Ontario Review Board
Re: Faramorz Afzali
ORB File No: 7867
Hearing held on: Thursday, May 29, 2025
Place of hearing: St. Joseph's Healthcare Hamilton (Via Zoom Video Conference)
Pursuant to: Section 672.81(2.1) of the Criminal Code
Before: Alternate Chairperson: Mr. M.D. Segal Members: Dr. B. Sheppard Dr. G. Nexhipi Mr. K. McKenna Ms. R. MacIntyre
Parties Appearing:
Accused: Faramorz Afzali Counsel: Mr. A. Confente
The person in charge of hospital: Counsel: Ms. L. Barney
Attorney General of Ontario: Counsel: Mr. B. Adsett
REASONS FOR DECISION
(Dated June 9, 2025)
Introduction
Faramorz Afzali, age 33, was found not criminally responsible on account of mental disorder on March 22, 2021, on a charge of assaulting a peace officer, contrary to the Criminal Code. Mr. Afzali, who was on a Detention Order at the Forensic Psychiatry Program of St. Joseph's Healthcare Hamilton (the “hospital”), appeared before the Ontario Review Board (the “Board”) on May 29, 2025, virtually, in respect of a Restriction of Liberty. Mr. Afzali was admitted to the hospital on March 20, 2025, following a positive urine drug screen analysis for cocaine. Mr. Afzali continues to be in hospital.
The Board had before it the following:
- Exhibit 1 - Restriction of Liberty Hospital Report dated May 23, 2025.
- Exhibit 2 - Hospital Report dated September 17, 2024.
- Exhibit 3 - Restriction of Liberty correspondence.
In preliminary positions the hospital advanced that the Restriction of Liberty was necessary and appropriate and the least restrictive and least onerous action that could be taken, and that continues to be the case. Crown counsel agreed with the hospital position. Mr. Confente, for the patient, informed the Board that he had instructions not to contest the hearing.
Mr. Afzali is diagnosed with:
- Bipolar Affective Disorder, in remission.
- Unspecified Personality Disorder with narcissistic and avoidant traits.
Dr. S. Nagari, the patient’s psychiatrist, testified. Dr. Nagari reviewed how prior to the restriction Mr. Afzali had been residing at his brother's residence. His brother Amin is an approved person. Before that, he lived with his sister, Anisa. He has worked for his brother for two days a week at a Jiffy Lube.
In early March, the positive cocaine screen and collateral information from Mr. Afzali’s brother caused the hospital to act. The brother reported behavioural changes. Mr. Afzali was more irritable, including at work. He was resisting inquiries. Mr. Afzali’s whereabouts were not always known. Aggression experienced by the family in 2018 and 2019 had started to re-emerge. There were financial issues. Mr. Afzali had purchased a urine screen kit. He was asking others to provide urine samples.
During a visit with his case manager Mr. Afzali asked for a “therapeutic hug” which was odd. Upon admission to hospital, he was exceptionally preoccupied with when he could be released.
Mr. Afzali categorically denied cocaine use or soliciting urine. He did not admit to acting disrespectfully to his brother. There are children living in his brother's residence.
On May 24 he was late returning from a pass on hospital grounds. A call to Mr. Afzali’s cell phone was made. He claimed he misunderstood the curfew time although the 8:00 p.m. curfew when doors shut at the hospital is very well known.
Mr. Afzali began talking with his sister about staying with her again. She lives in Orillia which is outside the hospital’s catchment area.
Following the May 24 incident, he was wearing sunglasses at night. He appeared to be jollier. A blood test that followed the May 24 incident revealed the presence of methamphetamine, alcohol and cannabis. He declined to see an addictions counselor. Mr. Afzali said he missed being manic.
Mr. Afzali is now connected with an addiction’s counselor. He still does not view himself as having an addiction.
Mr. Afzali's privileges have been curtailed.
The forensic team was concerned with medication noncompliance.
Mr. Afzali was not candid with the team about seeking and receiving the administration of testosterone. The hospital had prescribed testosterone. The issue for the hospital is around secrecy and lack of transparency. The hospital requires full disclosure because testosterone is associated with aggression.
There have been concerns about undue pressure on family members by Mr. Afzali. Any future possible placement with family will need to be scrutinized. The sister’s residence is problematic because of distance including the challenges in monitoring compliance and avoidance of substances.
When Mr. Afzali realized his brother had provided information to the hospital, Mr. Afzali wanted to have him removed as an approved person. He relented when the hospital explained that it had the right to speak to family members regardless of their status as approved persons.
Mr. Afzali’s brother is not able to house Mr. Afzali anymore.
At present, there is no delusional thinking.
Going forward, complete honesty with staff is required. Not telling staff about substance consumption until a test is requested is unhelpful.
There continues to be a stark lack of insight regarding the risk of substances on his mental illness.
Lots of work remains. Mr. Afzali needs to regain the trust of the team.
Final submissions mirrored preliminary positions.
Analysis
- The Restriction of Liberty was well justified. In addition to a positive drug screen, there was reliable information regarding tampering with urine samples. Mr. Afzali has professed in the past an ability to “beat the system”. There were noticeable and concerning changes to behaviour and mental state. Much work is necessary to respond to substance abuse. Transparency and trust need to be strengthened. A cautious approach to increasing privileges, and any future placement in the community, needs be taken. The Board finds that the Restriction of Liberty was necessary, appropriate and the least restrictive and least onerous course that could be taken and continues to be so. We wish Mr. Afzali well as he works closely with the hospital.
DATED this 9th day of June 2025, at the City of Toronto, in the Region of Toronto.
Mr. M.D. Segal Alternate Chairperson
Office of the Registrar Ontario Review Board