Re: Athena Paul Kosy
ORB File No: 6099
Hearing held on: Friday, March 20, 2026
Place of hearing: North Bay Regional Health Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. M.D. Segal
Members: Dr. W. Komer
Dr. P. Wright
Ms. N. Nathanson
Mr. A. Bouvier
Parties Appearing:
Accused: Athena Paul Kosy
Counsel: Mr. C. Bracken
Person-in-Charge of Hospital Counsel: Mr. P. Trenker
Attorney General of Ontario: Counsel: Ms. M. Mazurski
REASONS FOR DISPOSITION
(Dated April 10, 2026)
Introduction
On April 12, 2012, Athena Paul Kosy was found not criminally responsible on account of mental disorder on charges of possession of a weapon for a dangerous purpose and fail to comply with a probation order contrary to the Criminal Code. Ms. Paul Kosy is subject to a Disposition of the Ontario Review Board (“the Board”) dated April 9, 2025, ordering a Conditional Discharge.
On Friday, March 20, 2026, the Board convened a hearing at the North Bay Regional Health Centre (“the Hospital”) to review Ms. Paul Kosy`s Disposition pursuant to section 672.81(1) of the Criminal Code. Ms. Paul Kosy was present and represented by counsel, Mr. Bracken. The issues to be determined at the hearing were whether Ms. Paul Kosy continued to constitute a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and, if so, what was the necessary and appropriate Disposition that was also the least onerous and least restrictive taking into account the factors set out in section 672.54 of the Criminal Code.
Position of the Parties:
The Hospital’s position is that the necessary and appropriate Disposition is a continuation of the current Disposition, that being, a Conditional Discharge.
Counsel for the Ministry of the Attorney General, Ms. Mazurski, supports the Hospital’s position.
Counsel for Ms. Paul Kosy, Mr. Bracken, indicated that this was a joint position. The Board appointed Mr. Bracken as counsel upon his request.
For the reasons that follow, the Board finds that a Conditional Discharge on the same terms as last year’s Disposition is the necessary and appropriate Disposition that is the least onerous and least restrictive.
Index Offences:
- The circumstances surrounding the Index Offence are set out in last year’s Reasons for Disposition.
In summary, on February 23rd, 2012, Ms. Paul-Kosy was in a public hotel in Sudbury. She became involved in a verbal altercation with a bartender and in the course of that paced about the bar holding a knife. The knife had a 3-inch blade. A patron took the knife away from her. She was subsequently arrested. At the time she was bound by a probation order dated September 7th, 2011, which included a condition that she keep the peace and be of good behavior.
Background Information Regarding the Accused:
- The Board admitted the Hospital Report, dated February 4, 2026, into evidence as Exhibit #1. The Hospital Report provides in-depth information concerning Ms. Paul Kosy, her personal history, mental health history, details of the index offence and course in Hospital and in the community subsequent to the date of the original NCR finding. As the Hospital Report was made an exhibit in this hearing, it is not necessary to reproduce the substantial background information it contains in these Reasons. We do note, however, certain highlights and the stated diagnoses of:
Schizophrenia
Substance Use Disorder (cocaine, marijuana, opiates), in full remission in a controlled environment;
Borderline Personality Disorder
- Ms. Paul Kosy is a 35-year-old First Nations woman who grew up in Sudbury. She has seven siblings, and her mother passed away in 2008. She has one son with whom she maintains a relationship while being raised by her paternal grandparents. She has a relationship with her father. She left school in grade 9 although since her hospitalization under the Board’s jurisdiction she completed her high school diploma in June 2022. She has no formal employment background.
Legal History:
- Prior to the Index Offences, Ms. Paul Kosy had an extensive criminal record starting in youth court in 2007. The record includes convictions for criminal harassment, assault, drug and prostitution offences, break and enter and numerous convictions for breaching court orders. Subsequent to the Index Offences she was convicted of assaulting a hospital staff member in 2016.
Substance Use History:
Ms. Paul Kosy was often homeless and living on the streets. She has a history of illicit drug use including crack cocaine, intravenous cocaine, cannabis, narcotics, and alcohol and has admitted to prostituting herself to gain money for her drug use.
It should be noted that while she has engaged in drug seeking behavior a number of times since her admission to Hospital under the ORB, in recent years, this has not been a feature of her conduct, and her drug /substance screens have been negative.
Psychiatric History:
- As indicated in last year’s Reasons:
Ms. Paul Kosy’s first admission to hospital with respect to mental health related issues was in January 2008 when she was brought to the emergency room of the Sudbury Regional Hospital by police after her brother had reported that his sister was “out of control” yelling and had a knife. Upon admission she admitted to hearing voices with both positive and negative command hallucinations. After several weeks she was discharged against medical advice with a diagnosis of schizophrenia, disorganized type, and marijuana abuse. Ms. Paul Kosy was admitted to hospital with respect to mental health related issues a further six times prior to the index offences.
A Community Treatment Order was issued in 2010. However, her psychiatrist and the Sudbury ACT-2 team were unable to maintain her in a stable psychiatric condition in the community because they were seldom able to locate her.
While in Hospital between 2012 and 2016, there were a significant number of incidents of assaultive, threatening, and aggressive behaviour.
