Ontario Review Board
Re: Moneka Wijesekara
ORB File No: 8629
Hearing held on: Thursday, December 18, 2025
Place of hearing: Ontario Shores Centre for Mental Health Sciences 700 Gordon Street, Whitby
Pursuant to: Section 672.47(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. C. MacIntyre, KC
Members: Dr. K. Hand Dr. M. Kalia Mr. E. Siebenmorgen Mr. R. Rainboth
Parties Appearing:
Accused: Moneka Wijesekara Counsel: Ms. M. Perez
The person in charge of hospital: Counsel: Ms. J. Szabo
Attorney General of Ontario: Counsel: Ms. N. MacDonald
REASONS FOR DISPOSITION
(Dated January 21, 2026)
Introduction
[1]. On September 6, 2024, Moneka Wijesekara was found not criminally responsible on account of mental disorder on charges of sexual assault, forcible confinement and identity fraud.
[2]. The court did not make a disposition and referred the matter to the Ontario Review Board. Accordingly, on December 18, 2025, the Ontario Review Board convened at Ontario Shores Centre for Mental Health Sciences (“Ontario Shores”) to conduct Ms. Wijesekara’s initial hearing and to make a disposition further to s. 672.47(1) of the Criminal Code.
[3]. At the outset of the hearing, the parties presented their initial positions. The hospital, supported by the Attorney General, submits that Ms. Wijesekara is a significant threat to the safety of the public and that she ought to be subject to a Conditional Discharge with terms and conditions outlined in the hospital’s June 26, 2025, Hospital Report. This report was filed as Exhibit 5 at this hearing.
[4]. On behalf of her client, Ms. Perez submitted that Ms. Wijesekara was not a significant threat to the safety that public and should be absolutely discharged.
[5]. At the conclusion of the hearing, the parties maintained their initial positions with Ms. Perez adding that in the event that the Board finds that Ms. Wijesekara is a significant threat to the safety of the public, her client agrees with the Conditional Discharge proposed by the hospital.
[6]. As the hearing progressed all parties agreed that a proposed condition, that being a no contact clause with the victim of the index offences, was unnecessary and need not be included in any Disposition.
[7]. For the reasons that follow, the Review Board concluded that at the present time Ms. Wijesekara is a significant threat to the safety of the public and agreed with the Conditional Discharge proposed by the hospital and supported by the Crown without the inclusion of the no contact condition.
Index Offences
[8]. A description of the index offences is outlined in the June 26, 2025 Hospital Report as extracted from the York Regional Police records. They are summarized as follows:
[9]. On March 12, 2023, Ms. Wijesekara attended the Cortellucci Vaughan Hospital with her father. Her family physician had suggested this visit as the accused had “a relapse, taking too much medication, not being able to stay still for about the last three to five days and getting worse”. She was seen by a Dr. Leung who felt that she was mentally stable at the time and she was advised to return later in the day. Instead, she and her father stayed in hospital. Later on that day, the accused left the waiting room that she and her father were occupying and entered the hospital room of a female patient. Ms.Wijesekara identified herself as a doctor to this patient and told her she would help her with her migraine symptoms. She first began massaging her head and then asked the victim to take her clothing off the upper portion of her body, whereupon she rubbed her back. She eventually advised the patient to take off her lower clothing when they were interrupted by the patient's boyfriend at which point the accused began yelling at him to leave the room and lunged at the door attempting to close it.
The accused’s screaming alerted the attention of nursing and security staff who had to pull the victim out of the room. While security attempted to restrain the accused, she began throwing punches and biting them. Eventually she was restrained and sedated and placed on a Form 1.
Background
[10]. Dr. Sebastien Prat was asked to provide a psychiatric assessment of Ms. Wijesekara to inquire into her criminal responsibility. Dr. Prat’s report of July 31, 2024, (Exhibit 4) as well as the hospital report of June 26, 2025, (Exhibit.5) should be referred to for information regarding Ms. Wijesekara’s background and medical and psychiatric history.
[11]. Ms. Wijesekara is now 28 years old. For about seven years prior to the index offences, she had been treated for bipolar disorder by psychiatrist, Dr. Kurup. This disorder had required several visits to emergency departments over the years when sleeping difficulties and early signs of manic symptoms were common. She was treated primarily with oral Abilify and monthly injectable medication.
[12]. Her longest period of hospital admission was from December 17 to 31, 2021, under Dr. Kurup’s care. She had been placed on a Form 1 for lack of competence to care for herself.
[13]. Ms. Wijesekara’s attendance at the emergency room on the date of the index offences was because of a lack of sleep and her father had identified early signs of relapse.
[14]. The accused and her father had waited for about eight hours in the waiting area of the hospital before the index offences took place. The accused’s father had noticed that his daughter was getting restless but overall, he felt her behaviour was appropriate. He was unaware of his daughter visiting another patient until he heard someone scream and seeing security staff around the victim patient’s room. According to him, his daughter’s increased agitation and erratic behaviour was uncharacteristic for her.
[15]. Ms. Wijesekara has no criminal record and there is no history of illicit substances and at the time of the index offence she had apparently been compliant with long-acting injectable Abilify.
