Re Chanelle Munsaka, 2025 CanLII 72922

Re: Chanelle Munsaka

ORB File No: 8744

Hearing held on: Monday, June 9, 2025

Place of hearing: Centre for Addiction and Mental Health

Pursuant to: Section 672.47(1) of the Criminal Code

Before:

Alternate Chairperson: Mr. J. Goldenberg

Members: Dr. R.W. Hill Dr. L. O. Lightfoot Ms. L. Banks Mr. J. Cyr

Parties Appearing:

Accused: Chanelle Munsaka Counsel: Mr. J. Kopman

The person in charge of hospital: Counsel: Ms. M. Warner

Attorney General of Ontario: Counsel: Mr. M. Feindel

REASONS FOR DISPOSITION

(Dated July 22, 2025)

Introduction:

1. On March 3, 2025, Ms. Chanelle Munsaka was found not criminally responsible on account of mental disorder (“NCR”) on charges of assault with a weapon, assault bodily harm, assault x 3, failure to comply x2 and assault peace officer, all contrary to the Criminal Code of Canada (the “Criminal Code”), in relation to incidents that occurred on August 10 and 11, 2022, April 24, 2024 and May 19, 2024. On finding Ms. Munsaka NCR, the Court did not make a Disposition but referred the matter to the Ontario Review Board (“ORB” or the “Board”) for an initial hearing.

2. On June 9, 2025, a panel of the ORB convened a hearing to make a Disposition as required pursuant to s.672.47(1) of the Criminal Code. Ms. Munsaka was present at the hearing with her counsel, Mr. J. Kopman.

3. The issues to be decided at this hearing are whether Ms. Munsaka meets the test of posing a significant risk to the safety of the public and, if so, a decision as to the necessary and appropriate Disposition to be made in the circumstances, including conditions to be attached to that Disposition, bearing in mind the four factors set out in s. 672.54 of the Criminal Code.

4. For the reasons set out below, the Board unanimously finds that Ms. Munsaka represents a significant threat to the safety of the public. The Board finds that the necessary and appropriate Disposition is that she be detained in the Women’s Secure Forensic Unit (“WSFU”) at the Centre for Addiction and Mental Health (“CAMH” or the “hospital”), on terms as set forth at the conclusion of these Reasons.

Positions of the Parties:

5. At the commencement of the hearing, all parties were canvassed as to their initial recommendations to the Board. Counsel for the hospital submitted that Ms. Munsaka represents a significant threat to public safety and that she should be ordered detained within the Forensic Service at the hospital with privileges extending to indirectly supervised passes on hospital grounds and accompanied passes into the community of the Greater Toronto Area (“GTA”).

6. Counsel for the Attorney General supported the hospital's recommendation regarding significant threat and the proposed Disposition.

7. Mr. Kopman submitted that his client is requesting an Absolute Discharge. Alternatively, counsel stated that if the Board determines that significant threat is established in this case, then he recommended that Ms. Munsaka be detained on a General Forensic Unit at the hospital with privileges extending to living in the community in approved accommodation.

8. All parties maintained their respective initial recommendations to the Board in closing submissions.

Index Offences:

9. The circumstances of the index offences are set forth in detail in the Hospital Report to the ORB dated May 11, 2025 (the “Hospital Report”) and may be summarized as follows:

“File Information: Assault with a Weapon

On Wednesday, August 10th, 2022, at 10:45 hrs, Ms. Munsaka was on board a streetcar at University. and Dundas Street West. She and the victim boarded the streetcar at the same time. Ms. Munsaka was described as “acting erratic”. She was saying bizarre things like “my blood is royal, yours is not”. Ms. Munsaka began pouring alcohol on TTC customers, including the victim Mr. Yip. Mr. Yip reacted and tried to activate the yellow alarm. He then exited the streetcar. Ms. Munsaka followed him off, was verbally abusive and then struck him very hard in the left shoulder with a bottle of wine. Mr. Yip described the force as an 8/10. The victim fell to the ground after being hit and sustained minor injuries (redness to his right arm and difficulty moving his arm). He ultimately declined medical attention.

