Ontario Review Board
Re: Hashmatullah Najibullah
ORB File No: 8231
Hearing held on: Monday, September 22, 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. B. Sheppard Dr. G. Eayrs Ms. M. Labrosse Mr. W. Apted
Parties Appearing:
Accused: Hashmatullah Najibullah Counsel: Mr. C. Barhydt
The person in charge of hospital: Representative: Dr. F. Moloney
Attorney General of Ontario: Counsel: Mr. C. Coughlan
REASONS FOR DISPOSITION
(Dated October 24, 2025)
Introduction
On February 13, 2023, Hashmatullah Najibullah, age 25, was found not criminally responsible on account of mental disorder on charges of assault and assault with a weapon, contrary to the Criminal Code.
Mr. Najibullah. is currently subject to a Detention Order with privileges up to and including living in the community of Southern Ontario in accommodation approved by the person in charge. On September 22, 2025, Mr. Najibullah appeared before the Ontario Review Board (the “Board”) at the Centre for Addiction and Mental Health (the “hospital”) for his annual hearing. Mr. Najibullah’s father, who is an approved person, attended the hearing. Exhibit 1 was a Hospital Report dated September 28, 2025.
In preliminary positions, the hospital recommended maintaining the current Disposition with two amendments: to add travel privileges within the province, outside Ontario, and internationally for a period of up to three weeks with an approved itinerary and in the presence of an approved person. This is meant to accommodate possible travel by the family to Afghanistan; and to reduce the reporting requirement to not less than once per month. Mr. Najibullah’s counsel noted at the outset that his client would prefer a conditional discharge but, in the alternative, would favour the expanded privileges outlined by the hospital. After reviewing and hearing the evidence and submissions, the Board concluded that a Detention Order remained the necessary and appropriate disposition.
Diagnosis
- Major Depressive Disorder, with psychotic features, currently in remission
Index Offence
- The summary of the index offences has been taken from the previous year’s Reasons for Disposition:
“Mr. Najibullah assaulted his 16-year-old brother on July 18, 2022, amidst an altercation with his father and brother over the car keys. He punched his brother in the face; his brother ran away. His father caught up to his brother by car and then Mr. Najibullah charged them with a kitchen knife.
On August 17, 2022, Mr. Najibullah attended the family home and entered it. He was on a recognizance of bail at the time with a term that he does not attend that location. He asked his mother for money and when she turned away, he stabbed her in the back of the neck with a knife.”
Background
- Mr. Najibullah’s background is taken from last year’s Reasons for Disposition, as follows:
“The Hospital Report contains a significant amount of information about Mr. Najibullah’s background and psychiatric history and need not be reviewed in detail beyond the following material points. Mr. Najibullah is a 24-year-old man (now 25) who was born in Afghanistan and immigrated with his family to Canada in 2006, at the age of six. He attended school until Grade 11. At that time, he experienced depression and dropped out of school. In May 2022, Mr. Najibullah was able to attend a few online courses through a Cyber Security Program.
Mr. Najibullah was involved in a car accident on July 13, 2022. He reportedly was taken to a hospital and was discharged that same day. Mr. Najibullah’s father reported that, following the accident, his son began to act differently. He was observed to be angry, aggressive and labile, and talking to himself at times. His family noticed and were concerned that he was consuming increasing amounts of cannabis and alcohol.
Mr. Najibullah reported that he started smoking cannabis at the age of 18. At first, it was for recreational use, however, later, he used cannabis to stay calm and to assist with sleeping, particularly when he was feeling depressed. Mr. Najibullah was seen in May 2016 at the Humber River Hospital outpatient clinic and diagnosed with Major Depressive Disorder, recurrent, moderate severity, and was treated with Prozac 10mg daily. However, Mr. Najibullah did not continue with his medication, olanzapine, as he felt that it did not help and he preferred to use exercise to manage his symptoms.
At the time of his arrest, Mr. Najibullah reported low mood, felt “depressed” and was hearing voices that continued while in jail. The voices and his mood improved after he was started on medications. Once admitted to CAMH, he was maintained on antidepressant medication, and the antipsychotic olanzapine was increased. His mental status remained stable, and he did not present with any active symptoms of psychosis.”
