Hiram Wachira, 2025 CanLII 102491

Ontario Review Board

Re: Hiram Wachira

ORB File No: 5536

Hearing held on: Wednesday August 27, 2025

Place of Hearing: Centre for Addiction and Mental Health

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

Before: Alternate Chairperson: Mr. R. Bigelow Members: Mr. M. Segal Dr. P. Prendergast Dr. M. Mamak Mr. S. Duffy

Parties Appearing: Accused: Hiram Wachira Counsel: Mr. W. Jaksa

The Person in Charge of hospital: Counsel: Ms. A. Marshall

Attorney-General of Ontario: Counsel: Ms. K. Kirec

REASONS FOR DISPOSITION (Dated October 8, 2025)

Introduction

1On January 21, 2010, Hiram Wachira was found not criminally responsible on account of mental disorder (NCR) on a charge of assault causing bodily harm contrary to the Criminal Code. He is currently subject to a disposition of the Ontario Review Board (the Board) dated September 12, 2024, ordering his detention at the Forensic Service of the Centre for Addiction and Mental Health (CAMH) with privileges up to and including residence in the community in supervised accommodation approved by the person in charge.

2On Monday, August 27, 2025, the Board convened a hearing at CAMH to review Mr. Wachira’s disposition pursuant to section 672.81(1) of the Criminal Code. Mr. Wachira was present at the hearing and represented by counsel, Mr. Jaksa. Although a Swahili interpreter had been ordered for the hearing, no interpreter appeared and counsel for Mr. Wachira advised that his client was willing to proceed without an interpreter and that he was satisfied that his client would be able to understand and participate in the proceedings. All parties joined in recommending that hearing proceed without the interpreter.¹

3The issues to be determined at the hearing were whether Mr. Wachira continues to represent a significant threat to the safety of the public as defined in section 672.5401 of the Criminal Code and, if so, to determine what was the necessary and appropriate disposition that was also the least onerous and least restrictive taking into account the factors set out in 672.54 of the Criminal Code.

Initial Positions of the Parties

4At the commencement of the hearing the parties were requested to provide their initial without prejudice positions with respect to the issues before the Board. Counsel for the Hospital indicated that it was the Hospital’s position that Mr. Wachira continued to represent a significant threat to the safety of the public and that the necessary and appropriate disposition was a continuation of the current detention order without change.

5Both counsel for Mr. Wachira and counsel for the Attorney General supported the Hospital position.

Evidence at the hearing

6The evidence at the hearing consisted of the Hospital Report dated August 8, 2025, and the oral evidence of Dr. K. Cross, a PGY5 Psychiatry Resident working under the supervision of Dr. Ali, Mr. Wachira’s treating physician.

Findings

7For the Reasons that follow, the Board finds that Mr. Wachira continues to represent a significant threat to the safety of the public and that the necessary and appropriate disposition is a continuation of the current detention order without change.

Index Offence

8The allegations surrounding the index offence as summarized in the last year’s Reasons for Disposition are as follows:

According to the supplementary record of arrest, the victim and the accused were both patients at St. Michael’s Hospital in Toronto, on the 17th floor. The victim, an 85-yearold male reportedly suffering from Alzheimer’s disease, was admitted to St. Michael’s Hospital on Saturday July 11th, 2009. Mr. Wachira, a 32-year-old male suffering from schizophrenia, was admitted to St. Michael’s Hospital on July 9, 2009.

At approximately 4:00 p.m. on Wednesday July 15th, 2009, the victim’s daughter was visiting her father in his room. She reportedly left the room to use the phone, during which time the victim left his room and walked into the accused’s room. Once in Mr. Wachira’s room, the victim was attacked by Mr. Wachira, who hit him with a chair numerous times about the head and body. The victim’s daughter, upon seeing her father missing from his room when she returned, went looking for him on the unit and found that he had been struck by the accused. She began screaming for help, at which time Mr. Wachira reportedly turned and chased her out of the room, holding the chair in a threatening manner. Hospital staff came to the assistance of the victim and his daughter and subsequently secluded Mr. Wachira until police arrived. When police officers arrived on scene, Mr. Wachira was reportedly sitting on his bed, eating his dinner, showing no remorse for his actions.

As a result of this incident, the victim suffered the following injuries:

• Two cuts to his right middle finger, requiring 5 sutures;
• Laceration to the inside of his mouth (right side), requiring 4 sutures;
• Laceration to the right side of his lip, requiring 3 sutures;
• Scrapes to his right cheek and chin;
• “Golf ball” size swelling to his cheek below his right eye;
• Possible loose lower tooth (doctors did not know whether this condition existed prior to the assault).

