Ontario Review Board
Re: Abdijabar Ahmed
ORB File No: 8001
Hearing held on: Thursday, February 13, 2025
Place of Hearing: Royal Ottawa Mental Health Centre
Pursuant to: Sections 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. P. Capelle
Members: Dr. G. Glancy
Dr. G. Boulais
Mr. P. Hageraats
Mr. A. Bernardo
Parties Appearing:
Accused: Abdijabar Ahmed
Counsel: Mr. M. Davies
Person in charge of hospital: Representative Dr. J. Gojer
Attorney-General of Ontario: Counsel: Ms. M. Dufort
REASONS FOR DISPOSITION AND DECISION
(Dated April 9, 2025)
Introduction:
On December 22, 2021, Abdijabar Ahmed appeared in court on charges of sexual assault(x2), attempt to commit sexual assault and obstruct peace officer, offences contrary to the Criminal Code of Canada.
The Court received expert psychiatric evidence establishing that Mr. Ahmed was suffering from a mental disorder when he committed the offences. Based on that evidence, the Court ruled that Mr. Ahmed was not criminally responsible on account of mental disorder (NCR).
Mr. Ahmed was assigned to the Ontario Review Board (ORB or “the Board”). He is currently subject to an ORB disposition dated February 21, 2024, ordering his detention at the Royal Ottawa Mental Health Centre (ROMHC or “the hospital”). Privileges were awarded, including the ability to live in the community in accommodation approved by the hospital.
On Thursday, February 13, 2025, the Board convened at the ROMHC to conduct an annual review. Mr. Ahmed appeared and was represented by counsel, Mr. Michael Davies. Also in attendance were two treatment team members: Lisa Fitzpatrick, the Canadian Mental Health Association (CMHA) case manager, and Meaghan Hartley, the hospital case manager.
At the hearing, the Board received direct expert testimony from Mr. Ahmed’s attending forensic psychiatrist, Dr. Julian Gojer. In addition, Dr. Gojer’s cumulative hospital report, dated February 6, 2025, was filed in evidence.
The issues to be considered by the Board are whether Mr. Ahmed presents a significant threat to the safety of the public, and if so, to determine the necessary and appropriate disposition.
Positions of the Parties
The Board was presented with a joint submission by all three parties, namely that Mr. Ahmed continues to present a significant threat and that, to manage the level of threat, a conditional discharge should be considered.
Speaking for the patient, Mr. Davies advised that Mr. Ahmed would consent to Dr. Gojer’s recommendation for a treatment order under section 672.55 of The Criminal Code. Mr. Ahmed would further consent to a term requiring that he live at his present group home.
For the reasons set out below, the Board adopted the joint submission.
Current Psychiatric Diagnosis
Schizophrenia
Mr. Ahmed’s condition is treated with psychiatric medication, oral Clozapine. The current dosage is at 350mg. Medication to deal with side effects is being provided.
Index Offences
- The circumstances appear in the hospital report and last year’s Reasons for Disposition dated March 26, 2024. In summary:
On December 25, 2020, the first victim and her boyfriend reported to police that Mr. Ahmed had followed them and come up to the female victim from behind and grabbed her buttocks.
A short time later, the second female victim was also walking in public. She heard someone breathing heavily behind her when Mr. Ahmed grabbed her buttocks. He then ran toward a third female, attempting to do the same, however the second female victim yelled out to her to run away.
Soon after, while the responding police officer was attempting to verify his identity, Mr. Ahmed reached out and lunged toward the female officer, trying to touch her buttock area. Ahmed was arrested and charged.
Personal Background
Mr. Ahmed is 29. He was born in Canada after his family arrived here in 1991 from Kenya. He has four older siblings. Mr. Ahmed stayed in Canada until Grade 6 when his mother returned with him to the family home in Nairobi. He has spent most of his life living with his mother or with other extended family members.
When Mr. Ahmed’s mother returned with him to Canada, he became aggressive and paranoid. A sister reported that the mother could no longer care for him. The family was not able to cope. Mr. Ahmed was sent to live in a shelter.
At the time of the index offences, Mr. Ahmed was homeless. Mr. Ahmed has not shown any signs of using recreational drugs. He reports he has never taken drugs or tasted alcohol.
In July 2019, as documented by Ottawa Hospital medical records, Mr. Ahmed began to feel suspicious about family members putting substances into his tea and food because he felt “high” - despite abstinence from drugs. He believed family members were tampering with his belongings.
