Ontario Review Board
Re: C. (K.)
ORB File No: 5593
Hearing Held On: Friday, March 27, 2026
Place of Hearing: Centre for Addiction and Mental Health
Pursuant To: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. L. Banks
Members: Dr. S. Lessard
Dr. J. Cheston
Ms. A. La Viola
Mr. J. Cyr
Parties Appearing:
Accused: C. (K.)
Counsel: Mr. A. Rai
The person in charge of hospital: Counsel: Ms. M. Warner
Attorney General of Ontario: Counsel: Ms. N. Engineer
*Pursuant to s. 672.501(1) of the Criminal Code, the Ontario Review Board prohibits the publication, broadcasting, or other transmission of any information that could identify a victim in this matter or a witness who is under 18 years of age.
REASONS FOR DISPOSITION
(Dated May 12, 2026)
OVERVIEW
- C. (K.) was found not criminally responsible on account of mental disorder on April 1, 2010, for the offence of sexual assault, contrary to the Criminal Code. He is currently subject to a disposition of the Ontario Review Board dated February 27, 2025, detaining him at the Forensic Service on an All-Male Unit of the Centre for Addiction and Mental Health, Toronto (“CAMH”). The disposition includes privileges, including the ability to live in the community, in 24-hour supervised and approved accommodation by the person in charge.
ISSUES
On March 27, 2026, the Board convened at CAMH for a hearing further to s. 672.81(1) of the Criminal Code to review the disposition. The Board was asked to determine whether C. (K.) represented a significant threat to the safety of the public at the time of the hearing, and further, what the necessary and appropriate disposition is in the circumstances according to the factors set out in s. 672.54 of the Criminal Code.
At the outset of the hearing, the parties made a joint recommendation that C. (K.) continues to represent a significant threat to the safety of the public, and that the necessary and appropriate disposition is a continuation of the current detention order, with no change at this time. In addition, Counsel for C. (K.) remarked on alternative housing options should continue to be considered in future.
FINDINGS
- After hearing the evidence, the Board found that C. (K.) continues to pose a significant threat to public safety, and the Board determined that the existing detention order remains the least onerous and least restrictive disposition capable of managing risk, protecting public safety, and supporting continued rehabilitation.
BACKGROUND
The Hospital Report dated March 11, 2026, was entered as an exhibit at the hearing. The following information, including the events surrounding the index offence, has been taken from the Hospital Report, summarized here as follows.
On January 6, 2010, while a patient at the Whitby Mental Health Centre (now known as Ontario Shores Centre for Mental Health Sciences), C. (K.) sexually assaulted a nurse by repeatedly grabbing her buttocks, touching her arms and face, attempting to kiss her. She also reported that he had previously sexually assaulted lower functioning patients on the unit and that this behaviour continued despite his transfer to another ward.
C. (K.) was born in Kuwait. His parents are originally from Goa, India. He immigrated to Canada in 2000 with his mother and siblings, later joined by his father. His childhood development was reported as normal. However, teachers noted concerns about concentration and motivation. He completed schooling in Kuwait with average grades. Later, cognitive testing indicated borderline intellectual functioning with deficits in verbal memory and executive functioning.
C. (K.) had no history of substance use, behavioural problems, or legal involvement.
C. (K.)’s current diagnoses are Schizophrenia (in partial remission) and Unspecified Paraphilic Disorder. He is currently incapable of consenting to psychiatric treatment (his brother is his substitute decision maker), and he is also incapable of managing his financial affairs (Public Guardian and Trustee acts on his behalf). He receives financial support from the Ontario Disability Support Program.
EVIDENCE AT THE HEARING
The evidence at the hearing included comprehensive testimony from Dr. I. Swayze regarding C. (K.)’s current mental health status and behaviour. Dr. Swayze testified that he became C. (K.)’s attending psychiatrist following his transfer to a general forensic unit in May 2025. He reported that over the past year, C. (K.)’s psychiatric presentation has remained stable, with no significant change associated with the unit transfer.
C. (K.) is treated with clozapine at therapeutic levels, with reported medication compliance. Residual symptoms remain present, including thought disorder, auditory hallucinations, and intermittent paranoia. These symptoms are generally mild but at times are associated with suspiciousness, verbal intrusiveness, and behavioural challenges. Dr. Swayze indicated that additional medication adjustments are limited due to limited efficacy and adverse effects associated with prior trials.
Dr. Swayze further testified that C. (K.) has a paraphilic disorder, including behaviour consistent with toucherism, primarily involving unconsented physical contact. He demonstrates these behaviours with female staff. Psychological testing has identified concerns regarding possible paraphilic interests, including paraphilic interests with younger adolescent girls. Treatment with Provera has been associated with a reduction in his sexualized behaviours, and his testosterone levels are near full suppression. Dr. Swayze stated that further hormonal intervention is not recommended, and that ongoing monitoring, including bone density screening, continues.
Dr. Swayze also described evidence of cognitive impairment of unclear origin. He noted that cognitive limitations affect C. (K.)’s capacity for behavioural regulation and engagement in treatment. He testified that the interaction of psychotic symptoms, paraphilic disorders, and cognitive impairment contributes to his overall clinical presentation.
With respect to management, Dr. Swayze stated that C. (K.) is supported by a structured behavioural plan that is reviewed and adjusted as needed. C. (K.) has remained on a general forensic unit over the reporting period. Dr. Swayze testified to one brief, preventative period of seclusion in January 2026, prompted by escalating verbal sexualization toward a nurse unfamiliar with the behavioural plan. He noted that there was no physical contact and no subsequent seclusion incidents.
