Re Adem Maya, 2025 CanLII 33820

Ontario Review Board

Re: Adem Maya

ORB File No: 8222

Hearing held on: Tuesday, March 4, 2025

Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas

Pursuant to: Section 672.81(1) of the Criminal Code

Before:

Alternate Chairperson: Mr. J. Weinstein

Members: Dr. R.D. Chandrasena Dr. B. Sheppard Ms. K. Tomaszewski Ms. C. Plyley

Parties Appearing:

Accused: Adem Maya Counsel: Mr. S.F. Gehl

The person in charge of hospital: Counsel: Ms. J. Zamprogna

Attorney General of Ontario: Counsel: Mr. D. Rows

REASONS FOR DISPOSITION

(Dated April 11, 2025)

Introduction:

1. On January 25, 2023, Mr. Adem Maya was found not criminally responsible on account of mental disorder, on charges of possession of weapon for dangerous purpose, failure to comply with undertaking (x2), utter a threat to cause death or bodily harm, assault with a weapon and aggravated assault, all contrary to the Criminal Code of Canada (“Criminal Code”).

2. Under his current Disposition, dated June 13, 2024, Mr. Maya is subject to the terms and conditions of a Disposition of the Ontario Review Board (the “Board”). Pursuant to this Disposition, he is detained at the Southwest Centre for Forensic Mental Health Care, St. Joseph's Health Care London, St. Thomas, Ontario (“Southwest”). This Disposition provides him with certain privileges, the highest level being to enter the communities of Elgin and Middlesex Counties, indirectly supervised.

3. On March 4, 2025, the Board convened a hearing at Southwest to conduct the annual review of the current Disposition.

4. Mr. Maya was present at the hearing and was represented by his counsel, Mr. S. Gehl.

5. A Hospital Report, dated January 17, 2025 (the "Hospital Report"), was entered as Exhibit 1.

6. The issue at this hearing is whether Mr. Maya is a significant threat to public safety, as defined in s. 672.5401 of the Criminal Code. If so, the necessary and appropriate Disposition in the circumstances must be determined, bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.

7. For the reasons set out below and based on the expert evidence and opinions before it, the Board concluded that Mr. Maya continues to present a significant threat to the safety of the public. The Board ruled that a Detention Order is the necessary and appropriate Disposition in these circumstances.

8. The Board agreed with the joint recommendation to amend the current Disposition, by removing the word “supervised” from the approved accommodation. The Board also agreed to add a term granting Mr. Maya passes up to 12 times a year, for up to 24 hours each, in Elgin and Middlesex Counties, accompanied by a person or delegate approved by the person in charge.

Current Psychiatric Diagnoses:

9. Schizophrenia

Substance Use Disorder

Intellectual Disability

Index Offences:

10. The circumstances giving rise to the Index Offences are extracted from last year’s Board Reasons, as follows:

“This information is from the Agreed Statement of Facts, not dated:

On Friday September 3, 2021, at approximately 7:00 am, Adem MAYA… went to the second floor and knocked at unit #205, where Timothy LINDSAY resided. LINDSAY did not really know MAYA, and had only met him 5 or 6 days earlier when MAYA knocked on his door by accident, looking for another tenant. Mr. Maya returned to LINDSAY’s apartment a few more times, requesting spaghetti sauce or cigarettes. LINDSAY gave him spaghetti sauce the first time he attended, but after this occurred a few times, LINDSAY told MAYA that he was not a grocery store and that there was a food bank downstairs in the building. MAYA responded by swearing and calling LINDSAY names. LINDSAY told him not to come back to his door.

On September 3, 2021, Timothy LINDSAY, answered the door when MAYA knocked on it. MAYA immediately began stabbing LINDSAY in his face, then in his arms, buttocks and abdomen. LINDSAY was stabbed a total of 6 times by MAYA. LINDSAY managed to go back into his apartment to get away from MAYA. LINDSAY was bleeding profusely from his wounds. After MAYA left, LINDSAY went downstairs to the office and asked the nighttime staff member for help. Staff called 911.

MAYA went to the 4th floor and began banging on the door of unit #404, which was the residence of Melissa SHIN (BYRNE). MAYA yelled at BYRNE to come outside and yelled “I will kill you!.” BYRNE did not answer her door, but sent an email to one of the staff members in the building for assistance. MAYA left the building and walked out the front door, down Erb St W, eastbound. Staff observed him leave and provided police with his description and direction of travel.

