Ontario Review Board
Re: Wazi Mensah
ORB File No: 8411
Hearing held on: Monday March 31, 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: Wazi Mensah Counsel: Ms. A. Murchison
The Person in charge of Hospital: Representative: Dr. J. Hwang
Attorney General of Ontario: Counsel: Mr. J. Wright
REASONS FOR DISPOSITION
(Dated May 27, 2025)
Introduction:
[1]. On October 23, 2023, Wazi Mensah was found not criminally responsible on account of mental disorder on charges of indecent act in a public place, criminal harassment (x3), sexual assault (x1) and fail to comply with a release order/failure to attend court (x3) contrary to the Criminal Code of Canada. He is subject to a disposition of the Ontario Review Board, dated January 30, 2024, detaining him at the Secure Forensic Unit of the Royal Ottawa Mental Health Centre (hereinafter referred to as “the Hospital”) with privileges up to and including that of living in the community in accommodation approved by the person in charge of the Hospital. That disposition also subjects him to certain conditions, including that of abstaining absolutely from the non-medical use of alcohol or drugs or any other intoxicant and that of submitting sample for the purpose of monitoring his compliance with the abstention condition.
[2]. On March 31, 2025, a panel of the Ontario Review Board convened a hearing at the Hospital to review that disposition pursuant to section 672.81(1) of the Criminal Code. Mr. Mensah was present for the hearing, represented by his lawyer Ms. Murchison. At the commencement of the hearing, Mr. Mensah confirmed his preference for the hearing to proceed in English.
[3]. The record for the hearing included the Revised Notice of Hearing dated September 11, 2024, the most recent Disposition (as mentioned) and Fresh Reasons for Disposition dated March 20, 2024. On the consent of all parties, a Hospital Report, dated December 14, 2024, was entered into evidence as an exhibit.
[4]. The parties were canvassed for initial positions. Dr. Hwang, Mr. Mensah’s treating psychiatrist spoke for the Hospital. She expressed the position that Mr. Mensah continued to represent a significant threat to the safety of the public as that term is defined in section 672.5401 of the Criminal Code and as it has been further explained by the Supreme Court of Canada in Winko v. British Columbia (Forensic Psychiatric Institute), 1999 CanLII 694 (SCC), [1999] 2 S.C.R. 625. She also expressed the position that it was necessary and appropriate, having regard to the objectives set out in section 672.54 of the Criminal Code, for Mr. Mensah to continue to be detained with the privileges and subject to the conditions set out in the previous disposition.
[5]. Both the representative of the Attorney General and counsel for Mr. Mensah agreed with the Hospital on both the threshold issue and the issue of disposition.
[6]. For the following reasons, the Board accepts the joint submission that Mr. Mensah continues to represent a significant threat to the safety of the public. It has further concluded that a continued detention disposition is necessary and appropriate, having regard to both the primary objective of assuring the safety of the public and the other objectives of ensuring that Mr. Mensah’s mental health and other needs are met, including the ultimate objective of reintegration into the community. The Board does not however consider that the primary objective is ensured where the detention disposition grants Mr. Mensah the privilege of living in the community in accommodations approved by the person in charge of the Hospital. Rather, given evidence of ongoing difficulties in terms of Mr. Mensah’s ability to care for himself and to attend to the requirements of daily living, together with the ongoing difficulties associated with the management of his treatment-resistant major mental illness, it is the Board’s conclusion that the objectives of s. 672.54 of the Criminal Code are only met by a privilege that contemplates 24/7 supervised accommodations in the community, approved by the person in charge of the Hospital.
Evidence at the hearing
[7]. The evidence at the hearing came from the Hospital Report mentioned and the live testimony offered by Dr. Hwang.
[8]. Turning first to the Hospital Report, it is cumulative in nature and includes many details associated with Mr. Mensah’s personal history as well as his history of struggles with major mental illness and use of substances. It sets out the circumstances of the index offences as also contained in last year’s Fresh Reasons for Disposition.
