Re: Kristina D. Saunders, 2026 CanLII 6265

Ontario Review Board

Re: Kristina D. Saunders

ORB File No: 8002

Hearing held on: Tuesday, January 13, 2026

Place of hearing: Ontario Shores Centre for Mental Health Sciences

Pursuant to: Section 672.81(1) of the Criminal Code

Before: Alternate Chairperson: Ms. L. Banks Members: Dr. R. Sheppard Dr. L. O. Lightfoot Ms. C. Murray Ms. R. Chopra

Parties Appearing: Accused: Kristina D. Saunders Counsel: Ms. J. Boissonneault

Person in charge of hospital: Counsel: Mr. K. Dow

Attorney General of Ontario: Counsel: Ms. N. MacDonald

REASONS FOR DISPOSITION

(Dated January 29, 2026)

Introduction:

1On November 30, 2021, Kristina Saunders was found not criminally responsible on account of mental disorder (“NCR”) on a charge of assault contrary to the Criminal Code. On December 21, 2021, Kristina Saunders was found NCR on a charge of arson contrary to the Criminal Code.

2Ms. Saunders is currently subject to a Disposition of the Ontario Review Board (“Board” or “ORB”) dated January 22, 2025 whereby she is detained at the Forensic Service of the Ontario Shores for Mental Health Sciences (“Ontario Shores” or the “hospital”) with privileges extending to living in the community in 24-hour a day supervised accommodation approved by the person in charge of the hospital.

3On January 13, 2026, a panel of the Board convened by to conduct Ms. Saunders’ annual review, pursuant to section 672.81(1) of the Criminal Code. Ms. Saunders attended the hearing and was represented by counsel, Ms. J. Boissonneault.

4The Hospital Report dated December 24, 2025 (the “Hospital Report”) was marked as Exhibit 1 at the hearing.

5The issues to be decided at the hearing were whether Ms. Saunders continued to meet the test of posing a significant threat to the safety of the public and if so, what is the necessary and appropriate Disposition, bearing in mind the four factors in section 672.54 of the Criminal Code.

6For the reasons that follow, the panel found that Ms. Saunders continues to represent a significant threat to public safety. The panel concluded that the necessary and appropriate Disposition, which is also the least onerous and least restrictive in the circumstances, is a continuation of the existing Detention Disposition with the amendments noted in her formal Disposition.

Position of the Parties:

7At the outset of the hearing counsel for the Hospital took the position that Ms. Saunders continues to represent a significant threat to public safety and that she should continue to be detained at Ontario Shores pursuant to her current Disposition subject to the following suggested amendments:

• add a travel pass to Newfoundland for up to two weeks, indirectly supervised, subject to the prior approval of the itinerary by the person in charge of the hospital (“PIC”); and

• amend 2(f) of the existing Disposition to extend the pass to up to seven days.

8With respect to anticipated request of counsel for Ms. Saunders related to the removal of paragraph 4 (d) (i.e., a prohibition on possession on incendiary devices), counsel for the hospital suggested that the prohibition should remain in Ms. Saunders’ Disposition but, there should be an exception added to allow Ms. Saunders to be in possession of a lighter and/or matches for the sole purpose of lighting her own cigarettes.

9Counsel for the Attorney General agreed with the hospital’s position on the appropriate Disposition and the recommended changes as stated above.

10Ms. Boissoneault stated that her client was supportive of the hospital’s position and she conceded the issue of significant threat for the purposes of this hearing. The only point of dissention from the hospital and Crown’s recommendation was that Ms. Boissonneault recommended that the prohibition on possession of incendiary devices be completely removed as it was no longer necessary or appropriate. If the Board considered the prohibition necessary and appropriate then counsel’s alternative recommendation was to accept the hospital’s position and allow Ms. Saunders to be in possession of a lighter or matches for the purpose of lighting her own cigarettes.

11All parties maintained their respective positions in closing submissions.

