Re: Ana Cornejo
ORB File No: 7548
Hearing held on: Tuesday, July 22, 2025
Place of hearing: St. Joseph's Healthcare Hamilton West 5th Campus, 100 West 5th Street
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. T. Mann
Members: Dr. A. Park Dr. G. Kerry Mr. D. D’Intino Ms. C. Plyley
Parties Appearing:
Accused: Ana Cornejo Amicus Curiae: Ms. C. Francis
The Person in Charge of Hospital: Counsel: Ms. L. Barney
Attorney General of Ontario: Counsel: Ms. C. Gzik
AMENDED REASONS FOR DISPOSITION
(Dated September 8, 2025)
Please see underlined changes at paragraph 31 of the original reasons made September 9, 2025.
Introduction
On May 21, 2019, Ana Cornejo was found not criminally responsible on account of mental disorder (NCR) on charges of arson: reckless disregard for human life and mischief: endangering life (x3), contrary to the Criminal Code. She is currently subject to a disposition of the Ontario Review Board dated July 29, 2024, directing that she be discharged subject to conditions.
On Tuesday, July 22, 2025, the Board convened a hearing to conduct the annual review of Ms. Cornejo’s disposition pursuant to s. 672.81(1) of the Criminal Code. Ms. Cornejo was present at the hearing. She was accompanied by her husband and some members of her treatment team. Ms. C. Francis was appointed by the Board as Amicus to assist the Board. Ms. Francis confirmed that Ms. Cornejo was content to proceed with the hearing in English and did not require assistance of an English-Spanish interpreter.
The issues to be determined at the hearing were whether Ms. Cornejo continued to represent a significant threat to the safety of the public as defined in s. 672.5401 of the Criminal Code and, if so, the necessary and appropriate disposition.
Positions of the Parties
- At the commencement of the hearing, the parties were asked to provide their initial without prejudice recommendations with respect to the issues before the Board. All counsel were joined in recommending that Ms. Cornejo be found to no longer pose a significant threat to the safety of the public and that she be discharged absolutely.
Index Offence
On March 1, 2019 there was a fire at [address redacted], Hamilton, which was at the time occupied by Ms. Ana Cornejo, her husband and their three children. All occupants were rescued. The cause of the fire was initially thought to have started accidentally from a fallen lamp. However, upon investigation it was discovered wires to the 2nd floor smoke detector had been cut. A couple of weeks later, Ms. Cornejo confessed to her spouse that she had intentionally started the fire and, eventually, confessed to police as well.
Ms. Cornejo admitted that her initial plan in setting the fire was to commit suicide, and to take the children with her, because she “didn’t want them to suffer any more”. She felt that she and her family had been under “spiritual attack”.
Background and Psychiatric History
Ms. Cornejo is 51 years of age. She was born in El Salvador and moved to the United States when she was nine. When she was 12, Ms. Cornejo immigrated with her family to Canada and has since remained in the Hamilton area. Ms. Cornejo completed secondary school in Hamilton but found herself unable to complete a college business administration program, leaving it after one year. Ms. Cornejo was a stay-at-home parent until her youngest child was six years old, following which she held part-time positions mostly in retail, food services, shipping and receiving and general labour.
Ms. Cornejo and her husband lived common law for 21 years until they married in 2017. Ms. Cornejo reports having a good relationship with her husband and cites him as a source of ongoing support. However, their relationship had become increasingly strained in the years prior to the index offences due to the decline in her mental health.
In 2016, Ms. Cornejo began exhibiting changes in her behaviour, becoming increasingly religiously preoccupied and experiencing a number of somatic complaints including feelings of static electricity throughout her body, pain in her head and chest and hypersensitivity to smells. These experiences seemingly coincided with the change in her and the children’s church affiliation from Catholic to Protestant (Pentecostal). Despite the urging of friends and family members, Ms. Cornejo declined to seek help to address her mental health issues because she felt she was having religious experiences.
Ms. Cornejo was assessed by the Crisis Outreach and Support Team (COAST) on June 23, 2018 after her husband contacted them to report ongoing concerns regarding her well-being, bizarre behaviour, and voiced suicidal ideation. Upon assessment by the COAST team, Ms. Cornejo spoke about her religious beliefs and stated she was no longer receiving God’s protection, and that she felt the need to wash and clean excessively as a means to cleanse herself of “bad” spirits. She did not meet criteria for civil commitment under the Mental Health Act at that time.
