Re: Randy J. Kurahara, 2025 CanLII 81160

Re: Randy J. Kurahara

ORB File No: 8501

Hearing held on: Wednesday, June 11, 2025

Place of hearing: Waypoint Centre for Mental Health Care

Pursuant to: Section 672.81(1) of the Criminal Code

Before:

Alternate Chairperson: Mr. P. Capelle Members: Dr. K. Hand Dr. G. Nexhipi Ms. M. Chamberlain Ms. B. Little

Parties Appearing:

Accused: Randy J. Kurahara Counsel: Mr. U. Agostino (via Zoom)

The person in charge of hospital: Counsel: Ms. J. Lefebvre

Attorney General of Ontario: Counsel: Ms. J. Armenise

REASONS FOR DISPOSITION

(Dated August 14, 2025)

Introduction

1On February 26, 2024, Mr. Randy Kurahara was found not criminally responsible on account of mental disorder on charges of assaulting a peace officer, contrary to the Criminal Code of Canada (the "Criminal Code"). Mr. Kurahara is currently subject to a Disposition of the Ontario Review Board (the "Board") dated June 12, 2024, detaining him at the High Secure Provincial Forensic Programs, Waypoint Centre for Mental Health Care (“Waypoint”), with hospital and grounds privileges, beyond the secure perimeter, escorted by staff.

2On June 11, 2025, a panel of the Ontario Review Board (the "ORB" or the "Board") convened a hearing pursuant to s. 672.81(1) of the Criminal Code of Canada. Mr. Kurahara was in attendance and was represented by his counsel, Mr. Agostino.

Preliminary Matter

3It was noted by all Panel members that when entering the hearing room Mr. Kurahara repeatedly stated that he cannot see well and needs his glasses.

Without Prejudice Position of the Parties

4Ms. Lefebvre, on behalf of the hospital, indicated that Mr. Kurahara continues to represent a significant threat and that no changes are recommended to his current disposition as set out on page 36 of the Hospital Report.

5Ms. Armenise, on behalf of the Crown, joined in the hospital position.

6Mr. Agostino, on behalf of Mr. Kurahara, advised that he had no instructions from his client with regard to the issue of significant threat or recommended disposition.

Index Offences

7The circumstances of the index offences are taken from last year’s Reasons for Disposition as follows:

“On Saturday February 11th, 2023 Kenora OPP were advised of an assault at the Kenora Jail involving an inmate and a guard. District Jail staff advise that Corrections Officer David CARRABS was assaulted by inmate Randy KURAHARA. While attempting to move KURAHARA from the day room to another room in the jail, KURAHARA began to act beligerant (sic) and when corrections officers opened the door to get to KURAHARA he spat at guards and hit Corrections Officer CARRABS in the left eye. CARRABS sought medical attention and did not sustain any injuries.

RANDY KURAHARA was identified by corrections staff.”

Current Diagnoses

• Schizophrenia,
• Attention Deficit Hyperactivity Disorder,
• Alcohol Use Disorder,
• Amphetamine-type Substance Use Disorder,
• Antisocial Personality Disorder,
• Traumatic Brain Injury.

Background

8The Hospital Report contains considerable detail about Mr. Kurahara’s personal and psychiatric background and need not be repeated in these Reasons. Some relevant information is nevertheless highlighted.

9Mr. Kurahara attended his 2025 annual ORB hearing seated in a chair equipped with Pinel restraints and accompanied by several staff. He is now thirty-one years of age and has experienced significant life challenges. He is single with no dependents and has lacked stable housing since leaving foster care in his teens. His time has been divided between hospitals and correctional facilities.

10Born to a Japanese father and Indigenous mother in Winnipeg, Mr. Kurahara experienced health complications at birth, likely related to his mother's alcohol consumption during pregnancy. His parents separated when he was one month old, and he lived with his mother until age five. At that point, child welfare authorities placed him and his siblings in foster care due to his mother's alcohol abuse issues. At age 10, he was made a permanent ward of the state with only supervised maternal visits.

11Starting at age 10 with cannabis, Mr. Kurahara's substance use expanded to include cocaine, ecstasy, mushrooms, and crystal methamphetamine. Alcohol use began at age 14 and became his preferred substance, often resulting in blackouts and disorientation.

