Ontario Review Board
Re: Ahmed Khalid
ORB File No: 8511
Hearing held on: Tuesday, August 26, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Mr. M.D. Segal Members: Dr. K. Hand Dr. M. Mamak Mr. R. Bigelow Mr. S. Duffy
Parties Appearing:
Accused: Ahmed Khalid Counsel: Ms. M. Murphy
The person in charge of hospital: Counsel: Mr. K. Dow
Attorney General of Ontario: Counsel: Ms. D. Silver
REASONS FOR DISPOSITION
(Dated October 8, 2025)
Introduction
Ahmed Khalid, age 34, was, on March 5, 2024, found not criminally responsible on account of mental disorder on a charge of aggravated assault, contrary to the Criminal Code.
On August 26, 2025, Mr. Khalid appeared before the Ontario Review Board (the “Board”) at the Centre for Addiction and Mental Health (the “hospital”) for his annual hearing. Exhibit 1 was the Hospital Report dated August 12, 2025. Mr. Khalid is subject to a Detention Order with privileges up to and including living in the GTA in accommodation approved by the person in charge.
In preliminary positions, the hospital advocated for no change, supported by Crown counsel. However, Crown counsel had questions about community living which had been the subject of a dissent in last year's Reasons for Decision. Patient’s counsel sought a Conditional Discharge. Significant threat was not contested. As the hearing progressed, additional issues surfaced including whether the prohibition against cannabis consumption should be lifted and the suitability of travel passes within Ontario. At the conclusion of the hearing, the Board resolved that a Detention Order continued to be the most appropriate disposition that balanced the protection of the public and the rehabilitation of the patient; that the cannabis ban continue to be in place; and that travel passes within Ontario on the same terms as found in current clause 2(h) ought to be included in the Disposition. At the outset of the hearing, Crown counsel helpfully provided information that the outstanding fail to comply charge, referenced on page 20 of the Hospital Report, had now been withdrawn.
Diagnoses
4.
- Schizophrenia
- Cannabis Use Disorder
Index Offence
- The circumstances giving rise to the index offence are taken from the Agreed Statement of Facts, as follows:
“According to the Agreed Statement of Facts dated January 22, 2024, Mr. Khalid resided at the Berkeley Residence, a rooming house, at 207 Berkeley Street, in Toronto. They slept in separate rooms. At approximately 8:20am on February 18, 2021, Mr. Khalid made accusations which the victim denied. The victim "decided to make a report against Mr. Khalid to staff at the Berkeley Residence." While the victim sat outside staff office, Mr. Khalid stabbed the victim thrice with a folding knife in the head and neck area. The victim suffered three stab wounds. One injury was to the upper left neck approximately 4cm in length. A second was over the left cheek, above the jaw line and closer to the ear. The third was "behind the right ear and appeared to be superficial.” The victim underwent exploratory surgery given the potential for a life-threatening injury and the presence of an expanding hematoma (bleeding). However, surgery "did not identify any major vascular (blood vessel) injury" and "an immediately life-threatening injury was excluded." Nonetheless, computer tomography (CT) imaging of the victim’s neck evidenced injury to the left cervical vertebral artery - "blood vessel inside the spinal column that is part of the circulation of the brain.”
Background
Mr. Khalid has never been married and does not have any children. He is supported by ODSP. He was born in Karachi, Pakistan and is the eldest of three siblings. His family came to Canada in 1997. In 2007, the family moved to South America in part because of Mr. Khalid’s difficulties in high school and because he had begun smoking cannabis. He returned to Canada on his own in 2009 to attend the University of Toronto. He failed most of his courses in second year and was evicted from his residence in 2011 for selling cannabis. He returned to South America for a short time. In 2012, he returned to Canada. He indicated “I just wanted to have an environment where I could smoke weed again peacefully”.
He resided for a short time with relatives, and then in an independent apartment. Over the next two years, Mr. Khalid lived on the streets in downtown Toronto before moving for four years into a condominium purchased by his family.
Mr. Khalid was first seen by a psychiatrist in 2004 at Sunnybrook Hospital (shortly before his 13th birthday). He was diagnosed with obsessive compulsive disorder. When Cognitive Behavioural Therapy was unsuccessful, he was prescribed sertraline, which improved the symptoms. Mr. Khalid’s parents found that he had begun using cannabis in 2006 and arranged for him to see an addictions counselor; he continued to use cannabis.
In 2011, his parents reported that he was acting oddly in public, including talking to himself and looking over his shoulder for no reason. In Saudi Arabia, Mr. Khalid’s parents received a prescription for risperidone liquid and put it in his food. They reported that his symptoms improved.
