Re: Safi Nur, 2025 CanLII 42639

Ontario Review Board

Re: Safi Nur

ORB File No: 8198

Hearing held on: Thursday, April 3, 2025

Place of Hearing: Royal Ottawa Mental Health Centre

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

Before: Alternate Chairperson: Ms. C. Finley Members: Dr. S. Lessard Dr. S. Wiseman Mr. D. Sandor Ms. N. Lemieux-McKinnon

Parties Appearing: Accused: Safi Nur Counsel: Ms. M. Munsterman Person in charge of the hospital: Representative Dr. A. Sandhu Attorney-General of Ontario: Counsel: Ms. M. Dufort

REASONS FOR DISPOSITION

(Dated May 7, 2025)

Introduction

1On December 21, 2022, Safi Nur was found not criminally responsible on account of mental disorder on a charge of assault with a weapon, contrary to the Criminal Code of Canada. She is currently subject to a disposition of the Ontario Review Board (ORB/the Board), dated February 22, 2024, detaining her at the Secure Forensic Unit of the Royal Ottawa Mental Health Centre (ROH/the hospital), with discretionary privileges up to and including the ability to reside in the community in approved accommodations.

2On April 3, 2025, the Board convened to conduct the annual review of Ms. Nur’s disposition pursuant to s.672.81(1) of the Criminal Code. Both Ms. Nur and her counsel, Ms. Munsterman, appeared by video conference.

3At the outset of the proceedings, all parties were canvassed as to their positions on the two issues to be determined by the Board: whether Ms. Nur continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate disposition having regard to the criteria set out in s. 672.54 of the Criminal Code.

4Dr. Sandhu, on behalf of the hospital, submitted that Ms. Nur continues to represent a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current detention order. The hospital also recommended that, in addition to the current requirement that she abstain from the non-medical use of alcohol or drugs or any other intoxicant, Ms. Nur’s disposition allow for a provision that any medical use of cannabis should be first approved by Ms. Nur’s forensic psychiatrist. Further, Dr. Sandhu submitted that Ms. Nur’s disposition should include an order that her care be transferred to the Centre for Addiction and Mental Health (CAMH) in Toronto. A Rule 13 request was sent to CAMH and a response provided to the panel. Ms. Dufour, on behalf of the Ministry of the Attorney General, and Ms. Munsterman concurred in the hospital’s positions. Thus, a joint recommendation was put before the Board.

Findings

5For the reasons that follow, the Board finds that Ms. Nur continues to represent a significant threat and the necessary and appropriate disposition is a detention order with the same terms and conditions, without any provision allowing for cannabis use. The Board also orders that Ms. Nur’s disposition should include a transfer of her care to CAMH.

The Evidence

6The evidence at the hearing consisted of the Hospital Report, dated March 13, 2025 (ex. 1), the Rule 13 request sent to CAMH dated March 18, 2025 (ex. 2), CAMH’s response to the Rule 13 request dated April 2, 2025 (ex. 3) and the viva voce evidence of Dr. Sandhu, Ms. Nur’s treating psychiatrist.

The Index Offence

7The circumstances of the index offence are taken from the Hospital Report, at p.11:

According to the Crown Brief Synopsis, on April 6, 2022, two of the victims performed a door knock on Ms. Nur’s door in the Ottawa Community Housing building, where there had been a fire in one of the units earlier that day and the workers were doing smoke detector checks. Ms. Nur allowed them entry but then went to the kitchen and got a kitchen knife before walking back towards the two victims with the knife in her hand. The two victims unsuccessfully de-escalated the scene, where Ms. Nur continued to yell at them, causing them to fear for their safety and exit the unit prior to calling 911. Following this incident, the other two victims were cleaning up the damage in the nearby unit that had the fire. When they exited the unit, they observed Ms. Nur exit her unit in the same hallway, and she had the knife in her hand. She began yelling at the second set of victims, telling them to get out of the building, and she walked towards them aggressively. The second set of victims feared for their safety, ran back in the unit, and called 911 while Ms. Nur began banging on the door and yelling for them to get out of the building. Ms. Nur kept pacing up and down the hallway banging on the walls with the knife. Police attended the scene, where they observed Ms. Nur with the knife in her hand. When demanded to drop the knife, Ms. Nur ran into her unit and locked the door. She eventually allowed police entry into her unit, and she was placed under arrest while the knife was seized.

