment with antipsychotic medication and the appropriate match to ongoing community support.
36Underlying her commitment to continuing life-long treatment with antipsychotic medication is her insight. Both Dr. Wilkie’s evidence and the Hospital Report describe Ms. Bisesar having very good insight. She acknowledges that she was psychotic at the time of the Index Offence driven by command hallucinations and, further, that she has a major mental illness, namely schizophrenia.
37While matching her to the appropriate mix of services in the civil mental health system has not occurred, as yet, the Forensic Outpatient Team is committed to providing ongoing care until such time as an appropriate match of similar services can be configured for Ms. Bisesar. Given Ms. Bisesar’s commitment to having ongoing community support in place, it seems likely she would be willing to agree to a voluntary Community Treatment Order as well, albeit this has not been explored with her. She would be eligible.
38It is my conclusion, based on the evidence, on the balance of probabilities, that Ms. Bisesar no longer presents a harm to the public as described in the Criminal Code of Canada and therefore, should be granted an Absolute Discharge.
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