Muneeb Ghawar, 2025 CanLII 33844

Ontario Review Board

Re: Muneeb Ghawar

ORB File No. 8487

Hearing Date: March 27, 2025

Hearing Location: St. Joseph’s Healthcare, Hamilton, West 5th Campus

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

Before:

Alternate Chairperson: Mr. M. Segal

Members: Dr. B. Sheppard Dr. G. Stones Ms. M. McKinnon Mr. K. McKenna

Parties Appearing:

Accused: Muneeb Ghawar Counsel: Mr. A. Confente

The Person in charge of Hospital: Counsel: Mr. S. O’Brien

Attorney General of Ontario: Counsel: Ms. K. Malkovich

REASONS FOR DISPOSITION

(Dated April 17, 2025)

Introduction

1Mr. Ghawar was found not criminally responsible (NCR) on February 9, 2024, for the criminal code offences of aggravated assault and disguise with intent.

2He is currently subject to a detention order under a Disposition dated March 14, 2024, with privileges that extend to entering the community of Southern Ontario accompanied by staff or a person approved by the person in charge.

3A panel of the Ontario Review Board (the panel) convened this annual hearing on March 27, 2025, at St. Joseph’s Healthcare, Hamilton, West 5th Campus (St. Joseph’s) to review the current Disposition pursuant to s. 672.81(1) of the Criminal Code of Canada.

4At the commencement of the hearing, the Hospital recommended that Mr. Ghawar remained a significant threat to the safety of the public, and that a continuation of the detention order was appropriate. It was recommending the same terms with the additional privilege of entering the community of Hamilton indirectly supervised. Counsel for the Attorney-General submitted that a continuation of the current Disposition was appropriate. She was not supporting the additional privilege. Counsel for Mr. Ghawar was supporting the Hospital’s recommendation and requesting that community living be added to the privileges in the Disposition.

5The panel concluded that a continuation of the current Disposition was appropriate with the added privilege of entering Hamilton indirectly supervised. The panel did not consider it appropriate to include community living in this year’s Disposition.

Index Offences

6The following is a synopsis of the facts pertaining to the index offences which occurred on February 3, 2023.

On Friday February 3rd, 2023 Sendi FARRANTO and Megan Carter were working at Sweet Releaf Cannabis store located at 1660 Upper James Street, Hamilton. At approximately 12:47 pm a male entered the store wearing a camouflaged jacket, a trapper hat just above his eyes, and a mask. He was the only person in the store other than the two employees. He asked Sendi FARRANTO for a Cannabis product and she came to allow him entry by removing a chain which prevents access. The male, later identified as Muneeb Ali GHAWAR, moved past the chain and behind Sendi FARRANTO when she turned her back to him and began walking towards the counter to complete the transaction. He pulled out a knife and began stabbing her with it in the back. She was stabbed upwards of 7 times and suffered a severed bicep and collapsed lung amongst other injuries (Aggravated Assault / Robbery) Once at the counter Muneeb Ali GHAWAR looked up to see that Megan CARTER was there and was yelling and screaming and going to get a phone to call 911. He then ran from the store. He left on foot and was later identified by detectives as Muneeb Ali GHAWAR. Detectives were able to find video footage of the accused being in the store on December 28th 2022 at which time he was not wearing a mask therefore concluding that he was wearing the mask on this occasion for the purpose of not being identified. (Disguise with Intent) On February 9th 2023 he was arrested without incident and his bail was opposed.

Hospital Report dated March 3, 2025

7The Hospital Report was prepared for this hearing and contains a detailed review of Mr. Ghawar’s personal and mental health history.

8Mr. Ghawar is diagnosed with Schizophrenia and Cannabis Use Disorder-in remission in a controlled environment.

9Mr. Ghawar has been experiencing mental health symptoms for many years, and he is now under the jurisdiction of the Review Board for the second time.

10In May 2014, Mr. Ghawar stabbed an acquaintance 5 times in the back and torso. He was charged with this offence and found NCR on October 15, 2014. He remained in hospital until March 2016, at which time he was discharged to live with his family. Mr. Ghawar was compliant with his medication, and met consistently with his outpatient team. On February 11, 2019, he was granted an absolute discharge. Mr. Ghawar continued to reside with his family until the recent index offence.