12Throughout his schooling, Mr. Kurahara demonstrated below-average academic performance and relationship difficulties. Multiple school expulsions marked his education history. At age 15, he briefly lived with his mother on a reserve before returning to high school. He left school permanently during Grade 11, at age 16, to seek work. His employment record is minimal, and he relies on disability benefits (ODSP) for financial support. Mr. Kurahara's housing history speaks to consistent instability. Even with support services, he has been evicted multiple times for violent behavior and property damage.

13Mr. Kurahara's criminal record includes 26 convictions between 2007-2021, ranging from various assault charges to non-compliance with court orders. Police records document 442 incidents involving him during this period.

14Mr. Kurahara received a psychiatric assessment for anger management and trust issues when he was 10 years of age. Doctors diagnosed him with Oppositional Defiant Disorder and Conduct Disorder. While he showed aggressive tendencies, he didn't display signs of major depression, anxiety disorder, or psychosis. His psychiatric treatment began at age 15 following a friend's suicide, when he exhibited depression and suicidal thoughts. Four additional youth admissions followed. As an adult, his hospital stays have featured paranoid thinking, aggressive behavior toward staff, and occasional self-harm. His diagnoses include Schizophrenia, Antisocial Personality Disorder, PTSD, and various substance use disorders. A significant head injury in 2021 resulted in traumatic brain damage, further complicating his condition. Since this injury, he has shown increased frustration together with decreased:

• independence,
• self-care abilities, and
• communication skills.

Evidence at Hearing

15Dr. Mishra confirmed that he had reviewed and adopted the contents of the Hospital Report. Overall, Mr. Kurahara’s presentation remains relatively unchanged. Seclusion relief occurs about once per week for room cleaning and a shower. Mr. Kurahara is allowed to walk back and forth to the shower room while co-patients are locked in their individual rooms. Mr. Kurahara recently had a trip to an off-unit canteen during a period of seclusion relief that went well.

16Mr. Kurahara will snort anything. Recent examples are drywall and apple sauce. The treatment team is fairly certain that any oral medication he is provided with will be diverted and snorted. At present he is required to accept valproic acid as a pre-curser to receiving stimulant medication. Stimulant medication may allow him to focus and think more clearly, or get a high from it, the distinction is difficult to make. Dr. Mishra added that Mr. Kurahara will be transitioned to Invega Trinsa (typically every three months) but administered at shorter intervals in his case, with the intention is to further decrease the duration of the intervals between injections. This will hopefully minimize his agitation in relation to receiving medications.

17Regrettably, as a result of human error, Mr. Kurahara recently received another patient’s clozapine. Fortunately, there were no side effects and Dr. Mishra reported that staff observed that Mr. Kurahara experienced his best day ever as a result.

18Mr. Kurahara does not believe he suffers from any mental illness or requires any medication. More specifically, he denies suffering from psychosis. He becomes agitated and will swear at staff or throw fluids if the issue of illness or medication is raised and is prone to escalate very quickly. At present, Mr. Kurahara is kept in a step-down room which features hardened drywall and is located physically closer to the nursing station. When he becomes angry, he may drink his own urine and bang his head vigorously on the metal door to his step-down room to the extent that the door shakes on its hinges. Head banging is not done with a knowing intention of self-harm. Dr. Mishra added that Mr. Kurahara’s water intake is monitored due to polydipsia.

19Dr. Mishra has requested an occupational therapy assessment and Mr. Kurahara has had two meetings in this regard to determine how best to have him participate in a care plan. A neuropsychology consultation is also envisioned to determine the impact on his current presentation and hopefully obtain some strategies to better manage his behaviour and illness.

20Mr. Kurahara has a good relationship with the spiritual care provider who he sees approximately once a week. Dr. Mishra opined that this is because that individual is not part of the treatment team. Dr. Mishra described his patient’s relationship with his occupational therapist as fair given that she provides him with activities to complete in exchange for snacks.

21The finding of significant threat relies on Dr. Mishra’s Risk Assessment and the HCR-20. Dr. Mishra is unaware of any Gladue reports initiated with regard to Mr. Kurahara. Reference was made to page 29 of the Hospital Report and Dr. Mishra confirmed that the “Rhonda” reference therein is to Mr. Kurahara’s substitute decision maker. When Dr. Mishra spoke with Rhonda she expressed concern with regard to his care, however, Dr. Mishra is unaware how frequently Rhonda and Mr. Kurahara communicate.

