Ontario Review Board
Re: Abdi-Aziz F. Abdulle
ORB File No: 5226-5988
Hearing held on: Monday, March 3, 2025
Place of Hearing: Royal Ottawa Mental Health Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. P. Capelle
Members: Dr. R. Kunjukrishnan Dr. G. Boulais Mr. P. Hageraats Mr. A. Bernardo
Parties Appearing:
Accused: Abdi-Aziz F. Abdulle Counsel: Ms. T. Bubis
The person in charge of hospital: Counsel: Dr. J. Gojer
Attorney General of Ontario: Counsel: Ms. M. Dufort
REASONS FOR DISPOSITION
(Dated May 5, 2025)
Introduction:
On November 25, 2008, Abdi-Aziz Abdulle, appeared in court on charges of utter threats, mischief, and failure to comply with an undertaking. In a later court proceeding held on October 21, 2011, he appeared on separate charges of assault, assault with a weapon, utter threats, indecent act and failure to comply with a recognizance. These are all offences contrary to the Criminal Code of Canada.
At each of the two court proceedings, expert psychiatric evidence established that Mr. Abdulle was suffering from a severe mental disorder when he committed the offences. Based on that evidence, the Courts found him to be not criminally responsible on account of mental disorder (NCR).
Mr. Abdulle is currently subject to a Disposition of the Ontario Review Board (ORB or “the Board”) dated October 17, 2023. He was ordered to be detained at the Brockville Mental Health Centre (BMHC). Pending transfer to the BMHC, Mr. Abdulle was ordered to be detained on an interim basis at the Secure Forensic Unit of the Royal Ottawa Mental Health Centre (ROMHC or “the hospital”).
The Board granted Mr. Abdulle the privilege of living in the community in accommodation approved by the hospital. He was also awarded travel passes for up to once per year, to travel outside Canada, indirectly supervised, upon first receiving hospital approval of his itinerary.
For various reasons, following the Board’s order transferring him to Brockville, Mr. Abdulle’s transfer to the BMHC was not carried out. He has instead remained in Ottawa under the care of the ROMHC since October 2023.
On March 3, 2025, the Board convened at the ROMHC to conduct an annual review. Mr. Abdulle attended in person. He was represented by counsel, Ms. Tamara Bubis. Two of Mr. Abdulle’s mental health workers were also present: Ms. Khadra Farah, registered nurse with the ROMHC forensic program, and Mr. Cory Woodward. Mr. Woodward is with the Canadian Mental Health Association (CMHA). He has been working with Mr. Abdulle for the past years.
The Board received direct testimony from Mr. Abdulle’s attending forensic psychiatrist, Dr. Julian Gojer. Documentary evidence was filed, including two hospital reports, dated September 12, 2024, and February 5, 2025.
The issues to be considered by the Board are whether Mr. Abdulle presents a significant threat to the safety of the public, and, if so, to determine the necessary and appropriate disposition. The Board was also asked to ensure that Mr. Abdulle’s psychiatric care be formally transferred back to the ROMHC.
Positions of the Parties
The Board was presented with a joint submission by all three parties, namely that Mr. Abdulle continues to present a significant threat and that to manage the level of threat a detention order, on much the same terms as before, is necessary and appropriate. The parties also agreed that the patient’s care should be assigned, not to the BMHC, but to the ROMHC, thus reflecting his current situation.
For the reasons set out below, the Board adopted the joint submission in all respects.
Current Psychiatric Diagnoses, Hospital Report dated – p. 103-105
- Bipolar Mood Disorder - last episode mania, in remission
- Cannabis Use Disorder
- Somatic Symptom Disorder - in remission
- Personality Disorder NOS
- Earlier Reported diagnoses include ADHD, PTSD and ASPD
- Mr. Abdulle is currently treated with psychiatric medications:
- Trinza - half dose, once every 6 weeks.
- Olanzapine for Insomnia
We also note from the documentation:
- Patient reports regular cannabis use, usually consuming s 0.2 g X5 of cannabis per day
- Patient remains capable of consenting to treatment.
- According to the hospital report, his prognosis for having no future manic episodes is poor.