Background Information Regarding the Accused

9Mr. Wachira’s is 47 years of age and was born in Kenya. He reports that he is the second child in a sibline of six with three brothers and two sisters and that his parents were teachers. He reports achieving a grade 12 education while residing in Kenya. Records indicate that he first came to Canada as a member of a national baseball team and then returned a year or two later when he was approximately 25 as a refugee claimant and has permanent resident status.

Substance Use History

10Although Mr. Wachira has denied using alcohol or illicit drugs, file information from 2007 indicates that he reported that he consumed two bottles of beer a day at that time. There is no evidence that he used cannabis or illicit drugs.

Legal History

11Mr. Wachira was found guilty of assault in June 2006 and was granted a conditional discharge with 12 months probation. In January 2007 he was charged with breaching his probation order by failing to report as directed.

Psychiatric History

12Mr. Wachira’s first hospitalization with respect to mental health related issues was in February 2007 when he was admitted to CAMH with respect to a fitness assessment on a charge of fail to comply with probation. While in detention awaiting trial, he was observed to exhibit psychotic symptoms but declined any psychiatric medication. On admission he was sexually preoccupied, guarded, delusional and appeared to be responding to internal stimuli. He required locked seclusion early on in his admission. With treatment with antipsychotic medication, his condition improved and by July he was found to be fit to stand trial and there was no evidence of psychotic symptoms, aggression, or sexually inappropriate behaviour or ideation.

13In July 2009 Mr. Wachira was arrested by police after being found running naked on the street and was hospitalized due to mental health related concerns. The index offence occurred at the hospital shortly after his admission.

Current Diagnosis

14Mr. Wachira’s current diagnosis is schizophrenia.

Evidence of Dr. Cross

15Dr. Cross indicated that he had been involved in Mr. Wachira’s care since July 2025, had reviewed and adopted the contents of the Hospital Report. He advised that Mr. Wachira had poor insight into his need for medication, only took medication because he was told to and had no idea what would happen if he stopped taking the medication. His current residence provides a high level of support including meals and medication supervision. In Dr. Cross’ opinion it was unlikely that Mr. Wachira would take medication without supervision given his lack of insight as well as a history of nonadherence.

16Dr. Cross stated that over the reporting year Mr. Wachira was found to be forgetful at times and there were questions regarding possible cognitive decline. A neurology referral has been submitted but no appointment date has yet been scheduled.

17Dr. Cross indicated that in his opinion, the Mental Health Act would be insufficient to manage Mr. Wachira’s risk given his poor insight and likelihood of his failing to recognize early signs of decompensation.

18In response to questions from counsel for Mr. Wachira, Dr. Cross agreed that Mr. Wachira had not acted out violently over the last five years and that his current behaviour was appropriate. He noted that at his current residence, although his medications were monitored, Mr. Wachira was free to come and go to and from there.

19In response to questions from panel members, Dr. Cross indicated there were no current plans to change medication and that the focus for the upcoming reporting year would be on improving insight and engagement in programming.

Final Positions of the Parties

20All parties maintained their initial positions at the conclusion of the hearing.

Analysis and Conclusion, Significant Threat

21The Board finds that Mr. Wachira continues to represent a significant threat to the safety of the public. He suffers from a major mental illness, schizophrenia, and displays limited insight into his illness, his need for treatment or his potential for aggression when untreated. Although adherent to medication, this is in a living situation where staff carefully monitor his compliance. The evidence clearly establishes a significant likelihood that absent the supervision of the board, Mr. Wachira would fall away from treatment, cease taking medication with a return of the psychotic symptoms he experienced at the time of the index offence resulting in a substantial increase of risk of physical and/or psychological harm to members of the public.

Analysis and Conclusion, Necessary and Appropriate Disposition

22The Board also finds that the evidence supports the joint submission that the current detention order without change to the terms is the necessary and appropriate disposition. The evidence clearly establishes that the Hospital needs the authority to approve accommodation in order to manage risk and meet Mr. Wachira’s needs. Given his lack of insight as well as increasing forgetfulness, he requires a residence with careful supervision in order to ensure that he is adherent to medication. Therefore, there is no air of reality to consideration of a conditional discharge.

Footnotes

1. 1A Swahili interpreter did arrive near the end of the hearing, but her services were not required.