Upon his return to Canada, Mr. Khalid followed up with his psychiatrist who diagnosed him with bipolar affective disorder and noted excessive cannabis use. In 2013, Mr. Khalid attended the Brampton Civic Hospital on four occasions within one month for behaviours which included agitation and paranoia. He received varying diagnoses including cannabis use disorder, and it was noted that his symptoms were exacerbated by cannabis use.
Throughout 2013 and 2014, he was hospitalized multiple times, and a Community Treatment Order (CTO) was issued. He was diagnosed with Schizophrenia, cannabis use disorder, and OCD. Through subsequent hospitalizations, he began receiving injectable antipsychotic medications, although he was inconsistently adherent with the medications.
In 2013, Mr. Khalid attended his mosque and threatened others and stated that he had a knife. Although a trespass notice was served on him, he returned the next day and threatened the Imam. Police found a knife in his possession. Charges were laid including aggravated assault, assault causing bodily harm, assault with a weapon, weapons dangerous, threatening death, and carrying a concealed weapon, but were withdrawn in 2015 when Mr. Khalid entered into a Peace Bond.
In 2017, Mr. Khalid moved to 207 Berkeley Street in Toronto, an assisted living facility. It was at this residence that the index offence occurred. Mr. Khalid stated that he moved to the residence because his parents evicted him from their condominium because he had been non-compliant with his CTO, but there was also evidence that he had threatened his father and sister.
Mr. Khalid was subject to nine CTOs between 2015 and 2020 and was consistently found incapable of consent to treatment despite his regular appeals to the Consent and Capacity Board. In 2020, his CTO was overturned for administrative reasons. He began to refuse medications.
Mr. Khalid stated that while in the past he had used many different substances including alcohol, psilocybin, cocaine, and cannabis; however, he had not used cannabis or any other substances for a few days prior to the index offence.
After the index offence, Mr. Khalid was incarcerated and then released and subject to a Judicial Release Order dated May 12, 2023. He was placed under conditions which included a prohibition from possessing weapons, to reside at 118 Dowling Avenue and to be in the residence between 11:00 p.m. and 6:00 a.m., not to contact the victim of the index offence or attend within 100 metres of his residence or other places he was known to be, to comply with the rules of his housing, to meet with his Fred Victor Concurrent Disorder Case Worker as directed by him, and to provide his Fred Victor Concurrent Disorder Case Worker with dates and times for his treatment/medical appointments. Mr. Khalid was also required to wear a GPS ankle monitor.
Evidence at Hearing
Dr. C. Arnold, a Psychiatric Fellow, testified. Dr. A. Ali, Dr. Arnold’s supervisor, observed.
Dr. Arnold noted that Mr. Khalid had been relatively stable of late. He is on a long-acting antipsychotic injection. Mr. Khalid continues to have residual symptoms.
When last admitted on October 29, 2024, it was because of decompensation in his mental status. He was more irritable and refusing to engage with the team. He was admitted on a Form 49. When in hospital, clozapine was added to his medications. Dr. Arnold was of the view that there was no legitimate reason to believe Mr. Khalid would have returned to hospital unless there had been a Detention Order. He was discharged on May 25, 2025, and resides at 118 Dowling, a residence supervised during the day. He shares a room. There are applications in for more supervised residences. When he returned to the community, he immediately went back to cannabis consumption.
There is continuing work done by the Forensic Outpatient Team to address improved insight regarding cannabis use and impacts, his mental health condition and symptoms, and an understanding of his index offence. A member of his team meets with him several times a week to work on these issues. Dr. Arnold has no concerns about Mr. Khalid being in the community at this time. Mr. Khalid has been compliant with his regular drug screens and agreed to a qualitative analysis of his THC consumption. Mr. Khalid’s goal is to reduce cannabis; the quantitative analysis does not bear out the aspiration.
Significant threat continues to be present given the history of violence and the history of decompensation. As well there is a long history regarding poor insight into his mental state, recognizing symptoms, and the relationship between symptoms and decompensation. There is also a long history of medication noncompliance. At this juncture there has been an insufficient period in the community. Before discharge, he spent many months in hospital and in essence was obliged to be abstinent.
Dr. Arnold testified that Mr. Khalid would not return willingly to hospital if he decomposed. A Form 49 was required to get him back to hospital the last time. Additionally, the hospital needs to approve suitable housing. Once he was stable, he was released in May as the hospital believed the risk could be managed in the community.