Background

8The Hospital Report contains detailed information about Ms. Nur’s background and psychiatric history and need not be reviewed here but for the following material points. Ms. Nur is a 23-year-old single Somalian woman who has a brother and sister, both of whom reside in Toronto. Her mother resides in Ottawa. As a result of significant mental health issues experienced by her mother, Ms. Nur has resided for the majority of her life in Toronto with her great aunt, whom she also refers to as her grandmother. Her father has had a limited involvement in her life.

9Ms. Nur’s mother has reported that she noticed a change in her daughter’s behaviour when Ms. Nur was 15. She was engaging in substance use on a daily basis. She reported auditory and visual hallucinations and paranoia and became aggressive toward family members. Ms. Nur’s mother was concerned that at a young age older men would befriend Ms. Nur and take advantage of her. Ms. Nur’s mother suspected that these older men would give her daughter drugs and possibly force her into sex work.

10In February 2019, Ms. Nur was admitted to the Children’s Hospital of Eastern Ontario (CHEO). She reported visual and auditory hallucinations, including hearing voices telling her to jump off a balcony. At the time she had been consuming cannabis.

11In July 2021, Ms. Nur moved into a subsidized apartment with Ottawa Community Housing. At the time, she was supported by Ontario Works. The Mobile Crisis Unit (MCIT) of the Ottawa Police received a number of calls from Ms. Nur reporting human trafficking and being tortured. They visited her address numerous times with no response. The police later received “a plethora of emails of a delusional nature”. When they went to check on her this time she answered. Police noted “the apartment was sparsely furnished, messy, and a strong smell of THC”. Ms. Nur was somewhat disorganized in her speech, and paranoid but at the time police did not identify any safety concerns nor grounds for apprehension.

12After Ms. Nur was arrested for the index offence, housing staff entered her unit to check on the status and noted that there was significant drywall damage, very few belongings and no furnishings apart from a chair and a tent in the living room. Given the nature of the index offence, Ms. Nur’s tenancy was terminated.

13Following the index offence, Ms. Nur was arrested and detained at the Ottawa Carleton Detention Centre. She was transferred to the forensic assessment unit at ROH on May 3, 2022, having been found unfit to stand trial and subject to a Treatment Order. Ms. Nur was ultimately found fit to stand trial and she remained in hospital after being found not criminally responsible.

14Ms. Nur’s mother would attend the hospital and visit with Ms. Nur. Unfortunately, the visits became more disruptive. Ms. Nur’s mother would be abusive, insulting and uncooperative with the treatment team. She repeatedly made derogatory and threatening remarks and called the doctors “liars, racists and snitches”.

15Around this time, Ms. Nur’s older sister contacted the treatment team. She shared that her mother lives with mental illness, though did not have a diagnosis. She expressed concern for her sister if she were to be placed in their mother's care. Ms. Nur’s sister further advised that their brother has been diagnosed with Schizophrenia and was currently incarcerated. She confirmed that her sister’s primary support is her grandmother.

16In January 2023, while still an inpatient, Ms. Nur tested positive for a cocaine metabolite. She denied ingesting or using cocaine.

17Ms. Nur was officially discharged from the hospital to Elmdale group home on July 10, 2023. At the end of August 2023, Ms. Nur disclosed that she had given much of her money to her mother and that she had purchased food and alcohol for her mother. She reported that providing for her mother was important in their culture and religion.

18Within a few months of Ms. Nur residing at the group home, the staff reported increasing difficulties with Ms. Nur’s mother, to the point where the manager was considering contacting the police to have charges laid.

19On October 18, 2023, Ms. Nur absconded from the group home and travelled to Toronto “to party”. She contacted the staff at the group home who noted that her mental status had deteriorated. She had long pauses in conversation and was described as “thought blocking” by the case manager. Her relatives in Toronto were unaware that she was in Toronto at the time.

