Re Ram Kamal Dubey, 2025 CanLII 94987

Re: Ram Kamal Dubey

ORB File No: 7852

Hearing held on: Tuesday, August 19, 2025

Place of hearing: Waypoint Centre for Mental Health Care

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

Before:

Alternate Chairperson: Mr. J. Weinstein

Members: Dr. S. Simpson Dr. J. Cheston Ms. K. Tomaszewski Ms. D. Smith

Parties Appearing:

Accused: Ram Kamal Dubey Counsel: Ms. M. Addie

The person in charge of hospital: Representative: Ms. T. Newman

Attorney General of Ontario: Counsel: Ms. S. Curry

REASONS FOR DISPOSITION

(Dated September 4, 2025)

Introduction

1. On February 14, 2021, Mr. Ram Kamal Dubey was found not criminally responsible on account of mental disorder, on charges of break and entering (committing), and aggravated assault, both contrary to the Criminal Code of Canada (“Criminal Code”).

2. Mr. Dubey is subject to a Disposition of the Ontario Review Board (the “Board”), dated August 28, 2024, which discharges him on certain terms and conditions.

3. On August 19, 2025, the Board convened a hearing at the Waypoint Centre for Mental Health Care (“Waypoint”) to conduct the annual review of the current Disposition.

4. Mr. Dubey was present at the hearing and was represented by his counsel, Ms. M. Addie.

5. A Hospital Report, dated June 26, 2025 (the "Hospital Report"), was entered as Exhibit 1.

6. The issues at this hearing are whether Mr. Dubey is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code. If so, the necessary and appropriate Disposition in the circumstances must be determined, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.

7. For the reasons set out below and based on the expert evidence and opinions before us, the Board concluded that Mr. Dubey continues to represent a significant threat to the safety of the public. The Board ordered that the necessary and appropriate Disposition in the circumstances is a continuation of a Conditional Discharge, with the changes recommended, and agreed to by all of the parties, and as set out in our formal Disposition.

Current Psychiatric Diagnoses

8. Schizophrenia

Cannabis Use Disorder, in sustained remission

Cocaine Use Disorder, in sustained remission

Index Offences

9. The circumstances giving rise to the Index Offences are extracted from last year’s Board Reasons, as follows:

“Aggravated Assault

Investigation:

This incident occurred between 4:30 AM and 4:35 AM. The accused broke into the rear of the residence by breaking the glass on the sliding doors and committed an indictable offence once in the residence (Count 1). He then walked upstairs where a physical altercation took place between the accused and homeowner, [Victim #1]. During the altercation, the accused at one point, assaulted the victim with a two by four piece of wood causing the victim’s left arm to break (Count 2), he then fled the residence through the front entrance in an unknown direction.

At 4:35 AM, [Victim #1] contacted police.

At approximately 4:39 AM, police arrived on scene and investigated this break and enter.

At 5:01 AM, the accused was located by police on the roadway near 1189 Ewing Crescent and was arrested by Constable Farrow #3275 for Break and Enter and Commit contrary to Section 348(1)(A) of the Criminal Code of Canada and Assault with a Weapon (later upgraded to Aggravated Assault) contrary to Section 367 of the Criminal Code of Canada. The accused was read his rights to counsel and caution and transported to Trillium Hospital for minor scratches to his hands.

Police spoke to the victim who advised the above. There are no other damages other than those listed above to the rear door. The victim sustained a broken forearm and minor head injuries (concussion).

At 8:02 AM, police searched the accused’s blue winter jacket and located a small Ziploc bag containing a white powder substance believed to be cocaine. At 8:06 AM, police searched a Ziploc bag belonging to the accused and located a smaller Ziploc bag containing a brown powder substance believed to be heroin.

At 10:00 AM, the accused was advised of the following additional charges:

• Possession of Substances Schedule I (cocaine) contrary to section 4(1) of the Controlled Drugs and Substances Act

• Possession of Substances Schedule I (heroin) contrary to section 4(1) of the Controlled Drugs and Substances Act

• Aggravated Assault contrary to section 268(1) of the Criminal Code of Canada.”

Background

10. Mr. Dubey’s personal history, his mental health history, details of prior criminal convictions and contacts with police are set out in detail in the Hospital Report. They are accurately summarized in last year’s Reasons, as follows:

“His parents immigrated to Canada from New Delhi, India in 1970. Mr. Dubey is the youngest in a sibline of four and has three older sisters; Mr. Dubey and his family report that they enjoy a close relationship notwithstanding his many difficulties over the years.

