Ontario Review Board
Re: Ayanle H. Ali ORB File No: 7354
Hearing held on: Wednesday, March 12, 2025 Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Mr. S. Clapp Members: Dr. R. Sheppard Dr. S. Lessard Mr. D. Sandor Mr. J. Cyr
Parties Appearing: Accused: Ayanle H. Ali Counsel: Ms. M. Addie The person in charge of hospital: Counsel: Mr. J. McIntyre Attorney General of Ontario: Counsel: Mr. I. Sunderland
REASONS FOR DISPOSITION
(Dated April 30, 2025)
Introduction:
On May 14, 2018, Ayanle Hassan Ali was found not criminally responsible (“NCR”) on account of mental disorder on charges of attempt to commit murder (x3), assault causing bodily harm (x2), assault with a weapon (x2), and possession of weapon for dangerous purpose, all contrary to the Criminal Code. He is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated April 5, 2024, whereby he is detained at the Forensic Service of the Centre for Addiction and Mental Health (“CAMH” or the “hospital”) with privileges up to and including living in the Greater Toronto Area in accommodation approved by the person in charge. The Disposition also requires that Mr. Ali not possess any weapons, refrain from contact with the victims of the index offences, refrain from contact with uniformed military personnel, and not attend at any known military/forces installations or recruitment centres.
On March 12, 2025, a panel of the Board convened at CAMH to conduct Mr. Ali’s annual review pursuant to section 672.81(1) of the Criminal Code. Ms. Addie advised that Mr. Ali was sick and unable to attend the hearing; however, she had instructions to proceed. Neither Mr. McIntyre nor Mr. Sunderland objected to the panel making an Order excusing Mr. Ali from the hearing pursuant to section 672.5(10)(a) of the Criminal Code.
The Hospital Report dated March 1, 2025, was marked as Exhibit 1 at the hearing. In addition to the documentary evidence, Mr. Ali’s attending psychiatrist, Dr. A. Simpson, gave evidence.
The issues to be decided at the hearing were whether Mr. Ali continues to meet the test of posing a significant threat to the safety of the public and, if so, what is the necessary and appropriate Disposition, bearing in mind the four factors in section 672.54 of the Criminal Code.
Position of the Parties:
- At the outset of the hearing, the parties were asked for their initial without prejudice positions. Mr. McIntyre, on behalf of the hospital, took the position that Mr. Ali remained a significant threat to the safety of the public, but that his risk could be managed under a Conditional Discharge. Mr. Sunderland, on behalf of the Attorney General, took the position that there should be no change to the current Detention Order Disposition. Ms. Addie stated that the issue of significant threat was conceded, and that her client agreed with the position of the hospital.
Findings:
- For the reasons that follow, the panel found that Mr. Ali continues to represent a significant threat to public safety. The panel concluded that the necessary and appropriate Disposition, which is also the least onerous and least restrictive in the circumstances, is a Conditional Discharge with terms and conditions similar to those in the current Detention Order, as well as the addition of a residence and a consent to treatment condition. The full list of conditions is set out at the end of these Reasons.
Index Offences:
- The index offences occurred on March 14, 2016, and are summarized in the Hospital Report as follows (at pages 6-7):
“In summary, Mr. Ali entered the Canadian Forces Recruiting Centre in Toronto and immediately attacked the Corporal who was seated at the entrance. Mr. Ali repeatedly punched the Corporal in the head, and then took a large kitchen knife from a folder he was carrying and lunged at the Corporal, slashing and stabbing at him with the knife, causing a three-inch gash to the Corporal’s arm. The attack was interrupted by a Petty Officer who armed himself with a chair, using it to shield himself and force Mr. Ali away from the Corporal. Mr. Ali tried to attack the Petty Officer with the knife but could not because of the chair. Mr. Ali then ran into the Recruiting Centre and began chasing a Sargeant, swinging his knife at her on more than one occasion, barely missing the back of her neck. Mr. Ali encountered another Sargeant who had slipped and fallen in the chaos. Mr. Ali was observed to slash and stab the Sergeant several times in the upper torso and head while he was on the ground (a witness stated that the tip of the knife was facing the ceiling at this time). Mr. Ali was ultimately cornered. Items were thrown at him (including a photocopier) and he was tackled in attempts to disarm him, but he continued to come at staff with the knife. Mr. Ali was eventually pinned to the ground by numerous military officers, and they were able to get control of the knife. Mr. Ali’s iPod was noted to have an open file of the Quran Chapter two, and Mr. Ali was heard muttering a prayer as attempts were made to subdue him. Mr. Ali was then stripped of his clothing down to his underwear to ensure he had no secondary device on his person. None was found. The whole attack lasted less than one minute. Mr. Ali was described as running around in a frantic manner.”