Sgt. MacINTYRE located MAYA walking near 300 Erb St W in Waterloo. Sgt. MacINTYRE approached MAYA. MAYA had a knife in his hand. He advanced toward Sgt. MacINTYRE, still holding the knife. Sgt. MacINTYRE unholstered his firearm and demanded MAYA drop the knife and get onto the ground. MAYA refused to comply and continued to advance toward Sgt. MacINTYRE while holding the knife. Another officer arrived to assist, and Sgt. MacINTYRE deployed his CEW. MAYA dropped to the ground, then got up and began to run away toward McDougall Road. He was still holding the knife. Police chased him. MAYA threw the knife into a vacant lot near 11 McDougall Road and was arrested near 23 McDougall Road.

MAYA was advised of his Rights to Counsel and Caution. He was taken to Grand River Hospital as a precaution, but was released from hospital later that same morning and taken to Central Division.

While at Grand River Hospital, MAYA made various, unelicited utterances, including that he “freaked out this morning” because he could not sleep and that he believed the victim was racist. He did not elaborate on this belief. Once at Central Division, MAYA was interviewed by police. He told police he was tired because people were making noise all night and he missed his bedtime. He said that multiple people were “egging him on.” He claimed to hear people chatting about him every night, calling him names which was not fair because he was the only Black guy there.

LINDSAY was taken to Hamilton General Hospital for his injuries which included a stab wound to his left arm, a stab to his left buttocks, two stab wounds near his right eye and two stab wounds near his lower abdomen. He remained in hospital for 3 days. He required sutures to control the bleeding to the wounds on his face. The wounds in his abdomen, back, arm and buttocks were stapled. A CT scan of his head revealed a chip fracture to his maxillary sinus area. By November 26, 2021, LINDSAY’s injuries had healed and he did not require any further treatment.”

Background Information:

11. Mr. Maya’s personal, medical, psychiatric, and criminal offence histories are set out in detail in the Hospital Report. They are accurately summarized in last year’s Reasons, as follows:

“Mr. Maya hails from Khartoum, Sudan. His early years were traumatic. After his family and his tribe were attacked, they fled to Ethiopia when he was six years of age. He moved to Canada when he was ten years old to live with an uncle who had five children of his own. Mr. Maya describes his living conditions as difficult, with his uncle being verbally and physically aggressive at times. His living environment in these and his early years lacked rules or structure and he was exposed to substances and was truant from school. He was expelled from his secondary school after an assault on school property. He may have been suspended three times from school and he dropped out in grade 12.

Prior to the index offence Mr. Maya lived in supported and subsidized housing. There appears to have been no time when he was employed.

Mr. Maya began using cannabis and alcohol in his early teens. He has also used crystal methamphetamine. He had been taking this at the time of his index offences.

Mr. Maya was apparently first diagnosed with schizophrenia in his teens. His psychosis and substances were treated in an adolescent program in October of 2009 at the Grand River Hospital in Kitchener. Mr. Maya reports other hospitalizations as well as being under the care of an Assertive Community Treatment Team in Kitchener.

Mr. Maya’s involvement with the criminal justice system began as a youth. The Hospital Report contains a summary of his charges and convictions between 2006 and 2018. They include assaults and weapons charges, uttering threats, mischief and many failures to comply with court dates or terms of probation or recognizance.

The Hospital Report relates:

‘Since 2012, he has been working with various multi-disciplinary agencies to assist him in taking medication and accessing housing. In 2015, he began working with Thresholds Homes and Supports Assertive Community Treatment Team. He was noted to do well with medication compliance; however, would “sabotage his living situation and relationships for those around him.” He was supported by an addiction specialist, psychiatric nurse and a psychiatrist.

Mr. Maya has been supervised on 10 different probation orders since he was a youth. He was noted to have difficulty complying with community supervision... Mr. Maya has been confirmed as having a diagnosis of schizophrenia. He first developed psychotic symptoms in 2008. The most prominent symptoms of schizophrenia in his case are persecutory delusions, auditory hallucinations and thought disorder. He has described derogatory and persecutory hallucinations over many years, and his symptoms appear to be only partially treated by antipsychotic medication. Mr. Maya perceives that others are ridiculing or insulting him, and he perceives voices talking about sexual themes.

Mr. Maya has had the support of a community mental health team, however his engagement with the team has at times been quite poor. He has been consistently adherent to receiving a 4-weekly antipsychotic injection, but his compliance with oral medication has been inconsistent, and he has often been avoidant of his team and psychiatrist.’

In a psychiatric assessment by Dr. Roland Jones of October 11, 2022, personality disorder was considered. “He appears to have several characteristics of antisocial personality disorder, including a failure to obey laws and norms by engaging in behaviour which results in criminal arrest; impulsive behaviour; irritability and aggression; blatantly disregards safety of self and others; a pattern of irresponsibility and lack of remorse for actions. There is an overlap between chronic symptoms of psychosis and features of antisocial personality disorder, such that it can be difficult to tease them apart. Once Mr. Maya’s symptoms of psychosis are more effectively treated, it will be possible to appraise his personality more accurately. It is likely however that he has antisocial personality traits in addition to schizophrenia.”