On August 23, 2016, due to lack of a full-time psychiatrist, Ms. Paul Kosy was transferred from the North Bay Regional Mental Health (“NBRMHC”) to the Southwest Centre for Forensic Mental Health. She remained there until 2018, when she transferred back to NBRMHC.
In recent years, Ms. Paul Kozy’s mental status has become much more stable. In March 2023, she was granted a Conditional Discharge.
While in Hospital and the community, Ms. Paul Kosy has sought out programming related to her Indigenous culture at Native Services, Regional Aboriginal Mental Health Services and Minowacihewin Regional Service for Indigenous People. In 2018, she had an assessment with an Aboriginal Mental Health Services clinician, where she identified her Aboriginal culture as very important to her. She has participated in sweat lodge ceremonies and Powwows. In 2020, when she was approved for unsupervised visits with her father, Regional Aboriginal Services provided the transportation. This service also provided her with funding and support when she completed her Ontario Secondary School diploma in 2022.
Overall, Ms. Paul Kosy has had a positive year. She has been living in the community at a 24/7 supervised residence. She has significant support including bi-monthly video appointments with her psychiatrist, monthly in-person visits from the Forensic Outreach staff, three weekly home visits with the Assertive Community Treatment Team (“ACTT”) and monthly meetings with the ACTT psychiatrist.
She has engaged with her church. She is satisfied with her housing situation that provides health support, social support, and a safe environment. She relies on her support team for medication adherence. She has progressed in insight and judgment but can become overwhelmed and anxious.
On April 6, 2025, she went to the Hospital Emergency Department suffering from respiratory issues. She was hospitalized until April 14. She reported suicidal and paranoid thoughts, and command hallucinations, symptoms that can arise when she is unwell.
A January 31, 2025, report reviewed and updated previous risk assessment results concluding:
In considering the PCL-R:2 and HCR-20V3, historical, and protective factors, it is our current opinion that her:
Risk for Future Violence is Moderate (without all the supports in place)
Risk for Serious Physical Harm (i.e., severity of the violence) is High
Risk for Imminent Violence is Low (given all the supports in place)
(pg. 111 Hospital Report)
- On January 23, 2026, when treatment team met, their opinion concurred with the risk assessment report that the risk of recidivism is considered low with forensic oversight and the current structured support in place.
Evidence at the Hearing:
Dr. Kolawole, Ms. Paul Kosy’s treating psychiatrist, provided evidence for the Hospital. Ms. Paul Kosy had a positive year. She is residing at a privately run group home outside Sudbury. Dr. Kolawole has visited and described it as a very high quality residence providing comprehensive support, meals, and medication support to 12 individuals.
Ms. Paul Kosy is further supported by the Hospital’s Forensic Outreach Team, the ACTT and CMHA. The medium to long term plan is to continue and increase the role of ACTT while correspondingly reducing the frequency of engagement with the Forensic Outreach Team eventually transitioning Ms. Paul Kosy to the care of the civil mental health system, including prescribing medication.
Ms. Paul Kosy has expressed her wish to live independently but Dr. Kolawole noted that would be a challenge for her.
Dr. Kolawole noted Ms. Paul Kosy’s turbulent history of violence and aggression. He credits the mandated structure and external control of the current Disposition for helping her to become as well as she has and abstaining from substances. It is hoped that over the next year, a picture will emerge as to what will be needed for her to manage without the jurisdiction of the Board.
Upon questioning from the Board, Dr. Kolawole indicated that Ms. Paul Kosy continues to be connected to Indigenous services and programming. She has family connections and visits have gone well. With support from ACTT and the Forensic Outreach Team, she engages in recreation activities, shopping, and activities.
Analysis and Conclusions:
Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board finds that Ms. Paul Kosy continues to pose a significant threat to the safety of the public that can be managed by the terms of the Conditional Discharge in place.
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. Kolawole in addition to the documentary evidence before us.
The Board takes into consideration the evidence in the Hospital Report (pg. 112) regarding the continued need for oversight to manage risk:
The treatment team opines that the risk of recidivism is considered low with forensic oversight and the current structured support in place.
The treatment team unanimously believes that Ms. Paul Kosy continues to meet the threshold for significant threat to the safety of the public. Without structured support, she would likely stop taking medications, leading to mental health deterioration, increased psychotic symptoms (auditory hallucinations, paranoid, and delusional ideations), thoughts of self-harm and harm to others, and an increased risk of aggressive and violent behaviour.
Ms. Paul Kosy has made significant progress and has done well in the past year. The Board accepts the treatment team’s plan to gradually reduce reliance on the forensic team and increase the involvement of ACTT over the course of the next year in preparation, hopefully, for a future move away from the forensic system. This demonstrates an appropriately cautious but progressive approach that is warranted in view of Ms. Paul Kozy’s history, risk assessment, and the fact she can continue to experience symptoms of her illness when she is unwell, which occurred as recently as April of 2025.
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, Ms. Paul Kosy’s reintegration into society and her other needs, the necessary and appropriate Disposition is a continuation of the Conditional Discharge, upon the terms as currently in place.
The Board commends Ms. Paul Kosy for the progress she has made and wishes her well for the coming year.
DATED this 10th day of April 2026, at the City of Toronto, in the Region of Toronto.
Ms. N. Nathanson
Legal Member
__________________
Office of the Registrar
Ontario Review Board