Index Offences:

12The index offences are set out in the Hospital Report at pages 3-5 in detail and are summarized here. As noted above, there were two separate index offences. With respect to the assault charge, Ms. Saunders assaulted a hospital visitor on January 8, 2020, while she was an inpatient on the psychiatric unit at Peterborough Regional Health Centre by repeatedly punching her on the head. Nursing staff immediately intervened and contacted security, who contacted Peterborough police for further assistance. Ms. Saunders appeared agitated and mentioned several times that people were trying to kill her, including her mother and other family members. The victim complained of a bump on the top of her head and likely had other bumps and bruises.

13With respect to the charge of arson, Ms. Saunders started a fire in her apartment in Peterborough on September 20, 2020. She had spent the night with Mr. Eskins, who advised that they had consumed alcohol together and engaged in sexual intercourse. Mr. Eskins told the police that Ms. Saunders had been playing with a lighter throughout the day, and she lit his pants on fire as well as the couch in the apartment. He was able to extinguish the fire at that time. Later in the day, Mr. Eskins fell asleep on the couch and awoke to the smell of smoke in the apartment and observed the couch fully engulfed in flames. He fled from the building and found Ms. Saunders standing out front of the building. The property manager of the building had experienced ongoing issues with Ms. Saunders since she moved into the building a few weeks prior. She had observed Ms. Saunders attempting to light the front porch and railing on fire. She had contacted both the Canadian Mental Health Association (CMHA) and police to advise of the ongoing issues. In total, three addresses were involved in the fire and a total of 26 residents were displaced due to the fire.

14The Hospital Report indicated that when Ms. Saunders was interviewed by police on September 20, 2020 she stated, “I wasn’t trying to kill anybody” and “I was forced to set a fire, I was harassed by these people, I don’t know who these people are […] I think they’re ghosts or something […].

Personal Background:

15Ms. Saunders’ personal and psychiatric history are set out in the Hospital Report and will not be repeated in detail here. In summary, Ms. Saunders was born and raised in Peterborough with two younger brothers. Her parents divorced when she was 19 years old and she continued to live with her mother. Ms. Saunders’ mother began noticing changes in Ms. Saunders’ behaviour when she was 13-14 years old when she stopped watching television. She was diagnosed with depression and also attended at the hospital regularly with various physical complaints.

16Ms. Saunders finished high school and attended college where she studied art and design, and then trained to be an education assistant. She stopped attending school in 2005 around the time of her initial index offence. Ms. Saunders also worked at a pizza restaurant and a cleaner. She is currently supported by the Ontario Disability Support Program.

17Ms. Saunders reported that she had been in a number of romantic relationships with older men throughout her life. She had been engaged to another forensic patient recently, but the relationship ended.

18At the time of the index offences, Ms. Saunders was living in a CMHA supported apartment in Peterborough. She had previously resided in shelters and reportedly had been banned from all shelters in the Peterborough area.

Criminal History:

19The Hospital Report stated that Ms. Saunders had a charge of theft under $5000 in 2004 for which she received a suspended sentence and 18 months probation.

20In 2005, she was found NCR on a charge of cause bodily harm by criminal negligence. This charge involved intentionally driving her mother’s vehicle (which she had stolen) into a gas station. Ms. Saunders was under the jurisdiction of the ORB from 2005 until June 2016 when she received an Absolute Discharge.

21The Hospital Report also mentioned other charges in 2020 where Ms. Saunders allegedly assaulted a paramedic and a nurse, and unlawfully entered a dwelling house, and failed to comply with release order.

Psychiatric History:

22Ms. Saunders’ psychiatric history is outlined in the Hospital Report in detail at pages 6-9. Ms. Saunders did not have any psychiatric admissions prior to the initial index offence in 2005. Following this she was detained at Providence Care from 2005 to 2010 under the jurisdiction of the ORB. She lived in a 24-hour supervised group home from 2010 to 2011 but was returned to hospital from 2011 to 2013 as a result of synthetic cannabinoid use and a deterioration in her mental state. She was discharged to the community again in December 2013 and resided in an independent apartment with supports in Kingston. She did well in this setting and was eventually granted an Absolute Discharge in 2016.