Course Since Last Disposition:

12. The Hospital Report sets out in detail Mr. Maya’s course since his last Disposition. The following excerpts are relevant:

“Throughout the reporting period, Mr. Maya continued to demonstrate, and voice being impacted by the positive symptoms of his mental illness, e.g., psychosis, delusions and hallucinations. Related to this demonstration, there was a significant incident on September 22, 2024, as it was noted he was experiencing auditory hallucinations about a co-peer.

During this incident, he made violent threats about smacking this individual if staff do not confront the situation. He then proceeded to spiral even further and called staff “fucking pussies” and expressed paranoia around staff in thinking staff were out to get him. He then proceeded to present signs of behavioural instability (e.g., closed fists, aggressive posturing, and intense eye contact) to which it was decided that he be placed in seclusion for safety purposes. He was removed from seclusion the following day.

Another fixed delusion he has is that staff can see his dreams and expressed some anxiousness around this as one dream involved him partying and seeing zombies, he believed this would impact his treatment progress.

Similar to the last reporting period, his main source of stress is the inability to smoke cigarettes and manage his cravings. On occasion, he believed that his disciplinary actions (reduced privilege levels) as a result of smoking on hospital property was because of his skin colour (black) as opposed to acknowledging the hospital rules. He does not seek staff support when faced with these cravings, which will likely continue in the next reporting year.”

Position of the Parties:

13. Counsel for the hospital, for the Attorney General and for Mr. Maya advised that this was a joint submission. They all adopted the hospital’s recommendation of continuation of the Detention Order, with the addition of passes up to 12 times a year, for 24 hours, in Elgin and Middlesex Counties, accompanied by a person or delegate approved by the person in charge. All parties also agreed to delete the word “supervised” in the requirement that he reside in accommodation approved by the person in charge.

14. Counsel for Mr. Maya advised that significant threat was not in dispute for the purposes of this hearing.

Evidence at the Hearing:

15. The Board had available to it the evidence and documents forming the Record, including the Exhibits, and oral evidence from Dr. Mokhber.

16. Dr. Mokhber, Mr. Maya’s treating psychiatrist, co-authored the Hospital Report. She testified:

a) She has been Mr. Maya’s treating psychiatrist for almost two years.

b) In the past reporting period, the treatment team noticed a substantial improvement in Mr. Maya’s mental status after they started treating him with clozapine.

c) Mr. Maya still suffers from both auditory, and visual, hallucinations; however, his level of insight into his major mental illness and need for treatment is improving. He is now able to recognize that these experiences are not real and that they are products of his major mental illness.

d) The treatment team has had difficulty getting Mr. Maya to cooperate and engage with recommended psychoeducation programs. One of the difficulties faced by both the treatment team and Mr. Maya is his cognitive disability, which requires program modification, to accommodate his learning abilities.

e) Mr. Maya recently started to engage in a program on the treatment unit called Illness Management Recovery. This program helps patients better understand their illnesses, recommended treatments and plans for the future. Mr. Maya has been a good participant.

f) The program also deals with substance abuse issues, which is a main risk factor for Mr. Maya. He has gained some level of understanding of the impact substance use has on his mental status. All of his urine drug screen tests have come back negative.

g) Mr. Maya has been on the waitlist to meet with a psychologist, and he will be able to begin sessions on March 7th.

h) The plan is for Mr. Maya to engage in the necessary psychoeducational programming to allow him to be transferred to the rehabilitation unit.

i) Mr. Maya has engaged in many recreational programs and has done very well in them.

j) Mr. Maya has a very close friend whom he refers to as his “brother.” The treatment team has engaged with the friend in the past, encouraging him to become an approved person. While they have not yet been successful, they are hopeful that the friend will agree in the coming year.

k) The treatment team agrees that Mr. Maya no longer requires supervised accommodation; he is showing progress with his new medication regimen, and he will be engaging in further programming.

l) The main challenge is that Mr. Maya still has a strong desire to smoke cigarettes. He has clearly indicated that he does not wish to quit smoking, nor does he wish to engage in any programs, or consider pharmacological help, to stop.

m) Mr. Maya could be described as a very empathetic and kind individual.

n) Mr. Maya’s DSO application is still pending.

