Re: Flora Sadik
ORB File No: 7623
Hearing held on: Wednesday, November 5, 2025
Place of hearing: St. Joseph's Healthcare Hamilton West 5th Campus, 100 West 5th Street
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Ms. L. Banks Members: Dr. W. Johnston Dr. G. Nexhipi Mr. B. Little
Parties Appearing: Accused: Flora Sadik Counsel: Ms. K. Edward
The Person in Charge of Hospital: Counsel: Mr. S. O’Brien
Attorney General of Ontario: Counsel: Mr. B. Adsett
REASONS FOR DISPOSITION
(Dated November 12, 2025)
Introduction:
[1]. On October 25, 2019, Flora Sadik was found not criminally responsible (“NCR”) on Criminal Code (the “Code”) charges of assault with a weapon and failure to comply with a probation order.
[2]. Ms. Sadik is currently subject to a disposition of the Ontario Review Board (“ORB” or the “Board”) dated October 18, 2024, detaining her at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton, West 5th Campus (the “hospital”), with the outer limit privilege to live in the community anywhere in Ontario in 24-hour-a-day supervised accommodation approved by the person in charge.
[3]. On November 5, 2025, a panel of the Board convened a hearing in person at the hospital to review Ms. Sadik’s disposition pursuant to s. 672.81(1) of the Code. Ms. Sadik was present at the hearing and was represented by counsel, Ms. K. Edward.
[4]. The issues for the Board to decide are whether Ms. Sadik poses a significant threat to the safety of the public and, if so, what is the necessary and appropriate Disposition for the coming year based on a consideration of the factors in s. 672.54 of the Code.
[5]. For the reasons which follow, the Board finds Ms. Sadik is a significant threat to the safety of the public and the necessary and appropriate Disposition for the coming year is a continuation of the current Detention Order, unchanged.
Initial Positions of the Parties:
[6]. At the outset of the hearing, the parties were canvassed as to their initial recommendations. Hospital counsel recommended a continuation of the current Detention Order Disposition with no amendments. Crown counsel supported the hospital’s recommendation.
[7]. Counsel for Ms. Sadik indicated that she was not contesting the issue of significant threat and indicated her client’s support of the hospital’s recommendation.
[8]. All parties maintained their joint recommendation to the Board in closing submissions.
Index Offences:
[9]. The circumstances of the index offences are excerpted from last year’s Board Reasons dated November 4, 2024, as follows:
“On June 12, 2019 at 2:00pm, Flora SADIK had an argument with her sister Faith SADIK in the kitchen of their home located at 16 Millwood Place in the city of Hamilton.
Flora called 911 screaming hysterically that ''they stole my daughter's pictures''. Faith also called 911 reporting that Flora attacked her in the kitchen. Faith said Flora was on crystal meth. Flora called 911 a second time to ensure police were coming.
Police arrived and found Flora sitting on the front step bleeding from a minor cut under her right eye. EMS attended and treated Flora, but she refused to go to the Hospital. Flora also refused to be taken to a shelter stating she had bus tickets and would leave once she got her daughter's pictures and a pink bag from inside the residence. Flora was not interested in charges.
Police spoke to Faith who had some scratches on her neck. Faith advised she and Flora argued over food. Faith was not supportive of charges. Faith, their mother Suzan SADIK, and other sister Fadia SADIK advised police that they just want Flora out of the house.
Flora retrieved her pink bag and then walked away from the residence. Police left the area.
At around 2:50 pm, Flora returned to 16 Millwood Place and entered the unlocked residence. Flora went upstairs to retrieve more of her property. Flora then went to the kitchen and argued again with Faith. Faith told Flora to leave.
At 2:55 pm, Faith called 911 and asked police to return as Flora was refusing to leave.
Flora then grabbed a kitchen knife and proceeded to stab Faith multiple times. Flora then fled the residence still holding the knife.
Police located Flora near Cardinal Dr and Millwood Place and at 3:00 pm arrested her for Assault with a Weapon. She was advised of her rights to counsel and caution.
Police attended 16 Millwood Place and found Faith suffering multiple stab wounds. Police administered First Aid. EMS transported Faith to St. Joseph's Hospital.
