Re: Alexandra Fayad
ORB File No: 6270
Hearing held on: Friday, April 10, 2026
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Fromstein
Members: Dr. J. Kis Dr. A. Kerry Hon. N. Kozloff Mr. S. Doherty
Parties Appearing:
Accused: Alexandra Fayad Counsel: Ms. M. Addie
The person in charge of hospital: Counsel: Ms. M Warner
Attorney General of Ontario: Counsel: Mr. M. Feindel
REASONS FOR DISPOSITION
(Dated May 13, 2026)
Introduction
On January 16, 2013, Ms. Alexandra Fayad was found not criminally responsible (“NCR”) on account of mental disorder on four counts of assault, contrary to the Criminal Code of Canada. Ms. Fayad is currently subject to a Disposition dated April 15, 2025, discharging her on conditions. These include, among others, that she reside at 506 – 1674 Eglinton Avenue West and report to the hospital not less than once every four weeks. She is required to abstain from the use of intoxicants and to supply urine samples for analysis.
On April 10, 2026, this panel of the Board convened at the Centre for Addiction and Mental Health, Toronto (“CAMH”) to conduct the annual review of Ms. Fayad’s Disposition. Ms. Fayad was present and represented by counsel, Ms. Addie.
The purpose of the hearing was to determine if Ms. Fayad meets the threshold of significant threat as defined in s. 672.5401 of the Criminal Code and if so, what is the necessary and appropriate Disposition, which is also least onerous and lease restrictive, pursuant to the factors set out in s. 672.54 of the Criminal Code.
Position of the Parties
At the outset of the hearing the parties were asked for their initial positions. Ms. Addie conceded the issue of significant threat. Ms. Warner on behalf of the hospital, Mr. Feindel on behalf of the Crown and Ms. Addie on behalf of Ms. Fayad jointly recommended that there be no change to the current Disposition.
The parties maintained their joint position at the conclusion of the evidence.
Index Offences
- The index offences took place on 4 separate dates in 2012. On these occasions Ms. Fayad accosted strangers and applied physical force to them, causing some discomfort. The injuries that were sustained by the victims were not more than transient.
Evidence at the Hearing
- The evidence at the hearing was comprised of the Hospital Report, Exhibit 1 and the testimony of Dr. Kravtsenyuk.
Background
Ms. Fayad’s background is set out in detail in the Hospital Report, so it need not be repeated. Briefly summarized Ms. Fayad is presently 38 years of age. She has not had contact with her biological father since age 8. She lived with her mother until age 14 at which time she left home and high school after her mother’s boyfriend attempted to sexually molest her. She has one brother. Ms. Fayad had one son who was taken into custody of the CAS at birth and subsequently adopted.
Ms. Fayad commenced alcohol and cannabis use at age 14 and has used a wide variety of psychoactive substances, including crystal methamphetamine and crack cocaine. It is noted that her regular use of substances likely contributed to her decline in functioning and exacerbated her mental illness. She has a dated criminal conviction, for theft under.
Ms. Fayad was diagnosed with schizophrenia at the age of nineteen and was treated with medication. She had admissions to hospital and also received out-patient treatment.
Following the NCR finding Ms. Fayad was admitted to CAMH in 2014. Her initial behaviour was challenging but improved with time. Ms. Fayad was able to be discharged to community living in December 2015 to low support housing with supervised medication. She was readmitted to hospital in 2018 due to allegations of threatening and intimidating co-residents. She was next discharged to the community in December 2018 to high support, fully supervised housing.
Ms. Fayad continues to be assessed as incapable to consent to psychiatric treatment and her mother acts as her substitute decision maker (“SDM”). Ms. Fayad is treated with clozapine, an antidepressant and a mood stabilizing medication. She receives medications also on a PRN basis. She has been medication compliant. As incapable she could be certified under the Mental Health Act under Box B criteria.
Ms. Fayad’s insight into her mental illness and need for treatment as well as the negative effects of substance use are very limited. She continues to assert clearly that if granted an absolute discharge by the ORB she plans to discontinue all medication and psychiatric follow-up. It was indicated at last year’s hearing that her undeveloped insight is a barrier to her achieving full community integration and Absolute Discharge.
Diagnoses
- Her diagnoses include Schizophrenia, Substance use Disorder, in Remission, and Pervasive Developmental Disorder.
Recent Year
Ms. Fayad continues to reside at Regeneration Community Services’ Oakwood Arch high support residence. It is a 24-hour supervised residence where Ms. Fayad’s medications are supervised by staff. Her adherence to her medications has been generally good. A few doses were missed due to sleeping in but did not result in any decompensation.