Dr. Swayze testified that C. (K.) has participated in available programming, including cognitive adaptive training and regular meetings with a behaviour therapist. He stated that C. (K.) has not engaged in physical violence and that his mood has remained stable, with no evidence of a mood disorder or significant anxiety symptoms. Dr. Swayze reported that C. (K.)’s continued placement on a general forensic unit reflects the current management approach.
Regarding discharge planning, Dr. Swayze testified that C. (K.) remains on waitlists for high intensity supportive housing. He stated that delays are attributable to limited availability and funding constraints. Ongoing efforts to identify an appropriate community placement were confirmed. Dr. Swayze also noted regular involvement by C. (K.)’s parents and reported that C. (K.) frequently expresses a desire to return home, which he understood as a wish to live with his family. Dr. Swayze testified that this was not considered a safe option. He concluded that the current plan involves maintaining stability while seeking a community placement capable of providing a comparable level of structure and support that he receives in the hospital.
SUBMISSIONS
Counsel for the hospital submitted that the existing disposition remains appropriate, relying on the clinical evidence that C. (K.)’s psychiatric condition has remained stable, that his residual symptoms and behavioural risks are being effectively managed through medication and a structured behavioural plan, and that continued hospitalization is necessary pending the availability of appropriate high intensity, 24-hour supervised, community housing. Counsel for the Attorney General supported the hospital’s position in all respects.
Counsel for C. (K.) emphasized C. (K.)’s progress over the reporting period, including his successful transition from a secure forensic unit to a general forensic unit, his maintenance on that unit throughout the year without any physical violence, his engagement in programming and regular behavioural therapy, and the absence of further seclusion other than a single brief incident. Counsel further highlighted C. (K.)’s positive family involvement, his expressed wish for community reintegration, submitting that the disposition should continue to promote stability while prioritizing efforts toward suitable community placement.
ANALYSIS AND CONCLUSION
(a) Significant Threat
The Board must first decide whether C. (K.) continues to pose a significant threat to the safety of the public, as defined in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625. A significant threat exists where there is a real risk of serious physical or psychological harm to members of the public, resulting from conduct that is criminal in nature, and where that risk is not merely speculative.
After considering all of the evidence, including the Hospital Report and the testimony of Dr. Swayze, the Board is satisfied that C. (K.) continues to meet this threshold. Although his psychiatric condition has remained generally stable during the reporting period, this stability has been achieved in a highly structured hospital environment with close supervision and enforced pharmacological and behavioural interventions.
The index offence involved sexually violent conduct in a hospital setting. The evidence also shows a longstanding pattern of sexually inappropriate and intrusive behaviour toward staff and vulnerable individuals and staff. Dr. Swayze testified that C. (K.) continues to experience residual psychotic symptoms, including thought disorder, auditory hallucinations, and intermittent paranoia. At times, these symptoms contribute to suspiciousness and behavioural dysregulation. In addition, C. (K.)’s paraphilic disorders remains relevant despite a reduction in overt sexualized behaviour following anti‑androgen treatment.
The Board accepts that C. (K.)’s current risk is being managed rather than resolved. C. (K.)’s cognitive impairments significantly limit his insight and ability to regulate his behaviour. The combined effects of schizophrenia, paraphilic disorder, and cognitive deficits create a complex risk profile. The January 2026 incident involving escalating sexually explicit verbal behaviour toward nursing staff – while preventative in nature and resolved before any physical contact – demonstrates that risk-related behaviours persist even in a controlled setting and require active monitoring.
The evidence also establishes that C. (K.) remains incapable of consenting to treatment and continues to require substitute decision makers for both medical and financial matters. His compliance with treatment depends on external controls rather than internal insight. The Board is satisfied that, without continued supervision, medication oversight, and structured behavioural management, there would be a real risk of serious psychological and physical harm to the public arising from sexually intrusive and potentially criminal conduct. This risk is not speculative.
(b) Necessary and Appropriate
The Board must next determine the disposition that is necessary and appropriate in the circumstances. The disposition must reflect the principle of the least onerous and least restrictive alternative that protects the public, while also considering C. (K.)’s mental condition, rehabilitation, reintegration, and his other needs as required by s. 672.54 of the Criminal Code.
The Board acknowledges the progress C. (K.) has made during the reporting period. The evidence shows that he has remained psychiatrically stable, compliant with clozapine and hormonal treatment, and engaged in available therapeutic programming, including cognitive adaptive training and behavioural therapy. The Board also notes the absence of physical violence and his successful management on a general forensic unit.
However, this progress remains closely tied to a high level of institutional structure, intensive supervision, and enforced treatment compliance. The Board accepts that suitable community placement options capable of providing an equivalent level of support are limited, and that C. (K.) remains on waitlists for high intensity supportive housing. The Board accepts that placement with family is neither safe nor viable, and that any premature reduction in supervision would substantially increase risk.
The Board is satisfied that a conditional discharge would not provide a sufficient framework to manage C. (K.)’s ongoing risks, given his cognitive limitations, lack of treatment capacity, and history of sexually intrusive behaviour. Practical reliance on the Mental Health Act alone would not ensure timely or effective intervention should he decompensate or disengage from treatment in the community. At this stage, detention remains the only disposition capable of providing the necessary oversight, protecting the public, and supporting continued rehabilitation while appropriate community resources are pursued. It is important that the hospital retain the authority to approve his placement in the community when he is ready for the transition. In addition, the hospital requires the means to rapidly readmit C. (K.) under a warrant of committal should he relapse into substance use or should a decompensation of his mental state occur.
Accordingly, the Board finds that continuation of the current detention order is the necessary and appropriate disposition and remains the least onerous and least restrictive means of managing risk in the circumstances.
DATED this 12th day of May, 2026, at the City of Toronto, in the Toronto Region.
Ms. A. La Viola
Legal Member
Office of the Registrar
Ontario Review Board```