Evidence at Hearing
Dr. Fiona Moloney, a Psychiatry Resident who has been treating the patient since July, testified. Dr. M. Choptiany, who supervised the patient prior to July, observed the hearing. There are no updates or recent changes. Dr. Moloney noted that the most important event this reporting year was the patient’s discharge into the community in September of 2024. Mr. Najibullah lives with his mother, father and younger brother. It has been a good year overall.
Mr. Najibullah works for his brother-in-law in the auto repair business. He also does some car detailing on his own account.
In April, there was a change to Mr. Najibullah’s antipsychotic medications to address weight gain concerns. The transition went smoothly. Weight has come down, supplemented by Mr. Najibullah’s exercise regimen.
Mr. Najibullah receives 1:1 psychotherapy that began last September. The focus is on preventing substance relapse and teaching coping mechanisms.
There have been no hospital readmissions. Mr. Najibullah has been medication compliant. All urine screens have been negative.
Mr. Najibullah is capable to consent to treatment. There has been discussion with the patient about changing from an oral antipsychotic to a long-acting injection, but Mr. Najibullah has not been keen, perhaps because of concerns about potential side effects. This is so despite the hospital assuring Mr. Najibullah that there would be no side effects in switching to the long-acting injection of the same medication with a comparable dose. The hospital is interested in a long-acting injectable to provide another layer of security.
Mr. Najibullah has given up his previous practices of water fasting and eating once a day. The focus in the upcoming year, which is the second year following discharge into the community, will be:
revisit a long-acting injection
explore the diagnosis
explore insight into the index offence
support the patient’s career and educational interests, and
ensure stability in the face of stress.
Mr. Najibullah is interested in opening his own car repair business. He is also wishing to pursue continued studies in cyber-security.
Dr. Moloney opined that given Mr. Najibullah’s history of violence, and his diagnosis, a Detention Order is necessary. If there is a decompensation, it will more likely involve depressive symptoms such as becoming withdrawn and mood changes. He would not meet the terms of the Mental Health Act while in that condition. The early stages of decompensation would not satisfy the Mental Health Act. It would be critical to intervene early. This is especially so given the family whom he lives with was the target of the index offences.
According to the doctor, decompensation might happen because of changes in his medication, or a return to substances, or other destabilizing changes such as travel.
The doctor was in favour of reducing the reporting frequency. When first released, Mr. Najibullah was seen twice a week by his case manager and once a week by a psychiatrist.
There were no concerns about the travel privilege that was being suggested bearing in mind it would be with an approved person.
While a conditional discharge may permit the accused to be arrested, the hospital would want to intervene before that eventuality could arise.
In cross-examination, patient’s counsel elicited from the doctor that there was a similar degree of oversight whether there was a detention order or a conditional discharge. Mr. Najibullah has agreed to all hospital suggestions. There has been no decompensation this year. Mr. Najibullah has indicated that he has no interest in returning to cannabis use.
Questions from the Board underscored that the patient’s family is well engaged with the treatment team. The family can detect mental health changes. Mr. Najibullah, himself, does not have a good sense of what his symptoms were at the time of the index offence. The symptoms have been in remission for two years coincidental with the administration of medication. If Mr. Najibullah began to become unwell the onset of decline would be rapid.
Mr. Najibullah testified. His goal is an absolute discharge as quickly as possible. He indicated that he is now prepared to take a long-acting injection.
In final submissions hospital counsel, as all counsel, acknowledged that Mr. Najibullah has had a very successful year. The hospital is concerned about a deterioration, and the ability to admit him before the risk of violence becomes real. The record discloses the concern in graphic form. In between Mr. Najibullah’s first index offence and the second, a matter of 12 days, Mr. Najibullah was seen by CAMH Emergency Department but was released because the symptoms he displayed were not pronounced. Yet, almost immediately, Mr. Najibullah committed exceedingly serious and dangerous index offences. As Dr. Moloney stated, the team has not observed Mr. Najibullah unwell. The hospital wants to be cautious. These are relatively early days, and the team needs to know more about Mr. Najibullah.
Crown counsel agreed with the hospital and noted the hospital’s desire to approve housing. Patient’s counsel stressed Mr. Najibullah’s exemplary behaviour and a supportive family.
Analysis
The Board observed that Mr. Najibullah’s index offences were exceedingly serious and dangerous. Mr. Najibullah has only been in the community since last September.
