Re Iesha Mitchell, 2026 CanLII 18271

Re: Iesha Mitchell

ORB File No: 7893

Hearing held on: Tuesday, November 4, 2025

Place of hearing: Centre for Addiction and Mental Health

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

Before:

Alternate Chairperson: Mr. J. Weinstein

Members: Dr. L.E. Cappe

Dr. S. Wiseman

Ms. N. Nathanson

Mr. J. Cyr

Parties Appearing:

Accused: Iesha Mitchell

Counsel: Ms. A. Szigeti

The person in charge of hospital: Representative: Dr. P. Darby

Attorney General of Ontario: Counsel: Ms. V. Culp

REASONS FOR DISPOSITION

(Dated March 4, 2026)

Introduction

1. On March 26, 2021, Ms. Iesha Mitchell was found not criminally responsible on account of mental disorder, on charges of assault with a weapon (x3), assault (x2), weapons dangerous, and carry concealed weapon, all contrary to the Criminal Code of Canada (“Criminal Code”).

2. Ms. Mitchell is subject to a Disposition of the Ontario Review Board (the “Board”), dated October 23, 2024, which orders that she be detained at the Forensic Service of the Centre for Addiction and Mental Health, Toronto (“CAMH”). Pursuant to this Disposition, Ms. Mitchell is permitted to live in the community, in accommodation approved by the person in charge. While living in the community, she is to report to the person in charge at CAMH not less than once every two weeks.

3. On November 4, 2025, the Board convened a hearing at CAMH to conduct the annual review of the current Disposition.

4. Ms. Mitchell was present at the hearing and was represented by her counsel, Ms. A. Szigeti. Ms. Mitchell’s father was also in attendance.

5. A Hospital Report, dated October 16, 2025 (the "Hospital Report"), was entered as Exhibit 1.

6. The issues at this hearing were whether Ms. Mitchell is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code, and, if so, what is the necessary and appropriate Disposition in the circumstances, 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 Ms. Mitchell 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 that Ms. Mitchell be discharged subject to certain terms and conditions, as set out in our formal Disposition.

Current Psychiatric Diagnosis

8. Schizophrenia

Position of the Parties

9. Dr. Darby, as representative of the hospital and as the most responsible physician, counsel for the Attorney General, and counsel for Ms. Mitchell advised that this was a joint submission: all were adopting the hospital’s recommendation of a Conditional Discharge, in accordance with the terms set out in our formal Disposition.

10. For the purposes of this hearing, counsel for Ms. Mitchell advised that she would not be arguing the issue of significant threat, but would leave it up to the panel to make its own finding.

Index Offences

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

“On February 8, 2019, in the City of Brampton, victim 1 was walking home from Centennial Mall with her daughter, victim 2. Ms. Mitchell, a stranger to the victims, began swearing and yelling at victim 1 without provocation. Ms. Mitchell chased the pair across the street and attempted to stab victim 1 in the back three to four times. She lunged at victim 2, attempting to stab her. She pushed victim 2 onto the driveway. The blade contacted both victims but did not penetrate them. The victims were able to flee and contacted police.

Ms. Mitchell walked to nearby Centennial Mall swearing and yelling at random patrons. When told to watch her language by victim 3, Ms. Mitchell produced the same knife from her jacket pocket and attempted to stab victim 3. Victim 3 was able to take Ms. Mitchell to the ground and was assisted in restraining her until police arrived.”

Background and History

12. Ms. Mitchell’s background and history are outlined in the Hospital Report, and they are accurately summarized in last year’s Reasons:

“Ms. Mitchell attended special education classes as a child. She left home at the age of 19 and resided in shelters until eventually returning home after receiving a diagnosis of schizophrenia by Dr. Rzadki at William Osler Health Care. She then attended Canadian Beauty College in Etobicoke for one year and finished her diploma at age 25.

Ms. Mitchell had a psychiatric admission in March 2011 when she reported hearing voices. She saw a psychiatrist twice in May 2011. She had further psychiatric hospitalizations in September 2011, September 2012, and January 2014. She was prescribed an injectable antipsychotic medication in 2013, with good effect. The Hospital Report notes that Ms. Mitchell confirmed that, at the time of the Index Offences, she had not been taking medication for two months.

Ms. Mitchell was charged with mischief and assault with a weapon in 2012 and cause a disturbance in 2014. These charges were all stayed by the Crown.