File Information: Assault Cause Bodily Harm

On Thursday, August 11th, 2022 at approximately 8:58 am, the victim was leaving Jack Layton Ferry Terminal, located at 9 Queens Quay W, in the city of Toronto, when the accused, Chanelle MUNSAKA, without provocation, punched her in the head. Ms. McMartin was dropping off her child at the ferry to go to camp, and was waving good bye when Ms. Munsaka started bothering her. Witnesses Darlene Boyd and Aisha Dhanji saw Ms. Munsaka screaming at the victim. Ms. Munsaka did not have a top on. Ms. Munsaka was approaching the victim and was aggressive. Ms. Munsaka stole the victim’s bike and went to throw it in the water. The victim tried to pull the bike back. Meanwhile, Ms. Munsaka was slapping the victim’s head. Both the victim and Ms. Munsaka fell to the ground in the struggle for the bike. Ms. Munsaka started to kick the victim while she was on the ground, and slap her face repeatedly. Ms. Munsaka then was slamming the bike into the victim. The violence lasted at least 5 minutes. The victim was screaming for help during the incident. Ms. Munsaka was screaming “whore” at her, and “you whore, you rape and murder children.” Ms. Munsaka eventually got up and walked away, and was still screaming at the victim as she walked away.

Ms. Dhanji started to videotape at the end of the incident, capturing part of the assault, Ms. Munsaka topless, and the victim pleading for the ambulance. Ms. Munsaka again approaches the victim and says “you’re obviously a whore” while the bystanders try to intervene to get Ms. Munsaka to back away. Ms. McMartin was in distress and in pain, complaining of her dislocated shoulder.

Witness Darlene Boyd (911 caller) positively identified the accused. Ms. Boyd was walking her dog and saw the assault. She was familiar with Ms. Munsaka from seeing her in the area acting irate and aggressive. (Ms. Boyd saw Ms. Munsaka screaming and threatening a woman with her two children days prior. A couple days prior to that, Ms. Boyd saw Ms. Munsaka laid out on a park bench masturbating.) MUNSAKA was located a short distance away by officers at 9:06am and subsequently placed under arrest.

She was read her rights to counsel and cautioned. She was very irate during the arrest, as captured on BWC Video #11701. She was screaming that it was the white woman who assaulted her first, and that she did nothing wrong. She repeated variations of “I did nothing fucking wrong” while screeching. The accused was transported to 52 division and held for a show cause bail hearing. She was non-sensical during the booking process (ie., talked about being kidnapped from Morocco).

File Information: Assault x 2 and FTC

On the 14th of February, 2023, Ms. Munsaka appeared before the Honourable Justice F. O Donnell located at the Central West Region Ontario Court of Justice, 45 Main St E, Hamilton, Ontario, to answer to the charges of Fraudulently Obtain Beverage and Fail to Comply with Release Order.

Ms. Munsaka subsequently entered into a Probation Order issued by the Honourable Justice F. O Donnell. This Probation Order is valid for 18 months from the date issued. This Probation Order had very specific conditions which the accused agreed to abide by while on probation. One of these conditions stated the following: Keep the Peace and Be of Good Behavior.

On Wednesday, April 24th, 2024, Ms. Munsaka entered the LCBO located at 87 Front St E, and selected two bottle of Kraken spiced rum. The accused walked throughout the store, and concealed one bottle within a bundle of clothing she was carrying. The accused then attended the cash area and attempted to pay for the single bottle she was holding. Staff requested the accused pay for the second bottle in her possession, which she refused, and left the store past all points of sale (Charge 1).

Ms. Munsaka was confronted by security officers who asked that she return the items. She dropped the bottle to the ground which then broke. Ms. Munsaka then threw coffee in one of the security officer’s face, Mr. Madaan (Charge 2). The two security officers then attempted to place the accused under arrest, but she then began kicking them (Charge 3). She then spat on one of the officers, Mr. Madaan (Charge 4). She was screaming and using volatile language throughout the interaction. Mr. Madaan described her as “very sick” and saying “racist words.” Mr. Singh indicated that she was verbally abusing them by saying “I’m not gonna come with you Indians.” Police attended, continued the arrest and read the accused her rights to counsel. A Police records check was conducted with the identification provided by the accused and two probations orders came to light and thus it was determined that she was not keeping the peace and was not being of good behaviour (Charge 5 and Charge 6). The security guards did not sustain any visible injuries, however were in some pain and were experiencing shortness of breath.

Property: Two bottles (375ml) of Kraken rum valued at $36. All stolen property was recovered. She was described by witness Heather Campbell to be “clearly alerted.”

When initially placed in the police cruiser, she was irate and nonsensical, screaming. She indicated that her dad is Lucifer, among other things (see In Car Camera videos). Throughout the altercation, Ms. Munsaka was screaming that she was pregnant with quintuplets an alleged she had been kicked in the stomach, that the officers had “killed my babies.” Out of an abundance of caution, she was transported to St. Michael’s Hospital and seen by the attending physician. At 12:53 AM, the accused was medically cleared by Dr. Mackinnon. She declined to take any tests that would determine whether or not she was pregnant.