Fadia and Suzan witnessed the incident.
Faith suffered a stab wound to her mid left thigh, 1-1/2 to 2 inches long and approximately 1/2-inch-deep; a stab wound to her left palm near the thumb, 1-1/2 inches long and 1/4" deep; a cut behind her left ear approximately 3 inches long. Stitches were required to close Faith's stab wounds. Dr. Jared PATY advised Faith's injuries did not appear to be life threatening. Faith signed a consent form for release of medical records.
Flora is currently bound by two Probation Orders each with the condition not to possess any weapons and keep the peace and be of good behaviour.
Flora SADIK is charged with Assault with a Weapon and Fail to Comply Probation x 4.”
Personal History:
[10]. The Hospital Report dated September 24, 2024 details Ms. Sadik’s background, personal history and criminal offending, and need not be repeated in detail. Some relevant information will be highlighted below.
[11]. Ms. Sadik is 33 years old and has been under the Board’s jurisdiction for 6 years.
[12]. Her childhood was chaotic and her family life was characterized by marital conflict, domestic violence and highly sexualized behaviour. Ms. Sadik was made a Crown ward when she was 11 years old. Between 2004 to 2011, Ms. Sadik moved between 43 placements including group homes and foster homes.
[13]. Ms. Sadik did not finish high school. She has no known employment history.
[14]. Ms. Sadik is single. In 2016, Ms. Sadik had a daughter who was apprehended by CAS soon after her birth.
Criminal History:
[15]. Prior to the index offences, Ms. Sadik had a criminal record commencing in 2007 (as a youth). Her criminal record includes 25 convictions for assault (including assault bodily harm and assault peace officer).
Psychiatric History:
[16]. Ms. Sadik’s first known psychiatric admission was in 2010. Subsequently, she was assisted by the Hamilton Assertive Community Treatment Term and a Community Treatment Order. Since 2016, MS. Sadik has been assisted by multiple community agencies including Development Services Ontario (“DSO”).
Current Diagnoses:
[17]. Her current diagnoses are:
Schizoaffective Disorder, bipolar type;
Attention Deficit Hyperactivity Disorder (“ADHD”);
Post-Traumatic Stress Disorder (“PTSD”);
Borderline Personality Disorder features;
Stimulant Use Disorder, in sustained remission in a controlled environment; and
Mild Intellectual Disability.
Evidence at the Hearing:
[18]. Dr. S. Baldeo gave the evidence for the hospital at the hearing. He has been Ms. Sadik’s attending psychiatrist since July 2024. Dr. Baldeo authored the Hospital Report, and he adopted its contents in his evidence.
[19]. Ms. Sadik continues to be assessed as incapable for treatment decisions and for property. The Office of the Public Guardian and Trustee is her Substitute Decision Maker (“SDM”) for both. The mainstay of her treatment is the antipsychotic medication, clozapine, which she receives orally on a daily basis. She is also treated with daily oral doses of mood-stabilizing medications, epival and lithium carbonate. Ms. Sadik is predominantly cooperative with medication administration. Dr. Baldeo stated that he believes she is optimally treated at this time. He did note that her diagnoses of PTSD and Borderline Personality Disorder features continue to inform her often challenging presentation.
[20]. In terms of her mental state, it has remained largely at baseline, consistent with previous years. She experiences symptoms of psychosis in that she expresses the belief that she is related to various celebrities and that at times she hears the voices of her family at night. She has denied any thoughts of harming herself or others over the year in review. The doctor stated she continues to experience intermittent residual symptoms of grandiose and persecutory delusions.
[21]. Behaviourally, Ms. Sadik has made some gains in her ability to regulate her emotions and mood pattern is described as “labile”. This year, she has been better able to settle by going to her room when she is starting to get agitated. To her credit, there have been no instances of direct physical aggression toward others.
[22]. Despite improvements in her presentation, the Hospital Report indicates “Otherwise, she has continued to have periods of verbal aggression, particularly when her needs are not met, she feels she is being treated, unfairly, or when she is being woken from sleep when she doesn’t want to be. Ms. Sadik has required ongoing redirection around rules of not touching co-patients, the need to maintain appropriate boundaries, and the importance of refraining from using words that can be triggering or offensive to others.