22Responding to questions from Ms. Armenise, Dr. Mishra stated that his patient’s presentation on today’s date is associated with stress in appearing before the Board and because his condition and treatment are being discussed which is a trigger for his agitation. Mr. Kurahara’s verbal ability is impacted by an injury he suffered to his larynx. Dr. Mishra added that when Mr. Kurahara speaks slowly, he is much easier to understand.

23The primary objective in the year ahead is to get Mr. Kurahara out of seclusion. Mr. Kurahara’s last seclusion relief occurred on June 6th. Dr. Mishra added that seclusion relief is offered almost daily although Mr. Kurahara is often unsuitable for or will decline that opportunity. When he exercises seclusion relief this typically occurs from one to two hours because the seclusion relief team has a finite amount of time they can dedicate to each patient. Dr. Mishra noted that on June 2nd Mr. Kurahara spent 45 of the 60 minutes of his seclusion relief period shouting at and insulting staff.

24It is anticipated that Mr. Kurahara will remain on the Beckwith Program for the next 12 months as he is higher functioning. For example, Mr. Kurahara will make notes on the Hospital Report and ask specific questions concerning its content. The objective is to treat him with clozapine as this would increase the likelihood of ending seclusion and enable his participation in programming. The treatment plan envisions a regimen of Invega Trinsa together with clozapine. However, clozapine can only be prescribed at present in liquid form. Injectable clozapine is not yet available in North America as the associated blood monitoring equipment is not yet commercially viable.

25Dr. Mishra stated that he has not seen Mr. Kurahara wearing glasses for at least the past two weeks. The doctor will ask the unit manager to look into this issue. Dr. Mishra added that Mr. Kurahara has never complained to him that he could not see.

26Mr. Kurahara is frustrated that he is not going anywhere soon. He has been diagnosed with antisocial personality disorder as well as with PTSD traits given the multiple traumas he has experienced in his life. Unfortunately, the impact of these diagnoses has not yet been explored given his current very unsettled presentation.

27Mr. Kurahara was called to give evidence. His speech was difficult to comprehend, and he was therefore asked to try and speak more slowly. He stated that he would like to be remanded in two weeks. Mr. Kurahara showed the panel page 1 of the Hospital Report on which he has written “no” beside all diagnoses except for Antisocial Personality Disorder. Mr. Kurahara explained that he does not have this disorder, rather, he has a Disruptive Behavioural Disorder.

28Asked if he has a hyperactivity disorder, Mr. Kurahara reiterated that he has a Disruptive Behavioural Disorder which he describes as ADHD x 2.87, at a minimum.

Closing Observations

29Ms. Lefebvre submitted that the hospital relies on the oral evidence of Dr. Mishra in conjunction with the evidence in the Hospital Report that the threshold for significant threat is met. Ms. Lefebvre added that the findings of the risk assessment are clear. Mr. Kurahara remains in seclusion with spiritual support. The plan is for a neurocognitive consult in the coming months. Some work is required for him to get out of seclusion. Ms. Lefebvre noted that last year’s Reasons for Disposition indicate that no Gladue Report was previously identified, however, because Mr. Kurahara has Indigenous ancestry on his mother’s side, the propriety of a Gladue Report is left to the Board.

30Ms. Armenise indicated she had nothing to add whereas Mr. Agostino submitted that he is hopeful that the hospital will succeed in getting Mr. Kurahara out of seclusion.

Analysis and Decision

(a) Significant Threat

31Ongoing significant threat to the safety of the public cannot be speculative. It must entail a real risk of serious physical or psychological harm arising from conduct that is both serious and criminal in nature.

32In determining whether Mr. Kurahara continues to represent a significant threat to the safety of the public the Board has carefully analyzed the evidence as it relates to the Supreme Court of Canada decision in Winko, 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625.

