Re: Kareem Bishop
ORB File No: 8891
Hearing held on: Wednesday, January 7, 2026
Place of hearing: Waypoint Centre for Mental Health Care
Pursuant to: Section 672.47(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Finley
Members: Dr. R. Wood Hill Dr. G. Stones Ms. C. Murray Mr. J. Cyr
Parties Appearing:
Accused: Kareem Bishop Counsel: Ms. C. Francis (via Zoom)
The person in charge of hospital: Counsel: Mr. J. Thomson
Attorney General of Ontario: Counsel: Ms. S. Curry
REASONS FOR DISPOSITION
(Dated January 16, 2026)
Introduction
On October 20, 2025, Kareem Bishop was found not criminally responsible on account of mental disorder on charges of common nuisance, forcible confinement, assaulting a peace officer and mischief all contrary to the Criminal Code of Canada. Mr. Justice Waby declined to make a disposition and remanded the matter to the Ontario Review Board (“ORB”/“the Board”) for an initial hearing. Pursuant to a Warrant of Committal dated October 20, 2025, Mr. Bishop was transferred to Waypoint Centre for Mental Health Care (“Waypoint”/“the hospital”).
On January 7, 2026, the Board convened a hearing at Waypoint to determine whether Mr. Bishop represents a significant threat to the safety of the public, and if so, the necessary and appropriate disposition having regard to the criteria in s. 672.54 of the Criminal Code. Mr. Bishop was present and represented by Ms. Francis.
At the outset of the proceedings, counsel for the hospital and the Ministry of the Attorney General submitted that Mr. Bishop represents a significant threat to the safety of the public and the necessary and appropriate disposition is a detention order at the High Secure Provincial Forensic Division of the hospital.
Ms. Francis indicated that it was Mr. Bishop’s position that he should never have been found NCR of the index offences, he does not represent a significant threat and, therefore, an absolute discharge should follow. However, should the panel find that the threshold for significant threat had been met, Mr. Bishop submitted that a less secure facility with community living would be the necessary and appropriate disposition.
Findings
- For the reasons that follow, the panel found that Mr. Bishop represents a significant threat to the safety of the public and the necessary and appropriate disposition is a detention order at the High Secure Provincial Forensic Program at Waypoint.
The Evidence
- The evidence at the hearing consisted of the Hospital Report (ex. 1), dated December 11, 2025, and the viva voce evidence of Dr. Mishra, Mr. Bishop’s treating psychiatrist, and Mr. Bishop.
The Index Offences
- The circumstances of the index offences have been taken from the Hospital Report at pages 2-3:
Charges:
CC 430 (4) Mischief/Damage Property Not Exceeding $5000
CC 279 (2) Forcible Confinement
CC 180 (1) (a) Common Nuisance
On December 8th, 2024, at approximately 00:00 AM, the accused, Kareem a BISHOP, attended the A&W Restaurant at 1390 Nilson Rd. Toronto.
The restaurant has many large glad mugs to serve beverages.
At approximately 02:30 AM, the accused took one large glass mug without permission and smashed it onto the ground (charge 1).
The victim, [name redacted], feared for her safety and started walking towards the only exit door of the restaurant to leave. The accused locked the door from inside and stood before her, blocking her path to the exit. The victim asked the accused: “Can I leave?” The Accused replied “No”. The victim remained trapped inside the restaurant for over 20 minutes till the Police arrived (charge 2).
The accused continued to stand in front of the exit door and removed the fire extinguisher from the wall. His erratic behaviour obstructed the public from leaving, confined them inside the restaurant, caused them to fear for their safety, and prompted the witness, [name redacted], to call police (charge 3).
Officers arrived on the scene and observed the accused standing at the door and blocking the exit. Police arrested the accused, transported him to Toronto Police 42 Division, and held him for a show cause hearing.
Charge: Assault Peace Officer
On Tuesday January 21st, 2025, the victim, as well as other Toronto South Detention Centre staff attended the C4A area with the intention to meet with the accused for the purposes of relocating him. As staff opened the cell door, the accused made attempts to step out of the cell against the protocol and direction of staff members. The accused then became combative which resulted in numerous staff members being required to gain physical control of the accused. During the struggle, the accused kicked the victim in the stomach (charge).