Index Offences
Events of April 8, 2008:
On April 8, 2008, Mr. Abdulle attended the residence of his brother and sister-in-law and knocked on the door. The sister in-law did not want to admit Mr. Abdulle into her home because he was talking incoherently and based on his prior conduct. She asked family members to shut off all lights and not open the door. Mr. Abdulle started yelling and screaming. He threatened to kill his brother. Eventually, he kicked the door off its hinges while continuing to scream and threaten his brother.
At this time Mr. Abdulle was bound by a court undertaking to be of good conduct and behavior. He breached the undertaking given the events noted above.
Events of June 4, 2011, and September 7, 2011
The NCR finding of October 21, 2011, was based on Mr. Abdulle’s earlier plea of guilty to common assault. He acknowledged having been involved in an incident in June with the ten-year-old daughter of a friend. Initially, he was charged with sexual assault or sexual interference. The facts accepted by the court were that, when visiting friends, he had propositioned a young girl and made contact by hugging and grabbing her.
The same NCR finding of October 21, 2011, dealt with a separate incident from September 7, 2011, at the St. Laurent Shopping Centre in Ottawa. Mr. Abdulle had chased an individual who was not known to him, threatening that individual with a weapon, a screwdriver. Mr. Abdulle removed all his clothing. He chased the victim, screaming “you fucked my sister and I’m going to kill you”. Soon after on the same offence date, he appeared at the Cité Collegial in Ottawa. Wearing only a large orange tarp, he stopped to flash three women saying, “how do you like this?”
Personal Background
Mr. Abdulle is 45. He was born in Mogadishu, Somalia and is the youngest of six siblings. He has only two relatives living in Canada, a sister and an older brother.
Mr. Abdulle reports very little memory from his childhood in Somalia. It appears he had some quite bad experiences in wartime. When in kindergarten, Mr. Abdulle left Somalia with his brother and the family of a sister-in-law, initially moving to Italy. He remained there until Grade 4 and then moved to New York City before relocating to Buffalo, before ending up in Toronto in 1992, where he claimed refugee status. Mr. Abdulle and his family have lived in Ottawa since 1992, initially in a shelter until they later found housing and employment.
Since 1992, Mr. Abdulle has lived with his brother and sister in-law on a sporadic basis. When not with them, he has lived in more than 20 different houses and apartments.
Mr. Abdulle started his Grade 7 education in Canada. He went up to Grade 10. While in high school, there were suspensions and expulsions.
According to his brother, Mr. Abdulle fell into the wrong crowd at the age of 15 or 16. He started to use drugs. Behavioral problems began.
Mr. Abdulle began working part-time at the age of 12. He has had various jobs in coffee shops. For a short time, he worked as a factory worker - but he quit after receiving a first pay cheque.
In 2006, Mr. Abdulle told the hospital social worker he had been working as a drug dealer. In that discussion, he appeared “very proud of his choice in lifestyle, explaining that he did well financially”. Later, Mr. Abdulle clarified that he had only sold drugs for about six months before quitting after getting caught. Mr. Abdulle is supported by the Ontario Disability Support Program. He currently manages his own finances.
He does not appear to be involved in any long-term intimate relationship.
The record of criminal convictions began in May 2003 when Mr. Abdulle was 24. Included are convictions for violence. He has at least one entry for carrying a concealed weapon, in addition to a robbery conviction, an assault, drug trafficking, possession of unauthorized firearm, and multiple breaches of court orders.
Mr. Abdulle’s immigration status in Canada remains unsettled. The Government of Canada has yet to rule on his application for refugee status.
Previous Psychiatric History
Mr. Abdulle had his first contact with psychiatry at age 18 when he was admitted to the Montfort Hospital. He remained there for more than a month and was diagnosed with depression. Following discharge, he did not comply with prescribed medications.
In January 2000, Mr. Abdulle was hospitalized for three weeks. He was in a manic phase of Bipolar Disorder. A month later, he was readmitted for two months, again after a manic phase. In the following years, Mr. Abdulle had multiple admissions to hospitals. In recent Reasons dated January 4, 2024, at para. 15, the Board noted a previous panel’s observations:
- Mr. Abdulle lacked insight into the risk using cannabis posed to his major mental illness.