January 19, 2023
According to the Crown Brief Synopsis, on January 19, 2023, at around 17h00, a Westin hotel staff member was walking to her vehicle in the parking garage shared with the Rideau Shopping Centre when Mr. Mensah approached and faced her as she was at her vehicle. She did not feel safe turning her back to Mr. Mensah, and she asked what he wanted. She then observed that he had his penis removed from his pants, and he was masturbating.
June 24, 2023
According to the Crown Brief Synopsis, on June 24, 2023, at about 20h11, a female staff finished her work inside the Rideau Shopping Centre and took the ascending escalator when Mr. Mensah followed her onto the escalator. Mr. Mensah then walked up the escalator until he positioned closely to the victim on her left side. He then used his right hand to touch her buttocks while whispering in her ear, “hey, baby girl.”
June 27 to 30, 2023
According to the Crown Brief Synopsis, on June 27, 2023, Mr. Mensah had conditions under a Release order that included not entering the area or region bounded by Rideau Street to the North, MacKenzie King Bridge to the South, Nicholas Avenue to the North, and Colonel By Drive to the West. This was in addition to the condition to not contact or communicate in any way with two particular individuals, including attending their work or any addresses they were known to frequent as well as not to attend the Rideau Shopping Centre or the Westin Hotel. Mr. Mensah attended the Rideau Shopping Centre on seven occasions between June 27 and 30, 2023, failing to comply with three separate conditions of his release order. He was also observed by security on June 30, 2023, exposing his genitals to the public and using his right hand to masturbate with his exposed penis directed toward people on the public sidewalk.
July 26 and 27, 2023
According to the Crown Brief Synopsis, on July 26, 2023, Mr. Mensah exposed his genitals at 208 Presland Road, which was witnessed by an individual named Jocelyn Lalonde. Mr. Mensah returned to this address the following day, where another witness, Timothy McGahey, who contacted the police and followed him until he was arrested, confronted him. Jocelyn confirmed with the police that Mr. Mensah was the same male who had continued to harass the housing co-op by loitering, peering into house windows, and attempting to access vehicles on the property, which was after he was advised to stay off the property. Jocelyn reported having interacting with Mr. Mensah on many occasions, finally making reports to the police regarding incidents that occurred on July 16, 2022, August 28, 2022, and September 01, 2022. Further investigation revealed that a Release Order dated July 20, 2023, which included a house arrest condition noting that he was to remain in his designated residence except for medical emergencies, legal appointments, or while with the person approved by the medical treatment team or with the surety, bound Mr. Mensah.
[9]. According to the Hospital Report, Mr. Mensah was born and raised in the Côte d’Ivoire. His mother was a successful businessperson, and he has an older brother, Marc-Irsen. His family has no known history of mental health or addictions issues. Mr. Mensah did, however, live a traumatic childhood as his mother was imprisoned for three years, with collateral information suggesting that she was tortured over that period of time. His family lost most of their wealth as a result by the time war broke out in the country. Mr. Mensah’s primary caregivers – his governess and maternal grandmother – died while his mother was incarcerated.
[10]. Records suggest that Mr. Mensah’s history of mental health issues began to manifest itself in adolescence where he began exhibiting difficult behaviours. He immigrated to Canada in 2017 to study and to pursue a better life but struggled to socially integrate. He lived with his brother and his mother joined them in 2018. His mother and brother form Mr. Mensah’s primary source of informal supports, with his mother being the most involved with Mr. Mensah’s treatment team at the Hospital.
[11]. Mr. Mensah has some high school education but has yet to graduate. Symptoms of his major mental illness, namely difficulties with motivation and delusions, have prevented him from obtaining his high school diploma. Similarly, Mr. Mensah’s limited work history has been interrupted by his major mental health issues. He is now financially supported by the Ontario Disability Support Program.
[12]. Turning to the Hospital Report’s treatment of Mr. Mensah’s Psychiatric History (page 12 of the Hospital Report), Mr. Mensah first had contact with mental health professionals on February 21, 2018. At that time, he was assessed in response to concerns expressed by staff at the Youth Services Bureau’s young men’s shelter regarding possible psychotic symptoms associated with cannabis use. Mr. Mensah was endorsing paranoid ideas and had been smoking about a gram of cannabis per day. When examined by medical professionals, Mr. Mensah maintained a preoccupation with his genitals and disclosed a history of auditory hallucinations that were degrading and insulting in nature. Mr. Mensah was resistant to both medication and programming.