Ms. Cornejo’s husband reported his wife began to express suicidal ideation two months prior to the index offences. He indicated she would make statements such as “I’m not going to live to tomorrow,” and “I will pass in my sleep.” He added that his wife would purchase gifts for their children prematurely in the event she was no longer around, and on one occasion he found a rope in the living room after she made comments stating he would find her hanging. Ms. Cornejo reported that her general practitioner suggested she seek counselling for her ongoing issues, but Ms. Cornejo declined as she did not believe she suffered from mental health issues.
Substance Use History and Criminal Record
- Ms. Cornejo does not have any substance abuse issues, past or present. She does not have a criminal record.
Current Diagnosis/Treatment Capacity
Ms. Cornejo’s diagnosis is Major Depressive Disorder with Psychotic Features. She remains incapable to consent to treatment with antipsychotic medication. Her husband continues to be her Substitute Decision Maker (SDM).
Ms. Cornejo was first admitted to SJHH on April 11, 2019, under a Form 48 Assessment Order. Following the NCR finding on May 21, 2019, she was returned to the Forensic Assessment Unit to await her initial ORB hearing which was held on July 18, 2019. The Board ordered that Ms. Cornejo be made subject to a detention order with privileges up to and including entering the community of Hamilton accompanied by staff or an approved person. On August 6, 2020, at her annual review, the ORB continued the detention order but granted expanded privileges up to and including community living in Southern Ontario.
The following year, on May 4, 2021, Ms. Cornejo was discharged to living in the community of Hamilton, initially with her sister, then to a basement apartment in a house and later to an independent apartment in the building where her sister resided. On July 21, 2021, the ORB issued a detention order with privileges up to and including community living in Southern Ontario. At her annual hearing on July 25, 2022, the ORB issued a conditional discharge, which continued in each subsequent annual review thereafter (in 2023 and 2024).
Ms. Cornejo experienced an acute relapse of psychotic and depressive symptoms in June of 2020, prompting a change in her medication regimen to include a long-acting injectable antipsychotic. She has remained behaviourally, affectively and cognitively stable since that time.
In sum, Ms. Cornejo has made slow but steady progress while under the jurisdiction of the Board.
Evidence at the Hearing
The Board admitted into evidence the Hospital Report dated July 7, 2025. In addition to reviewing the documents forming the Record and the Hospital Report, the Board had the benefit of hearing oral evidence from Ms. Cornejo’s attending forensic psychiatrist, Dr. O. Kolawole. Dr. Kolawole has treated Ms. Cornejo for approximately six years. He endorsed both the contents of the Hospital Report and its recommendations as to significant threat and disposition. The doctor also gave a brief overview of Ms. Cornejo’s progress over the last reporting year in support of the hospital’s recommendation that she now be granted an Absolute Discharge.
Dr. Kolawole advised the Board that Ms. Cornejo has continued to make good progress. She has remained asymptomatic for mood, anxiety and psychosis and is compliant with her medication regimen Ms. Cornejo has always been amenable to working with her treatment team. She has successfully managed her stress levels. There have been no incidents of violence or aggression or concerning behaviours of any sort. With psychoeducation, her insight into her long-term mental disorder has improved, relative to her presentation last year. Ms. Cornejo works full time, engages in recreational activities and has successfully vacationed with family members, including a recent trip to El Salvador. She continues to enjoy strong family support. As noted above, her husband is her Substitute Decision Maker and has been educated on early warning signs of decompensation in Ms. Cornejo’s mental state.
Importantly, Ms. Cornejo has successfully rekindled her relationship with her eldest daughter, which had been strained for the last number of years following the index offence. The rekindling of the bond between Ms. Cornejo and her eldest daughter was work that the team had started last year. As noted, it has progressed in a positive way; they go out together, run errands together and spend time together, all successfully. Ms. Cornejo is very happy about this development. Consequently, she has a strong external motivating factor to stay well.
Ms. Cornejo continues to live independently in the community, separate from her family and no change is expected to these arrangements in the shorter term, as they appear to work well for Ms. Cornejo and her family. She is often at the home with everyone. Ms. Cornejo is not pushing to move back into the family home but is waiting until everyone in the family is ready. Dr. Kolawole agreed that family therapy or counselling might be beneficial in the future to facilitate Ms. Cornejo’s eventual return to the family home, to address any residual concerns regarding familial relationships and to develop a concrete plan.