While subject to a Conditional Discharge Disposition, Ms. Mitchell jumped off a thirty- foot-high bridge in an attempt to end her life on July 3, 2022, after a fight with her parents. She suffered multiple serious injuries and required surgical trauma care at St. Michael’s Hospital. She was placed on a Mental Health Act (MHA) Form 1 and subsequently a Form 3. If not for her ongoing surgical and orthopedic treatment at St. Michael’s, she would have refused to stay in hospital or to eventually be transferred to CAMH for psychiatric care. On August 3, 2022, there was a clear exacerbation of her psychotic symptoms and she was observed responding to unseen stimuli. She was again placed on MHA forms at that time. With ongoing psychoeducation, she agreed to increase her dose of Olanzapine to 15mg. She remained at St. Michael’s Hospital until she was transferred to the General Forensic Unit at CAMH on August 16, 2022, on a Form 3, and subsequently a Form 4. On September 12, 2022, Ms. Mitchell was made a voluntary patient.

Ms. Mitchell is not capable of consenting to treatment. The finding of treatment incapacity was upheld by the Consent and Capacity Board on December 2, 2022. Her parents are joint substitute decision makers in this regard.”

Course Since Last Disposition

13. Ms. Mitchell’s course since her last Disposition is set out in detail in the Hospital Report. The following extracted paragraphs are relevant to this hearing:

“Ms. Mitchell's presentation has been stable over the last year. There have been no readmissions to hospital. She has been compliant with her medication. She met with her clinical team at her residence or at a local community location.

At the beginning of the year, Ms. Mitchell remains somewhat guarded and superficial. To her credit, there has been significant improvement over the last year. She has been much more forthcoming with the clinical team.

Ms. Mitchell continues to have somewhat limited understanding of her diagnosis but is now able to acknowledge that the index offence occurred while she was unwell. She has been more open to discussing symptoms of her mental illness and its relationship to the index offences. She became quite tearful on one occasion, indicating that she wished that she did not have a mental illness.

Ms. Mitchell engaged in one-to-one therapy with Dr. Cripps, psychologist, until February 2025.

There have been no incidents of concern over the last year.

Mr. Mitchell resides with her parents. There has been no need for them to supervise her medication. She is quite independent with her activities of daily living.”

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. Darby. Dr. Darby authored the Hospital Report. He testified as follows:

a) He is Ms. Mitchell’s attending psychiatrist and visits her every two weeks in Brampton, at her parents’ residence, where she is currently residing.

b) Her case manager, who was also in attendance, also visits Ms. Mitchell on a regular basis.

c) Ms. Mitchell had a very good year. He would describe this year as a significant improvement from the previous reporting year.

d) The treatment team has no concerns about Ms. Mitchell’s compliance with her medication regimen.

e) In previous years, he would describe Ms. Mitchell’s engagement with the treatment team as superficial and somewhat dismissive. Previously, Ms. Mitchell was not able to acknowledge having a major mental illness, nor the need for her antipsychotic medication. In the past reporting year, Ms. Mitchell’s attitude towards her need for medication, and her acknowledgement that she does suffer from a major mental illness, have improved tremendously. In fact, he would use the term “a significant breakthrough.”

f) Ms. Mitchell now acknowledges that she suffers from a major mental illness and that it caused her to commit the Index Offences.

g) Ms. Mitchell’s engagement with both him and her case manager has been very good.

h) Ms. Mitchell is currently working at Swiss Chalet.

i) A Conditional Discharge is appropriate because Ms. Mitchell has a much more collaborative relationship with the treatment team. Should Ms. Mitchell suffer a decompensation, she would be much more open about her symptoms. Either she would consent to readmission to the hospital, or she could be certifiable under Box B of the Mental Health Act.

j) For the reasons set out in the Hospital Report, Ms. Mitchell continues to represent a significant threat to the safety of the public. At the time of the Index Offences, which were serious, Ms. Mitchell presented with psychotic symptoms of her major mental illness. She has a history of noncompliance with, and minimizing the need for, ongoing medication and, until this year, very limited insight into her mental illness. To her credit, Ms. Mitchell has made significant progress, but a Conditional Discharge is still the necessary and appropriate Disposition for the safety of the public.

15. In response to questions from counsel for the Attorney General, Dr. Darby testified:

a) Ms. Mitchell’s long-acting injectable medication is being administered by the treatment team, every two weeks.

b) It is unnecessary to specify a residence in the Conditional Discharge Disposition, as he does not believe Ms. Mitchell has any plans to move from her current residence. If she were to want to move in the future, she would be open to discussing this change with the treatment team.

c) It is unnecessary to include a consent to treatment clause in her Conditional Discharge Disposition, as Ms. Mitchell has, in recent years, been compliant with her medication regimen, which is a long-acting injectable.

d) The treatment team has a very good, ongoing relationship with Ms. Mitchell’s parents, as does Ms. Mitchell.