23Ms. Saunders had multiple admissions to Peterborough Regional Health Centre and Ontario Shores between 2016 and 2020 presenting with a variety of psychotic symptoms. She was consistently diagnosed with Schizophrenia, Cannabis Use Disorder, and Borderline Personality Disorder. She was discharged to group homes and shelters but these were short lived. She was treated with a variety of antipsychotic medications and was placed on at least one community treatment order. Nonadherence to medication, as well as cannabis use were consistently noted.

24The Hospital Report stated that Ms. Saunders was highly unwell, with significant psychotic symptoms and disorganized behaviour, when admitted to Ontario Shores following the index offences in 2020. She was agitated and threatening towards staff and required locked seclusion.

Current Diagnoses:

25Ms. Saunders’ current diagnoses are:

Cannabis Use Disorder, and

Cluster B personality traits.

Evidence at the Hearing:

26In addition to the documentary evidence, Ms. Saunders’ attending psychiatrist, Dr. C. Harrigan, gave oral evidence. The doctor endorsed the contents of the Hospital Report and advised there were no material updates thereto.

27Ms. Saunders continues to be assessed as incapable to consent to treatment and the Public Guardian and Trustee acts as her substitute decision maker (“SDM”). Under her SDM’s consent, Ms. Saunders receives treatment with the oral antipsychotic medications, Clozapine and Aripiprazole. She also receives an antidepressant, Fluoxamine.

28Ms. Saunders’ mood is generally stable and she is better able to self-regulate than in the past. The Hospital Report indicates that, “she occasionally references beliefs related to telepathic, but these do not appear to meet the threshold for delusional beliefs. She also occasionally references experiencing auditory hallucinations, but she has not been observed to be attending to internal stimuli.”

29Of note, even within the highly structured environment of a hospital setting, Ms. Saunders was noncompliant with her clozapine medication for four days in November 2024 in an effort to “prove” to the treatment team that she does not suffer from mental illness requiring medication. Due to her experience of physical side effects from stopping this medication, she reported her noncompliance to nursing staff and agreed to re-titrate the medication up to its previously prescribed dosage. She has remained medication compliant since that time despite the fact that she continues to express that she is uncomfortable with the side effects of her medication.

30In terms of her insight, Ms. Saunders continues to have poor insight into how her treatment with Clozapine has attenuated her psychotic symptoms. Her adherence to her medications is externally motivated as she does not appreciate that she derives any benefit from this medication. In the past, she has stated that she thinks clearer when not taking Clozapine. Similarly, Ms. Saunders is unable to appreciate that this medication has also resulted in reduction of her engaging in violent conduct; however, she attributes this change to the exercise of her willpower.

31Over the past reporting year, Ms. Saunders had remained an inpatient on the General Forensic unit, FCRU, under Dr. Harrigan’s care.

32Ms. Saunders has been an active participant in an intensive relapse prevention program entitled "Contingency Management". After successfully completing the program, she enjoyed extended periods of sustained abstinence over the course of the year. During these periods of abstinence, she was able to use indirectly supervised privileges on hospital grounds and in the community.

33Unfortunately, Ms. Saunders relapsed to cannabis use on a number of occasions which resulted in her privileges being placed on a temporary hold. Often when her urine drug screens (“UDS”) returned positive for the presence of cannabis, she would deny use and claim that her cigarettes must have been laced with cannabis without her knowledge, or, alternatively, that she must have inadvertently inhaled second-hand cannabis smoke from others in her proximity.

34On April 1, 2025, Ms. Saunders’ UDS tested positive for the presence of cocaine and her privileges were put on hold. Later, on September 23, 2025, her UDS return positive for cannabis. She denied use and stated that it was likely attributed to her inhalation of second-hand smoke from others in her proximity.