There is a video of her in the ambulance where she continues to be nonsensical. The accused was subsequently transported to 51 division and held for a show cause hearing.

File Information: Assault, Assault Peace Officer, and FTC

On May 19th, 2024, the accused approached child victim #1, his parents and his older sibling from behind as the victim and his family were walking northbound on Spadina Avenue towards Dundas. Dad was holding the victim’s hand. The victim was talking to his older brother (11 years old) as they walked along. Mom was eating as they walked. They stopped at an intersection and waited to cross the street.

Ms. Munsaka walked up to them and started screaming about randoms things, “gibberish, none of it made any sense”. She yelled at the 8-year-old victim and his family “go back to your country”. She then turned her attention towards the dad, but instead punched the 8-year-old victim in the right cheek, close to his eye, with her closed fist (Charge #1).

She further told the 8-year-old: “go back to where you come from, Asian…” He was scared. She knocked him backwards. He was shocked. He had some swelling/redness to his face and initially iced it. He declined medical attention. She continued screaming, calling them “Niggers” and more gibberish. [Dad is white, mom is Asian and the kids are thus mixed-race.] The victim’s mother and father intervened. The victim’s mother ushered the children into a nearby business for safety. The victim’s father followed Ms. Munsaka as he called police. The victim’s father, Mr. Kavanagh, described Ms. Munsaka as “crazy, screaming at the sky.” She was pulling her clothes off and walking around naked at times. Mom and dad were freaked out, and shocked and wanted to press charges.

Mr. Kavanagh indicated that she was either under the influence, is mentally ill, or is both. He further described her as “crazy” and “not in her right mind”. Ms. Munsaka turned around and fled, while Mr. Kavanagh was pursuing her and giving live updates to the 911 operator.

One female officer, PC Toteda, attended and tried to arrest Ms. Munsaka by taking physical control of her arm. Ms.Munsaka raised her hand in a stabbing motion while holding a broken glass tube (crack pipe). She further screamed “My dad is Lucifer, fuck the police, leave me alone.” PC Toteda backed away to de-escalate the situation. Ms. Munsaka was resisting arrest and was trying to leave. She said “I didn’t do shit. That kid obviously stole my powers.” She then held up the crack pipe and threatened to stab the

officer “in the fucking eye.” She refused to drop the pipe while PC Toteda continued pursuit. PC Toteda continued pursuit at a distance and Ms. Munska continued to be aggressive, raising the crack pipe and screaming “you fucking whore.” Additional officers attended and ordered the female to the ground which she refused.

PC Bains (male) attempted to take control of the accused and she punched him in the side of his head (Charge #3). Additional officers took the accused to the ground. The accused then bit PC Toteda on the right hand. (Charge # 4). The struggle to control Ms. Munsaka continued and then she bit PC Palumbo (male) on the hand (Charge #5). Fortunately, PCs Toteda and Palumbo were wearing gloves and the accused bit did not break the victims skin but did leave bruising. Ms. Munsaka screamed that she is pregnant and that the officers were squishing her babies. She then scream/cried uncontrollably while the

police continued to hold her on the ground, screaming “Lucifer.” Even once grounded, Ms. Munsaka refused to comply with the officers. She then threatened PC Krusky: “you’re fucking dead whore, my dad is Lucifer.” She continued to scream nonsensical things like “I’m Aphrodite” and that she “will kill you all.” She was eventually handcuffed and carried into the scout car.

She was then read her rights to counsel and transported to 14 Division. However, she refused to identify herself. During the struggle two (2) additional officers sustained additional cuts to their hands from the glass “crack pipe”. Once at 14 Division the accused was eventually identified and it was found that the accused is currently on two (2) separate probation orders. Both probation orders have conditions of the accused to “Keep the Peace and be of good behaviour” (Charge#6 and Charge #7). The accused wasadvised of her further charges and held pending a show cause hearing.”

Personal Background:

10. The Hospital Report outlines Ms. Munsaka’s history and background and need not be repeated here in detail as this document was entered as an Exhibit at the hearing. We do note that Ms. Munsaka is a 32-year-old single woman with no dependents. She was born in Ottawa and grew with up her mother, stepfather and sisters. She has not had contact with her biological father since age 3.

11. Ms. Munsaka completed high school in 2010 in Kanata, Ontario. Health records indicate that she grew up in an “unstable and chaotic” household and experienced verbal and physical abuse as a child. Her mother and stepfather struggled with substance abuse issues. The Children’s Aid Society was involved but Ms. Munsaka was never apprehended.