[13]. From December 18 to 27, 2019, Mr. Mensah was admitted to the Montfort Hospital as a result of decompensated Schizophrenia. His symptoms were treatment resistant to a long-acting injectable antipsychotic (Invega Sustenna). As a result, it was proposed that he be prescribed the oral antipsychotic medication, Clozapine but when doubts arose that Mr. Mensah would comply with oral medications, he was discharged instead with only the Invega Sustenna prescription. A year later, he was admitted again to Montfort Hospital for disorganized behaviours and incapacity to care for himself. He was discharged with a higher does of Invega Sustenna and was readmitted again to Montfort Hospital on a Form 47 under a Community Treatment Order owing to noncompliance with medications and missing appointments. He was in a decompensated state and was started on a different long-acting injectable (Fluanxol) and discharged to return from August 17 to September 15, 2021, as a result of aggressive and disorganized behaviours in the form of violence towards his mother and another person, risk of evictions, and voiding on cars in public. He was started on a second antipsychotic with noted improvement as to organization. Mr. Mensah continued to express poor insight into his major mental illness.
[14]. Mr. Mensah had further struggles with his major mental illness in 2022 that included admissions to Montfort Hospital, again on a form 47. His lack of insight and pattern of noncompliance with prescribed antipsychotic medications contributed to acute decompensation. He displayed agitation, screaming, sexual advances to women around him, regular use of cannabis and poor hygiene. On occasion, and following use of cannabis, he appeared dissociative. His family reported declines in Mr. Mensah’s social skills. Meanwhile, Mr. Mensah reported not believing that he had a mental illness or diagnosis and expressed paranoia that people around him were stealing some of his belongings. He said that he was not prepared to regularly accept either his long-acting antipsychotic medication or his oral antipsychotic. Finally, on December 19, 2022, Mr. Mensah was brought to the Montfort Hospital by police on a Form 2 filled out by his mother as a result of his strange behaviours.
[15]. Mr. Mensah is diagnosed with:
- Schizophrenia, continuous
- Cannabis Use Disorder, in sustained remission, in a controlled environment.
He is capable to make decisions concerning treatment, but incapable of managing his own finances.
[16]. Regarding Mr. Mensah’s use of substances, the Hospital Report says that short periods of abstinence correlated with noted improvement in Mr. Mensah’s mental status. He engaged better with the team, exercised better hygiene, was more sociable and overall, more stable though residual psychotic symptoms persisted. Mr. Mensah has struggled however to incorporate the education offered to him concerning the interaction of substance use and mental health.
[17]. The Hospital Report’s update for the purposes of this hearing begins at page 25 of 33. It explains that when he was transferred from the Ottawa Carleton Detention Centre to the Hospital’s Forensic Assessment Unit, Mr. Mensah exhibited a variety of sexually disinhibited behaviours. He was disorganized as to thought. Efforts to address his symptoms with clozapine were partially successful, bringing down the frequency and intensity of Mr. Mensah’s sexually disinhibited behaviours. He continued however to struggle with disorganized behaviour and thought. Even with modifications to his medication, Mr. Mensah has struggled with erratic behaviours. He continued to manifest the negative symptoms of his psychosis. He has been tangential in conversation, has manifested a lack of motivation and has been socially withdrawn. While there was some improvement from November 2024 in terms of hygiene and appropriate use of humor while engaging with staff, Mr. Mensah’s agitation increased in intensity and frequency. He became physically assaultive with other patients and endorsed persecutory delusions requiring further adjustments to Mr. Mensah’s medications.
[18]. Mr. Mensah remains on the Hospital’s Forensic Assessment Unit. Overall, his insight and judgment regarding his mental illness and need for treatment is limited.
