A judge will consider whether a Toronto woman facing terror-related charges needs a mental health assessment to determine if she’s fit to stand trial.

Rehab Dughmosh was handcuffed and held at the wrists by a pair of guards wearing helmets, facemasks and padding in her court appearance via video Monday. Her face and head were uncovered, though she has worn a niqab at previous court appearances.

The judge asked Dughmosh several questions through an interpreter, about her understanding of the court process.

“You are all infidels. I do not worship what you worship,” Dughmosh responded each time, in Arabic, without looking directly into the camera.

Later, while a Crown prosecutor attempted to speak, Dughmosh said in English, “Those people hurt me here,” appearing to nod toward the guards.

Dughmosh was arrested in June for allegedly brandishing a golf club and knife at a Canadian Tire in Scarborough. She has pledged allegiance to Daesh in court, declared that she does not believe in the Canadian legal system and said that “if you release me, I will commit these actions again and again and again.”

She has told the court she does not want legal counsel, and plans to plead guilty to her charges, which include one count of leaving Canada for the purpose of participating in a terrorist group and multiple counts each of attempted murder, assault with a weapon, carrying a dangerous weapon and carrying a concealed weapon, all “at the direction of, or in association with, a terrorist group.”

Dughmosh refused to appear in person or by video at her last three scheduled court dates, and had to be brought before a video camera by force Monday.

Dughmosh was judged mentally fit for trial at her early court appearances. She was responsive and demonstrated an understanding of the role of the court and its officials, federal prosecutor Bradley Reitz told the court.

But statements by a family member, contained in the Crown’s evidence, suggest there is reason to believe Dughmosh has some form of mental illness, said Ingrid Grant, a lawyer appointed to the case as amicus — someone who assists the court by making sure all relevant evidence and arguments are properly presented, particularly when the accused represents themselves.

Based on her actions Monday, Dughmosh should be assessed by a doctor to determine whether she is still fit, Grant told the court.

The judge agreed there was enough evidence to consider an assessment, and will decide next Monday whether to order that an assessment take place.

Dughmosh’s case is one of many raising concerns among lawyers about the way the courts handle an accused person’s mental health.

“It’s so frustrating, because ever since funding cuts to hospitals, the criminal courts have become the (authority) that primarily deal with mental health,” former assistant Crown attorney Daniel Lerner said.

“And you can tell the options that criminal courts have are not pretty and they’re mainly not that effective.”

Being declared “fit” for trial requires only that the accused person has a basic understanding of the court process, what they are charged with, what it means to be under oath, who the judge, prosecutors and defence lawyers are and what they do.

“It’s a very low standard to meet,” Lerner said. “It’s very basic. You might have serious mental illnesses, you might have irrational delusions, but you might still be able to answer all those (fitness requirement) questions properly, in which case you’re fit.”

If, at any time, a judge has evidence that a person is unfit for trial, they can order that the accused undergo a formal fitness assessment by a doctor.

The fact that Dughmosh refused for so long to come to court, and does not have a lawyer to appear in her place made it difficult for the court to determine whether enough evidence for an assessment existed, said lawyer Jessyca Greenwood, who specializes in mental health-related cases but is unconnected with the Dughmosh case.

“I’ve been able to get a doctor to see my client at the jail before, when they were refusing to come to court in that case,” Greenwood said.

“But I, as the defence lawyer, was in court and explained to the judge what was going on, and then based on the (client’s) repeated refusal to come to court and the information I gave, the judge made that order,” she added.

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If an accused person consents to a fitness assessment, the process can last up to 30 days, according to public information provided by Legal Aid Ontario. If they do not want to be assessed, the process is capped at five days, although in either case a judge can extend the assessment by an additional 30 days, as they deem necessary.

If the doctor performing the assessment determines that the accused is not fit for trial, they can be sent for treatment, until they are well enough to be qualified as “fit.”

That treatment could result in the accused being kept in a high-security hospital for years, Lerner said.

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