Mr. Dubey appears to have had the benefit of growing up in a stable home environment. Reportedly, he had a prosocial peer group and got along well with others. Mr. Dubey describes himself as having been a “happy kid, but a little shy.” His grandmother was reportedly very protective of him and would not allow him to be disciplined or for any limits to be set. A sister described him as being doted on by the family given that he was the youngest child and the only boy. As a youth, there were no behaviours suggestive of conduct disorder, no reported history of fire setting, cruelty to animals or people, stealing or vandalism, or lying. He was never involved with the police as a youth.

Although described as “an average student,” Mr. Dubey was unable to complete his secondary school education and dropped out in grade 10. He subsequently completed credits to obtain his grade 10 during evening classes and later completed a course in graphic design during an 18-month long sojourn in India at the age of 15 when his parents sent him there to live with a paternal uncle. Mr. Dubey worked sporadically at his family’s business which manufacturers custom sign boards.

Mr. Dubey has a significant history of psychiatric and behavioural difficulties, including a number of admissions to hospital for court-ordered assessments of fitness and criminal responsibility. The earliest of these hospitalizations appears to have been at Waypoint from December 10, 2013 to February 6, 2014, pursuant to a Form 1 completed when he was incarcerated at Maplehurst Correctional Complex. Diagnostic considerations at that time included unspecified psychotic disorder and differential diagnoses of schizoaffective disorder or bipolar disorder. Prior to this detention he had reportedly been using cannabis on a regular basis.

More generally, the Hospital Report indicates that Mr. Dubey has a long history of polysubstance abuse including stimulants, narcotics, ecstasy, marijuana and cocaine. Mr. Dubey reported first using recreational drugs at the age of 12. His substance use was often correlated with the onset of behavioural dysregulation and psychosis. As for his pattern of substance use prior to the Index Offence, Mr. Dubey has consistently self- reported to Waypoint staff that he was using, in combination, cannabis, cocaine and what he terms “opium” [heroin] between his release from Toronto South Detention Centre in mid-December 2019 and the date of the Index Offences. He describes his substance of choice as cannabis.

With respect to Mr. Dubey’s psychiatric and behavioural difficulties, the Hospital Report relates that his course prior to coming under the jurisdiction of the ORB was marked by repeated lapses into substance use which at times prompted aggression and psychosis when intoxicated. Of note, historically there was a divergence in clinical opinion as to whether or not Mr. Dubey suffered from an underlying major mental illness such as schizophrenia or a substance-induced psychotic disorder. By 2019, it became clear that Mr. Dubey was vulnerable to psychotic deterioration when using street drugs and that he had not been successful avoiding substance use despite having engaged in rehabilitative programming for this issue.”

Course Since Last Disposition

11. Mr. Dubey’s course since his last Disposition is set out in detail in the Hospital Report. The following extracted paragraphs are relevant to this hearing:

“FMTST met with Mr. Dubey every second week through the period in review, and Dr. Ismail saw him quarterly. Mr. Dubey was “consistently engaged” during visits with the team. He was cooperative and compliant with requests for urine drug screens, which were all negative.

Mr. Dubey was provided additional supports by the Forensic Supportive Housing Program (FSHP), run under the umbrella of the Canadian Mental Health Association (CMHA), who provided a housing subsidy and case management services; they met with him twice weekly.

”. Mr. Dubey completed an eight week Illness, Management, and Recovery (IMR) group this review period, facilitated by the Mobile Treatment and Support Team. Feedback from the facilitators was “very positive, highlighting Mr. Dubey as an active participant who completed all homework assigned” (Community Clinician Pre-Board Report). He also consistently attended a Concurrent Disorders group, held on Fridays at Wendat in Midland.

Mr. Dubey visited with his family in Brampton on multiple occasions over the course of the year. He independently arranged transportation to his sister’s in the Greater Toronto Area, and was often provided a ride home by family. Noted was that he was diligent in reporting any absences of greater than 24 hours from his residence, even though this was not required. No issues were reported during his visits.”