[23]. The doctor was asked to describe the clinical year for Ms. Sadik and he advised that she has shown improvements in her behavioural presentation and there was a notable reduction in problematic incidents. The doctor also indicated that she has been better able to utilize her passes without incident, go on outings, interact with others. Appropriately, and was also more involved in on unit programming. Despite these improvements, Dr. Baldeo stated that Ms. Sadik continued to engage in incidents of rule breaking and behavioural episodes.
[24]. Over the year in review, Ms. Sadik has remained an inpatient on Orchard 3 at the hospital. Unfortunately, Ms. Sadik has, on many occasions, temporary holds on her privileges, due to returning to the unit late, smoking in prohibited areas, and not following the criteria established for the use of certain privileges.
[25]. The Hospital Report at pages 104 to 106 details several notable incidents which relate to instances of verbal aggression, verbal threats of harm, use of profanity towards staff, making obscene gestures, agitation, and difficult interactions with staff and co-patients, including late return from a pass and her attempt to bring contraband onto her unit (cigarettes and a lighter).
[26]. The Hospital Report stated that due to PASSPORT funding, Ms. Sadik receives approximately $31,635 annually and this funding is applied to secure a PASSPORT/Anchor worker who accompanied Ms. Sadik to access the community, without members of the hospital’s forensic team. The PASSPORT funding allows for approximately 9 hours a week of 1:1 support. Some of these outings included travel to Port Dover, visits with family members, recreational activities and shopping. All visits have gone well and Ms. Sadik enjoyed a very positive relationship with her PASSPORT worker and followed direction. These excursions and support yielded a marked improvement in the quality of her life. Unfortunately, Ms. Sadik’s PASSPORT worker resigned approximately six weeks ago. The treatment team was able to secure a new PASSPORT worker within weeks but that individual was not an optimal match for Ms. Sadik and accordingly, the team continues to search to identify an appropriate PASSPORT worker to support Ms. Sadik.
[27]. In terms of her use of passes, Ms. Sadik currently enjoys privileges up to level 4 for access to the community, accompanied by staff, or her PASSPORT worker. Ms. Sadik does not have an Approved Person. She was also able to exercise, indirectly supervised privileges on hospital grounds (level 3) this reporting period, successfully using over 300 passes. She continues to participate actively in off-unit recreational programming while maintaining the use of indirect passes.
[28]. A Behavioural Therapy worker continues to meet regularly on a 1:1 basis with Ms. Sadik for ongoing maintenance of coping skills and teaching alternative and appropriate replacement behaviours. As well, Ms. Sadik continues to have a Behaviour Support Plan and supplemental safety plans for the use of off-wards privileges.
[29]. In response to questions posed by a panel member, Dr. Baldeo stated that Ms. Sadik is not currently engaged in any formal Dialectical Behavioural Therapy or PTSD programming. In part, this is because she suffers from Mild Intellectual Disability and modified programming is not currently available. Additionally, the doctor noted that in the past, Ms. Sadik has been unwilling to engage in therapeutic or vocational programming. Dr. Baldeo testified that he will investigate the availability of these types of programs for Ms. Sadik should she be receptive to same.
[30]. The treatment team recommends that Ms. Sadik continue with ongoing teaching and maintenance of replacement behaviours and coping skills and attend psychoeducational programming over the upcoming reporting year.
[31]. Dr. Baldeo testified that Ms. Sadik continues to express underdeveloped insight into the nature of her major mental illness and the importance of medication to attenuate her symptoms and stabilize her mood. The doctor was also clear that Ms. Sadik does not appreciate, to any extent, the risk of substance use in exacerbating the symptoms of her mental illness. She often jokes about how she would like to use drugs, but then often quickly recants the statement as she knows substance use is against hospital rules and the terms of her Disposition. To her credit, all urine drug screens conducted over the year in review returned negative.
