Re: Minata Kromah
ORB File No: 7821
Hearing held on: Friday, June 20, 2025
Place of hearing: North Bay Regional Health Centre – North Bay Site
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. Fraser
Members: Dr. R. Kunjukrishnan Dr. G. Stones Ms. C. Murray Mr. A. Bouvier
Parties Appearing:
Accused: Minata Kromah Counsel for Accused: Mr. N. Grehl
The person in charge of hospital: Counsel: Mr. P. Trenker
The person on behalf of hospital: Ms. C. Condie
Attorney General of Ontario: Counsel: Ms. D. McCaig
REASONS FOR DISPOSITION
(Dated August 15, 2025)
Introduction
On December 16, 2020, Ms. Minata Kromah was found not criminally responsible (“NCR”) on a charge of aggravated assault contrary to the Criminal Code of Canada (the “Criminal Code”).
On June 20, 2025, a panel of the Ontario Review Board (“Board” or “panel”) convened to review Ms. Kromah’s current Disposition pursuant to s. 672.81(1) of the Criminal Code. At the time of the hearing, Ms. Kromah was ordered detained within the Forensic Programs at North Bay Regional Health Centre – North Bay Site (“NBRHC” or “the hospital”), with privileges up to and including living in the community of North Bay in accommodation approved by the person in charge.
Ms. Kromah was present at the hearing and represented throughout by her counsel, Mr. Nick Gehl.
A Hospital Report dated May 22, 2025, was entered as Exhibit 1 at the hearing. In addition to the documentary evidence, Ms. Kromah’s attending psychiatrist, Dr. Gillian Munro gave evidence.
The issues to be determined are whether Ms. Kromah continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate Disposition to manage that risk having regard to the criteria set out in s. 672.54 of the Criminal Code. Mr. Gehl also requested that the Board consider the transfer of Ms. Kromah to St. Joseph’s Healthcare Hamilton (“SJHH”), pursuant to a Rule 13 request. Mr. Gehl had not received a response from SJHH to his written requested dated June 3, 2025.
For the reasons set out below and based on the evidence and opinions before us, the Board found that Ms. Kromah continues to represent a significant threat to the safety of the public. The Board finds that a continuation of the Detention Disposition within the Forensic Programs at NBRHC is the necessary and appropriate Order having regard to the safety of the public, which is the paramount concern, and also having regard to Ms. Kromah’s mental health, reintegration into society, and her other needs. The Board did not order her transfer to SJHH.
Current Psychiatric Diagnoses:
- Schizophrenia; and, Substance Use Disorder, severe, in early remission in a controlled setting
Position of the Parties:
At the commencement of the hearing, the parties were canvassed for their without prejudice positions. The hospital, represented by Mr. Trenker, supported by counsel for the Attorney General, Ms. McCaig, took the position that Ms. Kromah continues to represent a significant threat to the public and the necessary and appropriate Disposition is a continuation of the current Detention Order on the same terms as last year.
Counsel for Ms. Kromah, Mr. Gehl, conceded the issue of significant threat and agreed with the hospital’s recommendations. Ms. Kromah is seeking Conditional Discharge. Also, Ms. Kromah requests a transfer from NBRHC to SJHH.
The hospital and Attorney General do not oppose the transfer request of Ms. Kromah though they do not agree it is a good idea.
Index Offence:
- The details of the index offences are found in the Hospital Report. They are summarized as follows:
On August 17, 2019, at approximately 12:20 a.m. Minata Kromah was seated at a bus stop in the City of Kitchener. The victim, JN, was walking home when Ms. Kromah ran at him screaming and shouting “I’m going to kill you.” Ms. Kromah stabbed JN multiple times in the left shoulder, the left lower leg, and the right lower abdomen over the course of the incident. A witness heard the commotion and ran to intervene at which point Ms. Kromah fled the area on foot. A second witness called 911 and police and EMS attended. JN was transported to hospital for emergency treatment. Ms. Kromah and JN were unknown to each other. Ms. Kromah was found by police approximately 30 minutes later, on a bus not far from where the assault took place. The police searched Ms. Kromah’s purse and located a 10” kitchen knife inside with red staining on the blade.