- Mr. Ali was acutely unwell at the time of the index offences and reported that he felt like he was “living in a world full of voices.” He believed that people were monitoring him and out to get him, and that the government was trying to break him down and incapacitate him. He had a plan to be a martyr so that life could be better.
Background:
Mr. Ali’s personal background is set out in detail in the Hospital Report and will not be repeated here. Briefly summarized, Mr. Ali is a 37-year-old single man who was born in Montreal and grew up in Toronto. He graduated from high school and attended the University of Toronto and the University of Calgary. He did not finish a degree. Mr. Ali lived in Toronto and Edmonton between 2009 and 2012 working in various “side jobs.” He is Muslim and attends Mosque regularly.
Mr. Ali has strong family support from his three adult sisters and his father. He is close to his mother, who has a history of untreated schizophrenia. Mr. Ali’s parents separated in 2006; however, Mr. Ali’s father remained involved and supportive of the children. Mr. Ali’s father remarried and had a daughter, but his second wife passed away some years ago.
At the time of the index offences, Mr. Ali was living with his mother and was unemployed. He has no history of substance use.
Criminal History:
- Mr. Ali had no prior criminal record or police contact.
Psychiatric History:
According to the Hospital Report, Mr. Ali had no formal psychiatric history, but his family reported that he had been symptomatic for some time prior to the index offences. As a teenager, he experienced obsessions and compulsions and had difficulty concentrating in school. He began to hear voices, had ideas of reference, and was consistently concerned about the government watching him. He no longer spent time with friends, did not leave the house, and spent long periods of time alone in his room staring at the wall. He threw out almost everything from his room including his mattress and spent hours copying books.
Mr. Ali was detained at St. Joseph’s Healthcare Hamilton (“SJHCH”) from 2018 to 2023 following the NCR finding. He was compliant with medications and was described as a “model patient.” Some residual symptoms were noted, including delusional thought content where he felt he was being monitored by the government. He was described as having fluctuating symptoms and partial insight. Mr. Ali obtained passes to attend courses at McMaster University, as well as passes into the community with family members who were Approved Persons (Mr. Ali’s father and sister).
An early Board hearing was held in March 2023, and Mr. Ali’s Disposition included a transfer to CAMH and a provision allowing him to live in the Toronto area. Mr. Ali was discharged to live with his father in June 2023, and was being treated with a long-acting injectable antipsychotic medication. Mr. Ali was followed as an outpatient by SJHCH until the CAMH Forensic Outpatient Psychiatry Service was able to take over. This occurred in August 2023.
Mr. Ali’s housing with his father proved to be problematic in that he did not have his own room and was sleeping on the sofa. Therefore, he moved to his mother’s apartment to live with her and one of his sisters. While there was some concern about this arrangement given Mr. Ali’s mother’s untreated mental illness, and issues that had arisen in the past, the Hospital Report stated that Mr. Ali showed good insight into his mother’s behaviour and was much better able to cope with any issues that may arise. Following an initial trial, this placement proved successful and Mr. Ali remained living there at the time of the hearing.
Mr. Ali’s diagnosis is Schizophrenia. He is capable of consenting to treatment and managing his finances.
Evidence at the Hearing:
The Hospital Report stated that Mr. Ali had a good year. He prefers to live a quiet lifestyle and continues to feel uncomfortable due to the public nature of his index offences. Mr. Ali is described as experiencing “persistent low-grade paranoid ideation” and being somewhat difficult to engage in conversation, however, these experiences decreased over the reporting year as Mr. Ali became more comfortable with the CAMH team and was better able to reflect upon and manage his symptoms.