35Dr. Harrigan stated that in previous years when Ms. Saunders was confronted with positive UDS, she would typically deny drug use despite objective evidence to the contrary. In fact, historically, she would become more fixed in her position and would often become emotionally dysregulated when challenged by staff. Dr. Harrigan stated that Ms. Saunders would disengage from any discussion on the positive UDS. In contrast, Dr. Harrigan testified that this year, when confronted with a positive UDS, Ms. Saunders may initially deny her use, but over time, she would correct her initial denial and would often acknowledge use. As well, this year, Ms. Saunders is able to tolerate discussions with her team members about the triggers for substance use and possible management strategies to assist her in maintaining her abstinence. Ms. Saunders no longer disengages from the team and Dr. Harrigan stated that this is a significant improvement and positive step forward. She is able to, over time, be more forthcoming with the treatment team.

36Dr. Harrigan commented that over the past year, Ms. Saunders has been capable of achieving sustained periods of abstinence of up to five months at a time. This is a significant accomplishment.

37Dr. Harrigan commented that Ms. Saunders has worked very well with her allied hospital treatment team which includes: a psychologist, a concurrent disorders specialist, a behavioural therapist, her psychiatrist and her peer support worker. All of these professional supports have commented that they are impressed with her level of engagement and her transparency.

38The Hospital Report states that Ms. Saunders has continued to engage in one-to-one weekly psychological therapy. These sessions utilise Dialectical Behaviour Therapy and Cognitive Behaviour Therapy, distress tolerance, and emotion regulation skills to support Ms. Saunders in her goals of increasing her tolerance for intense emotions, coping with psychosocial stressors, and substance relapse prevention in support of her long-term goal of successfully transitioning to a community residence. Since August 2025, therapy sessions have also focussed on addressing Ms. Saunders’ transient symptoms of panic and anxiety, often in connection with independent travel.

39Ms. Saunders has also been working on a weekly basis with Peer Support Specialist, Ms. Conlin. This year, Ms. Conlin accompanied Ms. Saunders into the community to assess how well she was able to navigate public transportation within Whitby. In November 2025, Ms. Conlin accompanied Ms. Saunders to Peterborough via public transportation systems and she spent several hours with her mother in the community.

40Ms. Saunders has also been active in volunteering with a program called “Art with a Heart”. She volunteers in twice a week by helping people with developmental disabilities participate in various art activities. Dr. Harrigan advised that Ms. Saunders has been commended by her volunteer colleagues for her contributions to the Art with a Heart program.

41Ms. Saunders remains in contact with her family although she does not have an Approved Person at this time. Ms. Saunders has successfully spent day passes with her mother who lives in Peterborough and these passes went well, without incident. Ms. Saunders wishes to spend more time with her mother and is requesting that the passes be extended to permit this. To date, Ms. Saunders has established phone contact with her father and she has expressed a desire to visit with him in the future.

42An Occupational Assessment was conducted to determine Ms. Saunders’ capacity to live independently. The results of the assessment indicate that she is best suited to live in supportive, supervised housing. She is currently on the waitlist for McKay House, a 24-hour-supervised group home through Durham Mental Health Services.

43The Clinical Assessment of Risk contained in the Hospital Report, identified the following areas of clinical concern:

• Ms. Saunders suffers from a severe form of treatment resistant schizophrenia, symptoms which have only been controlled with treatment with Clozapine

• Ms. Saunders continues to harbor overvalued ideas related to telepathy, and reports experiencing occasional auditory hallucinations

• Ms. Saunders was noncompliant with her clozapine for four days in November 2024 in an effort to “prove” to the treatment team that she does not suffer from a mental illness such as schizophrenia

• Ms. Saunders let’s continue to have episodes of cannabis use, resulting in brief holds on her privileges

• Ms. Saunders’ insight into her illness, and need for treatment with clozapine, remains chronically poor.

44No further evidence was called by the parties.

Analysis and Conclusion:

45Based on the Hospital Report and the evidence of Dr. Harrigan, the panel found that Ms. Saunders represents a significant threat to the safety of the public. This issue was not in dispute at the hearing. While Ms. Saunders has demonstrated steady and significant improvement and ongoing stability over the past year, she still suffers from a treatment-resistant illness. She continues to harbour overvalued ideas related to telepathy, and reports experiencing occasional auditory hallucinations.