- Mr. Abdulle was rigid when it came to recommended medications and only agreed to medications that suboptimally treated his Bipolar Disorder.
- Mr. Abdulle suffered from a chronic and difficult to treat form of Bipolar Disorder that required a detention disposition so as to bring him quickly to hospital in the event of decompensation which would happen rapidly were he to use cannabis.
- Mr. Abdulle has a long history of major mental illness leading to many admissions to hospital and of discontinuance of treatment following discharge. He has a significant criminal record that involved assaultive behavior. Both the 2008 and 2011 index offences involved violent and threatening conduct.
The same Board Reasons, dated January 4, 2024, summarize evidence provided by Dr. Gojer at the review hearing held on October 11, 2023. Dr. Gojer explained how it was important to maintain a strong safety net to manage the significant risk posed. Dr. Gojer confirmed that cannabis is a problem, both in terms of Mr. Abdulle’s major mental illness and in terms of maintaining the strong safety net needed to manage him. Mr. Abdulle’s available housing options were based on a requirement that he abstain from the use of cannabis.
At the same review hearing held on October 11, 2023, Dr. Gojer testified that if Mr. Abdulle were to receive an absolute discharge, he would decompensate rapidly. Dr. Gojer referred to Mr. Abdulle’s history of lack of insight into his need for recommended medications and the impact of the use of cannabis on his mental stability.
Dr. Gojer also referred to reports of concern from the housing agency, Salus Fisher. There were various incidents leading to hospitalizations whereby Mr. Abdulle had attended barefoot and in an unintelligible state. Dr. Gojer also described Mr. Abdulle’s rigidity about recommended medications in that Mr. Abdulle would express his strongly held view that medications were “not going to work”.
At the same ORB review hearing held in October 2023, Dr. Gojer acknowledged that - following the 2011 NCR finding - Mr. Abdulle had not attracted any further criminal charges. That said, it was recognized that Mr. Abdulle had been brought to hospital in August 2023 on a Form 1 while in an aggressive state. Dr. Gojer attributed the lack of police charges to quick and responsive actions of the treatment team and other supportive agencies, forming the strong safety net already in place.
Course in Treatment, Since October 2023
Mr. Abdulle had several more hospital admissions in the following reporting period. Each admission related to hypomanic episodes. One was associated with his use of PCP. All admissions were done under the Mental Health Act or were voluntary in nature. Most arose with Mr. Abdulle presenting in disorganized and manic states.
The last hospital report notes that Mr. Abdulle has not really been violent to anyone, nor has he broken the law. In July 2024, he broke a window at his Salus housing apartment building for which he later made restitution. Mr. Abdulle explained how he had broken the window after losing his keys and wanting to get into the building. The incident saw Mr. Abdulle face a threat of eviction by the Salus landlord.
The CMHA worker, Mr. Cory Woodward, has been meeting Mr. Abdulle irregularly, usually once a month, for brief periods of time.
Between August 2023 and August 2024, there were seven hospital admissions. He spent a month at the Brockville hospital following a decompensation, the result of medication non-adherence. In late October 2023, Abilify was discontinued. He was started on Trinza 350mg, administered every three months. More recently, a change was made, to deal with the patient’s concerns about side effects.
Mr. Abdulle continues to smoke cannabis. He has no intention of stopping.
In Dr Gojer’s report dated September 12, 2024, the following passage appears at p. 103:
In reviewing his history, since the last index offence in 2011, he has continued to have manic episodes. However, he has not been charged with a criminal offence. When ill, he brings himself to our outpatient department and cooperates with being admitted voluntarily or sent to a hospital on a Form 1. He stays in hospital for a few days, stabilizes on medication, is released and the cycle repeats itself. This pattern is likely to continue for the foreseeable future. At the height of his psychosis, he has not truly been violent toward any person. Mr. Abdulle in the last few years has been more at risk of harm to self and mainly in the form of personal neglect. He has taken himself to a general hospital for admission, brings himself to our hospital and is admitted or sent to a general hospital. His admissions are short, he is generally cooperative with treatment and otherwise will follow-up regularly with his appointments.
The last annual review, held on October 11, 2023, saw the Board order a transfer of care from the ROMHC to the BMHC. However, in the months following, the actual transfer was not effected. Mr. Abdulle has remained in Ottawa, under Dr. Gojer’s care.