The Hospital Report included the following statements about Mr. Ali’s insight (at page 27):
“Regarding insight and judgment, Mr. Ali recognized that he had an illness requiring treatment and expressed satisfaction with his current medication. He demonstrated the ability to assess and reality-test mild psychotic symptoms that may occasionally emerge. He was motivated to rebuild his life while acknowledging the challenges involved in the process.
He expressed remorse for past events and the harm caused to others. His regret has reinforced his commitment to ongoing treatment and maintaining his well-being, as he was determined not to repeat such behaviors.”
The Hospital Report also noted Mr. Ali’s considerable strengths in terms of prosocial attitudes, stable and consistent work approaches, and a very supportive family. He is struggling to find an occupational direction in life and remains troubled by the heavy degree of stigma associated with his illness and the index offences.
The Hospital Report stated the following about Mr. Ali’s Clinical Risk Factors and Re-offence Scenario (at page 29):
“Mr. Ali’s risk of reoffending stems directly from the re-emergence of positive psychotic symptoms that exceed his ability to reality test and self manage. The circumstances that would place him at risk of the re-emergence of such symptoms would be stressful life circumstances, poor compliance with medication or other factors that may precipitate re-emergence of symptoms. He is likely to become more preoccupied with persecutory ideations and delusions involving both religious and political themes. He would then be likely to lose function, socially and educationally. As far as can be seen, that re-emergence of symptoms and decline in function is likely to be slow and progressive rather than sudden.”
The final risk judgment according to the Structured Clinical Judgment in the Hospital Report concluded that Mr. Ali was at a low risk of violence, and this would not change should he be granted a Conditional Discharge.
It was the unanimous opinion of the clinical team that Mr. Ali was ready to progress to a Conditional Discharge given his clinical, housing, and interpersonal relationship stability, as well as his relationship with the clinical team.
Dr. Simpson testified that he has been Mr. Ali’s outpatient psychiatrist since August 2023. He stated that Mr. Ali has been engaged in treatment with no readmissions to hospital, has stable accommodation, has had no substance use or breaches of his Disposition, nor any wider destabilizers this year. He has lived with his mother and sister for over a year without issue, and he has no plans to move until he receives an Absolute Discharge from the Board. His insight into his mental illness and the need for medication is internally driven.
When asked about the issue of significant threat, Dr. Simpson explained that Mr. Ali’s risk is symptom driven, and although he has responded to treatment, he still has some low-level symptoms that he copes with through skills he has learned in cognitive behavioral therapy (“CBT”). Mr. Ali has shown considerable stability, but his long-term wellness is still a “work in progress.” While Dr. Simpson was supportive of Mr. Ali progressing to a Conditional Discharge, he maintained that Mr. Ali remains a significant threat to the safety of the public and requires supervision. Dr. Simpson noted that Mr. Ali still has work to do in the areas of occupational and social reintegration which could be major stressors going forward.
Dr. Simpson explained that any relapse would likely be slow with a progressive worsening. He was of the opinion that the Mental Health Act (“MHA”) would be adequate to bring Mr. Ali to the hospital in the event of any decompensation. Dr. Simpson testified that Mr. Ali has been fully compliant with his medication, he has no pattern of relapse, and he is now able to speak about his symptoms. Dr. Simpson also noted that Mr. Ali’s family are well-attuned to Mr. Ali’s illness and would certainly speak to the team if they observed any relapse. When asked whether he thought that Mr. Ali would return to the hospital voluntarily, Dr. Simpson responded that he believed that Mr. Ali would cooperate if he was asked to do so by the treatment team or his family. He qualified this by stating that this has never happened before, so it is difficult to predict, but he was of the opinion that a Form 2 obtained by Mr. Ali’s family would be sufficient in any event.
Dr. Simpson did not think that Mr. Ali was ready for an Absolute Discharge as his recovery tasks are “too complex.” Dr. Simpson noted that Mr. Ali’s mental illness likely progressed over many years and culminated in the very serious index offences. As such, a cautious and gradual approach needs to be taken, with Mr. Ali demonstrating that he is able to manage each step without relapse. The treatment team will continue to work with Mr. Ali on managing his mental illness, continuing to improve his insight, and job coaching.
When asked about the conditions that would be necessary and appropriate for a Conditional Discharge, Dr. Simpson responded that they should be the same as the most recent Detention Order (clauses 4 (a) to (d)), with the addition of a consent to treatment condition, a residence condition, and reporting not less than once every two weeks.