The team has spent a considerable period of time providing psychoeducation to Ms. Cornejo focused on further developing her insight, but there is still room for improvement. At times she has questioned her need to remain on psychiatric medications and her understanding of the nature of her mental illness is not robust. Dr. Kolawole explained that his decision to continue the finding that Ms. Cornejo remains incapable to consent to treatment, so that both Box A and Box B criteria of the Mental Health Act can be invoked if necessary. Ms. Cornejo no longer meets the criteria for a Community Treatment Order (CTO) or for intensive support from an ACT team, but Ms. Cornejo’s status of incapable to consent to treatment for her psychiatric condition is a protective factor. Mrs. Cornejo’s husband has been her SDM since the index offences and now has a better grasp of the implications of her mental health diagnosis, including her need for long-term treatment and follow-up.
A transition to long-term, community-based care has commenced. Ms. Cornejo is connected with a family health team of which she has been a patient for about 20 years, so staff there are familiar with her. There is a family physician at the clinic and Dr. Kolawole has since handed over prescribing her medication to the family health team prescriber. Mrs. Cornejo has now had two cycles of her long-acting injectable antipsychotic medication at the clinic. The family health team also has direct access to the family health psychiatric team; if there is a future need for a psychiatric assessment of Ms. Cornejo, it can be easily accomplished. Dr. Kolawole confirmed that the family physician might not see Ms. Cornejo on the days when she attends the clinic for her injection but would have regular reviews with her at the approximate frequency of once every two or three months which would then give them an opportunity to do a full mental status examination.
The family doctor is aware that the treatment team’s recommendation is for an Absolute Discharge and is agreeable assuming responsibility for her psychiatric care.
Dr. Kolawole does not anticipate that transitioning away from the Forensic Outpatient Team to the community-based treatment team will cause any stress for Ms. Cornejo and that as long as she continues to take her medication, he expects that she will remain stable.
Questions from the panel focused on the limitations still evident in Ms. Cornejo’s insight. Although she completed further focused psychotherapeutic education prior to the completion of the last reporting year and has continued to work with the treatment team thereafter, the doctor agreed that Ms. Cornejo continues to provide somewhat vague initial responses to interview queries. Similarly, she seems hesitant at times to fully discuss early warning signs of psychiatric decompensation, and how she might cope with stressors, which reflects some avoidance of difficult topics. Dr. Kolawole agreed that Ms. Cornejo does struggle to discuss the details of the index offence. The doctor indicated it was not unusual for some patients to be reluctant to experience discussing the fine details of their index offences as they find it re-traumatizing. Overall, Dr. Kolawole was not worried about limitations in Ms. Cornejo’s insight in that Ms. Cornejo appreciates that she was ill at the time, that she has a diagnosis of major mental disorder, that she needs to remain well first and foremost for herself, and also for her family and the community to which she belongs. Dr. Kolawole felt reasonably confident Ms. Cornejo would continue to be medication compliant at least over the next six to 12 months due to the combination of Ms. Cornejo’s internal motivation to remain well and the extrinsic supports that have been put in place for her.
The panel queried Dr. Kolawole about the change in Ms. Cornejo’s risk assessment in 2025 as compared to previous years in 2021, 2022, 2023 and 2024 wherein she was assessed as posing moderate to high risk of violently re-offending under an Absolute Discharge.
Currently, it is deemed that if Ms. Cornejo were to receive an Absolute Discharge her risk is assessed to be low in the shorter term and low moderate in the longer term. Dr. Kolawole endorsed the risk assessment set out in the Hospital Report. Dr. Kolawole agreed that Ms. Cornejo’s risk could increase if the supports and safeguards that have been put in place were no longer present, i.e., if a different physician in the community were to make her capable to consent to treatment with psychiatric medication and her husband were no longer the SDM, or if she were to stop taking her medication, but Dr. Kolawole does not see this happening in the near future. Dr. Kolawole confirmed that Ms. Cornejo’s daughter has also received psychoeducation and now has a better understanding of her mother’s illness which was instrumental in her being able to successfully engage with her mother over the last reporting year.
Submissions
Hospital counsel submitted that Ms. Cornejo has lived in the community for a number of years, including under the terms of a Conditional Discharge for the last three, and has done very well with no significant concerns from the treatment team. Ms. Cornejo has a lot of support from her family. She described Ms. Cornejo as a model patient and noted that the treatment team was unanimous in recommending an Absolute Discharge. Counsel for the Attorney General adopted the Hospital’s submissions.