12. Ms. Munsaka began courses at Algonquin College and Carleton University but was unable to continue with her education due to the onset of her mental health symptoms.

13. Ms. Munsaka reported that she began using cannabis at the age of 14. Her near daily use continued until her most recent incarceration. Ms. Munsaka self-reported using alcohol between Grade 9 and 10 to the point of experiencing blackouts. She was also using crystal methamphetamines three to five times a week prior to the index offences. To fund her drug use, she would engage in sex work. Ms. Munsaka also reported use of cocaine which she began using at the age of 18, and then heavily at the age of 21. She has also used crack cocaine. Ms. Munsaka denied a history of intravenous drug use. She has not engaged in any significant addiction treatments.

Criminal History:

14. According to the Hospital Report, Ms. Munsaka received a conditional discharge and 18 months’ probation with a weapons prohibition in connection with an August 2023 charge of assault peace officer. In February 2024, she was charged with fraud and failure to comply with the release order and she received 15 days pre-sentence custody and 18 months’ probation.

15. Her history also includes a reported incident in July 2022, where she was apprehended by police under the Mental Health Act (“MHA”) on a Form 1 for alleged aggression in the community. In July 2022, Ms. Munsaka called police as she was experiencing paranoia. She had not been compliant with her medication for over a month and was feeling suicidal. She was apprehended and taken to the hospital. Further, on May 8, 2023, at the Queenston Lewison Border crossing, police were notified that Ms. Munsaka had walked across the border and was turned around by United States border agents. She had in her possession a Form 42 MHA Form and police officers were called. She had been discharged from the hospital the previous day and the Form had expired. She denied suicidal or homicidal ideation and the police transported her to a nearby restaurant at her request.

Psychiatric History:

16. At age 20, in May 2013, Ms. Munsaka was seen in the emergency department at Queensway Carleton Hospital Ottawa and she reported experiencing several months of psychotic symptoms including command hallucinations. She had no prior psychiatric history and was diagnosed with query “first episode of psychosis, secondary to polysubstance use, bipolar disorder manic episode.” She was prescribed olanzapine.

17. Ms. Munsaka has had intermittent contact with psychiatric hospitals over the years. She moved to Toronto in February 2016 and was seen and followed in CAMH’s Crisis Clinic by psychiatrist Dr. Zhou in April 2016. She was started on aripiprazole. She had a brief voluntary admission in May 2016 and was treated with 15 mg of aripiprazole, resulting in improvement of symptoms. She was discharged against medical advice on May 16, 2016. She did not follow-up with her outpatient appointments with Dr. Zhou after this discharge.

18. The Hospital Report details on pages 4-15 Ms. Munsaka’s numerous contacts and admissions at psychiatric hospitals in the Province. Her history is marked by both voluntary and involuntary MHA admissions, leaving hospital against medical advice, non-compliance with medications and treatment supervision when living in the community.

19. Following the first set of index offences in August 2022, Ms. Munsaka was detained at Vanier Centre for Women from August 12 to October 5, 2022. She was referred to FEIS at the Vanier Centre for Women on August 12, 2022. On August 23, 2022, Ms. Munsaka was seen by forensic psychiatrist Dr. R. Jones. Ms. Munsaka was found unfit to stand trial in court on September 27, 2022, and a treatment order was issued. She was subsequently transferred to CAMH for the treatment order. She remained at CAMH until December 2, 2022. On December 2, 2022, Ms. Munsaka was determined to be fit to stand trial, and she was discharged after her return to court. She was diagnosed with schizoaffective disorder, bipolar type. It was noted that she continued to have paranoid and grandiose delusions at discharge. She was discharged to a shelter.

20. In May 19, 2023, Ms. Munsaka was seen by CAMH FEIS and forensic psychiatrist, Dr. I. Ray after being detained at Vanier since May 10, 2023. During the assessment, she was noted to be paranoid and grandiose. Her thought process was disorganized and included flight of ideas. Her judgment was impaired and her insight poor. The diagnostic impression was schizoaffective disorder.

21. From June 15 to August 17, 2023, Ms. Munsaka was admitted to the Forensic Inpatient Assessment Unit pursuant to a treatment order after having been found unfit to stand trial. During this hospital stay, Ms. Munsaka was noted to be grossly disorganized, disinhibited, sexually preoccupied and intrusive with other co-patients. She required chemical restraints and use of seclusion room for safe management. As her admission progressed, she showed some improvement with the use of paliperidone injections and the medication, divalproex. She was found fit on August 17, 2023 and was discharged to a shelter. Within days of her discharge, she presented to hospital after calling 911 endorsing suicidal concerns in the context of psychosis. She remained in hospital as a voluntary patient until December 5, 2023. She refused to start an injection antipsychotic medication. When her community passes were held, Ms. Munsaka left hospital against medical advice.