Dr. Simpson was asked about the term in Mr. Ali’s current Disposition that allows for international travel to Saudi Arabia for up to three weeks with an approved itinerary. Dr. Simpson testified that Mr. Ali and his father had planned this trip for last year, but there was a delay in Mr. Ali obtaining his passport. The trip will likely occur this year, so Dr. Simpson supported including a provision allowing for this travel. It was noted by a member of the panel that last year’s Disposition did not state that the travel needed to be with an Approved Person (perhaps inadvertently). Dr. Simpson testified that any travel should be with an Approved Person (likely his father) who understands Mr. Ali’s needs. He also stated that they would work out the details and timing of any travel around Mr. Ali’s injection.
Mr. Sunderland asked Dr. Simpson whether Mr. Ali expressed any concerning ideological views recently. Dr. Simpson responded that it is difficult to tease out these issues when the content of a person’s delusions overlap with their faith. Faith is a big part of who Mr. Ali is, but it was Dr. Simpson’s opinion that Mr. Ali does not hold extremist views, nor does his Mosque or his family. Dr. Simpson stated that he had spoken to Mr. Ali about these types of issues, and described a situation where Mr. Ali was convinced that a web attack at the Toronto Public Library was a result of his actions. Mr. Ali was able to talk about his experiences and beliefs and eventually was able to “shake it off.” While Dr. Simpson acknowledged that this was a relevant consideration, he stated that any extremist views had not been active since the index offences.
Mr. Sunderland also asked Dr. Simpson about the stability of Mr. Ali’s household given his mother’s untreated mental illness. Dr. Simpson explained that Mr. Ali’s mother’s and father’s apartments are close to each other and one daughter lives with each of them. He described them as a “family system” that works collaboratively to support Mr. Ali. Dr. Simpson described Mr. Ali’s sisters as “very impressive” and stated that they are up front with him. They are also very familiar with their mother’s mental health issues, which Dr. Simpson understood to be chronic low-grade symptoms.
In response to questions from Ms. Addie, Dr. Simpson confirmed that Mr. Ali’s only medication is a monthly long-acting injectable antipsychotic medication. He agreed that if Mr. Ali missed an injection, it would be noticed by the treatment team, as well as Mr. Ali’s family who are very supportive of ongoing treatment for him. Dr. Simpson also confirmed that he was confident that the family would contact the treatment team if they had any concerns. Dr. Simpson testified that it had been nearly 10 years since the index offences, and a lot had changed since then. Although Mr. Ali is living with his mother again, he is now receiving treatment, has insight into his symptoms, and his family is educated about his illness.
Members of the panel asked Dr. Simpson about Mr. Ali’s social isolation and breakthrough symptoms. Dr. Simpson explained that Mr. Ali was never an outgoing person, but he did have friends, so it was hard to know whether his isolation was due to negative symptoms or anxiety around the notoriety of the index offences. When asked about Mr. Ali’s desire to change his name in light of the notoriety of the index offences (especially in our digital age), Dr. Simpson responded that Mr. Ali had not taken any steps yet. In terms of his breakthrough symptoms, Dr. Simpson described them as “fearful” and not violent.
Submissions:
Mr. McIntyre maintained the hospital’s position that Mr. Ali remained a significant threat to the safety of the public, and that his risk can be managed on a Conditional Discharge with the recommended conditions. He submitted that there was no longer a need to approve Mr. Ali’s housing and the MHA was sufficient to manage any decompensation in the community. Mr. McIntyre noted that Mr. Ali has had a consistent positive trajectory with no issues, including the move to his mother’s home over one year ago.
Mr. Sunderland maintained the Attorney General’s position that Mr. Ali remained a significant threat to the safety of the public with a risk of serious physical violence. He stated that a continuation of the Detention Order was necessary and appropriate because Mr. Ali continues to experience symptoms that are the same as those that were present at the time of the index offences. He also submitted that a Detention Order is required to bring Mr. Ali back to the hospital swiftly as he may not meet the requirements of the MHA.