16. In response to questions from counsel for Ms. Mitchell, Dr. Darby testified:

a) Ms. Mitchell has made significant gains in her insight and in her engagement with the treatment team.

b) The treatment team is satisfied with the structure she currently has in her life, including her employment at Swiss Chalet. Ms. Mitchell has been open to engaging in more programming, should the team recommend it and should her time permit.

c) Ms. Mitchell is compliant with her medication regimen.

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

a) It would be premature for the treatment team to consider transitioning Ms. Mitchell to a civil-based mental health support system. Furthermore, it is very difficult to get proper follow-up in Brampton with a civil psychiatrist. When the time is right for her to be granted an Absolut Discharge, she would most likely continue to be seen by a forensic psychiatrist at CAMH, until a non-forensic psychiatrist became available.

b) Both himself and her case manager will continue to work with Ms. Mitchell, to solidify, and increase, her insight into her major mental illness and her need for ongoing medication.

c) Ms. Mitchell is much better engaged, and open, with the clinical team, and she sees them on a regular basis, so there is less of a need to rely on her parents to pick up subtle signs of decompensation in Ms. Mitchell’s mental stability.

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 finds that Ms. Mitchell 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. Darby, in addition to the documentary evidence before us.

21. Ms. Mitchell suffers from a major mental illness, consisting of symptoms of psychosis, and she was diagnosed with a schizophrenic illness since age 19. When unwell, she has presented with auditory, and persecutory, delusions. She has been aggressive at times when apprehended under the Mental Health Act.

22. Ms. Mitchell is an individual who has committed serious violent offences while acutely mentally ill.

23. In particular, the Board relies on the Clinical Risk Factors/Re-offence Scenario and the Composite Assessment of Risk set out in the Hospital Report:

Ms. Mitchell’s criminogenic risk factors include: active symptoms of a major mental illness, non-compliance with medication, lack of adequate support system (personal and professional), unexpected stressors in life, limited coping strategies, and guardedness in disclosing her psychotic experiences.

In risk assessment, one of the best predictors is a patient’s history of violence. Ms. Mitchell’s offence appears to have occurred when she was in a floridly psychotic state precipitated by medication discontinuation.

If Ms. Mitchell were to re-offend, this will likely transpire in the following way: absent treatment and supports (professional and personal), psychosocial destabilizers will likely lead to non-compliance with medication, failure to cope, and increased guardedness which will result in inadequate psychiatric treatment and worsening of her mental state, including an emergence of psychotic symptoms, which will then increase her risk of violence.

Overall, results from the current assessment indicate that Ms. Mitchell poses a Low risk to violently reoffend on a detention order disposition, but a Moderate risk in the context of a premature conditional discharge. Given her history of mental illness, previous violence when unwell, limited insight into the impact of her illness and treatment on risk of future violence, the clinical team opines that she continues to meet the threshold for a significant threat to the safety of the public as defined in Section 672.5401.

24. To her credit, as set out in the Hospital Report, and as testified by Dr. Darby, Ms. Mitchell has been much more forthcoming, and much less guarded, with her clinical team over the last year. She has acknowledged that she was suffering from a mental illness at the time of the Index Offences. She has spoken with considerable emotion about her struggle to accept the fact that she suffers from a mental illness.

25. The Board accepts Dr. Darby’s evidence that the Mental Health Act would be sufficient to manage Ms. Mitchell’s risk to public safety. Further, as Ms. Mitchell is unable to consent to treatment, Box B under the Mental Health Act would be available in a timely fashion. Finally, Dr. Darby testified last year that he would like to see sustained improvement in Ms. Mitchell’s engagement with the treatment team before he could recommend a Conditional Discharge. He, in fact, has seen the initial stages of sustained improvement over the past reporting year.

26. 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 mental condition of Ms. Mitchell, her reintegration into society and her other needs, the necessary and appropriate Disposition is a Conditional Discharge, upon the terms set out, and agreed to by all the parties, in our formal Disposition.

DATED this 4^th^ day of March, 2026, at the City of Toronto, in the Region of Toronto.

Mr. J. Weinstein

Alternate Chairperson

__________________

Office of the Registrar

Ontario Review Board