- In her accounts of the index offence, Ms. Kromah reported that she was high on crystal methamphetamine and had nowhere to go. She was scared and felt vulnerable. She carried a knife for protection. Voices told her to hurt someone, and she said the voices were really bugging her, so she stabbed the male victim. Ms. Kromah felt the voices were real and if she did not do what they asked they would kill her or twist her fingers off. Ms. Kromah felt she had to stab the victim to protect herself.Mr. Backlund is a 60-year-old male born in Ontario and raised in Thunder Bay. He left school at age 16 in grade 11.
Background and History:
The Hospital Report contains extensive information regarding Ms. Kromah’s background and history, which need not be repeated here in detail. However, the following particulars are noteworthy.
Ms. Kromah is a 34-year-old woman born in Liberia, and now a permanent Canadian resident. She experienced developmental delay as a child. She recently successfully completed her General Education Development (“GED”), which is a high school equivalency test. Ms. Kromah became pregnant twice as a result of sexual assaults by the time she was 13 years old and had a daughter resulting from the final rape soon after coming to Canada. Ms. Kromah’s mother took over the care of Ms. Kromah’s daughter when the child was nine years old because Ms. Kromah had begun to leave the child with a boyfriend when she went out to use substances and later moved to Alberta.
Ms. Kromah has an extensive substance use history. She used cannabis from age 18 to 23 and started using crystal methamphetamine when she stopped using cannabis. Ms. Kromah lived on the streets or in shelters since 2014.
Ms. Kromah has a significant criminal history, commencing in 1981. Prior to the index offence in 2019, Ms. Kromah accumulated ten assault charges as well as charges of robbery, possession of a Schedule 1 substance, mischief under $5000, and unlawfully in dwelling house. She has a lengthy history of failing to comply with a recognizance, breach of probation orders, and failing to attend court.
Ms. Kromah’s has a history of psychiatric admissions starting in 2016. She had four visits to the emergency department at Grand River Hospital in 2016 and 2017 with complaints of visual hallucinations, disorganization, and aggressivity. In each case her symptoms were attributed to substance use. The Hospital Report also referenced health care records from Vanier Centre for Women from January to April 2018 where Ms. Kromah presented with paranoia, suspiciousness, incongruent laughter, flight of ideas, disorganized thoughts, delusions of being controlled, and auditory hallucinations.
Ms. Kromah is capable to consent to treatment. She was on a trial of “self-medication” starting in late fall, 2024, which initially went well. This involved the medications being packaged in a blister pack and Ms. Kromah being responsible to request the medication from staff. However, self-medication was discontinued in early 2025 after she missed doses of medication on four occasions.
Random urine samples throughout the reporting year all have been negative for substances and alcohol. Ms. Kromah is attending programming to address substance abuse.
Ms. Kromah is supported by the Ontario Disability Support Program (“ODSP”).
Ms. Kromah has continued to reside at Hummingbird Lodge, which is an all-female forensic unit. This unit offers intensive treatment, rehabilitation, and behavioural management services with a focus on trauma-informed care. Ms. Kromah has had some difficulty with rule adherence and has required education on program guidelines that clearly prohibit the exchange of goods or money between patients unless overseen by staff. She required ongoing education on appropriate public displays of affection in hospital. Ms. Kromah is beginning to transition to programming and activities in the community with a view to reintegration. It is likely she will begin her reintegration into the community in the coming year.
Ms. Kromah has indicated that she would like to reside at the Transitional Rehabilitative Housing Program (“THRP”) operated by the forensic program and known as Maplewood House. The home is staffed by members of the Forensic Outreach team 12 hours per day, six days per week, and provides a supportive housing environment for residents to develop life skills as they transition toward independent living.
Ms. Kromah has maintained her placement at Snack Shack (a patient-operated on-site canteen). She began a volunteer role at a church soup kitchen in January 2025 and became indirectly supervised in that volunteer role in April 2025.
Evidence at the Hearing:
Dr. Munro testified that she has been Ms. Kromah’s forensic psychiatrist since March 2024. Ms. Kromah currently resides at Hummingbird Lodge, which is a specialized female-only trauma-focused treatment program. There are three phases to the treatment program including stabilization, primary treatment, and reconnection and reintegration (which prepares patients for transition out of the program). Ms. Kromah has just completed the second phase of the trauma-focused treatment program, which is the only program to offer treatment of complex trauma specifically for women in a mental health facility in the Province of Ontario. Hummingbird Lodge has eight beds, so the treatment team on this unit has more time and availability for Ms. Kromah than on other units.