Position of the Parties

12. The representative for the hospital, counsel for the Attorney General and counsel for Mr. Dubey advised that this was a joint submission: all were adopting the hospital’s recommendation of a continuation of the existing Conditional Discharge Disposition, with the following changes:

a) In paragraph 1(a), replacing the requirement to reside at a specified address with a requirement to reside within the catchment of Waypoint.

b) Reducing his reporting from not less than once every two weeks to not less than once every four weeks.

c) Adding a requirement for written notification of any change to the existing address or telephone number, to be sent to the person in charge of the facility (“PIC”), or his or her designate, and to the Board, 24 hours in advance .

d) Adding travel passes for up to 14 days, outside of the Province of Ontario, but only within Canada, upon first obtaining an approved itinerary from the PIC.

13. For the purposes of this hearing, counsel for Mr. Dubey advised that significant threat was not in dispute.

Evidence at the Hearing:

14. The Board had available to it the evidence and documents forming the Record, the Exhibits, and oral evidence from Dr. Ismail.

15. Dr. Ismail co-authored the Hospital Report, and he testified as follows:

a) He adopts the contents of the Hospital Report, and he agrees with the joint recommendation.

b) He relies on the risk assessment, on pages 35 to 37 of the Hospital Report, as to why it has been determined by the treatment team that Mr. Dubey continues to represent a significant threat to the safety of the public.

c) Mr. Dubey has done very well this past reporting year. He has been adherent with his medication regimen, and there have been no issues with substances. Mr. Dubey is taking two different courses related to concurrent disorders. He is very good at reaching out to the team when he is having any issues or problems.

d) Mr. Dubey agrees with the treatment team that his success in the community is related to the current structure provided to him, by both the inpatient forensic psychiatric team and the FMTST. Both Mr. Dubey and the treatment team agree that small stressors tend to derail him; accordingly, they have all agreed to proceed cautiously, in small, incremental steps, rather than to remove too much structure at one time. Therefore, the treatment team wishes to change the reporting from not less than once every two weeks to not less than once every month. They will progress Mr. Dubey slowly to reporting monthly.

e) Mr. Dubey’s current coping mechanism to deal with stressors is to seek support from one of Waypoint’s clinicians by telephone. To his credit, he is very willing to reach out to his clinicians and the treatment team. Mr. Dubey has taken courses in cognitive behavioural therapy for psychosis, and the treatment team hopes that he will be able to use the skills he has learned to become more independent, relying less upon the team.

f) All Mr. Dubey’s urine drug screen samples have come back negative. Mr. Dubey has completed two concurrent disorder programs to help him remain abstinent from substances.

g) Mr. Dubey has a very narrow social network. He tends to depend upon his family, who live in Brampton, and with whom he has a very strong connection. It should be noted that his mother was in attendance for this hearing.

h) As noted on pages 33 and 34 of the Hospital Report, Mr. Dubey was having some relationship issues in May, with his mother. He did reach out for support from FMTST, which helped him manage the situation.

i) Mr. Dubey suffers from severe sleep apnea. He does have a CPAP machine, but he is not using it as often as he should. However, the apnea is not a concern with respect to his risk to the safety of the public,

16. In response to questions from counsel for Mr. Dubey, Dr. Ismail testified:

a) Before the team would recommend an Absolute Discharge, they would like to see Mr. Dubey be associated with some type of ACT team. Mr. Dubey is still choosing whether he wants to live in Brampton or in the catchment area of Waypoint.

17. In response to questions from the panel, Dr. Ismail testified:

a) Mr. Dubey did not have any criminality in his development years; that his problems commenced around 2011, when he started misusing substances, which led to the onset of his psychosis.

b) The VRAG assessment score is quite high, as it reflects Mr. Dubey’s history. However, Mr. Dubey’s low PCL-R score indicates that he does not have a personality disorder.

c) There was no HCR-20 assessment done this year, and it would be important to complete an assessment before the treatment team could recommend an Absolute Discharge.

d) The current diagnosis on the front page of the Hospital Report should be changed. Both his Cocaine Use Disorder, and his Cannabis Use Disorder, should be recategorized, from “Severe, in early or sustained remission,” to “In sustained remission.”

e) Although Mr. Dubey has not used substances for a while, the treatment team still feel that his insight into the importance of abstaining from substances is not fully developed and that he is externally motivated. As such, it is necessary to keep the abstain clause within his current Disposition. Before they could recommend the removal of the abstain clause, they would have to see improvement in Mr. Dubey’s insight, so that his motivation for abstinence becomes less reliant on the external motivation of a prohibition in his current Disposition.

f) As set out in the Hospital Report, NA and AA are not appropriate outside sources for Mr. Dubey in the community. The treatment team can provide other after care support for Mr. Dubey’s substance issues.

g) The treatment team would like to see Mr. Dubey continue to engage in cognitive behavioural therapy, to help him handle stressors, including the ability to remain abstinent from substances.