[32]. Dr. Baldeo opined that if Ms. Sadik was not under the jurisdiction of the Board, she would be very likely to stop taking her medication and/or revert to the use of illicit substances. He anticipated that this would result in an exacerbation of her mood lability and would be highly likely to result in her experiencing a decompensation in her mental state in a relatively rapid manner, followed by likely criminal offending which could include serious violence.
[33]. The doctor noted that the psychological risk assessment completed by Dr. Moulden (clinical psychologist) in 2023 describing Ms. Sadik’s risk as low to moderate on a Detention Order and the risk would be high for violent recidivism if Ms. Sadik was not under the Board’s jurisdiction. Dr. Baldeo agreed this risk assessment remains accurate and valid.
[34]. In returning to the evidence on significant threat, the doctor noted the serious nature of the index offence (Ms. Sadik stabbed her sister with a knife), her lengthy criminal history, the ongoing lability in her mood (rapid and often exaggerated changes in mood), her ongoing episodes of verbal aggression and threats of harm to others, and her underdeveloped insight into the nature of her major mental illness and the need for medication.
[35]. Dr. Baldeo confirmed the recommendation of the hospital’s position that a Detention Order remains both necessary and appropriate for risk management purposes. First, the hospital requires the authority of a Detention Order to approve Ms. Sadik’s placement in a supervised community residence to ensure medication adherence and observation of her mental status. The doctor pointed out the current community living term in her Disposition is for 24-hour supervised accommodation and anything less in terms of supervision and support would be inadequate. In addition, should there be any deterioration in Ms. Sadik’s mental status when living in the community, the doctor stated that appropriate risk management would require her immediate return to hospital to protect public safety. The doctor did not believe that the provisions of the Mental Health Act would be sufficient as the deterioration would be extremely significant and likely would have already resulted in violence to others.
[36]. Ms. Sadik continues to enjoy the support of her parents and has had contact both in person and over the phone with all of her siblings with the exception of her sister Faith (the victim of the index offences). Ms. Sadik’s family members have expressed that they are not yet prepared to have in-person contact with her in public or on hospital grounds without hospital staff or her PASSPORT worker’s supervision. Dr. Baldeo stated that family relationships are “complicated” and it is unclear if they are positive for her mental health; however, Ms. Sadik views her family relationships as being important supports for her.
[37]. In response to a question from the panel, Dr. Baldeo confirmed that Ms. Sadik engaged in individual counselling in April 2024 to address issues related to healthy relationships and boundaries. Her participation was positive. However, Dr. Baldeo was not aware whether Ms. Sadik had been offered an adapted trauma-informed intervention recommended by Dr. Moulden to address her extensive trauma history.
[38]. With regard to Developmental Services Ontario funding for potential community housing for Ms. Sadik, the doctor advised that there has been progress made in the visibility of her case to DSO coupled with a reduction in her estimate of costs for residential funding given the progress in her behavioural functioning. Although her needs remain very complex and specific, the residential care costs are now reflective of her current improved level of functioning.
[39]. Of note, on May 15, 2025, Ms. Sadik matched with a DSO bed with The Salvation Army. It was a shared apartment, where Ms. Sadik would have 2 other roommates, with her own room and one staff for all three residents, 24 hours, 7 days a week. The placement was not considered ideal as her roommates were male; however, given the shortage of DSO beds, the clinical team agreed to move forward with the match. The hospital was advised in August 2025 that the placement was not approved by the housing provider due to the roommates being males.
[40]. The Hospital Report states,“While this is disappointing, overall, it signals tremendous progress that Ms. Sadik is being actively discussed for matching opportunities and had one match. As Ms. Sadik continues to progress it adds hope that when another offer is made, she will be accepted and ready to move forward.”
[41]. The Hospital Report indicates that Ms. Sadik struggles to understand that the delay in her discharge to community living is related to the availability of appropriate housing. This continues to be a source of frustration for her and she often expresses her feeling that she believes the treatment team is not working hard enough on finding her housing.