In terms of the transfer request, Ms. Kromah believes another hospital would place her in the community sooner than the program at NBRHC. This is not likely the case and would likely be a step back for her. Moving to another hospital would require the staff to get to know her and assess her for privileges before being placed in the community. Dr. Munro stated that Ms. Kromah may achieve community placement as early as this coming reporting year if she remains at NBRHC.
Dr. Munro testified that there have been a number of issues holding Ms. Kromah back from community living. Ms. Kromah struggles with insight into the challenges she may face in maintaining stability and abstinence from non-prescribed substances in the community. She was placed on “self-meds”, which is a program where Ms. Kromah is to go to staff and ask for her medications at the specified times. Initially, self-meds went well but over the course of a couple of months she stopped taking the initiative to go to staff to ask for her medications. The treatment team has been discussing starting Ms. Kromah on self-meds again in the next few months. When she transitions to the community, Ms. Kromah’s insight into her illness and need for medications will be necessary for her success. Ms. Kromah has a history of only intermittent adherence to psychiatric medications in the community. Ms. Kromah minimizes her need for medications.
Ms. Kromah also requires reminders to adhere to unit and program guidelines, but Dr. Munro considers this a minor issue, manageable issue.
Ms. Kromah will require a moderate level of support in a community placement. She has some cognitive impairments that will likely need additional supports moving forward. Ms. Kromah is interested in a placement at Maplewood House, which is a transitional home. Currently, Maplewood has no beds available, but the treatment team is exploring other options for placement that may be a better fit for Ms. Kromah.
Dr. Munro testified that if Ms. Kromah is Conditionally Discharged, she would not be able to be safely managed in the community. She has not resided in the community since 2014. Transition needs to be done slowly and with caution during which time the treatment team will support her as needed. Although she is currently doing well, she struggles with insight into the need for medication and abstinence from substances. The treatment team needs to trial her in the community to ensure her stability. She has a significant history of violence including the index offence. Her risk of violence is closely related to her mental health. Due to her trauma history, she still relies on adverse coping strategies and is vulnerable to negative peer influence. Under a Conditional Discharge she would likely return to substance use, not adhere to medication, and experience psychiatric decompensation. Ms. Kromah has not arranged anywhere to live in the community if she is Conditionally Discharged. If she tried to find housing on her own, she would have significant difficulties finding suitable accommodation within her ODSP income level.
Dr. Munro testified that Ms. Kromah has not yet been assigned a community transition manager. If her progress goes well, a community transition manager may start to be involved in Ms. Kromah’s case within the next six months.
In response to questions of Mr. Gehl, Dr. Munro testified that cognitive testing has been delayed at NBRHC for Ms. Kromah because there is not a psychologist on-site to do the cognitive assessment. Dr. Munro believes that if Ms. Kromah were transferred to Hamilton there would be a psychologist on-site to do the cognitive assessment. Ms. Kromah has made incremental improvements in the reporting year including learning skills to function in the community. She has completed bus transit training and is able to return to the hospital by bus on time. She has exercised indirectly supervised privileges to visit her family. Unfortunately, Ms. Kromah engages in problematic behaviours such as minimizing her mental illness, having co-patients do things for her that she should do, and attempting to leave her employment at the Snack Shack to use her indirectly supervised privileges for the purpose of smoking. Dr. Munro confirmed that the last time Ms. Kromah had a urine drug screen that returned positive for substances was 2022 or 2023. She has not attempted to access or obtain substances in the past reporting year, which could indicate an improvement in Ms. Kromah’s insight surrounding substance use.
In response to questions of the Board, Dr. Munro testified Ms. Kromah understands that if she is transferred to a new hospital considerable time will be needed for the new treatment team to get to know her well enough to consider discharge. However, Ms. Kromah does not believe this fact. Rather, she continues to believe she will be discharged faster if she is transferred to another hospital. Dr. Munro stated that it is counterproductive to transfer Ms. Kromah at this time. She would likely spend a significant amount of time detained in another hospital as staff get to know her and assess her for privileges. She would start with no privileges, and it could be a long time for her to achieve the privilege level she enjoys currently at NBRHC. The doctor was also aware that SJHH has lengthy waiting lists for transfer admissions.