46Her insight into her illness and the need for medication remains somewhat underdeveloped and historically, in 2024, Ms. Saunders engaged in cheeking her antipsychotic medication for approximately four days to demonstrate that she would be fine without it. While Ms. Saunders’ compliance is primarily externally driven, over the past year in review, she has remained entirely compliant with her prescribed medications within the structured environment of the hospital. The Hospital Report indicates that Ms. Saunders would be likely to decompensate rapidly if she was noncompliant with her Clozapine.

47Having come to a finding of significant threat, we must craft a Disposition which is necessary and appropriate as well as least restrictive and least onerous. In the Board’s assessment, Ms. Saunders’ existing Detention Order remains necessary and appropriate at this time to safely manage her risk to the public.

48We congratulate Ms. Saunders on her many successes over the past reporting year. She has remained compliant with her prescribed medications, and, as a result, she has achieved clinical stability with a significant attenuation in the symptoms of her illness. Ms. Sanders has not engaged in any incidence of physical aggression towards others and she has not presented as a management problem. She has successfully advanced up the privilege ladder and has been able to access the community on and indirectly supervised basis. She has developed a positive therapeutic alliance with her treatment team including her psychologist, her concurrent disorders worker, her peer support worker and her behavioural therapist.

49Although there were instances of relapse to substance abuse over the past reporting year, we are mindful of the doctor’s evidence that Ms. Sanders had significantly fewer incidents of cannabis use, and significantly longer periods of sustained abstinence, allowing her to progress to greater liberties. As well, she was more capable to address the triggers for these instances of relapse.

50Ms. Saunders is currently on near the top of the waitlist for McKay House. She is currently designated as ALC indicating her readiness for discharge to the community at this time.

51The hospital continues to require oversight regarding her community residence in order to ensure that McKay House provides her with the support, supervision, monitoring and structure that she will require in order to safely manage her risk to others. Without that structure, including ensuring medication compliance, Ms. Saunders would be likely to decrease or stop her medications with a resulting increase in her psychotic symptoms, and, in that state, she would be likely to act out violently.

52A Detention Order is also necessary to effect Ms. Saunders’ expeditious return to hospital should she become unwell when residing in the community, whether as a result of medication non-compliance, relapse to substance use, breakthrough symptoms, or otherwise. Given her risk profile, public safety is not sufficiently protected by relying on Ms. Saunders’ uncertain cooperation with a voluntary return to hospital. Further, it is also not sufficient from a risk management perspective to wait until Ms. Saunders satisfies certification criteria under the Mental Health Act to effect a hospital readmission. For all of these reasons, the panel decided that a continuation of the existing Disposition is the necessary and appropriate Disposition at this time to safely manage Ms. Saunders’ risk to the public.

53The Board is in favour of extending the duration of Ms. Saunders’ indirectly supervised community passes to up to one week to allow Ms. Saunders to spend more time with her mother who is a significant support for her.

54The Board is also supportive of the inclusion of a travel pass to Newfoundland to allow Ms. Saunders to spend time with her father. We are confident that the hospital will proactively support Ms. Saunders to manage any stressors related to such a trip given the history of sexual assault perpetrated against her by her father.

55With regard to the inclusion of a prohibition on Ms. Saunders being in possession of incendiary devices, we are cognizant that Ms. Saunders’ index offence is arson and that she has a concerning history of fire-setting. Ms. Saunders is on the cusp of transitioning to community living which often poses additional stressors. At this juncture, we find it is pre-mature to remove the prohibition on incendiary devices. The Board is mindful that Ms. Saunders has not engaged in fire-setting since the index offence in 2020 when she was quite ill. We are also aware that Ms. Saunders has been appropriate when smoking cigarettes on indirectly supervised passes over the past year, without incident. At this juncture, the Board finds that it is reasonable to allow Ms. Saunders to be in possession of matches or a lighter for the purpose of lighting her own cigarettes. In our assessment, this additional liberty will allow the treatment team to assess Ms. Saunders’ ability to appropriately and safely manage this greater liberty in the context of less supervision.

56In making this Disposition, the panel reviewed the provisions of section 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Ms. Saunders’ mental condition, her reintegration into society, and her other needs.