22. Following the commission of the second set of index offences, Ms. Munsaka was detained at Vanier Centre for Women and assessed by the FEIS and forensic psychiatrist Dr. K. Patel who noted that she presented as paranoid, grandiose and with self- referential delusional beliefs.

23. Ms. Munsaka was admitted to Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) between March 21 and April 2, 2025. The discharge diagnoses included schizoaffective disorder, bipolar type, and amphetamine-type substance use disorder. It was noted that she was transferred from Vanier Centre for Women to Ontario Shores on a Form 1 (and then Form 3) MHA. She was discharged from the hospital for transfer to CAMH in the context of a Warrant of Committal following her NCR finding.

Current Diagnoses:

24. Ms. Munsaka’s current diagnoses are:

Schizoaffective Disorder, Bipolar type; and

Substance Use Disorder, sustained remission within a controlled environment.

Evidence at the Hearing:

25. Dr. I. Ray testified at the hearing to supplement the documentary evidence available to the Board, which included, among other entries, three Victim Impact Statements. Dr. Ray stated that she has been involved in Ms. Munsaka’s care since April 30, 2025, when Ms. Munsaka was transferred to the Women’s Secure Forensic Unit (WSFU”). She adopted the contents of the Hospital Report.

26. Ms. Munsaka was initially admitted to CAMH’s Assessment and Triage Unit (“ATU”), a co-ed secure forensic unit; however, she began to incorporate male staff members and co-patients into her delusional experiences and it became necessary to transfer her to an all-female secure unit, WSFU, on April 30, 2025.

27. On admission to the hospital, Ms. Munsaka was continued on the medications she was treated with at Ontario Shores, including, a long-acting injection (“LAI”) of the antipsychotic medication, Aripiprazole, and a daily oral dose of an additional antipsychotic medication, Zuclopenthixol.

28. Dr. Ray provided an update to the Hospital Report and advised that Ms. Munsaka’s medications have been augmented by the introduction of Clozapine, which was initiated May 26, 2025. The doctor testified that the treatment team is currently in the process of titrating this medication up to a dose of 400 mg daily. Ms. Munsaka is presently at a dose of 200 mg daily. Although she continues to express delusions, the doctor reported that they appear to be less intense and Ms. Munsaka is observed to be less pre-occupied with them. Her Zuclopenthixol is in the process of being discontinued.

29. Dr. Ray responded to question posed by a panel member and indicated that it will likely take several weeks to increase Ms. Munsaka’s Clozapine to 400 mg daily. Further, she commented that it will likely be several more months before the team is able to assess the full impact of this medication on her mental state.

30. Since the initiation of Clozapine treatment, the doctor noted that Ms. Munsaka presents as more behaviourally settled and her sleep has improved. The doctor commented that Ms. Munsaka has been cooperative with the blood work protocols associated with treatment with Clozapine.

31. The Hospital Report indicates that despite treatment, Ms. Munsaka has presented with the following psychiatric symptoms:

• thought form disorganization and flight of ideas;

• paranoid delusions where she believes staff and co-patients are assaulting her while she is asleep;

• grandiose delusions that she invented a telepathic gun called the “pentagon” which she sold to the Canadian military and the CIA and that she invented a computer system; and

• bizarre delusions of misidentification wherein she beliefs Lucifer is either her father or uncle, and that Dan Seguin (a former Ottawa based CBC reporter) is her twin.

32. Dr. Ray testified that Ms. Munsaka was assessed as incapable to consent to psychiatric treatment on April 17, 2025 and that finding was upheld at a recent Consent and Capacity Board hearing on May 8, 2025.

33. Dr. Ray testified that when experiencing delusions that she was being raped, Ms. Munsaka was distressed, agitated and behavioural challenging and it was necessary to transfer her to a women’s only secure forensic unit to assist in her management of the delusions. As an additional precaution, the team has implemented a “two-person approach” protocol in managing Ms. Munsaka, requiring that staff interactions with her always require two staff members to be present.

34. Dr. Ray testified that when Ms. Munsaka arrived at CAMH from Ontario Shores, she had been treated with suboxone, which is an opioid agonist treatment for opioid use disorder. At CAMH, Ms. Munsaka underwent an addictions medicine assessment on April 4, 2025 and was diagnosed with an amphetamine-type substance use disorder and cannabis use disorder. As a result, the suboxone was gradually tapered and has now been discontinued.