11The Hospital Report indicates that Mr. Ghawar had been treated by a psychiatrist in the community since 2012, for anxiety and depression. In April 2014, Mr. Ghawar stopped taking his antipsychotic medication, and his mental health symptoms intensified almost immediately. According to his family, Mr. Ghawar became very anxious and irritable. He would refuse to leave the house alone. The parents advised that they did not see anything in his behaviour to suggest he was capable of assaulting anyone on the day of the index offence in May 2014.

12Mr. Ghawar has an older sister, Mahak Ghawar Khan, and an older brother, Tahamoor Ghawar Khan. Their mother is Ms. Mumtaz Khan, and their father is Mr. Mohammad Khan. The family immigrated to Canada in 1998.

13Mr. Ghawar has experienced 3 traumas where he suffered head injuries. The first occurred during his 1st year of studies at the University of Waterloo in 2008. He was assaulted during a robbery. The second occurred when he was in a motor vehicle accident in 2009. Soon after the accident he experienced headaches, and at least on one occasion suffered a panic attack. The third incident occurred in Waterloo when he intervened in a domestic argument involving his roommate. The male assaulted Mr. Ghawar. Following the third incident, the family advises that Mr. Ghawar complained that “something was blocking his brain”. His sister reported that he became depressed and withdrew from his family and friends. The Hospital Report suggests that Mr. Ghawar was likely experiencing the prodromal phase of Schizophrenia after this third incident.

14Mr. Ghawar has a criminal record that consists of an assault in 2012, mischief in 2012, break and enter in 2012, and assault with a weapon-break and enter-mischief in 2013.

15Mr. Ghawar reported that he started using cannabis when he was 15 years of age, stopped during his initial hospitalization, but resumed in August 2019 until April 2023.

16A psychological assessment was performed in 2014. The neuropsychological assessment revealed remarkable decline in intellectual capacity. The assessments referred to symptoms of paranoia and anxiety in response to perceived threats in his immediate environment. It also referred to Mr. Ghawar experiencing delusional beliefs and perceptual disturbances.

17A more recent assessment was conducted in August and September 2023. Mr. Ghawar expressed delusional thought content, such as the victim of the index offence was “selling bad cannabis to kids in order to draw them into sex trafficking”. The conclusions from the assessment were that Mr. Ghawar has limited intellectual abilities and experiences significant impairment in neurocognitive functioning which is likely the result of his mental illness and substance use.

18During his initial mental status examination for the current index offence, Mr. Ghawar appeared distressed, anxious, and guarded when discussing the index offence. As the interview progressed Mr. Ghawar’s thought form became disorganized and disjointed. He acknowledged longstanding auditory hallucinations, and displayed indications of paranoia and grandiose delusions. Mr. Ghawar also acknowledged that he had stopped taking his medication prior to the index offence and was smoking marijuana. He had not been consistently taking his antipsychotic medication for a few years prior to the index offences according to his brother.

19The Hospital Report indicates that Mr. Ghawar has been pleasant and appropriate with staff and compliant with unit rules this past year. His behaviour has essentially been unremarkable. Mr. Ghawar has attended various therapeutic programs, and completed an on-line French course from the University of Waterloo. He has not been involved in any conflicts or displayed any aggression, and he has not consumed any illicit substances.

20He did exhibit an episode of psychosis on May 30, 2024. During clinical rounds, his assigned nurse observed Mr. Ghawar masturbating in his room. Mr. Ghawar invited the nurse to enter his room and examine his ankle. A short time later, Mr. Ghawar rang the bell for attention. A different nurse responded to the call. Mr. Ghawar was fully dressed, and he asked if the wound to his ankle could be cleaned. He was advised that his assigned nurse would attend to the wound. The assigned nurse found Mr. Ghawar standing naked in his room. When subsequently questioned about these events by his attending physician Mr. Ghawar indicated that the nurse had tried to seduce him. He then expressed a belief that the nurses were having sex with patients; he could hear them discussing pornography in the hallway and making plans to seduce the patients.

21His mother, the substitute decision maker, did not accept this behaviour was a result of psychosis, and suggested he was naked because he was simply hot.

22Mr. Ghawar’s mother has been an approved person since July 2024. He has been exercising community privileges with his mother for up to 12 hours, 4 times per week.