[16]. Dr. Prat observed that Ms. Wijesekara had had several decompensations over the years and experienced manic symptoms that were difficult to treat. When she became unwell, this occurred quickly and her symptoms are serious and not obvious to others.
Evidence at Hearing
[17]. Dr. Claire Harrigan testified on behalf of the hospital. She is the author of the June 26, 2025 Psychiatric Assessment as ordered by the Ontario Review Board. Dr. Harrigan adopts the contents of that report in which she outlined an assessment of the accused’s risk as follows:
“For the following reasons, it is my opinion that Ms. Wijesekara meets the threshold for significant threat to the safety of the public, despite there also being many positive factors in her favour. Ms. Wijesekara has a diagnosis of a major mental disorder, that being Bipolar Affective Disorder Type 1 with Psychotic Features. Despite having relatively prolonged periods of stability (e.g. 2017-2021; 2021-2023) when she has been living at the family home with her parents, Ms. Wijesekara has had a number of hospitalizations since 2017 where she has presented with manic symptoms (euphoric or irritable mood, pressured speech, distractibility, flight of ideas) and psychotic symptoms (grandiose, religious, erotomanic delusions, disorganized speech and disorganized behaviour). When she is acutely unwell, she engages in verbal and physical aggression. She also becomes highly intrusive with others, behaviours which have not only contributed to the Index Offences, but which have resulted in Ms. Wijesekara being the victim of assault. Due to her aggression whilst unwell, she has required the use of seclusion and chemical and physical restraints to ensure her safety and the safety of others. Ms. Wijesekara has no insight into the need for hospitalization or treatment during periods of decompensation, and it is largely due to her parent’s oversight and their attunement to her sleep patterns that she has been brought to the attention of medical professionals.
Ms. Wijesekara has a history of non-compliance with both oral and injectable antipsychotic medications. This is despite her seemingly demonstrating good insight into the need for medication upon discharge after hospitalizations. At times, signs of her decompensation can be subtle, such as prior to the Index Offences in March 2023 when she was assessed and deemed not to be certifiable. Ms. Wijesekara has also decompensated significantly in the context of non-compliance with oral medication despite documented compliance with her depot antipsychotic medication. This appeared to be the case just prior to her three-month long hospitalization in May 2024 where she was mostly confined to the PICU in order to effectively manage her aggression. Additionally, symptoms of her illness appear to have become more treatment resistant with each subsequent decompensation, as evidenced by the number of failed medication trials during her most recent hospitalization prior to finding a combination of medications that have been effective.
At this point in time, symptoms of Ms. Wijesekara’s illness appear to be stable on her current medication regimen. She has not required hospitalization since her discharge in August 2024. She also appears to be balancing her educational and employment responsibilities well. She is currently living at home and she does have outpatient follow-up with Dr. Kurup. However, of significant concern is that Ms. Wijesekara has decompensated in precisely this same context, with these same supports, in the past. Ms. Wijesekara is highly sensitive to psychosocial stressors, and early signs of decompensation can be difficult to discern (e.g. changes in her sleep patterns). As recently as April 2025, she has contemplated switching her injection to one that has been ineffective in the past due to side effects with her current medication. Ms. Wijesekara has also expressed some ambivalence about continuing to live with her parents, who are a significant protective factor for her given their ability to closely monitor her sleep patterns and her stress levels. They also act as a safeguard; in that they have a proven history of taking Ms. Wijesekara to hospital if they notice any signs that she might be becoming unwell.”
[18]. Dr. Harrigan also provided an Addendum of October 7, 2025, (Exhibit 6) to the above-noted report wherein Ms. Wijesekara admitted that she felt ashamed of the index offences and that she had no sexual attention towards the victim and just wanted to heal her.
[19]. Following the index offences Ms. Wijesekara’s community psychiatrist, Dr. Kurup, had discussed the possibility of adding lithium to her medications and also suggested a trial of clozapine due to the treatment resistant nature of her bipolar illness.
[20]. Clozapine treatment began at the end of September. When Dr. Harrigan spoke with Ms. Wijesekara the week before the hearing, the titration process of clozapine was taking place and her previous risperidone injection had been terminated.
[21]. Dr. Harrigan testified that when she spoke to Ms. Wijesekara, she was continuing to do work shifts at Winners and was planning on taking three biology courses at university. She was attending her doctor’s clinic for blood work weekly and attempting to improve her sleep pattern.
[22]. Dr. Harrigan believes that Ms. Wijesekara’s planned academic courses could be stressful for her and could interfere with her sleep. Her symptoms seem to be managed on clozapine though Dr. Harrigan perceived that there were still some elements of hypomania evident, primarily grandiose and overvalued ideas, which do not reach the level of mania.
[23]. Dr. Harrigan testified that historically there seems to be a pattern to Ms. Wijesekara’s decompensation. Minor triggers might prompt this. She has a history of some noncompliance with medication. Her decompensation is rapid and takes place even when she is compliant with medication. In the past, academic stressors have triggered episodes, and Ms. Wijesekara needs some support in place to deal with this. Dr. Harrigan agreed that mental illness specific therapy focused on strengthening coping strategies and preventing clinical decompensation may be provided through an outpatient clinic as part of a broader risk-mitigation and non-medical management plan.