[42]. In terms of the plan for the upcoming reporting year, Dr. Baldeo would like to see:
Ms. Sadik’s ongoing adherence with her prescribed medications;
ongoing abstention from alcohol and substances of abuse;
improvement in her insight across all relevant domains;
a reduction in episodes of impulsivity and aggression;
her appropriate use of Level 4 indirectly supervised privileges; and
continued use of passes with a new PASSPORT worker and the development of a positive rapport between them.
[43]. Counsel for Ms. Sadik read a note authored by her client. It stated that over the upcoming year, her client hopes to visit with her father and brother, get a job and go to school. The note indicated that Ms. Sadik also hopes to earn the privilege to have more passes and greater personal space. Ms. Sadik also commented that she looks forward to living in supervised accommodation in the community.
[44]. No further evidence was called at the hearing.
Analysis and Conclusions:
[45]. The Board finds Ms. Sadik continues to pose a significant threat to the safety of the public based on s. 672.5401 of the Code, and Winko, and its related authorities. In Winko the court explained that the threshold of significant threat to the safety of the public was a significant one. The risk must not be speculative. It must be significant both as to substance (i.e. the nature of criminal offending if the person is the subject of an absolute discharge), and as to the likelihood of occurrence. It must be more likely than not that, if the person is discharged, that they will engage in criminal offending that is serious.
[46]. The Board notes that the parties did not contest a finding of significant threat. Despite this, the Board makes its own finding of significant threat to the safety of the public based on the expert evidence of Dr. Baldeo, as supplemented by the Hospital Report.
[47]. The Board notes that Ms. Sadik continues to be impulsive and to require frequent reminders around boundary setting. In the past reporting period, there has been several serious incidents which are highlighted in the Hospital Report including verbally aggressive behaviour, threats of physical harm, and possession of contraband items. Ms. Sadik’s insight into her mental illness, the benefits of medication and the dangers of substance use remains quite limited. This lack of insight is not determinative of significant risk, but it is significant contributing factor for Ms. Sadik and her risk profile.
[48]. The Board accepts the evidence of Dr. Baldeo that absent the oversight of the forensic system, Ms. Sadik would almost certainly cease taking her medication and would be likely to return to the use of substances. In that context, she would be likely to struggle to maintain appropriate housing in the community. The Board further accepts that this would lead to a likely re-emergence of symptoms of psychosis and mood lability and further impairment of her judgment. The offending history of Ms. Sadik supports the Board’s view that in a decompensated mental state, Ms. Sadik is a significant threat to the safety of the public. This arises primarily due to her propensity to become disorganized in her thinking and she also experiences both grandiose and persecutory delusions. It is in this context that Ms. Sadik is at a high risk of violence towards others.
[49]. The Board congratulates Ms. Sadik for the gains she has achieved over the past reporting year. Overall, her periods of dysregulation and distress have been shorter and less intense and they have occurred less frequently than in previous years. We are hopeful she will be able to maintain this positive trajectory going forward.
[50]. Ms. Sadik has a community living term in her current Disposition and this will remain the case. Ms. Sadik has not yet exercised the ceiling of her privileges including indirectly supervised passes into the community. If Ms. Sadik deteriorates while in the community, it will be imperative for risk management to return her promptly to the hospital at the first sign of decompensation. This can be optimally achieved on a Detention Order. On the evidence of Dr. Baldeo, which the Board accepts, a return to the hospital for stabilization and treatment is not as certain, or as prompt, under the provisions of the Mental Health Act. In Ms. Sadik’s case, this is critically important in the Board’s view to ensure public safety.
[51]. The Board is also satisfied that the Detention Order is necessary for the hospital to approve 24-hour supervised accommodation for Ms. Sadik. Based upon all of the expert evidence before the Board, Ms. Sadik will require a high level of supervision and support when she is ready to be placed in the community to live. This can only be accomplished on the terms of her existing Detention Order and not on a Conditional Discharge.
[52]. In arriving at our Disposition, the Board has considered the paramount factor of public safety, Ms. Sadik’s community reintegration, her mental condition, and her other needs, all as required by s. 672.54 of the Code.
DATED this 12th day of November 2025, at the City of Toronto, in the Toronto Region.
Ms. L. Banks Alternate Chairperson
Office of the Registrar Ontario Review Board