20Within a matter of days, Ms. Nur was found by police at her mother’s residence and was brought to hospital. She told the team she went to Toronto by herself to visit friends of her boyfriend. She admitted that she smoked cannabis and did not want to offer many details. She did not take oral medications during this time and returned to Ottawa and “drove around” for two days. She was placed on a Form 1 by Dr. Sandhu for an acute change in mental status involving possible delusions and labile emotional expression. She was admitted to the Montfort Hospital where she remained for a week and was then discharged back to the Elmdale group home.

Course Since the Last Disposition

21Ms. Nur reported that she was interested in leaving Elmdale due to concerns with co-residents, who she said were rude and aggressive towards her. In March 2024, Ms. Nur began a trial at another residence in Ottawa, Mon Plaisir Residence. She officially moved to that residence on March 27, 2024. At the time, she also expressed an interest in moving to Toronto to be closer to her supports, in particular her great aunt.

22In April, 2024, Ms. Nur’s brother made inquiries about Ms. Nur going to Toronto to celebrate Eid with the family. However, at that time, Ms. Nur was in a relationship with a co-patient and she became more distant with her great aunt and family members in Toronto. She indicated that she was no longer interested in moving to Toronto and the plans to celebrate Eid did not occur.

23Ms. Nur’s relationship with the co-patient ended, which caused her to experience stress and low mood. Unbeknownst to the treatment team, Ms. Nur began to spend time with her mother. She was able to maintain her abstinence from cannabis and other substances throughout this time.

24In late October, Ms. Nur contacted her case manager urgently, reporting that members of her group home staff were upset and yelling at her. Ms. Nur once again asked to move residences. Her treatment team scheduled alternative group home visits. In late November, Ms. Nur contacted her case manager stating she would be missing group as her mother was sick. She advised that she would be staying with her mother for one night. The case manager was concerned that during the call, Ms. Nur was being told what to say by another person in the background. Later that week, Ms. Nur missed her appointments with her addictions counsellor, recreational therapist, and occupational therapist.

25In the first week of December, Ms. Nur’s mother began calling the treatment team and expressing that her daughter was unjustly medicated. When contacted by the treatment team, Ms. Nur indicated that she wished to continue residing with her mother. Members of the team attended Ms. Nur’s group home and collected her leftover medications. Notably, her nightly medication had many missed doses in the preceding weeks.

26Within a few days, Ms. Nur’s mother kicked Ms. Nur out of her residence and threw out all her belongings, leaving Ms. Nur without any clothing. Ms. Nur told the treatment team that her mother had financially and physically abused her. All her ODSP funds had been depleted. Ms. Nur also told the team that she had used cannabis routinely over the preceding two weeks.

27After a few days residing with a friend, Ms. Nur contacted her great aunt who arranged for a rideshare for Ms. Nur to Toronto. Her extended family was adamant that she stay in Toronto as she was unsafe in the same city as her mother. The treatment team considered a Form 49, however, given that there was no hospital bed available and Ms. Nur had no accommodation, the warrant was not sought. The team was concerned that if Ms. Nur was returned to Ottawa, she would resume residing with her mother.

28Ms. Nur’s current diagnoses are Schizophrenia and Cannabis Use Disorder. She is capable of making treatment decisions. There have been no positive symptoms of her psychosis and no indications of Ms. Nur experiencing paranoia. Arrangements have been made for her to receive her long-acting injections of antipsychotic medications while in Toronto. Since her arrival, she briefly resided with a family friend and then transitioned to Youth Horizons Shelter. She currently is staying at the YMCA women’s shelter.

29Dr. Sandhu testified before the panel. He has been Ms. Nur’s treating psychiatrist for over two years. He testified that Ms. Nur was enjoying ongoing stability until the latter part of the year. At that point, she reengaged with her mother, disengaged with the treatment team, and used cannabis on a regular basis. In his opinion, Ms. Nur’s mother’s untreated mental illness impacts on Ms. Nur’s ability to care for herself. It is a barrier for the team to provide adequate care to Ms. Nur.

30Since Ms. Nur has been in Toronto, the treatment team has been able to conduct virtual assessments and provide ongoing support for Ms. Nur. She continues to engage with the team until such time as her care is transferred to CAMH. Her great aunt also has been meeting with the treatment team and continues to be a significant source of support for Ms. Nur.