Throughout the current reporting period, Mr. Abdulle has provided urine drug screens upon request. Each result was positive for THC. On December 18, 2024, his urine also tested positive for cocaine metabolite and methamphetamine.
The most recent hospital admission was on December 30, 2024. Mr. Abdulle arrived at the outpatient department in a manic state. He wore a shirt with no coat and a plastic shoe cover. He reported having used “Tina Turner” (methamphetamine). He had recently given his house keys to two different individuals, one of whom was staying at his apartment on and off. Mr. Abdulle reported having thrown out his bed mattress, stating there were bed bugs. On a previous occasion, Mr. Abdulle had thrown away his furniture when not well. He was admitted to the Queensway Carleton Mental Health Unit, to be stabilized until being discharged on January 28, 2025.
After January 28, 2025, when he returned to his Salus Housing apartment. Mr. Abdulle missed his February 3 appointment with Dr. Gojer.
In Dr. Gojer’s most recent report, he notes the following:
Mr. Abdulle suffers from a Bipolar Mood disorder. He also suffers from a Cannabis Use Disorder. More recently, his urines have been positive for cocaine and crystal meth. His insight into the use of cannabis and its probable effect in triggering manic episodes is absent. He has also had manic episodes when not using cannabis and while in hospital. Mr. Abdulle has rigid and fixed views about his treatment. He has been managed in general hospitals in the last two years under the Mental Health Act. The treatments are short and upon discharge he does not comply with the use of Lithium which is believed to be helpful for him. He quickly becomes capable after treatment and does not wish to continue on Lithium, which I believe will assist in management (of) future manic episodes.
Mr. Abdulle seems to have been managed, albeit not fully effectively, under the Mental Health Act. It is likely one will see ongoing episodes of mania requiring hospitalization.
- Later in the same report, Dr. Gojer comments as follows:
His risk of harm to the public is dependent on how quickly the Mental Health Act is used to manage him. It is theoretically possible that if left to his devices, he could deteriorate to a severe manic state and pose a risk to members of the public. This theoretical possibility needs to be weighed with the ongoing support he receives from CMHA, that he has an apartment funded by Salus Fisher and over the last two years has been seen fairly quickly when ill and has taken himself to hospital where he is detained on a Form 1 of the Mental Health Act.
- Dr. Gojer concludes that the ideal management plan is to manage the patient under a detention order. Dr. Gojer expresses concern about the most recent use of crystal meth and cocaine. This leads Dr. Gojer to err on the side of caution. Public safety cannot be assured on the same path where continuous admissions and discharges are becoming more difficult to arrange. Other involved hospitals are giving the ROMHC some ‘pushback’. They may no longer be prepared to admit Mr. Abdulle. In Dr. Gojer’s last written comments, he concludes: “A detention order… is the least restrictive method of managing his risk”.
Evidence at the Hearing
In direct testimony at the hearing, Dr. Gojer recommended that it makes more sense, now that Mr. Abdulle has remained in Ottawa, that his forensic psychiatric care be formally reassigned to the ROMHC. Dr. Gojer confirmed, he will continue as the most responsible physician.
In recommending that a detention order is necessary and appropriate, Dr. Gojer pointed to three factors on which he bases his position: The chronic history of fluctuating mental illness; a chronic history of cannabis use; and the more recent use of cocaine.
Dr. Gojer explained that tools available under the Mental Health Act are no longer able to completely contain Mr. Abdulle’s behaviours and risk to the public. In Dr. Gojer’s view, a Form 49 is needed to persuade either the ROMHC, or other hospitals, to admit the patient into care and to keep him for a sufficiently long period of restabilization.
Confirming that Mr. Abdulle has not involved himself in any overtly violent offending, Dr. Gojer also noted that there was an incident of criminal offending on one occasion. While trying to get back into his apartment after he had given away his keys to others, Mr. Abdulle set off a fire alarm. This incident, like others, arose when Mr. Abdulle was again in a manic state.
