Re: K. (K.)
ORB File No: 7950
Hearing held on: Wednesday, January 14, 2026
Place of hearing: North Bay Regional Health Centre
Pursuant to: Sections 672.48(1) & 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. P. Hageraats
Members: Dr. J. Watts Dr. G. Stones Ms. M. Chamberlain Ms. C. Plyley via video conference
Parties Appearing:
Accused: K. (K.) Counsel: Mr. T. Whillier
Person in charge of Hospital: Representative: Ms. C. Condie Counsel Mr. P. Trenker
Attorney General of Ontario: Counsel: Ms. M. Mazurski
REASONS FOR DISPOSITION
(Dated February 23, 2026)
Introduction:
On September 23, 2021, K. (K.) was found unfit to stand trial on account of mental disorder on charges of aggravated assault, assault with a weapon, assault a peace officer, resist peace officer (x2), fail to comply with release order and utter threat to cause death or bodily harm. These are offences contrary to the Criminal Code of Canada.
K. (K.) is currently subject to a disposition of the Ontario Review Board (“ORB” or “the Board”), dated February 18, 2025, ordering his detention at the North Bay Regional Health Centre - Forensic Programs (“NBRHC” or “the Hospital”).
Privileges were awarded to include residence in the community within the catchment area of the hospital in accommodation approved by the person in charge. K. (K.) was also granted the privilege of entering the community within Ontario accompanied by staff or a person approved by the person in charge, or by community agency staff.
On Wednesday, January 14, 2026, the Board convened at the NBRHC to review the disposition.
K. (K.) was present. He was represented by counsel, Mr. Thomas Whillier. A Hospital Report, dated December 2, 2025, was filed in evidence.
The issues to be determined are whether K. (K.) remains unfit, and, if so, to arrive at the necessary and appropriate disposition.
Positions of the Parties:
All three parties were in essential agreement: K. (K.) remains unfit to stand trial, and the current detention order should remain in place, on much the same terms.
Mr. Whillier advised that, to the extent he was able to receive instructions, K. (K.) was clear in having earlier told his counsel that he wished additional privileges, namely, to permit him indirectly supervised access to the hospital and grounds.
For the reasons set out below, the Board adopted the parties’ joint submission. K. (K.)’s request for indirectly supervised access to the hospital and grounds was denied.
Current Psychiatric Diagnoses, Hospital Report, p. 61:
Schizophrenia
Fetal Alcohol Spectrum Disorder
Intellectual Disability
Cannabis Use Disorder, in remission in a controlled environment
- K. (K.) is treated with psychiatric medications. These consist of:
Paliperidone palmitate 150mg every 21-days
Loxapine succinate 140mg combined daily dose
Sertraline HCl 150mg daily
Benztropine mesylate 2mg twice daily
Lorazepam 1-2mg PRN
Lorazepam 1-2mg IM PRN ONCE
Loxapine succinate 25-50mg PRN
Loxapine HCl 50mg IM PRN ONCE
Alleged Offences:
- The circumstances are described in the Hospital Report and in last year’s Reasons for Disposition dated February 18, 2025. There were three separate incidents in all, arising in March 2021.
Incident 1 - On March 5, 2021, the complainant’s granddaughter, K. (K.)’s younger sister, came to her residence and told her that K. (K.) had started a fire in his bedroom at their home. The complainant went to that home and found a burnt blanket outside on the stairs. The complainant went into K. (K.)’s bedroom and sat next to him on the bed. He put a cigarette out on his tongue. She told them not to do that. He then grabbed a glass ashtray and struck her on her head a couple of times. She had to hold him down to get him to stop. She then managed to get away when the police were called.
Incident 2 - On March 5, 2021, at approximately 3 PM, K. (K.) asked his uncle to give him some money and when he refused, K. (K.) became angry. He grabbed a dull knife and stabbed him on the nose and left side of the back area. He also punched the complainant three times in the face before fleeing the residence. Police were called and located K. (K.). As they approached, he put up his hands as if to engage in a fight with the police. However, he then began running and police followed until he fell on the ground. When the police attempted to handcuff him, he resisted by holding his hands in front of his chest. He was arrested and taken to the police station where he threatened the three officers involved in his arrest.