Ms. Addie adopted the submissions of the hospital and noted that Mr. Ali has worked well with every treatment team since he has been under the jurisdiction of Board. He has been stable for over five years, including almost two years in the community. Although he has had some breakthrough symptoms, Ms. Addie submitted that the Hospital Report and the evidence of Dr. Simpson was clear that Mr. Ali has learned to use CBT and identify the symptoms. It was also clear that these episodes were occurring much less frequently than they had in the past. Finally, Ms. Addie confirmed that Mr. Ali was agreeable to there being a consent to treatment condition in a Conditional Discharge Disposition. She also provided Mr. Ali’s current address so that it could be included in a residence condition.
Analysis and Conclusion:
The panel found that the evidence contained in the Hospital Report and presented by Dr. Simpson clearly supported a finding that Mr. Ali continues to represent a significant threat to the safety of the public. While Mr. Ali has progressed consistently over the past number of years, he still continues to experience some breakthrough symptoms and has some important areas of recovery to address, including social and occupational reintegration. The panel was also cognizant of the seriousness of the index offences.
The panel concluded that the necessary and appropriate Disposition is a Conditional Discharge with the conditions recommended by the hospital and set out below. The panel accepted the expert evidence of Dr. Simpson that although Mr. Ali continues to experience some low-grade symptoms, they occur much less frequently, and he is able to identify and manage them better. The panel also accepted Dr. Simpson’s evidence that while Mr. Ali’s housing was a concern last year, it has proven to be a stable and supportive environment for over a year now. His family is very knowledgeable, present, and supportive, and is likely to contact the treatment team with any concerns. Mr. Ali has been compliant with medication consistently and has a good rapport with the treatment team. Any emergence of psychotic symptoms is expected to be slow and progressive and would be noticed by his family and the treatment team if Mr. Ali did not identify them himself. Further, the panel agreed with Dr. Simpson’s opinion that the MHA would be sufficient to bring Mr. Ali back to the hospital if he did not agree to return voluntarily.
The panel found that a continuation of the Detention Order was not the least restrictive and least onerous Disposition in the circumstances of this case. The Hospital Report and the evidence of Dr. Simpson was clear that Mr. Ali’s risk can be managed with specific and fulsome conditions in a Conditional Discharge. These include a residence condition, a consent to treatment condition, no contact provisions, and a reporting requirement of every two weeks. Mr. Ali has progressed significantly in his recovery and things are not the same as they were at the time of index offences. Mr. Ali is motivated to maintain his well-being and rebuild his life and is determined that events like the index offences will not occur again. In this context, the panel concluded that a Conditional Discharge Disposition will protect the safety of the public and also meet Mr. Ali’s recovery needs.
Mr. Ali will be discharged subject to the following conditions:
(a) reside at 275 Albion Road, Toronto, ON;
(b) report to the person in charge of the Centre for Addiction and Mental Health, Toronto or his or her designate, not less than once every two weeks;
(c) refrain from having in his possession any firearm, ammunition or other offensive weapon, or being in the company of any person possessing a firearm other than a peace officer;
(d) on his consent, agree to take medication and treatment as prescribed by his psychiatrist or as directed by the person in charge of the Centre for Addiction and Mental Health, Toronto, or his or her designate, in accordance with s.672.55(1) of the Criminal Code;
(e) advise the person in charge of the Centre for Addiction and Mental Health, Toronto, or his or her designate, in advance, of any absence from his residence of 24 hours or more;
(f) notify, in writing, the person in charge of the Centre for Addiction and Mental Health, Toronto, or his/her designate and the Ontario Review Board 24 hours in advance of any change of existing address or telephone number;
(g) not attend at any known military/forces installations or recruitment centres;
(h) refrain from contact with uniformed military personnel;
(i) refrain from contact or communication, direct or indirect, with the victims of the index offences;
(j) not travel outside of Ontario unless it is with an approved person, upon first obtaining approval of his itinerary by the person in charge of the Centre for Addiction and Mental Health, Toronto, or his or her designate, and such travel to not exceed three weeks;
(k) upon notice, attend before the Ontario Review Board as required; and
(l) keep the peace and be of good behavior.
DATED this 30th day of April, 2025 at the City of Toronto, in the Toronto Region.
Ms. S. Clapp Alternate Chairperson
Office of the Registrar Ontario Review Board