Counsel appearing for the Attorney-General, Ms. Dufort, inquired about the existing travel privilege. As worded, international travel is possible up to once a year. Dr. Gojer agreed with counsel’s suggestion that the wording be changed in that it should be for a period no longer than three months and only in the company of a responsible person who would first have to be approved by the hospital. Dr. Gojer added that before any travel could be contemplated, Mr. Abdulle would first have to demonstrate ongoing stability for at least six months.
Responding to questions posed by Board members about the current housing arrangement, Dr. Gojer confirmed: it is not easy to manage Mr. Abdulle in his present situation. Were Mr. Abdulle to lose his present supportive housing provided by Salus Fisher, his stability would be at greater risk. In such an event, the hospital would need to act swiftly, especially were he to lose his accommodation. Dr. Gojer did note that Mr. Abdulle has a positive rapport with both Mr. Woodward, the CMHA worker, and the forensic nurse, Ms. Khadra Farah.
The parties called no further evidence.
Submissions of the Parties
Counsel for the Attorney-General and for Mr. Abdulle confirmed they agreed with the hospital recommendations. Speaking for her client, Ms. Bubis stated that Mr. Abdulle is agreeable to continuing under the same detention order. They did not take issue with the anticipated finding of significant threat. Ms. Bubis advised they were content to have Mr. Abdulle’s mental health care formally assigned to the ROMHC.
Speaking for the Attorney-General, Ms. Dufort, stated that the second set of index offences arose in 2011 when Mr. Abdulle was already an NCR patient under the Board’s jurisdiction. This second set of offences came about shortly after Mr. Abdulle had lost his housing. Moreover, Mr. Abdulle had failed to disclose the fact that he was homeless to his then treating psychiatrist, Dr. Booth. Counsel stressed the importance of a detention order so that the hospital will retain the ability to act very quickly following any changes in the patient’s mental state. Counsel added that a detention order remains necessary and appropriate having regard to the strict need to have Mr. Abdulle reside only in hospital-approved accommodation.
Adopting the concerns expressed by Dr. Gojer, Ms. Dufort submitted that having Mr. Abdulle bring himself to a general non-forensic hospital, or having him brought there, is not a proper measure of control to keep the public safe. In such a context, it remains much too uncertain whether Mr. Abdulle would be admitted to hospital, and if admitted, whether he would be kept there for a sufficiently long period to regain stability.
Conclusions and Disposition
Based on the uncontradicted evidence and supported by the appropriate joint submission, the Board had no difficulty concluding that Abdi-Aziz Abdulle continues to present a significant threat to the safety of the public. This is based on the very concerning nature of the index offences, which include at least one serious violent offence. It is also based on the separate history of criminal offending and the continuing course of manic episodes and decompensated mental states over past years.
The Board remains quite concerned about Mr. Abdulle’s ongoing and committed use of cannabis. Our concern is further heightened by his recent consumption of even more powerful illegal substances, including cocaine. The public remains at risk given Mr. Abdulle’s demonstrated tendency to repeatedly decompensate, resulting in a never-ending sequence of hospitalizations. Clearly, the more limited tools available under the Mental Health Act have not provided any meaningful form of longer-term stabilization, as is required given the overall background and circumstances.
Dr. Gojer continues to express hope that Mr. Abdulle may cooperate with a possible medication change to Lithium. Mr. Abdulle has his own reasons, as Dr. Gojer has explained, for not taking up the recommendation of his psychiatrist about optimizing psychiatric medication. We note Dr. Gojer’s clear position that, in his professional medical opinion, Mr. Abdulle is likely to see greater long-term benefit to his mental state under a changed medication regime involving Lithium. While the Board is not able to tell either Dr. Gojer or the patient what medication he should be accessing for treatment, we can only recommend that Mr. Abdulle seriously engage in further discussions with Dr. Gojer and his treatment providers.
For the reasons stated above, having regard to the primary consideration of keeping the public safe, while balancing the patient’s mental condition, his reintegration and other needs, a detention order is provided, much on the same terms as before. There will be an order transferring the patient’s care to the ROMHC, along with a slight modification to the existing travel privilege.
We thank the parties and counsel for their assistance.
DATED this 5th day of May 2025, at the City of Toronto, in the Toronto Region.
Mr. P. Hageraats Legal Member
Office of the Registrar Ontario Review Board