35. Dr. Ray reiterated that Ms. Munsaka remains “floridly psychotic” at the present time, albeit her symptoms have improved somewhat since the initiation of Clozapine. In addressing Ms. Munsaka’s mental state, the Hospital Report states that “Her affect and mood ranged from irritability to elation. Though she denied experiencing auditory hallucinations, she appeared to be attending to internal stimuli. She also experienced paranoid and grandiose delusions. Her thought form and ideas were disorganized and flighted respectively. There were no self-harm or violent ideations.”

36. Dr. Ray acknowledged that Ms. Munsaka can present as argumentative and aggressive. She was observed on May 5, 2025 to be in an agitated state and was trying to push down a co-patient’s door. When staff and security intervened, she uttered a death threat and locked seclusion was deemed necessary in order for her risk to be optimally managed. She remained in seclusion for approximately 48 hours and was then able to be returned to WSFU.

37. Dr. Ray provided an update to the Hospital Report and advised that over the past week, Ms. Munsaka called 911 and reported being suicidal. She expressed her belief that people at the hospital were assaulting her. As a result, the doctor advised that Ms. Munsaka’s access to telephone privileges must be staff supervised.

38. Ms. Munsaka has also sent emails to Dr. Ray expressing her fear of certain staff members as she believed that she was being assaulted and raped at night. Since the initiation of Clozapine, she no longer initiates discussion about such alleged assaults unless probed by staff.

39. Dr. Ray advised that since being detained in the hospital, Ms. Munsaka has expressed having cravings for substances of abuse but she has not relapsed. Dr. Ray stated that her ongoing abstinence is primarily attributable to the fact that she has not had any passes or opportunity. Ms. Munsaka has undergone a substance use assessment and has been recommended for concurrent disorders programming and has indicated that she would be willing to participate in same.

40. When questioned by counsel for Ms. Munsaka, the doctor acknowledged that Ms. Munsaka is somewhat knowledgeable about the local shelter system and while she might be able to access temporary shelters, she does not have permanent stable housing available to her at the present time. The doctor advised that Ms. Munsaka has expressed her wish to leave the hospital and the team has some concerns about her potential for elopement. The doctor noted that Ms. Munsaka has very limited understanding about the ORB system and her detention in the hospital. This will be an area that will be targeted in therapeutic programming with the goal of improving her insight.

41. Dr. Ray testified that Ms. Munsaka’s current level of insight across all relevant domains is considered to be “extremely underdeveloped”. She does not agree that she suffers from a major mental illness and she minimizes the importance of medication to treat her illness. She is unable to appreciate that her conduct at the time of the index offences was driven by the fact that she was experiencing psychotic symptoms. She understands that her behaviour at that time was inappropriate. The doctor indicated that Ms. Munsaka has not yet been able to express remorse.

42. When asked about Ms. Munsaka’s insight into her substance abuse challenges, Dr. Ray stated that she recognises that substance use has impacted her life; however, she expresses superficial insight into the negative impact of her substance use on her mental illness.

43. In response to a question posed, Dr. Ray stated that once the Board issues a Disposition, Ms. Munsaka will likely be granted privileges on a graduated and step-wise basis. When asked about her likely progression, Dr. Ray stated that it is not known how Ms. Munsaka will respond to her augmented treatment with Clozapine once the dosage is optimized. If she achieves clinical stability, is able to use passes appropriately, and she remains medication compliant and abstinent of substances, then doctor opined that it is possible she may be a candidate for a transfer to the Women’s General Forensic Unit (WGFU”).

44. Dr. Ray endorsed the Risk Assessment contained in the Hospital Report which identifies the following risk factors to be of relevance to Ms. Munsaka:

“Historical risk factors that were present and highly relevant in Ms. Munsaka’s case included a history of:

• Violence

• Substance use

• Major mental disorder

• Traumatic Experiences

• Treatment or supervision response

Clinical risk factors that were present and highly relevant included problems with:

• Insight

• Violent ideation

• Symptoms of a major mental disorder

• Instability

• Treatment or supervision response”

45. When asked how Ms. Munsaka would present if she were to become treatment noncompliant, Dr. Ray stated that absent treatment, the symptoms of her illness would become more intensified and she would be highly likely to act out with physical violence as has been the case in the past. Again, the doctor reiterated that presently, even while medication adherent, Ms. Munsaka remains floridly psychotic.