There is some information to show that while he was in Nairobi, Mr. Ahmed was admitted to a psychiatric unit.
On March 17, 2021, a psychiatrist at the Ottawa Hospital assessed Mr. Ahmed. Mr. Ahmed was disorganized although he reported feeling elated. When Dr. Selaman assessed him on March 18, 2021, at the Ottawa-Carleton Detention Centre, Mr. Ahmed was described as catatonic and incoherent.
Mr. Ahmed’s capacity to consent to treatment fluctuates. He has been found incapable of consenting to treatment. His sister is the substitute decision-maker. Mr. Ahmed can manage his finances independently. Currently, he receives funds from the Ontario Disability Support Program.
At the time of last year’s annual ORB hearing held in February 2024, Mr. Ahmed remained on inpatient status at the ROMHC. In testimony before the Board, Dr. Gojer advised that Mr. Ahmed did not relate well to Dr. Selaman. At Mr. Ahmed’s request, Dr. Gojer assumed patient care on February 10, 2023.
The main issue in the previous reporting year leading up to February 2024 was Mr. Ahmed’s suboptimal response to antipsychotic medications. Clozapine medication was first started in June 2023. Since then, Mr. Ahmed has made some progress, while still experiencing side-effects. These have included over-production of saliva, some restlessness, and daytime drowsiness.
In that same reporting year, Mr. Ahmed did well with passes into the community. There were no behavioral issues. He got along well with staff.
At the time of last year’s annual review, the treatment team was looking into having Mr. Ahmed transition to community living. Encouragement was provided for Mr. Ahmed to participate more fully in counseling. He continued to struggle with negative symptoms of Schizophrenia. It was hoped he would continue to do well with a lower dose of Clozapine medication. Mr. Ahmed kept up good relations with others. Indeed, he was one of the hospital’s few patients who did not present any issue regarding illicit drug use.
At last year’s hearing, Mr. Ahmed’s insight into his mental illness was described as limited. He continued to not have a full understanding of the illness and would argue about whether he has a mental illness at all. That said, Mr. Ahmed was described as one of the most pleasant patients Dr. Gojer has had to deal with.
In the Board’s last Reasons, the panel noted that Mr. Ahmed’s primary risk factor was his major mental illness, Schizophrenia. He had been having problems with psychotic symptoms despite the use of injectable antipsychotic medications. There had been a history of problems with taking oral medication, disengagement from his treatment team and inadequate social support.
The Board noted that Mr. Ahmed had greatly improved through the latter half of 2023. They wrote as follows:
Continued wellness and stability depend on his strict compliance with Clozapine regime, managing side effects, ongoing psychoeducation, and further socialization in the community.
Course in Treatment, February 2024 to February 2025
Mr. Ahmed has had a reasonably good year. On April 18, 2024, the hospital discharged him to reside at the Whymering Group home, which is located close to the hospital. This group home is monitored 24 hours daily.
Mr. Ahmed has not needed to be hospitalized since April 2024. He has not displayed any behavioral issues. While somewhat isolated at the group home, where he sleeps a lot, he is described as passively compliant with treatment. He has not shown any aggression or violence. There have been no inappropriate sexual behaviours since the index offences of late 2020.
The hospital report notes that Mr. Ahmed continues to hold delusions of a grandiose nature. Dr. Gojer considers the delusions to be encapsulated, in that they do not interfere with the patient’s day-to-day behaviours. Dr. Gojer reports that Mr. Ahmed is open about sharing these delusions when they occur. Since starting on Clozapine medication, Mr. Ahmed has not reported any active hallucinations.
The hospital report contains separate assessments conducted by the occupational therapist and by the CMHA worker. In terms of his ability to function independently, as noted by Ms. April Stapleton, Mr. Ahmed continues to have various challenges in his ability to navigate independently in the community and to attend to certain activities of daily living. The report recommends Mr. Ahmed continue to attend occupational therapy programs.
In Ms. Fitzpatrick’s report, she notes that Mr. Ahmed has made significant progress now that he is in the community. He is very pleasant to deal with and is respectful and gentle in his approach. He accepts that medication has helped him. He has been taking his daily prescribed Clozapine dose.
Dr. Gojer reports that Mr. Ahmed will frequently request a reduction in the Clozapine dose, due to excessive salivation.
In Mr. Ahmed’s continuing grandiose delusions, he believes he will be receiving millions of dollars for inventions he has come up with. Mr. Ahmed cannot really explain any related details.