23The team, as noted in the Hospital Report, believes that Mr. Ghawar’s insight into his diagnosis, the impact of his diagnosis on his thoughts and behaviour, and the need for treatment is superficial and under-developed. He was able to identify his diagnosis as Schizophrenia, but not able to identify associated symptoms. He could not provide experiences of paranoia or paranoid thoughts from the past. Mr. Ghawar stated that he could not recall the details from the index offence, and he could not appreciate how cannabis use had impacted his mental status. It was also evident that Mr. Ghawar was trying to present himself and his progress in an overly positive light.

24In terms of Mr. Ghawar’s cognitive functioning, his thinking presents as mildly disorganized and tangential. It appears that his family have provided him with significant support with his school work, help completing assignments and staying organized, which has allowed him to complete the course requirements.

Testimony of Dr. Nagari and Mike Farranto

25Mr. Farranto is the husband of the victim of the index offence. He provided the panel with a victim impact statement that he read at the hearing.

26Mr. Farranto displayed tremendous courage presenting very difficult testimony concerning the impact this offence has had on his wife, himself, and their children. He advised the hearing that his wife lives in constant pain, with numbness in her left leg that makes walking difficult. Emotionally, she is constantly anxious, and has recently started taking antidepressant medication. She is unable to display affection to her husband or her children, which has been particularly difficult for their children. Mr. Farranto described his relationship with his wife as the role of a caregiver.

27Dr. Nagari is currently treating Mr. Ghawar, and was his treating psychiatrist after the first NCR finding.

28Dr. Nagari provided in his testimony an overview of Mr. Ghawar’s progress this past year. He referred to Mr. Ghawar having engaged in therapeutic programming, and having completed on-line courses. Mr. Ghawar has been compliant with his medication, and the level of paranoia has diminished significantly.

29Dr. Nagari referred to Mr. Ghawar’s lack of insight, and stated that Mr. Ghawar has difficulty applying the symptoms of his illness to his own situation, and is unable to appreciate the impact delusions have had on his behaviour.

30Dr. Nagari believes it is very important for Mr. Ghawar to participate in the Cognitive Behavioural Therapy for Psychosis group in this upcoming year.

31Regarding future housing for Mr. Ghawar, Dr. Nagari expressed concern that he was living at his parent’s home when he stopped taking his medication and deteriorated. The family did not advise Mr. Ghawar’s family doctor, who was administering the medication, that this had occurred. Similarly, Mr. Ghawar was residing in the family home at the time of the first index offence, and the family did not disclose to anyone that Mr. Ghawar had stopped his medication and his symptoms were intensifying. Dr. Nagari indicated that, when the Hospital is considering a recommendation for community living, it may suggest a supervised facility rather than the family home to ensure better support and communication.

32Dr. Nagari stated that he may consider increasing the dosage of the current medication, and perhaps, adding a 2nd antipsychotic. Dr. Nagari stated that there is a high risk of relapse with Mr. Ghawar, and then the associated violent behaviour as exhibited in the index offences.

33The Crown referred Dr. Nagari to various comments in the Hospital Report. Dr. Nagari acknowledged that after the psychotic episode in May 2024, involving the nurse and Mr. Ghawar masturbating, Dr. Nagari wanted to institute clozapine. After a short time of taking clozapine, Mr. Ghawar complained of side-effects, and the medication was discontinued. Dr. Nagari also acknowledged that Mr. Ghawar’s mother did not accept that this incident was a result of psychosis.

34Dr. Nagari confirmed that Mr. Ghawar is unable to connect medication to his mental health or recognize the symptoms of his illness. Dr. Nagari also agreed with the suggestion that Mr. Ghawar presents himself in an overly positive light.

35Counsel for Mr. Ghawar had Dr. Nagari confirm that education is important for Mr. Ghawar. Dr. Nagari indicated that if Mr. Ghawar was to live in the community in the near future it would likely be at the family home. Dr. Nagari also stated that to include a community living provision in the Disposition when there is little likelihood it would occur would be counter productive. Mr. Ghawar would assume the inclusion of this term meant he was progressing. Mr. Ghawar’s belief would not reflect the reality. It wouldn’t motivate him to engage in treatment, and would send him the wrong message. Dr. Nagari suggested that it would be appropriate to conduct a community living assessment in about 3 months, and if it was determined that community living was appropriate, an early hearing could be arranged.

