Ontario Review Board
Re: Samuel Bulis Thale (formerly known as Samuel Manyo Rebo)
ORB File No. 6846
Hearing Date: January 27, 2025
Hearing Location: St. Joseph’s Healthcare, Hamilton
Pursuant to: ss. 672.81(1) Criminal Code of Canada.
Before: Alternate Chairperson: Mr. J. Weinstein Members: Dr. R. Buckingham Dr. L. O. Lightfoot Ms. B. Little Mr. K. McKenna
Parties Appearing: Accused: Mr. S. Thale Counsel: Mr. L. Dimitry The Person in charge of Hospital: Counsel: Ms. L. Barney Attorney General of Ontario: Counsel: Mr. B. Adsett
REASONS FOR DISPOSITION
(Dated March 18, 2025)
Introduction
[1]. Mr. Thale was found not criminally responsible (NCR) for the Criminal Code offence of Assault Cause Bodily Harm on November 28, 2008.
[2]. He is currently subject to a discharge with conditions under a Disposition dated February 2, 2024.
[3]. A panel of the Ontario Review Board (the panel) convened this annual hearing on January 27, 2025, at St. Joseph’s Healthcare, Hamilton (St. Joseph’s) to review the current Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Thale attended the hearing.
[4]. At the commencement of the hearing, the Hospital recommended a continuation of the existing conditional discharge, but with the removal of the stated address on Aikan Avenue in Hamilton to facilitate a move to independent housing. This submission from the Hospital was supported by both counsel for the Attorney-General and counsel for Mr. Thale.
[5]. After hearing the evidence, the panel concluded that Mr. Thale remained a significant threat to the safety of the public, and that a continuation of the conditional discharge with the one modification suggested by the Hospital was appropriate.
Index Offence
[6]. The facts pertaining to the index offence are as follows:
“According to the Crown Attorney’s Case Report, Mr. Rebo [the name used by Mr. Thale at the time] assaulted the victim, Corrine Noftall, his co-worker at the Evening Telegram, in the vicinity of the Village Mall in St. John’s. Ms. Noftall did not know Mr. Rebo’s name. Ms. Noftall stated that Mr. Rebo approached her and some other coworkers while they waited for a bus near the mall. He was acting bizarrely - he stated, “What have you got in your mouth?” or “What did you put in my mouth?” and he began physically checking her pockets and throwing the contents on the ground. He then punched her in the face and neck. The incident was unprovoked. Ms. Noftall sustained a chipped tooth. When arrested by police, Mr. Rebo acknowledged the incident, but denied assaulting Ms. Noftall.”
Evidence at Hearing
[7]. The Hospital Report dated January 6, 2025, was prepared for this hearing, and filed as an exhibit. It contains extensive detail related to Mr. Thale’s personal and psychiatric history. The panel also heard the testimony of Mr. Thale’s treating psychiatrist, Dr. Kolawole.
[8]. Mr. Thale is single and has no dependents. He is diagnosed with schizophrenia and mild intellectual disability. He has no criminal record.
[9]. In 2005 he immigrated from South Sudan to Canada and settled in St. John’s Newfoundland. His parents were killed during ethnic disputes in South Sudan, and Mr. Thale spent time in a refugee camp before arriving in Canada.
[10]. The index offence occurred in St. John’s Newfoundland when Mr. Thale was 18 years of age. He was transferred to the jurisdiction of the Ontario Review Board in 2015, and admitted to St. Joseph’s in October 2015. He was initially discharged to live in the community in May 2016. After a few readmissions, Mr. Thale was discharged to live at Emmaus Place, where he currently resides, and he receives psychiatric care from the forensic outpatient team. He received a conditional discharge Disposition in 2018.
[11]. He voluntarily readmitted himself to the hospital in 2018 and 2019. He required support with social skills, and in maintaining appropriate boundaries with people. He had particular difficulty engaging with women appropriately. Mr. Thale has not been readmitted since 2019 but continues to need assistance with maintaining appropriate boundaries when interacting with women.
[12]. Mr. Thale is incapable to make treatment decisions, and these are made on his behalf by the Public Guardian and Trustee. He has been compliant with taking his medication but struggles with maintaining proper hygiene and keeping to a schedule.
[13]. The Hospital Report indicates that his care is complicated by cognitive impairments, disorganized behaviour, delusional thinking, and impulsivity. When the symptoms of schizophrenia are active, he experiences persecutory delusions, visual, auditory, and tactile hallucinations. He then becomes agitated and aggressive. The Report further indicates that Mr. Thale requires consistent and structured support to assist him with his daily living needs, and his behaviour with women. He consults with a psychologist weekly to help him with this behavioural issue.
[14]. There were a number of concerning incidents this past year indicative of his ongoing difficulty with women. On one occasion he touched the stomach of a female co-patient and made inappropriate comments to a female member of the staff. A female co-tenant of his residence complained of inappropriate sexual comments.
[15]. He also experiences paranoia in regard to other tenants, and is described as argumentative, and oppositional with delusional beliefs when not at his baseline.
[16]. Mr. Thale completed a General Arts and Science course at Mohawk College and is presently enrolled in another course. He is also employed 1-3 days weekly at a restaurant as a dishwasher.
[17]. The Hospital Report indicates that Mr. Thale required intense support from the outpatient team this past year. He experienced some breakthrough symptoms of his schizophrenia and has limited insight into his illness and the need for treatment. The opinion of staff is that without the oversight of the Review Board, Mr. Thale would cease his treatment, not take his medication, and likely travel to Newfoundland. This would result in a significant relapse of his mental health, and the likelihood of aggressive, violent behaviour.