Dr. Munro stated that if Ms. Kromah were Conditionally Discharged, there is a legitimate concern that she would come back to hospital if requested.
Dr. Munro testified that Ms. Kromah has reasonable insight into the severity of the index offence and the harm she inflicted on the victim, and she has expressed remorse. However, Ms. Kromah is dismissive that it could happen again.
Analysis and Conclusions:
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board independently finds that Ms. Kromah remains a significant threat to the safety of the public.
Ms. Kromah suffers from schizophrenia. She continued to suffer symptoms even after being abstinent from substances. When unwell, her psychotic symptoms include auditory hallucinations (including command hallucinations), visual hallucinations, thought broadcasting, ideas of reference, grandiosity, and paranoia.
Ms. Kromah has a history of intermittent compliance with her medication. She was not adhering to her medication regimen at the time of her index offence. This year she was unable to be reliably compliant when given the opportunity. It is highly likely that Ms. Kromah would disengage from treatment and mental health supports necessary to ensure her ongoing stability if she were not highly supported. In light of her vulnerability to peer influences, absent significant support and supervision, she would likely return to the use of substances. The index offence occurred in the context of untreated psychosis and substance use. In that state, Ms. Kromah is likely to engage in behaviours similar to those at the time of the index offence, which resulted in serious harm to the victim.
The Board accepts and relies on the risk assessments and the unanimous opinion of the treatment team in concluding that Ms. Kromah continues to pose a significant threat to the safety of the public.
In light of the Board’s finding of significant threat, it is charged with shaping the Disposition for the coming year.
The Board relies on the following excerpt from the Hospital Report in coming to its conclusion that the current high level of supports are necessary:
“In considering the PCL-R: 2 and HCR-20V3, historical, and protective factors, it is our current opinion that her:
Risk for Future Violence is High (without all the supports in place)
Risk for Serious Physical Harm (i.e., severity of the violence) is High
Risk for Imminent Violence is Low (given all the supports in place).”
It is clear to the Board that a continuation of the Detention Order is necessary to ensure that the hospital can continue to provide the intensive level of support and supervision necessary for Ms. Kromah to continue her rehabilitation and move forward to future reintegration into the community. Further, a Detention Order is necessary for the hospital to be able to approve Ms. Kromah’s housing should she become appropriate to live in the community in this year. Anything less than a Detention Order would put the safety of the community at significant risk.
The Board notes that Ms. Kromah remains an inpatient at the hospital and is now in the final phase (three) of the Hummingbird program. Once Ms. Kromah is ready for discharge to community living at the end of this phase, it will be critical for risk management that the hospital have the authority to direct where Ms. Kromah will reside. It is reasonable to conclude that she will require some level of supervision at her initial housing placement. It will be up to the hospital as to what will be the appropriate level of supervision and support commensurate with public safety.
Ms. Kromah’s request for a transfer is not necessary and appropriate. She is entering the third phase of the female-only trauma-focused treatment program at Hummingbird Lodge. This third phase of treatment prepares her for reintegration into society. The Board accepts Dr. Munro’s evidence that a transfer to St. Joseph’s Healthcare Hamilton would be counterproductive. A transfer would likely result in detention in hospital for a longer period of time while a new treatment team gets to know her and assess her for privileges. It is reasonable for the Board to conclude, on the totality of evidence, that Ms. Kromah would take longer to achieve the privilege level she now enjoys and would take longer for discharge to community living if she were transferred. The Board did not have the benefit of a written response from SJHH. The Board accepts Dr. Munro’s evidence that Ms. Kromah is likely to be granted community living in the coming year.
The Board congratulates Ms. Kromah on the gains she has made this year and wish her the best in the coming year.
The Board finds that the necessary and appropriate, least onerous, and least restrictive Disposition is a Detention Order within the Forensic Programs at NBRHC on the same terms as last year.
DATED this 15th day of August 2025, at the City of Toronto, in the Toronto Region
Ms. Christine Murray, Legal Member
__________________ Office of the Registrar Ontario Review Board