18. No other evidence was called.

Analysis and Conclusions

19. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees with the joint submission: Mr. Dubey remains a significant threat to the safety of the public.

20. In Winko, the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Ismail, in addition to the documentary evidence before us.

21. The Board agrees with the doctor’s evidence, that Mr. Dubey’s success this past year is a result of the structure and support currently provided to him, by both the FMTST and the forensic team. Mr. Dubey is very sensitive to stressors and small changes, so a cautious, stepwise approach is appropriate in the coming reporting year. The Board agrees that the loosening of his reporting requirements would help solidify his gains and ensure his success moving forward.

22. In particular the Board relies on the following excerpts from the Hospital Report;

“The following risk assessment was completed by Mr. Dubey’s attending psychiatrist, Dr. Ismail, on July 29, 2025:

Mr. Dubey has a longstanding history of schizophrenia and concurrent cocaine and cannabis use disorders, the latter currently in sustained remission. His index offense occurred while he was acutely psychotic and using substances, a combination which has historically been associated with significantly increased risk of violence. While he has made gains in treatment and has demonstrated relative stability in the community under the current Ontario Review Board disposition, these gains are heavily dependent on the structure, accountability, and support provided by the forensic system. His illness is chronic and severe, requiring continuous antipsychotic treatment to maintain stability, and he has recently agreed to an increase in the dosage of his long-acting injectable haloperidol, underscoring that his psychosis remains controlled only through intensive pharmacological management.

Mr. Dubey’s insight into his illness has improved but remains fragile and conditional. He has stated that he “knows he has to be on medication” and intends to continue treatment; however, this commitment has not yet been tested outside of the forensic framework. He openly admits anxiety about the loss of structure provided by his current conditional discharge and acknowledges that “it only takes one small slip” for him to relapse into previous patterns of substance use and instability. This self-awareness, while positive, also highlights the tenuous nature of his current remission and the reality that his abstinence and stability are highly dependent on external oversight. His historical pattern of relapse following disengagement from services provides further evidence that his risk for deterioration remains high should the safeguards of the current disposition be prematurely removed.

During this reporting period, Mr. Dubey engaged appropriately with his treatment team, completed illness management and concurrent disorders programming, and maintained sobriety, with all urine drug screens confirming abstinence. Nevertheless, he continues to display difficulties managing interpersonal stressors, illustrated by his reaction to the CPAP monitoring dispute, where he reportedly became “pretty upset, threatening lawyers” when challenged by service providers. Although this did not escalate to aggression, it demonstrates underlying challenges in emotional regulation and conflict resolution, both of which are recognized dynamic risk factors for violence in individuals with serious mental illness.

The risk factors historically associated with Mr. Dubey’s violent behavior— namely psychotic exacerbation and substance use—remain relevant. His psychosis is controlled only with consistent administration of high-dose long-acting antipsychotic medication, and his substance use disorder is in remission but vulnerable to relapse. The clinical team unanimously noted that his stability has been achieved and sustained because of the external structure imposed by the current conditional discharge. Removal or premature loosening of these conditions would reduce his accountability and weaken critical protective factors that are currently mitigating his risk.

Even Mr. Dubey himself has recognized the importance of continued support, expressing a preference to remain under a conditional discharge, albeit with reduced reporting requirements, until he is better established in his recovery.

In conclusion, Mr. Dubey continues to present a risk to public safety that is managed but not eliminated under his current disposition. His stability, abstinence, and engagement in treatment represent significant progress; however, these are contingent on continued oversight and support. A reduction in structure at this stage would create conditions under which his illness and substance use vulnerabilities could re-emerge, significantly increasing his risk of violent behavior. It is therefore my opinion that Mr. Dubey remains a significant risk to the safety of the public and that the current conditional discharge disposition must remain in place for at least another year to consolidate these gains and reduce the likelihood of relapse and associated risk.”

23. The Board congratulates Mr. Dubey on his considerable progress and accomplishments in this past reporting year.

24. In consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the other needs, the necessary and appropriate Disposition is the continuation of the Conditional Discharge Order, with the changes as recommended by the hospital, agreed to by all the parties, and set out in our formal Disposition.

DATED this 4th day of September 2025, at the City of Toronto, in the Region of Toronto.

Mr. J. Weinstein Alternate Chairperson

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Office of the Registrar Ontario Review Board