46. Dr. Ray anticipated that if Ms. Munsaka were not under an ORB Disposition, she would be highly likely to discontinue treatment in the community (as she has repeatedly done in the past), become homeless, experience stressors, and/or relapse to substance use. In that scenario, Ms. Munsaka would be likely to incorporate those within her proximity into her psychotic experiences and engage in violent behaviours towards them, as was the case at the time of the index offences.

47. The composite assessment of risk indicates that Ms. Munsaka’s risk for violence would be “high” in the absence of an ORB Order; however, it is assessed as “moderate” in the context of a Detention Order.

48. Dr. Ray explained that the hospital is not making a recommendation for a community living privilege at this juncture as the team does not believe it is at all likely that Ms. Munsaka will be an eligible candidate for discharge over the course of the upcoming year. The doctor commented that prior to discharge, the hospital will assess Ms. Munsaka’s community living skills and needs by conducting an Occupational Assessment and other assessments. Dr Ray stated that even if a community living privilege was granted by the OBB that the treatment team would not put Ms. Munsaka on any housing waitlists as it is not yet known what level of support and supervision she requires.

49. Dr. Ray added that the addition of a community living provision would likely lead to a perception by Ms. Munsaka that she was entitled to a discharge. That expectation would be likely to negatively impact her therapeutic relationship with her treatment team. When ready for discharge, the doctor acknowledged that Ms. Munsaka will likely require supervised housing in the community and that there will likely be waitlists for such housing.

50. Dr. Ray stated that Ms. Munsaka is in the early stages of her tenure under the Board and her mental state has not yet been fully stabilized. The plan going forward is that privileges will be offered to her on a graduated basis over the upcoming reporting year. As stated, the doctor indicated that at this early juncture, the treatment team did not consider it necessary or appropriate to add a community living privilege in her Disposition (even simply to assist with housing waitlists) as its inclusion would be likely to pose a barrier to Ms. Munsaka’s engagement with her care providers. Should the team find that Ms. Munsaka has progressed to the point that a community living privilege would be appropriate, then Dr. Ray testified that the hospital would request an early hearing to recommend it be included in her Disposition.

51. Dr. Ray summarized by stating that a Detention Order is the necessary and appropriate Disposition at the current time as Ms. Munkasa requires a prolonged period of time as an in-patient in order to:

• optimize her medications;

• stabilize her mental state;

• engage her in therapeutic programming, including substance abuse programming, as well as other modalities and programs to improve her insight across all domains (including potentially, CBT for psychosis, and mood regulation);

• interrupt her access to substances of abuse;

• closely monitor and support her; and

• allow her to demonstrate her ability to exercise increasingly liberal privileges while remaining abstinent of substances of abuse, and medication compliant.

52. No further evidence was called by the parties.

Analysis and Conclusions:

53. The Board unanimously finds that Ms. Munsaka poses a significant threat to the safety of the public. In coming to this conclusion, the Board notes the salient risk factors highlighted in the expert evidence of Dr. Ray and in the Hospital Report. Ms. Munsaka suffers from

Schizoaffective Disorder – bipolar type. As well, she has a longstanding history of Substance Use Disorder.

54. When ill, she has presented with a variety of psychotic symptoms, including delusional beliefs, paranoia, agitation, disorganized thought and behaviour. She continues to present with clear evidence of active psychotic symptoms of a paranoid nature and she is not yet optimally treated. Her risk profile is further elevated due to her underdeveloped insight into her mental illness, the need for medication, the impact of alcohol and illicit substances on her mental state, and her risk profile.

55. The panel notes Ms. Munsaka’s history of non-adherence to psychotropic medication when living in the community which has led to a deterioration in her mental status, with or without substance relapse, ,resulting in symptoms of psychosis.

56. This panel finds there is a foreseeable and substantial risk that Ms. Munsaka would be likely to commit a serious criminal offence, if discharged absolutely. If not under the Board’s jurisdiction, she would be likely to stop her psychiatric medication and suffer a deterioration into an acute psychotic state. In combination with substance use, she would be at high risk to become impulsive and act out violently. The Board had no difficulty in concluding that Ms. Munsaka presently poses a significant threat to the safety of the public.

57. This panel finds that a Detention Order is both necessary and appropriate to safely manage Ms. Munsaka’s risk to public safety. These are early days in her tenure under the ORB’s jurisdiction. Presently, she requires the structured environment of a hospital admission where she can be closely supervised and monitored. Ms. Munsaka does not have a residence in the community and had been homeless prior to her admission. We accept the hospital’s evidence that the external structure and oversight provided by an inpatient admission and her treatment with medications have been an integral part of the improvements in her mental status achieved over the course of her admission. Her continued detention in hospital will allow the treatment team to work closely with Ms. Munsaka to support her success in all of the areas identified herein.