Ms. Francis indicated she has known Ms. Cornejo since she first came under the jurisdiction of the Ontario Review Board and that she has come a long way. Ms. Francis emphasized the high degree of cooperation Ms. Cornejo has demonstrated in working with her treatment team and credited her love for her family as her primary source of motivation. Ms. Francis thanked Dr. Kolawole on Ms. Cornejo’s behalf for going above and beyond expectations in terms of the support he has provided to Ms. Cornejo and her family. Ms. Francis noted that an Absolute Discharge will not change Ms. Cornejo’s life regardless of whether she is under the jurisdiction of the Ontario Review Board, because with the help of her treatment team, her life has changed for the better and she wants to continue moving forward.
Analysis and Conclusions
Having heard and considered all of the evidence and the submissions of the parties, the Board agrees with the joint submission that Ms. Cornejo’s current constellation of symptoms and behaviours falls short of the threshold established in the case law to constitute a significant threat to the safety of the public. However, apart from the joint submission, the Board has no difficulty in coming to an independent conclusion that Ms. Cornejo no longer represents a significant threat. In coming to this conclusion, the Board relies on the uncontradicted expert evidence of Dr. Kolawole, the evidence set out in the Hospital Report, and in particular the risk assessment contained at pages 47 - 48 of the Hospital Report.
Ms. Cornejo has a history of major depression with psychotic symptoms. Her insight into her long-term mental disorder and need for medication has improved with psychoeducation. She has not had any incidents of violence or aggression in over six years. She has rekindled her relationship with her daughter. She works full time, engages in recreational activities and has vacationed with family members successfully. Ms. Cornejo does not have a history of substance use. Her husband continues to be her Substitute Decision Maker and has been educated on early warning signs of decompensation in Ms. Cornejo’s mental state. Her risk of violence re-offence is assessed as low in the shorter term and low-moderate in the longer term, with safeguards in place. Ms. Cornejo has been a patient at the family health clinic for about 20 years, and as such the staff are familiar with her and she with them. Her psychiatric care has already been transferred to the new clinic and she has received two injections. Ms. Cornejo is not pushing to move back into the family home and is waiting until everyone is ready. Ms. Cornejo has expressed a desire to eventually return to the family home, but she and her family have not discussed specific plans. The Board notes that the recommendation of the treatment team that Ms. Cornejo receive an Absolute Discharge was unanimous.
Despite reservations about Ms. Cornejo’s insight, the stability of her family reconciliation which is relatively recent overall and the potential for her to discontinue psychiatric medication due to limited insight into her need for it, the Board concurs that Ms. Cornejo no longer poses a significant threat. This is based on her consistent progress over the last three years on a Conditional Discharge, her compliance with treatment, her stable living and employment situation and complete lack of aggressive behaviour.
In coming to this decision, the Board carefully considered the decision of the Supreme Court of Canada in Winko v. British Columbia. In Winko, the Supreme Court of Canada held that restrictions can only be imposed on an NCR accused’s liberty if the evidence before the Board demonstrates that the accused actually constitutes a significant threat to public safety. Such threat is not to be presumed and there is no legal or evidentiary onus on the accused to demonstrate that he or she is not a significant risk: see Winko at paragraphs 46 and 54.
Section 672.54 of the Criminal Code does not permit a Review Board to refuse granting an Absolute Discharge if it has doubts whether the accused poses a significant threat to public safety. Rather, there must be a positive finding of significant risk to support restrictions on an individual’s liberty. Something less, for example, uncertainty, cannot suffice. If a Review Board cannot resolve the question of whether an NCR accused actually constitutes a significant risk of committing a serious criminal offence, the Board must grant an Absolute Discharge: see R v. Winko 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625 at paragraph 49.
In closely examining a range of evidence identified by the Supreme Court of Canada in Winko, the Board has concluded that Ms. Cornejo no longer poses a significant risk of committing a serious criminal offence. She has appropriate community-based mental health supports in place. While her insight remains somewhat shallow, the Board is mindful that some accused never reach the point of developing full and comprehensive insight and, provided other supports are in place to effectively mitigate risk, lack of insight in and of itself is not a reason to deny the granting of an Absolute Discharge.
For the foregoing reasons, it is the firm, considered and unanimous opinion of the Board that Ms. Cornejo no longer meets the threshold test for significant threat to the safety of the public and is therefore entitled to an Absolute Discharge. A disposition will issue accordingly.
The Board wishes Ms. Cornejo well in her future endeavours.
DATED this 8^th^ day of September 2025, at the City of Toronto, in the Toronto Region.
Ms. T. Mann Alternate Chairperson Office of the Registrar Ontario Review Board