[24]. The hospital’s overall plan is to manage Ms. Wijesekara on a Conditional Discharge. Dr. Harrigan observes that the Mental Health Act has been used appropriately in the past. Ms. Wijesekara will continue to live with her parents who are supportive and attuned to her illness. She will be followed by an outpatient team to provide close monitoring of her medication and behaviour and what triggers her stress.
[25]. Gaining weight on clozapine medication is a common concern, and it is a possibility that this might discourage Ms. Wijesekara from continuing this medication. Dr. Harrigan emphasizes that a balance of work, school, hobbies and sleep is required. Her loss of sleep is a predictor for decompensation. Dr. Harrigan testified that at times Ms. Wijesekara would be aware of sleep loss and it appears that her parents also notice this.
[26]. Ms. Wijesekara’s decomposition is not necessarily evident to those around her as illustrated by the index offences when her father, who was with her all day, did not anticipate her behaviour with the victim patient. Earlier that day she had been seen in that hospital by a psychiatrist who felt that she was stable.
[27]. Ms. Wijesekara has taken a semester off from school to deal with her mental and physical health issues and to adjust to the new medication. She has also reduced her work time. Dr. Harrigan agrees that these are positive acts undertaken by Ms. Wijesekara herself to help address her issues.
[28]. Dr. Harrigan agrees that Ms. Wijesekara has been cooperative throughout, yet the hospital is requesting that a Young clause be included as a condition in her Conditional Discharge. This allows staff to be proactive in getting her to hospital from her community home if a rapid decompensation takes place.
[29]. Dr. Harrigan testified that Ms. Wijesekara’s experience through the index offences and being in hospital has been quite disturbing for her. Dr. Harrigan describes her as a very social and empathetic person. Nonetheless, she needs external support from the hospital’s Forensic Outpatient Team with the added benefit of access to her psychiatrist, Dr. Kurup.
[30]. In submissions, the hospital and Crown Attorney maintained their initial request that the Board find that Ms. Wijesekara is a significant threat to the safety of the public and requires a Conditional Discharge to manage her treatment resistant bipolar disorder.
[31]. Ms. Perez asked for an Absolute Discharge for her client. She asserts that there is no evidence that she has caused anyone serious physical harm and that it is only speculative that there has been serious psychological harm.
[32]. Ms. Perez also points out that Ms. Wijesekara has gone to hospital to seek help over the years. She has used Dr. Kurup in the past and intends to use her services in the future. Ms. Perez suggests that a Conditional Discharge is an overly cautious approach.
Decision
[33]. The Board accepts the evidence of the hospital which supports a finding that Ms. Wijesekara is a significant threat to the safety of the public. The index offences themselves are an indication of behaviour that led to physical touching and coercion. It is neither difficult nor speculative to conceive of the distress of the victim when it became apparent that the accused’s actions were not legitimate and in fact involved fraudulent misrepresentation as a physician with physical touching that violated her privacy and bodily autonomy.
[34]. The hospital reports refer to Ms. Wijesekara being intrusive with other students when she was attending university and during a hospital admission in December 2021, her behaviour required physical and chemical restraints. These seemed to be coincident with her noncompliance with prescribed medication.
[35]. The Addendum to the Hospital Report refers to a three-month long hospitalization in May of 2024. Ms. Wijesekara was then so disorganized and aggressive due to her manic and psychotic symptoms that she remained in the Psychiatric Intensive Care Unit for most of that three-month period. This evidence bears out Dr. Harrigan’s opinion that Ms. Wijesekara’s symptoms appear to be becoming more treatment resistant with each subsequent decompensation. Without the added protection and monitoring provided through forensic oversight, there is a real and substantial likelihood of worsening decompensation leading to more serious levels of aggression.
[36]. These events are clearly related to Ms. Wijesekara’s manic symptoms of bipolar disorder. It is just as clear that Ms. Wijesekara is a high functioning individual with no previous criminal record and who is upset and remorseful about the events of March 12, 2023.
[37]. Nevertheless, Ms. Wijesekara is vulnerable to decompensation even when she is adherent to prescribed medication. On the evidence, she loses her insight when in such a state. The Board is satisfied that there is a real likelihood that when unwell, she will engage in conduct of a criminal nature that would result in physical or psychological harm that is serious and not trivial.
[38]. The Board also finds that a Conditional Discharge is the least onerous and restrictive disposition for Ms. Wijesekara at this time and that the management plan proposed by the hospital to include the Forensic Outpatient Service combined with Dr. Kurup’s support and that of her parents takes into account the safety interests of members of the public. The Board wishes Ms. Wijesekara well on her path to managing her illness.
[39]. In all the circumstances, the necessary and appropriate Disposition is a Conditional Discharge with the terms proposed by the hospital without the inclusion of the provision for no contact with the victim of the offence whom the accused does not know.
DATED this 21st day of January 2026, at the City of Toronto, in the Region of Toronto.
Mr. C. MacIntyre, KC Alternate Chairperson
Office of the Registrar Ontario Review Board