58. Further, when Ms. Munsaka is ready for discharge to the community, the hospital will require the authority to approve appropriate and forensically-supported housing for her. Additionally, a Detention Order grants the hospital the ability to address any potential mental status deteriorations and it provides the hospital with an efficient mechanism to expeditiously return her for readmission.

59. A Conditional Discharge would not provide the hospital with the risk management tools (referred to in paragraph 58 above) necessary to protect public safety. Further, the evidence indicates that Ms. Munsaka would be unlikely to agree to a hospital readmission if requested were she to be granted a Conditional Discharge. This would essentially leave the hospital in the position of having to wait until such time as Ms. Munsaka deteriorated to the extent that she could be certified under the MHA. Accordingly, the Board accepts the recommendation of the hospital and the Crown that Ms. Munsaka’s risk to the public can only be managed by a Detention Order at the present time.

60. When considering whether or not Ms. Munsaka’s Disposition should include a community living privilege, the panel has been mindful of the caselaw and, in particular, we have considered the Court of Appeal’s decisions of Sookram (Re), 2024 ONCA 823 and Simonic (Re), 2024 ONCA 573. These cases address, among other things, the issue of whether it might be necessary and appropriate for a Board to include a community living privilege in situations where the evidence indicates that there is no realistic likelihood of a patient’s discharge over the course of the upcoming reporting year.

61. The panel is aware that the case law has established that it is appropriate to include a community living privilege in a patient’s Disposition to facilitate a patient being placed on waitlists for housing or where there is a therapeutic benefit to including a community living term despite there being no air of reality to a patient being clinically ready for discharge over the upcoming year.

62. Specifically, in Simonic, the Court endorsed its previous decision in Kelly that community living shall be included in Dispositions to facilitate placement on waitlists or if there is a therapeutic benefit to such a term, including motivating a forensic patient to progress through the ORB system. Importantly, the Court in Simonic held that what motivates an accused or may be considered a therapeutic benefit is a matter of “clinical expertise”.

63. In Sookram, the Court suggested that there was no downside to including a community living term, even if for the sole purpose of placing the appellant on a housing waitlist if there is no evidence before the Board that including the term would have any “negative consequences” at all.

64. In this case, the expert evidence of Dr. Ray indicates that it is highly unlikely that Ms. Munsaka will be an eligible candidate for discharge to the community over the course of the upcoming year. Additionally, the expert evidence indicated that the necessary assessments have not yet been conducted and the treatment team does not know the level of supports and/or supervision she might need in her community placement. The doctor stated that, at this juncture, the hospital would not put Ms. Munsaka on housing waitlists even if her Disposition contained a community living provision. Finally, the doctor testified that the inclusion of a community living privilege would be likely to have the negative consequence of creating in Ms. Munsaka’s mind an expectation, or perhaps even an entitlement, that she should be discharged. There were concerns expressed by the doctor that the inclusion of a community living privilege would be counter-therapeutic and/or potentially lead to conflict between Ms. Munsaka and the treatment team. The doctor stated that any potential benefit that might be gained in terms of community housing waitlists would be overshadowed by the negative consequences of the inclusion of a community living privilege at this time. We unanimously concur.

65. Accordingly, we accept Dr. Ray’s evidence that the necessary and appropriate Disposition to safely manage Ms. Munsaka’s risk is that she be detained in the Women’s Secure Forensic Unit at the hospital subject to the following privileges, terms and conditions:

• to attend within or outside of the hospital for necessary medical, dental, legal or compassionate purposes;

• hospital and grounds passes, escorted by staff, accompanied by staff or an approved person, or indirectly supervised;

• passes into the community of the GTA escorted or accompanied by staff;

• she refrain from having in her possession any firearm, ammunition, or other offensive weapons, or being in the company of any person possessing a firearm other than a peace officer;

• she abstain from alcohol, drugs, or any other intoxicant; and

• she submit samples of her urine and/or breath to the person in charge of the hospital or his/her designate as requested by the hospital for the purpose of analyzing whether she has ingested alcohol, drugs or any other intoxicant.

66. 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, Ms. Munsaka’s mental condition, her reintegration into society and her other needs.

DATED this 22^nd^ day of July, 2025, at the City of Toronto, in the Toronto Region.

Ms. L. Banks

Legal Member

__________________

Office of the Registrar

Ontario Review Board