Ontario Review Board

Re: Mouhanad Ammar

ORB File No: 8361

Hearing held on: Tuesday, September 9, 2025

Place of Hearing: Royal Ottawa Mental Health Centre

Pursuant to: Section 672.81(2.1) of the Criminal Code

Before:

Alternate Chairperson: Mr. R. Steinberg

Members: Dr. G. Chaimowitz Dr. R. Cormier Mr. D. D’Intino Mr. R. Rainboth

Parties Appearing:

Accused: Mouhanad Ammar Counsel: Ms. M. Shukairy

Person in charge of hospital: Representative: Dr. F. Wood

Attorney-General of Ontario: Counsel: Mr. J. Ramsay

REASONS FOR DECISION AND DISPOSITION

(Dated October 7, 2025)

Introduction

1. Mouhanad Ammar was found not criminally responsible on July 26, 2023, of five counts of assault and one count of mischief. He has remained under the jurisdiction of the Ontario Review Board since that time and is presently subject to the terms of a disposition dated December 5, 2024, that orders his detention at the Secure Forensic Unit of the Royal Ottawa Mental Health Centre and grants him privileges, the most liberal of which permits him to live in the community in accommodation approved by the person in charge.

2. The hospital notified the Board by letter dated August 18, 2025, that Mr. Ammar had been admitted to the hospital from the community on August 12, 2025, and its letter served as notice to the Board of the restriction of his liberty, as required by s. 672.56(2)(b) of the Criminal Code. The Board therefore scheduled a hearing, as required by s. 672.81(2.1), to review the decision to significantly increase the restrictions on his liberty. The hearing was held at the Royal Ottawa Hospital on September 9, 2025.

3. At the outset of the hearing Dr. Wood stated the hospital considered the restriction to have been warranted since the date of Mr. Ammar’s readmission to the date of the hearing. He added that the hospital recommended Mr. Ammar be transferred to the Brockville Mental Health Centre. Mr. Ramsay supported the hospital position with respect to the liberty restriction and the transfer suggestion, and Ms. Shukairy, while not differing from the hospital position with respect to the restriction of liberty, opposed her client’s transfer to the Brockville Mental Health Centre.

Index Offences:

4. The facts of the index offences are set out in the September 5, 2025, Restriction of Liberty report prepared by the hospital and filed as Exhibit 2 at the hearing. On December 8, 2022, Mr. Ammar punched the victim in the face and then kicked him repeatedly in the body, neck and face without provocation while both were travelling on a train. On December 14, 2022, while on a bus in the City of Ottawa, Mr. Ammar approached the victim from behind and struck him in the left shoulder area. He then started to yell at the victim and then invited him off the bus to fight.

5. On December 18, 2022, while travelling on a bus in the City of Ottawa, Mr. Ammar stood and kicked the victim, who was seated and wearing headphones, in the head, causing his head to strike the window. The assault occurred without provocation. Mr. Ammar fled the bus and was later arrested.

6. In a second incident on December 18, 2022, Mr. Ammar walked across the street while yelling at a bystander. He then punched the victim in the abdomen and the right eye, breaking the victim’s glasses. The victim suffered a scratch to the lower side of his right eye and a black bruise to the upper side of that eye. Mr. Ammar was later arrested.

7. The offences set out above placed Mr. Ammar in breach of probation orders that were imposed on May 4, 2022, following convictions for three counts of assault, and on November 23, 2022, when he was convicted of three further counts of assault, assault with a weapon, committing an indecent act in a public place, and failure to comply with a probation order.

8. On February 2, 2023, Mr. Ammar entered the Social Services Centre, approached a random stranger and, without provocation, started to take off his jacket and stare aggressively at the individual before assuming a fighting stance. He then punched the victim multiple times in the face, causing him to lose consciousness and fall to the ground. Mr. Ammar continued to punch the individual in the face and the side of his head multiple times while the victim tried to protect himself by keeping his head down. Mr. Ammar was dragged back by staff who witnessed the assault. He left the scene and was arrested when he returned to the Service Centre on February 6th.