[19]. The Hospital Report includes a Violent Risk Assessment at page 30. Its contents and methodology were not questioned over the course of the hearing. It concludes that Mr. Mensah presents a high risk of future violence. Clinical factors relied upon in arriving at this conclusion include Mr. Mensah’s recent problems with insight (which is characterized as poor), recent problems with symptoms of a major mental disorder (Mr. Mensah continues to display disorganized thoughts and behaviours, persecutory delusions and the negative symptoms of psychosis), recent problems with instability and recent problems with treatment or supervision response. His illness is resistant to conventional treatment methods and benefit gained from antipsychotic medications has been limited.
[20]. Furthermore, the Violent Risk Assessment notes that Mr. Mensah has limited independent living skills. He is incapable of managing his own finances and needs to engage with an occupational therapist. He lacks significant personal supports outside of his mother who he refuses to see stating that she is “not my real mother.” He is likely to have “immense difficulties” adhering to the treatment plan. He is primarily motivated by external factors, such as his desire to transition to the Hospital’s Forensic Rehabilitation Unit.
[21]. In this setting, the Hospital Report describes Mr. Mensah’s most likely reoffence scenario. It says that, absent a disposition, Mr. Mensah would likely go off his medications or begin using substances again. This would worsen his psychotic symptoms. He would experience persecutory delusions and disorganized behaviour that includes hypersexual behaviours where he would target females in public or assault individuals that became the target of his persecutory beliefs.
[22]. The Hospital Report sets out the treatment plan for the next year. It includes adjustment of antipsychotic medications, engagement with the occupational therapist, work with a behavioural therapist to manage impulsivity and enhance motivation and will include encouragement of work with a recreational therapist. Addictions counseling will be encouraged. Once there is an absence of violence and ongoing engagement with therapy, he will be transferred to the Forensic Rehabilitation Unit and, presuming appropriate pass progression and a period of stabilization, Mr. Mensah’s assigned social worker will assist with transitioning to community living.
[23]. Dr. Hwang adopted the contents of the Hospital Report in her oral testimony and provided a helpful update. She indicated that since the authoring of the Hospital Report, Mr. Mensah had continued to experience fluctuating persecutory delusions surrounding another patient that led to two code whites due to increased risk of violence towards that patient. That patient was moved for a time to another unit and Mr. Mensah’s medications were adjusted again. That co-patient has returned to the unit and while Mr. Mensah still believes the past persecutory delusions were real, he no longer believes the co-patient is persecuting him and does not engage with that individual.
[24]. Dr. Hwang said that Mr. Mensah continues to manifest disorganized thought and behaviours and to express bizarre ideas. He believes that his mother is actually a nurse and that he was born from a basketball. Dr. Hwang expressed concern regarding Mr. Mensah’s ability to live independently. He has continued to show a lack of awareness of kitchen safety and has tried to use peanut butter to make his hair flatter. He has shown some slight improvement in his primary psychotic symptoms and has been responsive to education when making a sexually inappropriate comment to staff. He follows most of his behavioural plan when it comes to hygiene and groups but has limited insight into his psychosis in spite of medication. His disorganized behaviour is similar to that manifest at the time of the commission of the index offences. Dr. Hwang confirmed that the Hospital is working towards community living cautiously but with an awareness of waitlists, particularly where appropriate transitional, supervised, and other housing options with bilingual capacities are concerned. Happily, Dr. Hwang updated the Board that Mr. Mensah is now showing no concerns associated with medication compliance. To his credit he comes to the nursing station on his own without prompting to take his medications. He has not engaged in any attempts at diverting his oral antipsychotic medications since being placed on the Forensic Assessment Unit.
[25]. The parties and Dr. Hwang were advised of the concerns members of the panel had regarding a privilege permitting Mr. Mensah to live in the community in accommodations approved by the person in charge of the Hospital. When questioned by the panel in this regard, Dr. Hwang testified that, based on Mr. Mensah’s Occupational Therapy Assessment, it was doubtful that he would be able to move to independent living in the community, even with Hospital supports and the active involvement of the treatment team. She agreed that Mr. Mensah would need some level of supervision on a 24/7 basis. She did describe the accommodation provision globally as being motivating for him. She testified to the availability of 24/7 supervised group homes that were subject to the same waiting lists as are other group homes that offer support but not supervision. She expressed concern that, if some form of approved accommodation in the community were not included in the disposition, further delay would be occasioned in terms of Mr. Mensah’s ultimate transition to a supervised accommodation outside of the Hospital setting.