Currently Mr. Khalid attends CAMH four to five times per week permitting eyes to be on him. He attends for therapy sessions and staff supervised recreational activities. His oral medications are administered by a pharmacy. He attends 1:1 sessions regarding substance abuse and illness management. Mr. Khalid is now optimally medicated.
At present, his aggressive tendencies are under control. There have been no incidents of aggression in the last year. Mr. Khalid is a practicing Muslim and subscribes to avoiding violence.
When in hospital for several months ending in May there was a material change in his attitude toward medication recommendations. Prior to that, medication advice and administration had been a struggle.
Dr. Arnold is not ready to recommend removing the cannabis ban. It is a point of reference for therapeutic sessions and attempts to reduce consumption.
Mr. Khalid’s parents live in Texas. Although his current Disposition allows travel passes to the United States, it is silent regarding passes within Ontario. Dr. Arnold would have no objection to permitting passes within Ontario on the same terms as found in the present Disposition.
Cannabis consumption has not surfaced as an issue at the Dowling residence. The Hospital Report indicates that cannabis consumption was an issue at the residence until Mr. Khalid stopped using it in his room. Cannabis has not exacerbated Mr. Khalid's mental health since his release to the community.
Dr. Arnold views the schizophrenia as treatment resistant.
The team is of the view that a cannabis ban should remain, and that Mr. Khalid requires more supportive housing. The team is of the view that consumption of cannabis increases the risk of violence.
It has only been two and a half months since discharge into the community.
In closing submissions, the hospital repeated its position that a Detention Order was necessary and appropriate, that the cannabis ban was necessary, and that travel passes in Ontario on the same terms as found in clause 2(h) would not be opposed. Crown counsel no longer had issues regarding the community living provision. Crown counsel noted the brief amount of time in the community since discharge and reaffirmed the wisdom of retaining a cannabis prohibition. Crown counsel was supportive of travel passes within Ontario on terms. Patient’s counsel stressed that the reporting period had been free of violence. The evidence of the doctor was that a Forensic Outpatient Team would be available if a Conditional Discharge was imposed.
The Board had before it the hospital report dated August 12, 2025.
Analysis
Significant threat to the public was not contested. It is well made out in the Hospital Report and Dr. Arnold’s evidence. There is a history of violence, noncompliance with medication and treatment, and decompensation. Those risks are enhanced by constant, significant cannabis use.
The Board is of the view that a Detention Order is the appropriate disposition. A Detention Order is necessary to bring Mr. Khalid in if he compensated as he did last fall. A Form 49 had to be used as Mr. Khalid had stopped engaging with and listening to staff. Absent a Detention Order, it would have been difficult to get him back into hospital. In Dr. Arnold's view, the provisions of the Mental Health Act would be inadequate to deal with decompensation in a timely way. Additionally, the hospital is of the view that it must approve housing. The hospital is actively involved in attempting to arrange housing that has more support than the Dowling residence, where supervision is only available during the day. The Board relies on the Hospital Report at page 39 which indicates that a Conditional Discharge would be inadequate to address risk and that in the event of a Conditional Discharge his risk for violent re-offending continues to fall within the moderate high range.
When Mr. Khalid decompensates, he incorporates those around him into his delusions heightening the risk. This is what happened at the time of the index offence. Having him in his own room may be a prudent course. There continues to be value in the cannabis ban. Mr. Khalid has a long-standing addiction to it. While cannabis use has not recently impacted him, that has not always been the case. He was using in the lead up to the index offence.
The Board adopts the Hospital Report when it states at page 41:
“Mr. Khalid continues to consume cannabis while experiencing treatment refractory, if attenuated psychotic symptoms. Cannabis use likely contributes to worsening of symptoms at times and would definitely lead to decompensation without treatment with antipsychotic medications. Mr. Khalid will require ongoing monitoring in this regard.”
While not ideal that Mr. Khalid is in a breach of the ban, the Board is of the view that its presence in a Detention Order provides a point of reference for reducing consumption of cannabis and mitigates Mr. Khalid's desire to use extensively without controls.
The travel pass request should be acted on. His parents live in Texas. The current Detention Order permits travel to the United States on conditions which has not been acted upon yet. There is no reason for denying travel passes within Ontario on the same terms. Travel passes within Ontario may be more attractive at the outset than exercising travel passes to Texas. We wish Mr. Khalid well in the upcoming year.
DATED this 8^th^ day of October 2025, at the City of Toronto, in the Region of Toronto.
Mr. M.D. Segal Alternate Chairperson
__________________
Office of the Registrar Ontario Review Board