Background & History

9. Mr. Ammar’s background and history are detailed in the hospital report of November 19, 2024, and the restriction of liberty report of September 5, 2025 (filed at the hearing as Exhibits 1 and 2, respectively), as well as the Reasons for Disposition of January 20, 2025, following Mr. Ammar’s last annual hearing on November 19, 2024, and need not be repeated in detail here.

10. He is a 34-year-old single male with no children, who immigrated to Canada in 1966 from Syria. He was diagnosed with Schizophrenia by a psychiatrist in Edmonton, Alberta, in 2006 and was treated by the psychiatrist for two to three years thereafter. His next psychiatric involvement occurred on July 23, 2021, when he was admitted to the Etobicoke General Hospital following bizarre behaviour at Pearson Airport. Further psychiatric attendances and evaluations occurred while in and out of jail in 2022 and 2023.

11. The reports also refer to prior substantial daily use of crystal methamphetamine, former heavy alcohol use, and previous cocaine use. Mr. Ammar alleges he ceased using all illicit substances after needing to be briefly hospitalized for a cocaine overdose.

12. Mr. Ammar’s criminal record begins in 2012 and continues for a decade thereafter. It includes convictions of failing to attend court, mischief to property, failure to comply with bail and probation orders, and 11 convictions for assault.

13. The hospital report of September 5, 2025, details Mr. Ammar’s treatment since the last annual hearing. He was discharged from the hospital to the Grove Residence on March 28, 2025. However, he continued to have significant interpersonal difficulties with other tenants and staff at the home, the latter occurring when staff tried to provide education and direction.

14. Positive urine screens for methamphetamine were obtained on June 10, 13, and 18, 2025, and for cannabis and benzoylecgonine on June 10 and 13. He also had sexual relations on one occasion with a female peer from one of his outpatient groups. Staff at Grove residence reported a therapeutic impasse, as it was felt that Mr. Ammar’s deficits in independent living skills surpassed the ability of that residence to support and facilitate reasonable independent living, particularly in view of Mr. Ammar’s resistance to attempted interventions.

15. Mr. Ammar then moved to the Kimberlane residence, which is supervised all day, every day, on June 3, 2025. However, while there an ongoing deterioration in his mental health was observed. He became disorganized in both thought and behaviour and his personal

hygiene deteriorated. Mr. Ammar was no longer welcome at the home following an argument he had with the homeowners, who felt intimidated by his behaviour.

16. The Restriction of Liberty report states that Mr. Ammar was admitted to the hospital due to the ongoing decline in his mental health, his aggressive and volatile behaviour toward his treatment team and the owners of the group home, and his eviction from the residence. A shortage of forensic unit beds resulted in his admission to the Ottawa Civic Hospital on July 31, 2025, under the authority of a Mental Health Act Form 1.

17. Unfortunately, Mr. Ammar was discharged on October 12, 2025, from the Ottawa Civic Hospital by a psychiatrist who had taken over his care that day but failed to discuss his discharge with the treatment team beforehand. He was discharged with a prescription for Clozapine, given an appointment card for his electroconvulsive therapy (ECT) session at the Ottawa General Hospital on August 15, 2025, and was expected to reside at a shelter, despite no arrangements for such accommodation having been made before his discharge.

18. The treatment team was quite concerned about his discharge from Ottawa Civic Hospital and, fortuitously, contacted him on his mobile telephone. Notably, a homeless shelter was not approved accommodation within the terms of his Disposition and non-compliance with his Clozapine medication for several days would have required its recommencement at a much lower dose and titration upward over time. Such a development would, in the view of the treatment team, have been a major setback in his treatment. Discharge to a shelter for the homeless would also have placed Mr. Ammar in close proximity to illicit drugs, another significant risk factor.

19. He was therefore admitted to the Forensic Assessment Unit at the Royal Ottawa Hospital on August 12, 2025. A Rule 13 notice was sent on August 22, 2025, to the Brockville Mental Health Centre, which treatment providers felt could better accommodate Mr. Ammar’s treatment needs. The Brockville hospital responded in correspondence dated August 26, 2025, indicating its support for the proposed transfer.