17. In response to questions from counsel for Mr. Maya, Dr. Mokhber testified:

a) Mr. Maya’s friend, mentioned above, would be an appropriate approved person.

b) Mr. Maya is from Sudan; it is quite culturally appropriate for people of his heritage to refer to close friends as members of the family.

c) Once Mr. Maya is transferred to the rehabilitation unit, he will be able to have passes, which will allow him to smoke outside.

18. In response to questions from the panel, Dr. Mokhber testified:

a) Before the treatment team would recommend a transfer to the rehabilitation unit, they would need Mr. Maya to engage in the following activities:

i) Complete an Anger Management Program;

ii) Work with his psychologist on his insecure child attachment issues, as he is currently experiencing trauma as a result of his history; and

iii) Complete the Illness Management Recovery Program.

b) Mr. Maya’s cognitive impairment has lessened somewhat with the changes to his medication regimen.

c) While Mr. Maya is still experiencing auditory hallucinations, they are not distressing to him, and he is able to engage in appropriate coping mechanisms to handle them.

19. No other evidence was called.

Analysis and Conclusions:

20. Having heard and considered the entirety of the evidence as well as the submissions from the parties, the Board agrees that Mr. Maya remains a significant threat to the safety of the public.

21. In Winko, the Supreme Court outlined that, in coming to the conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence, including: the circumstances of the original offence; the past and expected course of the accused’s treatment; the present state of the NCR accused’s medical condition; the NCR accused’s own plans for the future; the support existing for the NCR accused in the community; and most importantly, the recommendations provided by experts who examined the NCR accused. In coming to our conclusion in this matter, the Board relies on the uncontroverted expert evidence of Dr. Mokhber, in addition to the documentary evidence before us.

22. Mr. Maya’s insight into the need for long-term treatment vacillates; without appropriate psychoeducation, supervision and redirection, he may fall away from treatment.

23. In particular, the Board relies on the Re-Offence Scenario and the Overall Clinical Assessment of Risk:

“Re-Offence Scenario:

Absent supervision, Mr. Maya would fall away from treatment and eventually decompensate. While unstable, he would likely cope with his symptoms by using substances, increasing his risk to re-offend, perceiving innocent stimuli as threats.

Overall Clinical Assessment of Risk

It is the opinion of the treatment team that Mr. Maya continues to pose a risk of serious physical or psychological harm to members of the public. The following evidence supports this opinion:

1. Mr. Maya continued to be symptomatic of his mental illness, schizophrenia. Despite the decrease in the frequency, he continued to be observed responding to unseen stimuli, and his thoughts, at times, were violent in nature;

2. Although Mr. Maya has been compliant with his medication regimen, he has been in a controlled and highly supervised environment. He has not been tested in a less restrictive environment. His insight into his need for long-term treatment also vacillated and ongoing education will need to be provided;

3. Mr. Maya’s level of insight into his illness, his need for treatment and his risk of violence remains underdeveloped and may not change;

4. Mr. Maya's substance use disorder has yet to be treated; although he is abstinent in the current environment, he has yet to be tested in a less restrictive setting;

5. Mr. Maya demonstrated cognitive, behavioural and affective instability during the reporting year. This contributed to clinical management issues. Without the supervision of the hospital these situations could have escalated;

6. Mr. Maya would not be able to obtain appropriate housing or mental health supports in the community if left to his own devices. He does require the support of DSO when living in the community; and

7. Mr. Maya’s personal support will need to be further assessed, specifically whether they could be considered risk-reducing.

Disposition Recommendation

The treatment team is recommending a Detention Disposition for the coming year. Mr. Maya was not considered for an alternative disposition. His clinical and future risk was deemed too high to consider less supervision at this time. He has a low degree of protection from risk and heavily relies on his current Forensic supports and the hospital environment, for not only managing his overall risk but in also attending to his activities of daily living. Absent these supports, it is likely he would decompensate and be left unable to obtain the appropriate supports necessary to maintain his stability.”

24. The Board agrees that Mr. Maya has made great progress in the past reporting year. With the changes in his medication regimen and his engagement in programming, it would be appropriate to remove the word “supervised” from his accommodation requirements. This change would allow the rehabilitation unit more flexibility in choosing appropriate housing for Mr. Maya in the future. It is also worth noting that Mr. Maya may also be entitled to housing through DSO, should his application be approved.

25. In consideration of all the evidence, submissions of the parties and criteria set forth in s. 672.54, the paramount consideration being the safety of the public, in addition to the mental condition of Mr. Maya, his reintegration into society and his other needs, a Detention Disposition, with the agreed changes by all the parties, is the necessary and appropriate Disposition in the circumstances.

DATED this 11th day of April 2025, at the City of Toronto, in the Region of Toronto.

Mr. J. Weinstein Alternate Chairperson Office of the Registrar Ontario Review Board