33The Board unanimously finds that Mr. Kurahara continues to pose a significant threat to the safety of the public. In arriving at this determination, the Board considered the joint position of the parties and accepted the uncontroverted evidence of Dr. Mishra that Mr. Kurahara continues to pose a significant threat. The Board also relies on the Hospital Report and the most recent Risk Assessment contained therein in determining that Mr. Kurahara suffers from Schizophrenia; a major mental illness, complicated by the four disorders identified in the Current Diagnoses heading of these Reasons for Disposition and a Traumatic Brain Injury. The Composite Assessment of Risk at page 35 of the Hospital Report merits reproduction as it encapsulates the risk to public safety currently posed by Mr. Kurahara:

Mr. Kurahara suffers from a complex set of problems which include prenatal exposure to alcohol, traumatic brain injury, schizophrenia, substance use disorder, and various medical conditions. He continues to display extremely poor impulse control and frustration tolerance, and experiences active psychotic symptoms. He displays no insight into his illness, the symptoms, and their link with violence and the risk to the safety of the public. He continues to act out violently on a regular basis in response to the slightest frustration. He has required seclusion for the entirety of his stay at this facility due to his impulsive nature and the ongoing risk of harm to others. His substance use, especially his propensity to actively seek substances, puts him at a very high risk of further deterioration in his mental state if this were available.

34Given the foregoing, the Board therefore accepts that absent an ORB Disposition, Mr. Kurahara would likely seek out substances and become non-compliant with prescribed medications. This would lead to decompensation and the re-emergence of behaviours similar to those seen at the time of the index offences. We are satisfied that absent an ORB Disposition, it is likely that Mr. Kurahara will cause serious physical or psychological harm to members of the public and such conduct will likely be criminal in nature.

(b) Disposition

35Flowing from the Board’s finding that Mr. Kurahara continues to pose a significant threat to the safety of the public it must shape a Disposition for the year ahead. Its paramount consideration in doing so must be the safety of the public while also considering Mr. Kurahara’s needs pursuant to s. 672.54 of the Criminal Code.

36The necessary and appropriate disposition for Mr. Kurahara provides him as much freedom as possible without subjecting the community to a real risk of dangerous behaviour.

37In considering Mr. Kurahara needs, the Board was attentive to how well he apparently responded to but one dose of clozapine, notwithstanding that it was administered/ingested in error. Clozapine currently can only be prescribed via oral ingestion. It clearly cannot be reliably administered to Mr. Kurahara given his propensity to snort anything. Therefore, the treatment team’s objective to treat him pharmacologically with Invega Trinsa in conjunction with clozapine is aspirational at this juncture.

38Last year’s August 13th, 2024, Reasons for Disposition at paragraph 49 state:

Mr. Kurahara made some comments about his indigenous heritage. He said that no “Gladue” report had ever been prepared for him. In terms of connecting with his Aboriginal culture, Mr. Kurahara would like to do smudging and to smoke tobacco. He wanted to go to the hospital in Brockville so that he could smoke, and specifically did not wish to go to Waypoint as he would not be able to smoke there.

39Mr. Kurahara is described as enjoying a good relationship with hospital’s spiritual care provider who he meets with regularly. As noted at Pages 28-29 of the Hospital Report Mr. Kurahara:

• has said prayers in Ojibwa-Cree,
• attended smudging ceremonies,
• was visited by the spiritual care provider prior to some seclusion relief periods in an attempt to dissuade Mr. Kurahara from spitting and using profanity.

40In light of Mr. Kurahara’s Indigenous heritage, the recommendation of Hospital Counsel and the particulars referenced above, this Panel of the Board hereby orders that a Gladue Report be prepared and distributed to the parties and the Board in advance of Mr. Kurahara’s 2025/2026 Annual Hearing. We are hopeful this process will provide some insights that will facilitate his rehabilitation, limit his need for seclusion and enable an augmentation of his privilege levels. The Panel also anticipates that the report generated subsequent to Mr. Kurahara’s upcoming neuropsychology consultation will be made available to the Parties and to next year’s Panel.

Conclusion

41Therefore, the Board unanimously determines that the necessary and appropriate Disposition required to manage the threat Mr. Kurahara poses to the safety of the public while still meeting his needs, remains a Detention Disposition with privileges, absent any changes.

42In making this Disposition, the Board carefully considered the positions and submissions of the parties, the Hospital Report and the evidence of Dr. Mishra and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Kurahara’s mental condition, his reintegration into society and other needs.