In the Hospital Report the following is stated which the Board accepts.
“Major Depressive Disorder, with psychotic features, currently in remission
The essential feature of a major depressive episode is a period of at least 2 weeks during which there is either depressed mood or the loss of interest or pleasure in nearly all activities. The individual must also experience at least four additional symptoms that include changes in appetite or weight, sleep, and psychomotor activity, decreased energy, feelings of worthlessness or guilt, difficulty thinking, concentrating, or making decisions, or recurrent thoughts of death or suicidal ideation or suicide plans and attempts. In some, psychotic symptoms such as hallucinations or delusions can occur during depressive episodes.
Mr. Najibullah has a history of Major Depressive Disorder. He was seen in May 2016 at the Humber River Hospital outpatient clinic and diagnosed with Major Depressive Disorder, recurrent, moderate severity, and was treated with Prozac 10mg daily. He was also referred for counselling. He reported seeing a psychiatrist twice in the past for depression and reported a suicide attempt by overdose at age 17. He had also dropped out of high school around this time in part due to his mental health issues. He reported a history of low mood for years but stated it improved after starting his current medication while arrested. At the time of his arrest, he reported low mood, felt “depressed” and was hearing voices that continued while in jail. The voices and his mood improved after he was started on medications. He has been vague in terms of describing the content of these auditory hallucinations though indicated that there may have been a “random voice” that told him to be aggressive. Based on available information, the working diagnosis remained a Major Depressive Disorder, with psychotic features, currently in remission.
It is also noted that Mr. Najibullah has a history of cannabis use. Mr. Najibullah reported smoking cannabis since the age of 18 and would use cannabis as a coping strategy for negative emotions. He reported increasing his use during periods of low mood. He reported hiding his cannabis use from his family. It appears his use also increased around the time of his index offence. The extent of his use is unclear, though he reported smoking on weekends in the month leading up to the index offence. Given the above information, there is a possibility that his increased cannabis use contributed to the emergence of psychotic symptoms. On the differential diagnosis would be a substance-induced mood/psychotic disorder, however this is less likely given the onset of depressive symptoms prior to reported substance use, and his report of relatively infrequent substance use.
Despite being on treatment and testing negative for prohibited substances during Mr. Najibullah’s first year under the ORB, Mr. Najibullah exhibited behaviours such as social isolation, amotivation, paucity of spontaneous speech, and restricted affect which is reminiscent of negative symptoms of a primary psychotic disorder. These symptoms improved after discharge from hospital and switch from olanzapine to aripiprazole and may also have been explained in part by medication side effects. Further, Mr. Najibullah’s family reported that he appeared to be at his premorbid baseline mental state. The possibility of a primary psychotic disorder (such as schizophrenia or schizoaffective disorder) should be considered on an ongoing basis but appears less likely at this time.
Mr. Najibullah also may have met criteria for a post-concussive syndrome following a motor vehicle accident that occurred in the week prior to the index offence. He noted changes in his cognition, and collateral information reported irritability, anger, and sleep disturbances. Psychological testing in June 2023 did not indicate any cognitive issues.”
From the above passage, unchallenged, the Board infers that more work is necessary to understand Mr. Najibullah and his diagnosis. Mr. Najibullah has a history of major depressive order dating back to 2016. The passage also reveals that Mr. Najibullah is at risk for relapse and it would be difficult to discern when symptoms of depression began to emerge. In other words, hospital counsel’s characterization of what happened between the index offences is very compelling. The Board further observes that Mr. Najibullah has only been on Aripiprazole since the spring. More medication changes, including a transfer to a long-acting injection, remain outstanding. Psychotherapy to address relapse prevention and coping is ongoing.
Finally, the very serious index offences targeting family members make them more vulnerable and supports caution. Safety concerns are always paramount. A conditional discharge would not be adequate to permit the hospital to intervene in early stages of decompensation and before The Mental health Act could be utilized. At the same time, Mr. Najibullah should be commended for his outlook and attitude and the progress he is making in the relatively brief time he has been in the community. The Board agrees with the suggested changes to the terms of the Disposition. We wish Mr. Najibullah well.
DATED this 24th day of October 2025, at the City of Toronto, in the Region of Toronto.
Mr. M.D. Segal Alternate Chairperson
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Office of the Registrar Ontario Review Board