20. The authors of the hospital report note that no feasible community discharge plan is presently available from the Royal Ottawa Mental Health Centre. Mr. Ammar has already left two supportive living facilities, and no others capable of providing more support than those exist in the Ottawa community. They opine that Mr. Ammar likely requires a prolonged stay in a rehabilitation unit with further monitoring of his medication and electroconvulsive therapy to optimize his mental health and functioning. In their view, Brockville is better suited to the provision of longer-term rehabilitation.

21. The authors maintain their view that Mr. Ammar continues to represent a significant threat to the safety of the public and note that risk assessments place him at moderate-to-high risk of future violence. They also express the view that the restriction of his liberty and readmission to hospital was warranted and has remained so until the date of the hearing, due to his mental decompensation and the escalation of risk factors that occurred while he was in the community, particularly the lack of approved accommodation.

22. In support of the recommendation for transfer to the Brockville Mental Health Centre they assert no feasible community discharge plan can be fashioned for Mr. Ammar in Ottawa after he was unsuccessful in two different 24-hour supervised group homes within a short time frame. Those residences are no longer available to him, and no other group homes exist in the Ottawa area that could offer him more support. Lastly, they opine that the conditions in the December 5, 2024, disposition ought to continue until Mr. Ammar is transferred to Brockville and suggest the only necessary changes for the coming year if transfer is ordered would involve substituting the names of the respective hospitals and communities while maintaining all conditions in the present disposition.

Evidence at the Hearing

23. Dr. F. Wood testified on behalf of the hospital and confirmed the contents of the September 5, 2025 hospital report. He agreed that no accommodation was available in the Ottawa community that could support Mr. Ammar’s needs and that he required a longer period of rehabilitation in a facility more equipped to do so than the Royal Ottawa Mental Health Centre.

24. He confirmed the escalating conduct, drug use, and deteriorating mental state referred to in the hospital report and set out above and asserted that Mr. Ammar’s readmission to hospital was warranted on August 12, 2025, and continued to be warranted until the time of the hearing. He thought mental decompensation and violent behaviour were likely to result from Mr. Ammar becoming non-compliant with his medication regimen and noted he has not yet become responsible for administering his medication.

25. He described the fortuitous circumstance when Mr. Ammar answered his telephone and cooperated with meeting the treatment team before his readmission to hospital following his discharge from the Ottawa Civic Hospital. He confirmed that failure to adhere to his Clozapine medication regimen would have been a major setback in his treatment, agreeing that titration upward from a lower dose over time would be required. He noted that Mr. Ammar was unable to use the public transit system to get to his August 15th electroconvulsive treatment and that no inquiry had been made before his discharge about the availability of accommodation at a shelter.

26. Dr. Wood supported Mr. Ammar’s transfer to the Brockville Mental Health Centre and noted that Dr. Hwang, Mr. Ammar’s treating physician, proposed the transfer due to the unavailability of accommodation in the Ottawa area and Mr. Ammar’s need for more time to develop independent living skills before he is again discharged to the community. He noted that Brockville has extensive rehabilitation programs from which Mr. Ammar could benefit, including on-site independent living units with the support of monitoring by staff.

27. In response to questions by Ms. Shukairy, Dr. Wood did not support an increase of the once weekly electroconvulsive treatment, currently part of Mr. Ammar’s regimen. He reported the treatment team feels Mr. Ammar is well medicated on his present medication regimen. He is taking substance abuse counselling following his use of illicit substances in June 2025.

28. He thought a transfer to Brockville could occur within a few months and favoured the terms of the present Disposition continuing until and after his transfer.

29. In response to questions from panel members, Dr. Wood stated that the Chief of Staff of Ottawa Civic Hospital was notified of the problematic discharge of Mr. Ammar without staff there having communicated with the attending physician at the Royal Ottawa Mental Health Centre.

