Re: Mohamed Ahmed
Re: Mohamed Ahmed (DOB: 01.01.74) ORB File No: 8462
Hearing held on: Friday, January 10, 2025 Place of hearing: Royal Ottawa Mental Health Centre Pursuant to: Section 672.81(2.1) of the Criminal Code
Before: Alternate Chairperson: Ms. M. Labrosse Members: Dr. S. Lessard Dr. R. Cormier Mr. D. D’Intino Mr. M. Hajek
Parties Appearing: Accused: Mr. Mohamed Ahmed Counsel: Mr. O. Abu El Hassan The person in charge of hospital: Representative: Dr. J. Hwang Attorney General of Ontario: Counsel: Ms. M. Dufort
AMENDED REASONS FOR DECISION
(Dated January 22, 2025)
Please see underlined change to original reasons made January 27, 2025: “Mohammed Ahmed” has been replaced with “Mohamed Ahmed” at page 1 and at the header on pages 2 to 6.
Introduction
On January 12, 2024, the accused was found not criminally responsible on account of mental disorder on charges of assault with a weapon, and mischief under $5000, contrary to the Criminal Code.
Mr. Ahmed is currently subject to a disposition of the Ontario Review Board, (the “Board”) dated June 7, 2024, detaining him in a secure forensic unit at the Royal Ottawa Mental Health Centre (ROMHC”/”the hospital”) subject to conditions inter alia at the discretion of the Person in Charge, and with privileges up to and including to live in the community in an accommodation approved by the Person in Charge.
By letter dated November 19, 2024, the Person in Charge of the Hospital advised the Ontario Review Board that Mr. Ahmed had been admitted to the Hospital as an inpatient. The letter indicates that the admission occurred on November 14, 2024.
On December 24, 2024, the Board received a Hospital Report for the Restriction of Liberty hearing, authored by Dr. J. Hwang.
A panel of the Ontario Review Board convened this restriction of liberty hearing, pursuant to Section 672.81(2.1) of the Criminal Code of Canada, on January 10, 2025, to consider if the initial and the continuing restriction of Mr. Ahmed‘s liberty were necessary and appropriate and the least onerous and least restrictive options available to the hospital to manage risk in all the circumstances.
Position of the Parties:
At the commencement of the hearing the parties were requested to provide their initial without prejudice positions with respect to the issues before the Board. On behalf of the Hospital, Dr. Hwang submitted that the both the initial and ongoing restrictions of liberty were necessary and appropriate in the circumstances.
Counsel for the Attorney General supported the hospital position.
Counsel for Mr. Ahmed took no position on these issues at the outset of the hearing.
Findings
- For the reasons that follow, the panel found that both the initial and the ongoing restriction of Mr. Ahmed’s liberty was necessary and appropriate in the circumstances.
Index Offence(s)
- The index offenses occurred on September 26, 2023. The following details are excerpted from the most recent hospital report:
On September 26, 2023, at approximately 11:20am, in the lobby of 190 Lees Avenue (where Mr. Ahmed resides), Mr. Ahmed approached Ms. Amy Desabrais, screaming and swearing at her because he believed she was recording him. She left the lobby and when she returned, Mr. Ahmed punched her in the back. This was witnessed by Ms. Meilan Sai. Mr. Ahmed screamed and swore at Ms. Desabrais until she was backed into a corner of the lobby, and then he swung his brown satchel bag (later found to be containing two Qurans) at Ms. Desabrais’ face, narrowly missing her and creating a hole in the lobby wall.
Ms. Desabrais told police on September 26 that she is the janitor of the building and was taking some photos of some damage to the building from an unrelated incident. She was then “berated and verbally assaulted” by Mr. Ahmed who “got in her face and scared her.” When Ms. Desabrais tried to turn to walk away back into the office, she was struck in the back with a closed fist in her shoulder area. She then got into the office and stayed until she believed Mr. Ahmed had left. She made her way out again with Ms. Stone to deal with a separate, unrelated issue. Mr. Ahmed was still sitting but he was quiet. He then started screaming again and followed Ms. Desabrais to the office. Ms. Desabrais was backed into a corner and Mr. Ahmed “screamed words that didn’t make any sense at her.” She was unable to make out what he was saying. He then suddenly tried to strike Ms. Desabrais in the face with his bag. He left a hold in the wall that was 3 inches long and had broken the drywall.
When constable Lewinson attended the scene, Mr. Ahmed could be heard speaking to himself but was not understandable. He was described as speaking in a “frantic manner.” He was yelling and speaking very quickly. The constable felt he was suffering from a mental health issue and tried to deescalate the situation. While the constables arrested and searched Mr. Ahmed, he “could not stand still” and he “would continually try to turn around and talk” to the constable about “unrelated matters to the event at hand.” Mr. Ahmed told the constable that “the lady” (Ms. Desabrais) was recording him and that he was being harassed.
During the drive to cell block, Mr. Ahmed “began drooling as he would periodically cry on the drive to the cell block.”
Diagnosis
Mr. Ahmed has been diagnosed with Bipolar Type I Disorder, most recent episode manic, in full remission.
He is incapable of consenting to treatment and his eldest daughter Aisha Ahmed was appointed as his Substitute Decision Maker (SDM).
Reason for Re-admission to the Hospital
Mr. Ahmed had been detained at the Ottawa Carleton Detention Centre (OCDC) and due to a lack of beds, upon his release August 9, 2024, he was residing at Kimberlane residence, which was a 24 hour supervised housing placement.