Background Information
The Hospital Report contains detailed information as to Mr. Bishop’s personal background and psychiatric history and need not be reviewed in detail in these reasons beyond the following material points. Mr. Bishop was born and raised in Toronto. He developed an interest in modelling between the ages of 14 and 15 and briefly did some work in that field. However, his personal appearance and behaviour began to decline in his late teens. He began using illicit substances, including daily cannabis use, and later admitted to being involved in drug trafficking.
During high school, Mr. Bishop’s then girlfriend became pregnant. Tragically, their child died as an infant. Mr. Bishop’s mother noted a change in her son’s behaviour. After spending a period of time isolated in his room, Mr. Bishop began to engage in problematic behaviour that resulted in several youth convictions. As a result, he did not complete high school.1
Mr. Bishop now has a significant criminal record which includes multiple convictions for offences involving weapons, assaults, threats and failing to comply with court orders. When he was not incarcerated, he often lived with friends or in shelters. In the fall of 2024, Mr. Bishop’s mother experienced health issues that necessitated her being in hospital for a month. When she returned to her home, she discovered that Mr. Bishop was living in her house with someone. They locked the door and would not let her in. Eventually, Mr. Bishop’s mother was able to gain access to her home, and she immediately changed the locks. She has not had contact with her son since December 2024.
Mr. Bishop has had multiple psychiatric fitness assessments while in the criminal justice system. The first was in the fall of 2009 at Providence Care Hospital (Kingston). During this admission, he reportedly responded to treatment with antipsychotic medication and received a diagnosis of “Schizophrenic Illness with Paranoid Features”. Over the next six years, he had two admissions for a fitness assessment at Waypoint and one at Ontario Shores Centre for Mental Health Sciences (Ontario Shores).
While at Ontario Shores, Mr. Bishop spent the majority of his admission in seclusion. He presented as disorganized and agitated. He smeared food and feces, urinated on the floor, tore up his bedding, and punched the lights and camera in his room, destroying them. He declined to take any antipsychotic or sedative medications. Following his assessment, he was returned to the Toronto South Detention Centre. A physician at the jail completed a Form 1 and Mr. Bishop was transferred to Scarborough Hospital. He was found to be incapable of making treatment decisions and his mother was designated his Substitute Decision Maker (“SDM”). During this admission to hospital, Mr. Bishop attacked two security guards when staff were trying to administer an intramuscular (IM) injection.
In January 2016, Mr. Bishop again was admitted to Ontario Shores for a fitness assessment. During his admission, he caused significant property damage to the seclusion room and “presented with challenging and problematic behaviours”.2 The hospital determined that he was unfit to stand trial and recommended that, if the Court found him unfit, any treatment order include that he be detained at Waypoint. Mr. Bishop was found unfit to stand trial and was detained at Waypoint. He remained unfit at the conclusion of the Treatment Order and was returned to Waypoint pending his initial hearing before the Board.
At that initial hearing, Mr. Bishop was found fit to stand trial and returned to court. The Court agreed that he was fit and a keep fit order was made. Mr. Bishop was returned to Waypoint. During his admission, he was violent towards staff, resulting in the need for seclusion. Mr. Bishop was subsequently discharged from Waypoint in May 2016.
From June 2016 to April 2020, Mr. Bishop was subject to a Community Treatment Order (“CTO”). His mother continued to act as his SDM and he received psychiatric support from a community psychiatrist. During this period, Mr. Bishop resided with his mother and was able to complete his GED. On April 30, 2020, Mr. Bishop was found “marginally capable to consent to his treatments”. Following that determination, Mr. Bishop declined to continue his CTO and became noncompliant with his medications.
In March 2021, Mr. Bishop’s mother contacted police due to a deterioration in her son’s mental status. He was brought to North York General Hospital by police and admitted. Another CTO was arranged. His mother again acted as SDM and his previous community psychiatrist resumed providing support. This CTO was renewed several times until it expired in August 2024. Following her own discharge from hospital in the fall of 2024, Mr. Bishop’s mother determined that she was unable to continue to support Mr. Bishop. At point, Mr. Bishop had not had an antipsychotic medication injection since February 2024.
Following his arrest for the index offences, Mr. Bishop was detained at the Toronto South Detention Centre. He continued to refuse medication. On February 26, 2025, he was admitted to the Centre for Addiction and Mental Health (“CAMH”) pursuant to a Form 1. Upon admission, he presented as disorganized and seclusion was determined to be necessary. He was given antipsychotic medication under the consent of his SDM. Once he was stabilized, he was returned to the detention centre. He continued to refuse medication while in the correctional system.