30. Neither counsel for the Attorney-General nor the accused adduced evidence at the hearing. Dr. Wood and Mr. Ramsay continued to support the hospital position regarding the restriction of liberty and the recommendation for transfer. Ms. Shukairy agreed the restriction of the liberty was and continued to be warranted but opposed the transfer to Brockville. She suggested that continuing to stay at the Royal Ottawa Hospital would afford Mr. Ammar the opportunity to develop the independent living skills and stable mental condition needed to enable his discharge to accommodation in the Ottawa community.

Conclusion

31. Having considered the exhibits, the evidence at the hearing, and the submissions of counsel, the panel concludes that the restriction of liberty involved in Mr. Ammar’s admission to and continued residence in the Royal Ottawa Mental Health Centre was warranted and continues to be warranted at the present time. It is clear the very supportive environments of the Grove and Kimberlane residences were insufficient to meet Mr. Ammar’s needs or to deal with his aggressive behaviour. When those residences became unavailable to him, his readmission to hospital was inevitable due to the unavailability of other local residences capable of supporting his needs.

32. The evidence establishes that no other community living arrangements were available that could provide supports beyond those offered by those two homes. It indicates that the Brockville Mental Health Centre provides longer term rehabilitation than the Royal Ottawa Mental Health Centre is able to offer. The evidence is clear that Mr. Ammar requires a prolonged stay at a rehabilitation unit with further monitoring of his medications and ECT to optimize his mental health and functioning, as well as to develop independent living skills that will facilitate his reintegration into the community.

33. We accordingly order Mr. Ammar’s transfer to the Brockville Mental Health Centre. Until he is transferred, the terms of the December 5, 2024 Disposition will continue.

34. The risk assessment and Mr. Ammar’s aggressive and deteriorating behaviour while in the community since the last hearing establish that he remains a significant threat to the safety of the public. The panel agrees with the recommendation of the hospital that following his transfer there be no change to the terms of the December 5, 2024, Disposition except the location of the hospital and the name of the community he is permitted to enter. The Disposition for the coming year will therefore include all terms of the December 5, 2024,

disposition, with the Brockville Mental Health Centre replacing references to the Royal Ottawa Hospital and the community of Brockville replacing references to the community of Ottawa.

35. Continuation of the present 200-kilometre travel provision in the new disposition will allow Mr. Ammar to travel to Ottawa from Brockville. Dr. Wood testified that the hospital would facilitate travel arrangements for his father and brother to visit him in Brockville.

36. The panel is concerned about the events of August 12, 2025, at the Ottawa Civic Hospital. The entire sequence of events was highly problematic. A forensic psychiatric patient was discharged to the community, without communication to his treatment team at the Royal Ottawa Mental Health Centre or regard to the terms of his disposition that required him, among other conditions, to live in approved accommodation; without consideration of the necessity of adherence to his Clozapine medication regime; and without any inquiry of his ability to use public transport and attend for his ECT treatment on August 15, 2025.

37. The hospital report establishes that the forensic team had previously communicated directly with Civic Hospital psychiatric staff regarding Mr. Ammar’s forensic status, and we find it incomprehensible that the psychiatrist on duty that day, although new to the case, failed to consult records and liaise with the treatment team at the Royal Ottawa Mental Health Centre before discharging Mr. Ammar. It had been expected that he would be transferred from the Civic Hospital when a bed became available at the Royal Ottawa Mental Health Centre. But for the fortuitous circumstance of Mr. Ammar having and answering his mobile telephone and the treatment team meeting him in the community and returning him to the hospital, it is likely harm would have resulted from him residing in a shelter or on the street and being unmedicated. We expect the relevant authorities have communicated with one another so that Ottawa Civic Hospital psychiatric staff are aware of the identity and status of forensic patients admitted to the hospital to accommodate those for whom beds are unavailable at the Royal Ottawa Mental Health Centre. This situation should never be allowed to recur.

DATED this 7th day of October 2025, at the City of Toronto, in the Toronto Region.

Mr. R. Steinberg Alternate Chairperson

Office of the Registrar

Ontario Review Board