Incident 3 - after his arrest with respect to incident 2, K. (K.) was released on bail with a condition that he not attend his uncle’s residence. On March 9, 2021, after receiving the complaint with respect to incident 1, the police attempted to locate K. (K.). He was found in his uncle’s residence having entered without his uncle’s knowledge. When the police attempted to arrest him, he began to fight with them, and the police were required to use pepper spray to control him. K. (K.) wiped his face with his hand and then licked the pepper spray from his hand.
Background History:
K. (K.) is 21. Until May 27, 2024, K. (K.) had remained on inpatient status in hospital. He was discharged to a group home on that date. However, by October 19, 2024, he required readmission to the hospital, where he has remained to date.
The readmission on October 19, 2024, followed an altercation with a co-resident. The group home was no longer able to meet his needs.
K. (K.) is single. He has no dependents. He has an older sister and a younger sister and is a member of the Attawapiskat First Nation. Before he was found unfit in September 2021, he lived with his family in Attawapiskat, an isolated community on the shores of James Bay in Northern Ontario.
The family speaks Cree. He has only limited ability to communicate in either Cree or English. In his early school years, K. (K.)’s mother noticed he needed extra help in school. When it was provided, she found it was not adequate for his needs. Despite his limitations, K. (K.)’s mother has reported how she was amazed by his ability to understand and use a computer.
By the age of 16, family members were reporting that K. (K.) had struggles with his behaviours. He was abusing substances and stopped going to school in Grade nine. Before the index offences, he had no criminal record. In January 2024, K. (K.) was charged with assault following an incident in his group home. By May 2024, the charge was stayed by the court.
Psychiatric History:
- As quoted in last year’s Reasons for Disposition dated February 18, 2025, K. (K.) has a documented psychiatric history.
Kariya was noted to have undertaken numerous admissions to hospital as a consequence of suicidal ideation and behavioural dyscontrol. In an admission from May 18, 2021, it was noted that he was placed on the adult side of the psychiatric unit as his behaviours were considered “inappropriate and risky for the pediatric unit”. He has been admitted to various locations including Sudbury, North Bay, and Timmins.
Kariya reportedly experienced a deterioration in his mental health status that involved “an episode of experiencing voices, flatness of affect, bizarre behaviours, latency of expression, and some abnormal movements such as unusual blinking, teeth grinding and such.” This was noted to have occurred in 2011; however, a specific timeline thereafter was not provided. It is also noted that he may demonstrate features characteristic of individuals on the autism spectrum, and this includes “interest in touching things for example when out for a walk” but there were no other specific repetitive behaviours or focus sets of interests that were consistent with an underlying diagnosis of autism spectrum disorder.
It is noted that he was seen by Dr. Richard Painter, a child psychiatrist at North Bay Regional Health Centre on May 16, 2021, and the diagnoses offered therein were “intellectual disability, cannabis use disorder and rule out unspecified psychotic disorder”. He has been placed on various medications in order to assist him in the treatment of underlying psychotic symptoms as well as symptoms associated with aggression.
At last year’s ORB Review hearing held on January 29, 2025, the Board was provided with a “Gladue Report”. The author noted that K. (K.)’s group home with Temiskaming Shores Community Living had advised that although they were no longer able to accept K. (K.), they had identified a group home in nearby Englehart, Ontario which would be better suited to his needs. Funding was being sought to renovate the bottom level of the residence. It was thought this would provide K. (K.) with his own apartment while still providing him access to full-time staffing support.
The author of the Gladue Report had discussed a potential move to Englehart with K. (K.)’s mother and grandfather. They both advised they would not oppose the move and that this could make family visits easier for them. It was also noted last year that K. (K.)’s mother was considering a move to the North Bay area to pursue her own educational opportunities. In the alternative, some consideration was being given to have K. (K.) transferred to North Bay Community Living.
The concerning incident that prompted K. (K.)’s rehospitalization was discussed at last year’s hearing. Dr. Munro testified that the person who K. (K.) punched was a new resident and was quite intrusive. K. (K.) is quite sensitive to intrusions into his personal space and can react aggressively at such moments. The incident of concern was a second such outburst in that reporting year so that the Hospital’s decision to readmit was designed to help develop a better behavioural plan to reduce the risk of further aggressive outbursts.
Course in Treatment, January 2025 to January 2026:
K. (K.) remains incapable to consent to treatment. Substitute consent is provided by his mother. Throughout the reporting period, he has remained compliant with his medication regime.
K. (K.) has required some follow-up by his general practitioner on the hospital unit. His physical health has been generally stable. Issues of self-control with food intake are being monitored.