Ten days after his release from OCDC, Dr. Selaman met Mr. Ahmed at her outpatient clinic and noticed a substantial change in his demeanour. Mr. Ahmed was resistant to responding to Dr. Selaman’s inquiries and Kimberlane staff observed that Mr. Ahmed had been absent from the residence all day and only returned to sleep.
This change in presentation was determined to be due to the stress of surgery Mr. Ahmed had undergone to address injuries he sustained from a violent assault he suffered while at OCDC. However, by mid-October 2024, Mr. Ahmed began to exhibit symptoms of hypomania, such as being guarded, verbose and confrontational. He was also noted to have not been sleeping well.
Due to Dr. Selaman's departure from the program, Mr. Ahmed's care was transferred to Dr. Wood in October 2024. Mr. Ahmed was engaging and polite during his encounter with Dr. Wood on October 29, 2024. His thoughts were linear and free of psychosis. Dr. Wood explored the potential for rapid cycling episodes, substance use, and a cognitive component in response to the occupational therapist and case manager's concerns. Admission to the hospital was being contemplated in the event that his behaviors continued to deteriorate.
On November 14, 2024, his case manager contacted the Kimberlane residence to inquire about any recent changes in Mr. Ahmed's behavior, as his family had reported these changes. The staff reported that Mr. Ahmed was combative during the previous evening's disturbance. He had swung a belt at a resident and urinated on the floor. He was returned to his room upon the arrival of the police. He continued to smoke in his bedroom and refused to take his medications.
His case manager subsequent to this conversation contacted Mr. Ahmed’s family. According to his cousin, Mr. Ahmed was present at the family-owned restaurant and was making threats to the staff. The family was wary about contacting the police, as they were concerned that he would retaliate if he found out that they had called 911. The family requested that the case manager contact the police instead. Form 49 was issued as a result of medication non-compliance and escalated agitation, and the police were notified.
As a result of these concerns, Mr. Ahmed was readmitted to the Forensic Assessment Unit on November 14, 2024, and remains at the hospital to date.
Evidence at the Hearing
Dr. Hwang provided evidence on behalf of the hospital. She testified that on January 2, 2025, Mr. Ahmed was transferred from the Forensic Assessment Unit to the Forensic Rehabilitation Unit and remains there to date. He has been compliant with his medication, and those medications are currently being adjusted to reduce the risk of polypharmacy and cognitive slowing.
It was determined that Mr. Ahmed’s readmission to hospital in November 2024 was due to medication non-compliance.
A bed is being held for Mr. Ahmed at Wymering transitional residence but his transition there will be done gradually, as it has been determined that Mr. Ahmed is very sensitive to environmental changes or stressors.
In response to questions from Ms. Dufort, Dr. Hwang testified that she anticipates a gradual transition back into the community for Mr. Ahmed to take place in the next month or two, but that he will continue to regularly return to hospital for therapy and medication administration.
In response to questions from Mr. Abu El Hassan, Dr. Hwang testified that the longer-term goal is to get Mr. Ahmed into Grove housing, where therapeutic programming can be done on site, but that at this time there is no placement available for him at Grove.
Dr. Hwang further offered that she would like to see Mr. Ahmed use his community passes appropriately, specifically that he is returning to the unit on time, and also that he abides by his itinerary and that the Hospital not receive any complaints from the community about Mr. Ahmed while he uses these passes, before his discharge into the community.
In response to panel questions, Dr. Hwang testified while that upon his initial admission to the FAU in November of 2024, Mr. Ahmed had been disrespectful, argumentative and sexually inappropriate – as outlined in the Hospital Report – that those concerns have since resolved and Mr. Ahmed has been polite and appropriate.
Lastly, Dr. Hwang explained that when he is medication non-compliant, Mr. Ahmed’s mental status can decompensate rapidly, which was alluded to in the Hospital Report which discusses that upon re-admission to the FAU in November 2024, Mr. Ahmed reported that he discontinued his medications two days prior.
Dr. Hwang agreed with the suggestion that Mr. Ahmed became psychologically unwell in as little as two days after ceasing his medications, which is consistent with his medical history.
Analysis and Conclusion
The evidence provided by the Hospital supports Mr. Ahmed’s readmission to the hospital. Mr. Ahmed became medication non-compliant in November of 2024 and experienced a rapid decompensation in his mental status, which resulted in uncharacteristic behaviour, including confrontational behaviour, urinating on the floor at his residence and threats being uttered to staff at his family’s restaurant.
According to the historical sections of the Hospital Report, when unwell Mr. Ahmed has been physically violent, verbally aggressive and sexually inappropriate in the community, as well as becoming guarded and uncooperative with the treatment team and community-based staff. These behaviours are then exacerbated by Mr. Ahmed’s inability to sleep well when psychologically unwell, resulting in Mr. Ahmed presenting as a significant threat to the safety of the public.
The Panel therefore finds that the initial and ongoing restriction of Mr. Ahmed’s liberty were both necessary and appropriate, and that the least onerous and least restrictive option was utilized by the hospital to manage the risks posed by Mr. Ahmed in consideration of the totality of the circumstances.
DATED this 22nd day of January 2025, at the City of Ottawa, in the Ottawa Region.
Mr. D. D’Intino Legal Member
Office of the Registrar Ontario Review Board