[18]. Dr. Kolawole testified that he has been treating Mr. Thale for almost 10 years. He was impressed with Mr. Thale completing his course at Mohawk College, and is improving his English language skills, while working in the restaurant. He advised that there have been no violent incidents this past year, and that Mr. Thale continues to be engaged with the treatment team.
[19]. Dr. Kolawole indicated, however, that there are areas where Mr. Thale requires more support. He referred to some breakthrough symptoms, and an increase in Mr. Thale’s paranoia. He also observed some thought disorganization, which resulted in Dr. Kolawole adjusting his long-acting injectable antipsychotic medication from every 12 weeks to every 10. He has also added oral medication which appears to be helpful.
[20]. Dr. Kolawole testified that Mr. Thale has benefitted from his regular meetings with the forensic psychologist. These meetings have helped to mitigate the risks associated with his social boundary and communication difficulties.
[21]. Dr. Kolawole testified that Mr. Thale’s insight into his illness remains limited, and he continues to require psychoeducation with regard to his illness and treatment.
[22]. He believes that the current conditional discharge is the appropriate Disposition to manage Mr. Thale’s risk in the community by providing him with an opportunity to have structured supervision. Dr. Kolawole believes it is significant that there have been no complaints from either Mohawk College or Mr. Thale’s employer concerning inappropriate behaviour.
[23]. Dr. Kolawole is recommending that the condition in the current Disposition requiring Mr. Thale to reside at Emmaus Place on Aikman Avenue be removed to allow Mr. Thale to pursue independent living at the appropriate time. Mr. Thale has advised Dr. Kolawole that he would prefer a residence where his meals are prepared for him and his room is cleaned by staff. This type of facility would be a residential care home, and Mr. Thale is currently on a waitlist for a residential care facility operated by the Good Shepherd network.
[24]. Counsel for the Attorney-General questioned Dr. Kolawole with respect to the breakthrough symptoms this past year, and the notable incidents that are identified on page 39 of the Hospital Report. Specifically, an incident occurred on September 9, 2024, where Mr. Thale was experiencing paranoia about other tenants entering his room at Emmaus Place. He saw a toothbrush that he did not recognize and assumed other tenants were entering his room. On September 30, 2024, Mr. Thale was not at his baseline and was argumentative and oppositional with staff at his residence when discussing the limits of his curfew. He was stating that he didn’t need to listen to the hospital or abide by a curfew because he had finished school and is now free. He was also expressing a long-standing delusional belief that he had wood in his ear.
[25]. Dr. Kolawole stated that the breakthrough symptoms have not been as severe this past year as they had been previously. The nature of the noted incidents throughout the year is similar to what was seen on September 9 and 30th. After the first incident PRN medication was provided which helped the paranoid thoughts settle, and after the second incident, an adjustment was made to his medication which helped Mr. Thale return to his baseline.
[26]. With regard to Mr. Thale’s insight, Dr. Kolawole testified that it remains limited. He is able to describe his diagnosis and highlight some of the symptoms, but it is difficult for him to link the diagnosis and its symptoms with his medication and the risk of relapse should he discontinue his medication. He also has difficulty relating the impact the use of substances would have on his mental health, and the relationship between substance use and the index offence.
[27]. In answer to questions from Mr. Dimitry, Dr. Kolawole indicated that Mr. Thale was compliant with the change in medication this past fall. Dr. Kolawole also agreed with the suggestion that there has been an improvement in Mr. Thales’s behaviour regarding boundaries and his social skills.
[28]. Dr. Kolawole believes that Mr. Thale benefits from the structure to his routine of attending school and working in the restaurant. He receives support from the school, and they have actually suggested that he reduce his caseload to make the course more manageable.
[29]. Dr. Kolawole indicated to a member of the panel that Emmaus Place is transitional housing, and it is expected that tenants would move to independent housing within a few years. Mr. Thale is currently on the waitlist for Community Homes for Opportunity, a residential care facility, which provides the cooking and cleaning Mr. Thale would like.
[30]. Dr. Kolawole was also asked if the breakthrough symptoms were a result of not being optimally medicated. He advised that it is difficult to know. It could relate to a change in a person’s environment, or just occur for no understandable reason with the person returning to baseline having had no changes made to their medication.
Submissions
[31]. At the conclusion of the hearing the parties continued to recommend a continuation of the conditional discharge with the removal of the residence term as requested by the Hospital.
Analysis
[32]. The panel accepts that Mr. Thale has been well managed on a conditional discharge, as evidenced by him successfully attending school and maintaining employment.
[33]. He has occasionally experienced breakthrough symptoms of his schizophrenia, which have resulted in paranoia, disorganized thought, and hallucinations. He continues to require assistance with his social skills, and essentially, becoming aware of inappropriate behaviour, particularly with women, and being sensitive to personal boundaries.
[34]. Dr. Kolawole testified that Mr. Thale’s insight is limited, and that it is difficult for Mr. Thale to appreciate the relationship between his medication and his mental health, and the detrimental effect substance use can have on his mental health. These factors support the conclusion that, absent the oversight of the Review Board, Mr. Thale would most likely retreat from the support he receives in the community, stop his medication, and experience a severe decline in his mental health. With his psychotic symptoms still present, even when medicated and supervised, the result would be behaviour that would put the public at a significant risk of harm.
[35]. A continuation of the conditional discharge is necessary and appropriate. It is also appropriate to remove the residence clause to facilitate a move to different housing at the appropriate time.
[36]. The panel has applied the principles provided in s. 672.5401 of the Criminal Code in arriving at this conclusion.
Dated this 18th of March 2025 at the City of Toronto, in the Toronto Region.
Kevin McKenna Legal Member
Office of the Registrar Ontario Review Board