Submissions
[26]. At the hearing’s conclusion, the parties renewed their joint submission as set out at the commencement. All agreed that the evidence supported the conclusion that Mr. Mensah continued to represent a significant threat to the safety of the public and that a continuation of his detention disposition was necessary and appropriate having regard to the objectives set out in section 672.54 of the Criminal Code.
Analysis and Conclusion
[27]. The panel agrees. While it benefitted from the joint submission, it careful considered of its own accord the evidence associated with the threshold finding that has been described by the Supreme Court of Canada in Winko as exerting a high onus. The panel was cautious, even in the context of a joint submission, to ensure that the conclusion that Mr. Mensah represented a significant threat was not driven solely by his major mental illness or lack of insight, but that the evidence established that there was a serious risk of physical or psychological harm to the public resulting from serious criminal acts that Mr. Mensah would commit in the absence of a disposition.
[28]. Mr. Mensah suffers from a major mental illness that is treatment resistant. That illness contributed to the commission of index offences that were serious. Mr. Mensah lacks insight into that illness, is externally motivated with regard to his antipsychotic medications and has a history of noncompliance with treatment recommendations that has resulted in decompensation, acts of aggression and of criminality towards strangers in the public. He has been repeatedly hospitalized as a result of his major mental illness. While in the Hospital he has continued to manifest the same difficulties that preceded the commission of the index offence. This has taken place in a highly controlled environment where he is incentivized as to medication compliance and where availability of substances is highly controlled. He has acted out on persisting persecutory delusions leading him to assault a co-patient and to act aggressively in response to past delusions. The evidence supports the conclusion drawn out in the Hospital Report that Mr. Mensah continues to represent a significant threat of serious physical or psychological harm to the public.
[29]. Turning to disposition, section 672.54 of the Criminal Code establishes the safety of the public as the primary objective of each disposition and its terms, conditions, and privileges. Other objectives include ensuring that the patient’s mental health and other needs are met, including the ultimate objective of the patient’s reintegration into the community.
[30]. The panel agrees that a detention disposition is necessary and appropriate to manage the risk posed by Mr. Mensah’s major mental illness. Any lesser disposition would be insufficient to assure the safety of the public. Any lesser disposition would insufficiently provide for Mr. Mensah’s mental health and other needs. Mr. Mensah suffers from a treatment resistant form of schizophrenia, the symptoms of which are exacerbated by substance use. He lacks insight into his major mental illness and his history of substance use raises concerns associated with his reintegration into the community. He continues to manifest the negative symptoms of his psychosis and has manifested aggressivity over the course of this review period. This mirrors his condition at the time of the commission of the index offences in spite of the fact that he has not used or had an opportunity to use substances in the Hospital’s highly controlled environment. The next year contemplates pass-progression and efforts to cautiously reintroduce Mr. Mensah to the community. The Hospital needs to be able to respond quickly to signs of decompensation, to ongoing symptoms of Mr. Mensah’s major mental illness, and to any attempts by Mr. Mensah to gain access to substances like cannabis as he progresses in the exercise of his privileges.
[31]. Regarding the privilege of living in approved accommodation in the community however, the Board has concluded that all of the objectives set out in section 672.54 of the Criminal Code warrant the granting of a privilege that limits approved accommodation to one that offers 24/7 supervision.
[32]. In Re Sookram, 2024 ONCA 823, the Ontario Court of Appeal said that, when dealing with community living, a Board must consider that privilege in accordance with the four factors set out in section 672.54 of the Criminal Code. The Court said that the disposition must be the least onerous and the least restrictive option available having regard to those objectives. It cited the decision of the Supreme Court of Canada in Pinet v. St. Thomas Psychiatric Hospital, 2004 SCC 21, [2004] 1 S.C.R. 528 at para 19
The objective is to reconcile the twin goals of public safety and treatment. In this process of reconciliation, public safety is paramount. However, within the outer boundaries defined by public safety, the liberty interest of an NCR accused should be a major preoccupation of the Review Board when, taking into consideration public safety, the mental condition and other needs of the individual concerned, and his or her potential reintegration into society, it makes a disposition order.