On June 27, 2025, Mr. Bishop was admitted to Waypoint for the purpose of an NCR assessment. Due to his history of aggression while in custody, he was placed in seclusion. He exhibited paranoia about staff and believed that they were spying on him and planning to harm him. He was abusive towards staff, in particular, female staff.
Mr. Bishop also was aggressive towards property on multiple occasions during this admission. He would engage in unprovoked kicking of his room door with extreme force. He also displayed attention-seeking behaviors. When staff attempted to engage with him, he would yell expletives at them. On multiple occasions, he covered the windows of his room and the camera in the seclusion suite. He attempted to flood the room more than once, and the water supply to his room had to be turned off to prevent the corridor being flooded and possible harm to staff. His behavior remained unpredictable.
On June 9, 2025, Mr. Bishop had to be moved to a different room. Throughout the transfer, he was very abusive towards staff. At one point, he grabbed hold of a member of staff and later punched another staff member in the head. Throughout this admission, Mr. Bishop displayed poor frustration tolerance. He was easily angered when he felt that his needs were not being taken seriously, or he was being asked to do things which he did not like.
COURSE SUBSEQUENT TO NCR FINDING
Mr. Bishop was admitted to the High Secure Provincial Forensic Division of Waypoint on October 23, 2005. He was resistive and struggled with both correctional officers and hospital staff. Handcuffs and shackles were required. Once on the unit, he was extremely agitated and would not cooperate with the removal of the restraints. He made several aggressive gestures towards staff such as dragging his thumb across his throat and making a gun shape with his fingers and pointing at staff. Chemical restraints were deemed necessary to allow staff to remove the mechanical restraints.
Mr. Bishop’s current diagnoses are Schizophrenia, Antisocial Personality Disorder traits, Cannabis Use Disorder, in early remission, in a controlled setting. He remains incapable to consent to treatment, and his mother continues to be his SDM.
Despite his mother remaining involved in his care, Mr. Bishop perceives himself to have little to no family support. He speaks negatively about his relationship with his mother, and often assigns blame to her for his current situation (as he reports that she forced him out of her home and into homelessness). He has declined to have any in-person visits, and has only spoken to her on the phone on one occasion. There has been no contact with other family members.
Mr. Bishop continues to be held in seclusion. Pursuant to the hospital’s robust seclusion policy, Mr. Bishop has been assessed daily for seclusion relief. His presentation and mental status have continued to fluctuate, resulting on several occasions when he either refused or was assessed as inappropriate for seclusion relief.
According to the Hospital Report, Mr. Bishop does not believe that he has a mental illness or had ever had one. He does not believe that he has ever needed treatment or that treatment has been beneficial to him. He similarly showed no understanding of the finding of NCR or the ORB process. Any attempts to explain this were met with resistance and denial.
Shortly before the hearing date, the clinical team met with Mr. Bishop to discuss the Hospital Report and the team’s recommendation to the Board. During the meeting, Mr. Bishop stated that he believes that he is being unfairly targeted and voiced hostility towards the system and rules. These beliefs appear to be driven by paranoid delusions. Mr. Bishop made veiled threats of violence saying that he could be expected to react in a way that he deemed fit if he was subjected to situations that he deemed unacceptable.
The Hospital Report includes the following summary of Mr. Bishop’s current insight:
“Mr. Bishop demonstrates significantly limited insight into his mental illness, risk for violence and treatment needs. He consistently denies having a mental disorder, denies any history of violence, and attributes his behaviour to others or external circumstances. He asserts that he does not need to be in hospital and is “not a risk to the public” despite substantial evidence to the contrary and maintains that he “did nothing wrong.” He also denies the need for medication, questioning why he should take treatment when he believes his “mind is not being deteriorated.”3
Mr. Bishop continues to display symptoms of psychosis, including disorganized thinking and paranoia. On occasion, this has resulted in him reacting aggressively when he feels threatened or misunderstood.
Dr. Mishra testified before the panel. He indicated that Mr. Bishop has a long history of schizophrenia, violence and noncompliance with treatment. He noted that one of the index offences involved institutional violence. On a positive note, Mr. Bishop did do well when he was subject to a CTO and was taking long-acting injections of antipsychotic medication pursuant to the consent of his SDM.
Dr. Mishra indicated that at present, Mr. Bishop’s mental illness is partially treated. He has received three doses of medication so far and some improvement in his mental status has been noted. The team is considering whether an increase in the current dosage may be required.
