The man accused of killing an Abbotsford, B.C. teen and wounding another in an apparently random attack at a high school has paranoid delusions about being followed by the CIA and has admitted to his doctor that he has killed someone, court heard.

Gabriel Klein was placed in seclusion at the Colony Farm Forensic Psychiatric Hospital after showing serious psychosis, hearing voices that commanded him to harm others, and admitting a history of violence, said his psychiatrist, Dr. Marcel Hediger.

“Mr. Klein has indicated to me that he has killed an individual and of course seriously harmed a second individual,” Hediger said.

The psychiatrist was testifying in a hearing to determine whether Klein is fit to stand trial for a second-degree murder charge relating to the death of 13-year-old Letisha Reimer. He is also charged with aggravated assault for an attack on a 14-year-old classmate at Abbotsford Senior Secondary School in November 2016.

In his report, Hediger concluded that in a clinical setting Klein was able to follow conversations, understood the court process in general, and was able to understand about a possible serious sentence if he is found guilty.

But the doctor also found Klein’s condition was “variable, fragile and likely to deteriorate with the added stress of appearing in court. This could result in Mr. Klein not meeting the criteria of being fit to stand trial.”

Among the concerns: Klein’s delusions that the CIA was somehow watching him through the hospital security cameras, that the guards at Surrey Pretrial Centre were poisoning him, and a violent incident where Klein followed through on disturbing auditory hallucinations.

“He was hearing voices telling him to rape and harm co-patients,” Hediger told the New Westminster court. “Mr. Klein had entered a patient’s room and urinated on the patient’s pillow and bed.”

Hediger said he believes Klein has schizophrenia and is currently mentally ill. He said he has concerns that there is a risk of violence, and that his delusions appear to be evolving.

The psychiatrist said Klein has been compliant at the hospital, but is intensely paranoid around corrections staff and sheriffs.

Klein has been treated with several antipsychotics, two on a maximum dose, but his response has been “partial,” the doctor said. There has been some improvement but the psychosis is not treated, and Klein needs more work.

He’s undergoing a change in medication right now and that could also change his mental state, Hediger said.

Lawyers will make submission Thursday to Judge Heather Holmes about whether the diagnosis means Klein is fit to stand trial. If it is determined that he's currently unfit, there will be delays.

For a community still reeling, the news of Klein's illness was not their first priority.

"Letisha was a vibrant, alive young lady. She just always had a smile, always lit up a room," South Abbotsford Church pastor Matt Ewert said.

"Those are the memories that we have of her."