[33]. The Ontario Court of Appeal goes on to state the fundamental question associated with community living privileges at paragraph 28 in Re Sookram:
The appropriate question was not whether the Board had sufficient evidence to satisfy it that the appellant was ready to transition to community living, but whether, in crafting the “least onerous and least restrictive” disposition available given the evidence and the balance of the four factors in s. 672.54 of the Criminal Code, the Board could include a community living provision with conditions.
[34]. There is no question that, for Mr. Mensah, a disposition that contemplates progression to the privilege of some form of community accommodation attends to his mental health and other needs. Mr. Mensah is showing motivation to progress to the Forensic Rehabilitation Unit. This is helping motivate his medication compliance and engagement with treatment team. Dr. Hwang testified of the motivational value of a community-accommodation privilege in the disposition. She also testified that the inclusion of the specific provision, while not necessarily helpful in gaining a place on a waiting list for Mr. Mensah, would remove practical obstacles should placement become available.
[35]. The question then is whether the Board “could” craft a disposition for Mr. Mensah that satisfies this primary objective absent a condition that the approved accommodation be subject to 24/7 supervision. In our view, it cannot. Mr. Mensah has a long-standing history of aggressivity, and sexual disinhibition driven by his major mental illness. It has contributed to index offences and further assaultive and aggressive incidents while on the Hospital’s Forensic Assessment Unit. Other patients and tenants in the Hospital, transitional housing, and in group homes are members of the public entitled to the Board’s consideration under the primary objective. Given the difficulties Mr. Mensah has exhibited to this point, the Board agrees that it is minimally intrusive that Mr. Mensah be offered the opportunity to progress meaningfully to a point of community reintegration, but the unpredictable and treatment-resistant nature of his symptoms make it such that the safety of the public cannot be assured absent 24/7 supervision in accommodations approved by the person in charge of the Hospital. Dr. Hwang testified that this level of supervision would be needed.
[36]. Furthermore, it is not possible to craft a disposition that attends to Mr. Mensah’s mental health and other needs in the absence of a privilege that encompasses 24/7 supervision in accommodations approved by the person in charge of the Hospital. Mr. Mensah has struggled significantly with hygiene, personal boundaries, and with the basic functions of daily living. His occupational therapy needs have been noted in cooking and kitchen scenarios where Mr. Mensah has engaged in activities and problem-solving that has exposed him to risk of burns, electrical shock, and exacerbation of his problems with self-care. Mr. Mensah has ongoing needs occupationally that demand supervision if his mental health and other needs are going to be met while living outside of the highly structured, supported, and supervised environment offered by the Hospital on either the Forensic Assessment Unit or the Forensic Rehabilitation Unit.
[37]. Mr. Mensah’s struggles with substance use and its correlation to rapid decompensation and aggression directed towards others, including strangers, is also a concern. Mr. Mensah has long-standing difficulties with cannabis. He has no insight into the impact cannabis has on his major mental illness. He will require 24/7 supervision if in the community where cannabis is available. This concern impacts both on the primary objective and on the other objectives set out in s. 672.54 of the Criminal Code. Absent some higher level of insight, particularly insight that is internally motivated, it cannot be said that the lesser provision of living in approved “accommodations-simpliciter” in the community can answer the risk of return to regular substance use and resultant rapid decompensation of psychotic symptoms that was described in the Hospital Report and in Dr. Hwang’s evidence.
[38]. As a result, the panel has concluded that Mr. Mensah continues to represent a significant threat to the safety of the public and that a detention disposition with privileges up to and including that of living in the community in 24/7 supervised accommodations approved by the person in charge of the Hospital. An order will issue accordingly.
[39]. The Board thanks all who participated in the hearing and extends its encouragement to Mr. Mensah for the course of the next period of review.
DATED this 27th day of May 2025, at the City of Toronto, in the Toronto Region.
D. Sandor
Legal Member
Office of the Registrar
Ontario Review Board