31In the Hospital Report, Dr. Sandhu has concluded that, based on risk assessment tools, Ms. Nur presents a moderate to high risk of future violence. She continues to experience problems with among other things accommodation, compliance with treatment, personal support and managing stress. She has been particularly susceptible to the negative influence of her mother. She also has continued to use cannabis when she disengaged with treatment. Dr. Sandhu testified that the hospital requires a detention order to allow for Ms. Nur to be rapidly brought to hospital to assess and manage her acute violence risk in situations where she would not meet the criteria under the Mental Health Act.

32In the response to the Rule 13 request, Dr. Darby from CAMH made the following observation with respect to Ms. Nur’s accommodation:

With Ms. Nur residing in Toronto without any in-person support or oversight from a forensic team and without stable long-term housing, CAMH has significant concerns about assuming Ms. Nur’s care. Should Ms. Nur persist in her request to remain in Toronto and the Board issues a disposition ordering her detention at CAMH, it is highly unlikely that CAMH would designate her current residence as approved accommodation. This would necessitate Ms. Nur's admission to hospital until she can be properly assessed and appropriate accommodation identified.

33In response to questions from the panel, Dr. Sandhu noted that to the knowledge of the treatment team, Ms. Sandhu last used cannabis in December 2024. He also advised that Ms. Nur has an allergy to cannabis and therefore should not be consuming it. He testified that a condition requiring a forensic psychiatrist approve any cannabis use would make it difficult for Ms. Nur to obtain a prescription from another doctor. In Dr. Sandhu’s opinion, most forensic psychiatrists would not approve cannabis use in Ms. Nur’s case.

34All parties maintained their initial positions.

Analysis and Conclusion

35The Board carefully considered the Hospital Report and the evidence of Dr. Sandhu and unanimously concluded that Ms. Nur continues to represent a significant threat to the safety of the public. Ms. Nur’s risk arises from her diagnoses of Schizophrenia and Cannabis Use Disorder with a history of medication noncompliance. Her symptoms of psychosis have been associated with substance use and have involved auditory and visual hallucinations. For much of the past calendar year Ms. Nur remained abstinent of substances. However, when she disengaged with the treatment team, she returned to cannabis use which resulted in a deterioration in her mental status. The index offence occurred in the context of noncompliance with treatment and cannabis use and involved threatening behaviour while armed with a knife.

36Having found that Ms. Nur continues to represent a significant threat to the safety of the public, the panel must consider the necessary and appropriate disposition taking into consideration the criteria set out in s. 672.54 of the Criminal Code, which includes the need to protect the public from dangerous persons, the mental condition of the accused, the integration of the accused into society and the other needs of the accused.

37The panel unanimously agrees with the joint submission that the necessary and appropriate disposition is a detention order. The panel accepts Dr. Sandhu’s expert opinion that, in order to manage Ms. Nur’s risk in the community, the hospital requires the ability to rapidly admit her when she is exhibiting a deterioration in her mental status and to keep her in hospital until she is stabilized. The hospital also requires the ability to approve Ms. Nur’s accommodations to ensure that she has the support and stability that she requires when living in the community. This is particularly critical in Ms. Nur’s case given her history of returning to reside with her mother in circumstances that are not conducive to her maintaining her own mental health.

38The panel declines to include a provision allowing for Ms. Nur to obtain approval to consume cannabis from a forensic psychiatrist. Dr. Sandhu was clear that Ms. Nur should not be accessing and using cannabis. Historically it has led to a deterioration in her mental status and has contributed to the onset of psychotic symptoms, similar to the time of the index offence. Further, she is allergic to cannabis.

39Finally, the panel agrees that there should be a transfer of Ms. Nur’s care to CAMH. She is currently residing in Toronto and has the benefit of supportive family members. A return to Ottawa would result in Ms. Nur having no support outside of the treatment team which has led to her turning to her mother, with disastrous results. Ms. Nur is aware that this transfer will likely result in her being admitted to hospital so that she can be assessed and appropriate accommodations be considered.

40In conclusion, the panel orders that Ms. Nur continue to be subject to a detention order with similar terms and conditions, including a prohibition for consuming cannabis. It is anticipated that a transfer of Ms. Nur will occur soon so that she will be able to access supports and appropriate accommodation in Toronto.