36Dr. Nagari indicated in answering questions from the panel that including a community living clause would raise false expectations for the family. He agreed with the suggestion that the family should have been more attentive to their son’s medication adherence and any change in behaviour since they underwent this experience when he was first in the forensic system.

Submissions

37The Hospital submitted that it would be very cautious when permitting Mr. Ghawar to exercise his privileges. The Hospital is aware that Mr. Ghawar progressed very well in the hospital, was granted an absolute discharge, and severely decompensated in 1 ½ years. The introduction of community passes indirectly supervised would be strictly controlled. Counsel submitted that passes with the family have gone well. Counsel submitted that the Hospital is firmly opposed to community living.

38The Crown reiterated its position of no change to the current Disposition. She submitted that indirectly supervised community passes create a risk to public safety. Counsel referred to the index offence as being very violent. She referred to Mr. Ghawar having a mental illness since 2009, and that the family has not developed proper insight into the symptoms of this illness. Counsel referred to the impact the offence has had on the victim and her family. The Crown also described the index offence occurring without warning, and that Mr. Ghawar’s behaviour was unpredictable. Dr. Nagari could not predict how quickly Mr. Ghawar could experience a psychotic relapse. The Crown submitted that Mr. Ghawar requires a longer period of stability before indirectly supervised passes to the community are permitted.

39Counsel for Mr. Ghawar submitted that, in addition to the Hospital’s recommendation, the Disposition should include a community living provision. This would be motivation for Mr. Ghawar, and the Hospital has the discretion to permit community living only when it deems it appropriate.

Analysis

40After considering the evidence, the panel accepts that Mr. Ghawar remains a significant threat to the safety of the public and that a detention order is necessary and appropriate.

41The index offence that is the subject of this hearing, and the index offence for which he was found NCR on October 15, 2014, were both extremely violent, and very easily could have resulted in the deaths of both victims.

42He has been diagnosed with a mental illness since 2009, and has a history of medication non-compliance and substance abuse. Mr. Ghawar was initially under the jurisdiction of the Review Board from 2014 to 2019, and after receiving an absolute discharge, he returned to substance use and stopped consistently taking his antipsychotic medication. He was residing with his family the entire time, and it is evident that they did not inform his doctor of changes in his condition that they must have observed.

43Mr. Ghawar experienced a psychotic episode in May 2024. It is concerning that his mother would not accept the behaviour as resulting from his illness, but rather, suggested he was simply hot. The family is either unaware of the symptoms, refuses to accept them, or refuses to report their observations to the Hospital. The Hospital may consider it necessary to educate the family on the importance of disclosing to the Hospital changes in Mr. Ghawar’s behaviour and any non-compliance with his medication, before considering the family residence as appropriate for Mr. Ghawar when he is discharged to live in the community.

44Mr. Ghawar has a criminal record that includes convictions for violent offences in 2012 and 2013.

45The panel is also satisfied on the evidence that Mr. Ghawar does not have proper insight into the relationship between his illness and his behaviour. Mr. Ghawar does not fully appreciate the need for antipsychotic medication, and does not understand the harmful effects substance use has on his condition.

46The Hospital’s recommendations are appropriate including indirectly supervised passes into Hamilton. Mr. Ghawar has had a positive year in the hospital. He would be permitted to enter Hamilton indirectly supervised for a limited period of time. Mr. Ghawar is now receiving his antipsychotic medication by a long-acting injectable, so it is not likely he would be in the community unmedicated. The panel expects, however, that the indirect passes will be used very cautiously. The panel would suggest that the Hospital consider inquiring of Mr. Farranto if he wants to be advised when Mr. Ghawar is exercising the indirectly supervised community passes.

47The panel does not believe that community living is appropriate. With his history of medication noncompliance, substance use, an emergence of psychotic symptoms, and extremely violent behaviour, Mr. Ghawar requires the monitoring and support provided in the hospital. Community living would present a very significant risk to public safety.

48In coming to this conclusion, the panel has applied the principles provided in s. 672.5401 of the Criminal Code.