K. (K.) has a significant history of substance use, particularly cannabis. During the reporting period, there was no evidence that he has had access to substances. All urine samples monitoring possible consumption of substances have been negative.
K. (K.)’s baseline intellectual deficits make it difficult to inquire further into his symptoms. His communication is limited. When responding to clear and direct questions, he will typically utter only one to two words. K. (K.) is frequently observed responding to internal stimuli which have not been responsive to pharmacological treatment. To the extent that he does communicate, he has described voices and the occasional visual hallucinatory experience. In October 2025, K. (K.) engaged in self-injurious behaviour. He said he had been cutting himself with a plastic knife. Staff observed superficial marks.
Apart from one incident, K. (K.) has not posed a significant management concern. On August 7, 2025, he grabbed a co-patient and punched him in the face. Following a code white, K. (K.) was placed in overnight seclusion and given PRN medication.
When spoken to the next day, K. (K.) could not say what it was that had made him angry, apart from claiming he was “frustrated” and bothered by perceptual disturbances (voices). He was remorseful and agreed to and did apologize to the co-patient. Since then, no further difficulties have been reported. It was also learned that, before the incident arose, the co-patient had been making provocative and unkind remarks to K. (K.).
K. (K.) has been living on a forensic rehabilitation unit where he generally keeps to himself and does not typically socialize with others. He needs a great deal of support and prompting to complete activities of daily living. The behavioural analyst completed a functional behavioural assessment to update the behavioural care plan. K. (K.) has been engaged in some functional communication training, acquiring skills to escape social situations and interactions when others come too close to him.
K. (K.) qualifies for Passport funding through Development Services Ontario (“DSO”). However, there are only few available passport workers in the area to help him with outings into the community. It is anticipated that a new worker may become available shortly and that K. (K.) will be able to start activities such as pet therapy in hospital before transitioning to supervision in the wider community. K. (K.) does participate regularly in a wide array of Indigenous cultural activities, including Bannock social and smudge. He receives support from a case worker with the hospital’s Mînowacihewin Indigenous Services.
The family offers K. (K.) their continued support. During the current reporting period, he received several successful visits from his mother, grandfather, a sister, and a nephew.
Staff and management at Community Living Temiskaming Shores are still engaged. They occasionally visit the hospital, wishing to continue their plan to have K. (K.) eventually return to their group home setting. Currently, the planned placement is not available. There have been delays in processing Community Living’s funding proposals. Dr. Munro advised more recently that hoped-for funding might be secured for the new fiscal year, starting in April 2026.
Evidence at the Hearing:
The Board received direct testimony from Dr. Gillian Munro, K. (K.)’s attending forensic psychiatrist since January 2024.
Before the hearing began, Dr. Munro met with K. (K.) to assess his fitness for trial. He continues to have a very limited understanding and cannot answer any of the standard questions on the “Taylor test.” Dr. Munro advised that K. (K.)’s capacity regarding fitness is not likely to change due to his underlying intellectual disability and Fetal Alcohol Syndrome.
Dr. Munro addressed K. (K.)’s request for indirect supervision to the hospital and grounds. She noted that K. (K.) has never had community access without supervision. His limited cognitive ability is such that he lacks understanding to be able to follow terms of his ORB disposition or hospital policies. On previous occasions, he has smoked cigarettes and cannabis. There is concern about his ability to even remain on the hospital grounds if not directly supervised.
Dr. Munro pointed to the significant history of aggression and assaultive behaviour which can arise when K. (K.) is distressed by either being touched or having his possessions touched. He was also described as quite vulnerable to exploitation and risks to his personal safety when out in public, given his limited cognitive ability.
Responding to questions posed by counsel and Board members, Dr. Munro stated that the Hospital has not provided K. (K.) with coaching on the issue of fitness. The occupational therapist felt that programs of this type are not appropriate, given K. (K.)’s level of cognitive disability. K. (K.) has been uninterested in any form of one-to-one coaching. He has also had times of “low mood,” which the Hospital has tried to address without success.
K. (K.) would very much like to be living in the community and to have more contact with his family. In his current situation, this remains very challenging, given financial and logistical factors relating to the family’s distant location in Attawapiskat.
K. (K.) goes out into the community regularly. He enjoys shopping and receives funding from DSO and Passport sources. Dr. Munro is hoping that new staff, who are now being trained to help him, will be able to implement greater access to community outings. K. (K.)’s last opportunity to enter the community unsupervised was when he had been living in Attawapiskat.