Dr. Gojer assesses Mr. Ahmed’s risk, while under treatment with Clozapine, to be low. Given the patient’s frequent requests to lower the medication dose, Dr. Gojer has some concern for the coming year about continued compliance. Therefore, according to Dr. Gojer, there is a risk of decompensation which could see the illness flare up, along with potential aggression. For this reason, Dr. Gojer believes the patient continues to present a significant risk to the safety of the public.
Acknowledging Mr. Ahmed’s improvement, Dr. Gojer believes that a loosening of the warrant is called for. Dr. Gojer recommends a conditional discharge, including terms - to be provided on a consent basis - that Mr. Ahmed be required to receive psychiatric treatment and that he be required to live at Whymering Manor.
Evidence at the Hearing
In direct testimony provided to the Board, Dr. Gojer spoke of Mr. Ahmed’s good relationship with him. He confirmed that Mr. Ahmed has progressed over the last year and a half. While Mr. Ahmed does not attend very many programs, he is still easy to relate to.
Some “quasi-psychotic symptoms” continue. Mr. Ahmed will often talk about stopping medication. Dr. Gojer clarified this, confirming that Mr. Ahmed has not stopped in his compliance with medication. Dr. Gojer further noted how they are trying to work around the unpleasant side effect of excessive drooling brought on by Clozapine.
Dr. Gojer responded to questions from both counsel. Mr. Ahmed’s current placement is working out well. Whymering Manor was described as “one of the better group homes we have in the city”.
Dr. Gojer further advised that Mr. Ahmed will cooperate with the treatment team and that his relationship with them is positive. Dr. Gojer advised that Mr. Ahmed has “sufficient insight to keep him going”, notwithstanding how he is bothered by side effects.
Mr. Ahmed benefits from community supports, including with family and attendance at the local Mosque. Mr. Ahmed never misses any appointments required of him, although, as before, he has not been attending that many programs.
Responding to questions posed by Board members, Dr. Gojer explained that oral antipsychotic medication is supplied by group home staff. They directly supervise Mr. Ahmed’s compliance. Dr. Gojer further advised he is giving some consideration to dealing with the side effects of excessive drooling by trying to slightly lower the Clozapine dose.
Dr. Gojer confirmed that Mr. Ahmed complies with blood level monitoring as is medically required for Clozapine. Dr. Gojer described Mr. Ahmed in complimentary terms, telling the Board, “He is an amazing man”.
The parties presented no further evidence.
Submissions of the Parties
The parties confirmed their earlier joint submission, namely that Mr. Ahmed’s condition continues to present a significant threat to the safety of the public although the level of risk he presents has lessened. Now that Mr. Ahmed is being successfully managed in the community, he can be overseen pursuant to terms of a conditional discharge.
Speaking for the patient, Mr. Davies added that Mr. Ahmed is on the right track and is improving. It is to his credit that he is dealing with the side effects and that he is dealing with the requirement to undergo blood testing.
Conclusions and Disposition
Based on the evidence, and supported by the appropriate joint submission, the Board had no difficulty concluding that Mr. Abdijabar Ahmed’s condition continues to present a significant threat to the safety of the public. This is based on the undisputed diagnosis of a severe mental disorder which led to the index offences. The finding is also supported by Mr. Ahmed’s continuing limitations which necessitate ongoing careful treatment, supervision and support, and which still need to be provided within a forensic context.
The Board accepts the hospital’s evidence that Mr. Ahmed has made commendable progress in the past year and a half. There was concern during the two previous years when Mr. Ahmed remained in hospital. It now appears he has started a successful transition into a closely supported form of community living. That said, Mr. Ahmed is not yet ready to transition to a lower level of supervision, much less to independent living on his own.
As was noted by last year’s ORB panel, it is essential that Mr. Ahmed continue to comply with his regime of psychiatric treatment, including his acceptance of prescribed psychiatric medication.
We commend Mr. Ahmed, notwithstanding the discouraging side effects he experiences, for continuing to work well with Dr. Gojer and the members of his hospital and community-based treatment teams. We encourage Mr. Ahmed to continue this path.
For these reasons, having regard to the primary consideration of keeping the public safe, and balancing the patient’s mental condition, his reintegration, and his other needs, a conditional discharge is granted. Specific terms will be consistent with the joint submission put forward.
We thank the parties and both counsel for their assistance.
DATED this 9^th^ day of April 2025, at the City of Toronto, in the Toronto Region.
Mr. P. Hageraats
Legal Member
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Office of the Registrar
Ontario Review Board