Her presentation continued to reflect chronic psychiatric symptoms, appearing at times disorganized, intrusive, and irritable with difficulty providing coherent narratives of events. She expressed on occasion paranoid and sexualized beliefs including suspicious thoughts about housing staff. Ms. Fayad requires prompts from housing staff to maintain her personal hygiene.
Ms. Fayad has regular contact with her mother and her long-standing friend Vita. Vita was present at the hearing in support of Ms. Fayad.
To Ms. Fayad’s credit she has not engaged in substance use, evidenced through negative urinalyses. Ms. Fayad has not engaged in any physical aggression or threatening behhaviour in the past year but there have been occasional interpersonal difficulties with co-residents. She remains disengaged in rehabilitative activities offered to her. Positively, she was able to utilize public transit independently.
Ms. Fayad was followed by a community family physician Dr. Swenson but missed scheduled appointments during the year and had applied for a new primary care provider at Womens College Hospital.
Ms. Fayad has remained psychiatrically stable without the need for readmission to hospital, however she continues to present with ongoing symptoms and poor insight into the key factors. Her mood shifts rapidly in response to minor stressors and psychotic stimuli. She is quick to anger and has difficulty managing this.
It is the hospital’s opinion that Ms. Fayad must live in a highly structured environment with staff consistently available to manage her behaviours and supervise her medication. This high supervision is opined as necessary to manage her risk.
The team is unanimous in recommending no change to her current disposition. Ms. Fayad has indicated that she would like to be absolutely discharged.
Testimony of Dr. Kravtsenyuk
Dr. Kravtsenyuk began working with Ms. Fayad in September 2025 when her former psychiatrist, Dr. Dupre, went on leave. Ms. Fayad managed the transition well. While Ms. Fayad has remained stable in the past year, her chronic mental illness is evident in daily interactions. She has remained stable and not required any readmission to hospital. Oakwood Arch Residence provides appropriate support. The existing conditional discharge Disposition ensures the safety of the public and supports Ms. Fayad’s reintegration.
The several incidents of missed doses of medication in the past year illustrate the level of support that is required to be maintained to ensure daily compliance. The team works well with the housing staff to obtain timely feedback. All of Ms. Fayad’s urines have been negative.
In response to questions Dr. Kravtsenyuk agreed that trauma informed care approach is important and is always taken into consideration in the team’s approach. However, given Ms. Fayad’s prominent primary major psychotic illness and chronic symptoms, at this time it may not prove beneficial to revisit past trauma with her.
Her diagnosis of Pervasive Developmental Disorder reflects Ms. Fayad’s complex psychopathology and compromised cognitive functioning. The diagnostic label is no longer used and Dr. Kravtsenyuk agreed that over the next reporting year the treatment team will consult with the neurodevelopmental team to seek diagnostic clarification. It is unknown whether she would be eligible for Developmental Service Ontario (“DSO”) funding, but a key issue would be Ms. Fayad’s willingness to work with others, as it can be very difficult for her to establish alliance.
Submissions
Ms. Warner expressed the hospital’s recognition that Ms. Fayad is doing well at her residence and has had a relatively stable year in the community. The hospital knows Ms. Fayad well. The team understands and is well equipped to support Ms. Fayad’s complex risk factors. Her high support home environment remains appropriate.
Mr. Feindel commended Ms. Fayad on having another very good year and adopted the hospital’s submissions.
Ms. Addie congratulated Ms. Fayad for having a very good year with wishes for another to follow.
Analysis and Conclusion
Having considered the evidence and the joint position of the parties the Board finds that Ms. Fayad meets the threshold of significant threat. She suffers from a chronic mental illness. Ms. Fayad’s history of violence including assaultive or threatening behaviour both in the index offences and afterwards, her psychotic and developmental illness, limited insight into her condition, need for treatment and risk factors for reoffence, and risk assessment scores all underly the finding of significant threat.
Ms. Fayad requires a highly structured environment where staff are consistently available to redirect problematic behaviours and supervise medication administration. She is well managed in her current residence.
We congratulate Ms. Fayad on the positive year and transition to the care of Dr. Kravtensyuk and maintaining herself in the community. She has support of her mother and her close friend, Vita. We wish her continued success.
For these reasons Ms. Fayad’s Disposition will continue without change.
We make this order in consideration of the primary factor, the safety of the public, Ms. Fayad’s mental condition, her reintegration into society and her other needs.
DATED this 13th day of May, 2026, at the City of Toronto, in the Toronto Region.
Ms. C. Fromstein
Alternate Chairperson
Office of the Registrar
Ontario Review Board