Counsel asked Dr. Munro when she thought K. (K.) would get to the point of being able to exercise indirectly supervised community access. She replied, “not before several years of work, if we even succeed.”
A Board member asked Dr. Munro about previous cognitive testing. She advised this would have been done in earlier years when K. (K.) was at Syl Apps. The Hospital is still trying to obtain documentation about this.
Dr. Munro testified that K. (K.) continues to be very heavily engaged with the Hospital’s Indigenous Services. In addition to daily smudge, wellness circle and sharing circle, K. (K.) is on a list to attend a pow wow on a reservation in March. They are also hoping he will be able to attend the Friendship Centre in North Bay and to receive suitable services there.
Dr. Munro confirmed that the group home agency personnel in Temiskaming, who are awaiting transition funding to move some other residents – and which would free up a bed for K. (K.) – do want to have him come back into their system.
The parties presented no further evidence.
Current Hospital Risk Assessment (Hospital Report, pp 22-23):
The treatment team members report that K. (K.) will require a high level of support and supervision for the foreseeable future. His insight into his mental illness and the need for reliable adherence to his medication regimen is limited. He lacks insight into his deficits and the need of ongoing support.
K. (K.) repeatedly expresses his wish to return to his home community of Attawapiskat, Ontario – a small, isolated community on the James Bay coast. The home community has limited mental health supports and resources which are not sufficient to manage the risk he poses to public safety. The treatment team believes it imperative that the Hospital maintain authority to approve the patient’s accommodation.
K. (K.) has a significant history of substance misuse which, in the past, has likely resulted in an exacerbation of psychotic symptoms. The treatment team reports, absent oversight and supervision, it is highly likely that K. (K.) will become non-compliant with treatment and revert to substance use. It was previously felt that a decompensation would likely occur rapidly in the absence of treatment. Given his propensity to engage in aggressive behaviour, if left to his devices, it is anticipated that K. (K.) would present an unacceptable level of risk to public safety.
Submissions of the Parties:
- Counsel appearing for the Hospital and for the Attorney General submitted, it is highly unlikely K. (K.) will reach a point in the next twelve months where he will be able to make successful use of indirectly supervised privileges. Counsel representing K. (K.) reiterated their earlier stated position to seek indirectly supervised privileges.
Conclusions and Disposition:
Mr. K. (K.) remains unfit to stand trial. This was not in dispute and is well supported by the evidence and expert testimony provided. Although not yet finally determined, K. (K.) may likely be permanently unfit to stand trial.
The Board finds that K. (K.) continues to present a significant threat to the safety of the public. Again, this was not in dispute. K. (K.)’s limitations lead him to engage in aggressive and violent behaviours that are criminal in nature involving serious potential harm to others. These behaviours arise from his combined condition of schizophrenia and intellectual disability by which he responds violently when experiencing distress. While none of this is K. (K.)’s fault, it must be dealt with. The requirement to have him remain subject to oversight by the Ontario Review Board is the least onerous and least restrictive measure available.
K. (K.)’s condition is such that he requires the more onerous control which is only available through a formal detention order. Once he comes to hopefully be discharged to a group home suitable for his supervision and needs, K. (K.) will continue to require very close follow-up. The Hospital needs to retain the ability to quickly return and admit K. (K.) to their care should he begin to demonstrate worsening signs of mental instability or behavioural challenges.
Following his discharge from hospital, the Hospital will require the ability to select, approve, and monitor K. (K.)’s place of supervised accommodation. Given his functional limitations, K. (K.) needs to be in a structured supportive setting carefully tailored to address his personal limitations and special needs.
The Board considered granting K. (K.) the ability to access the hospital and grounds, indirectly supervised. We do not see how this would be safe, either for him or for others who he happens to meet. Given K. (K.)’s impulses and cognitive limitations, it would be much too risky to permit him to go off on his own, unaccompanied.
For these reasons, having regard to the primary protection of the public, and balancing K. (K.)’s mental condition, his reintegration and other needs, a detention order will issue on the same terms as before, without change.
We thank the parties and counsel for their assistance.
DATED this 23rd day of February 2026 at the City of Toronto, in the Toronto Region.
Mr. P. Hageraats
Alternate Chairperson
__________________
Office of the Registrar
Ontario Review Board