On March 28, 2015, Kathryn Horne went over to Richard Pereira’s home to end their yearlong relationship, according to a friend.

The 58-year-old arrived at Pereira’s Brampton home, where he lived with his mother, around 5 p.m.

Seven hours later, Pereira’s mother called 911 for an ambulance for her son. The police arrived first and saw Pereira, 36, on the couch. He said he needed to die, that he was cursed by black magic and that he believed people wanted to kill him.

Before he could be taken to the hospital under the Mental Health Act, he told the officers to look in the basement. He’d done something bad, he said, and he did not want his mother to see.

His mother and two police officers found Horne’s body on the basement bathroom floor. She had been stabbed 34 times, twice in the neck.

It is well-established that when men kill their female partners it is often in the lead up to or after a breakup. In that way, Kathryn Horne’s murder fits the tragic patterns of intimate-partner homicides in the GTA.

What was unusual was Pereira’s documented months-long decline into symptoms of severe psychosis peaking at the time he killed Horne and, as a result, how close he came to being found not criminally responsible for her murder.

In a lengthy ruling released last month that lays out the complexity of cases involving accused people with severe mental illness, Superior Court Justice David Harris found Pereira guilty of second-degree murder despite his psychotic delusions. The verdict presents a serious issue at sentencing: what kind of treatment does an offender with a serious mental illness get while in prison?

“(Prison) isn’t designed for people with serious mental health issues,” said Catherine Latimer, executive director of the John Howard Society of Canada. While more efforts are underway to diagnose inmates when they arrive into the prison system, there still aren’t enough resources to treat them appropriately or humanely — resulting in them being placed in solitary confinement or similarly isolated conditions, she said. The risks they face in prison are also higher — multiple reports and inquests have found mentally ill inmate are at higher risk of self-harm and suicide, as well of being assaulted, sexually assaulted and otherwise harmed.

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There is no doubt Pereira killed Horne. He claimed he was not criminally responsible for her murder because he acted in self-defence. A voice in his head told him to kill her because she was part of a group that was out to get him and that she would slaughter him, his mother and his dogs, he said.

Pereira had an 11-year history of intermittent bouts of paranoid and persecutory delusions. In the six months before the homicide, symptoms of his psychosis increased — resulting in police charging him with mischief for falsely calling in a bomb threat in early March 2015. And on the day he killed Horne, witnesses saw symptoms of paranoid psychosis — though Horne herself did not appear to be aware of his deteriorating condition, Harris found.

But after what Harris called a “disastrous performance” by Pereira when he testified in his defence, Harris found him and his account of the murder neither credible nor reliable.

For one thing, Harris claimed he’d carried two kitchen knives around for months in the interior pocket of his jacket. He said he used the knives to kill Horne at the command of a voice he called “Gabor.” However, the jacket he identified was produced by the Crown and shown not to have any interior pockets. And the actual murder weapon was a different knife than the ones he described.

Harris also found there was no previous record of Pereira hearing voices other than a brief mention from 2004, and he did not mention hearing voices before his arrest.

He also noted there was evidence that Pereira “malingered” with the mental health professionals he spoke to after the killing, and that Pereira lied to the police about taking a number of pills, prompting them to take him to the hospital.

Pereira also wavered in his account of the frequency with which Horne came to his home and the amount of money she gave him. The loss of financial support was another potential motive for murder, Harris said.

The judge rejected an application by the Crown to use Pereira’s past criminal record, which included harassment and a minor assault involving three previous girlfriends in 2006, 2007 and 2010, as similar-fact evidence of violence toward women stemming from anger and jealousy. Only the first incident involved Pereira being “spurned as a lover,” Harris found, and it happened nine years before Horne’s murder.

The judge’s ruling thoroughly documents Pereira’s mental health history over 11 years, pieced together from hospital records, police records and the testimony of his family. The numerous interactions with authorities and mental health services preceding the murder bear similarities to many cases in which a finding of not criminally responsible has been made.

In 2014 he hired a private investigator to track down people he believed were following him — the investigator found that no one was.

In the fall of 2014, several months before he murdered Horne, Pereira repeatedly called 911 to report feeling scared because people were following him. In January 2015, he called 911 again to report two men in a car outside his home, saying he would harm himself and that “a dog can only be cornered for so long before it attacks.” He was taken to hospital by police twice under the Mental Health Act twice that month.

In March he was arrested after calling 911 from his neighbour’s home. He said the phones in his residence were “all off” because “we found a device in there, uh, had an electrician; it’s, uh, uh, like a bomb.” He was released on bail a week later, with a requirement to meet with a worker from the Canadian Mental Health Association, which he did days before the murder.

He was put on antipsychotic medication but was still displaying paranoia in the days leading up to the murder, at one point showing a family friend a newspaper wrapped around twigs he believed to be a bomb. He contacted the private investigator again and made a will. On the night of the murder, Pereira called the CHMA hotline but did not report delusions, just anxiety and stress.

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Harris noted that there was no indication given to anyone Pereira interacted with in the months leading up to the murder, including the CMHA worker, that he would kill Horne.

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After issuing his judgment, Harris asked Pereira’s defence lawyer Stephen Hebscher, to provide evidence at the fall sentencing hearing about what kind of treatment Pereira’s serious mental illness would get in the federal prison system.

Roughly 70 per cent of offenders admitted to federal custody report mental health symptoms. Of these, 36 per cent experience impairment in daily activities and thus meet criteria for a diagnosis of mental illness, CSC spokesperson Sarah Gilbert said. She added that the federal government is investing in measures to improve mental health care in the prison system.

There are five regional treatment facilities for men and one for women run by correctional services, as well as mental health units in prisons. Between 2014 and 2018, there were roughly 700 in-patient admissions to treatment centres each year, Gilbert said.

In serious crises, people who are incarcerated can also be transferred to hospitals under the Mental Health Act before being returned to custody, where the conditions might cause their mental health to deteriorate again, said Anita Szigeti, a long-time mental health lawyer.

And while the federal government is moving to change the way solitary confinement is used in prisons through Bill C-83, concerns still exist around what safeguards will be in place and how inmates with mental illnesses will be treated in the proposed new “structured intervention units.”

An interim Senate report on prison conditions released in February notes that mentally ill inmates have been placed in solitary confinement more often than those who do not have a mental illness, and found that sending inmates to mental health units can result in effective isolation.

Courts are also limited in the ways they can respond to people with mental illnesses, Szigeti said. There are 19 specialized mental health courts in the province which allow for some accused people to be connected with support services. There are also the rare findings of unfit to stand trial and not criminally responsible, intended to allow people who commit serious offences as a result of their mental illness to be sent for treatment in a hospital, rather than be incarcerated.

Mental illness can be also considered during a sentencing hearing, but much depends on the offence and whether it carries a mandatory minimum sentence.

There is little Justice Harris can do in Pereira’s case — he faces a mandatory life sentence for murder. The judge can only decide when he will be first eligible for parole, between 10 and 25 years.

Experts like Latimer and Szigeti have long argued there is a need for better mental health services for people in crisis so that the criminal justice system involvement can be avoided in the first place. People with mental illnesses are also more likely to be victims of crimes than perpetrators.

But when people with mental illness are charged with offences, they need legal representation, Szigeti said. She fears the province’s recent cuts to legal aid may result in more people with mental illnesses ending up in jail or prison because they don’t have an advocate to help them.

“This is a bit of a crisis moment for this population,” she said.