In Dr. Mishra’s opinion, Waypoint is the best placement for Mr. Bishop. As previously noted, he has a history of institutional violence. He currently requires seclusion while in the maximum-security facility. In the doctor’s opinion, a less secure facility would not be able to adequately manage the significant risk that Mr. Bishop currently poses.
Residing in the community also would not be appropriate to manage Mr. Bishop’s risk at this time. He has a history of aggressive behaviour while in the community, often in the context of noncompliance with medication. One of the index offences involved aggressive behaviour towards a complete stranger in a restaurant.
Dr. Mishra testified that the Mental Health Act would not be sufficient as it would not afford the team the ability to respond quickly enough to intervene and prevent Mr. Bishop from acting violently should he experience a deterioration in his mental status.
Dr. Mishra testified that Mr. Bishop’s presentation has improved with the initiation of antipsychotic medication. He continues to struggle with staff and can be irritable, suspicious and antagonistic. Mr. Bishop is getting closer to being able to demonstrate sufficient mental stability as to no longer require seclusion to manage his risk for violence.
Mr. Bishop testified that he does not believe that he represents a significant threat to the safety of the public. He does not believe that he is aggressive or threatening. He hopes that he will be able to live in the community, or if necessary, in a less secure facility.
Mr. Bishop indicated that he would continue to take his medication, which will ensure that he will not be in trouble with law enforcement. He indicated that he had a negative experience when he was admitted to Waypoint ten years ago. He would prefer to be detained at either Ontario Shores or CAMH. If allowed to reside in the community, he would go to the John Howard Society or reside with his mother, with whom he has a good relationship.
At the conclusion of the evidence, all parties maintained their respective positions.
Analysis and Conclusion
The panel carefully considered the Hospital Report and the evidence of Dr. Mishra and Mr. Bishop and unanimously concluded that Mr. Bishop remains a significant threat to the safety of the public. Mr. Bishop’s risk flows from his diagnosis of Schizophrenia. He has a long history of being noncompliant with medication which has led to acts of aggression in the community, correctional facilities, and hospitals.
Mr. Bishop continues to lack insight into his mental illness and the need for treatment. He has done well when subject to a CTO and taking treatment pursuant to his SDM’s consent. However, whenever he has had a choice whether to be compliant with treatment, he ultimately has declined. The following Composite Assessment of Risk as found in the Hospital Report, at page 36, is apposite:
“Mr. Bishop suffers from a major mental illness i.e., schizophrenia. Acts of violence can be anticipated when he is untreated and experiencing active symptoms of psychosis including paranoid and persecutory delusions, auditory hallucinations and disorganization. This was evident in the commission of the index offense in which he targeted a random stranger at a fast-food restaurant believing that she posed a threat to him. He had displayed poor compliance with treatment in the past unless it was mandated under the Mental Health Act. He continues to display active symptoms of psychosis with poor insight into his illness or the risk posed by him. He requires seclusion at present to manage the risk of violence to those around him. He will require ongoing supervision under the jurisdiction of the Ontario Review Board to manage the significant threat to the safety of the public that he poses due to the above-noted factors.”
Having found that the threshold for significant threat has been met, the panel also had to determine the necessary and appropriate disposition taking into consideration the criteria set out in s. 672.54 of the Criminal Code. The panel found that a detention order at the High Secure Provincial Forensic Program at Waypoint is necessary and appropriate to manage Mr. Bishop’s risk to the public. Mr. Bishop has a lengthy criminal history that includes significant violence. The index offences involve violence both in the community and in an institutional setting.
Notably, Mr. Bishop’s behaviour during the prehearing meeting was and remains concerning. It is reflective of his current mental status. He has no insight into his mental illness or the need for treatment. He continues to experience symptoms of illness, including paranoia. As a result, he objects to receiving any medication and reacts accordingly. He currently requires seclusion in a maximum-secure facility. However, Dr. Mishra has noted an improvement in Mr. Bishop’s mental status since the commencement of antipsychotic medication. Once Mr. Bishop achieves some stability, it is anticipated that his seclusion will no longer be necessary.
Accordingly, the panel finds that Mr. Bishop represents a significant threat to the safety of the public and the necessary and appropriate disposition at this time is a detention order at the High Secure Provincial Forensic Program at Waypoint with the terms and conditions as recommended by the hospital.
DATED this 16th day of January 2026, at the City of Toronto, in the Region of Toronto.
Ms. C. Finley
Alternate Chairperson
__________________
Office of the Registrar
Ontario Review Board