Ontario Review Board
Re: Roble Adam
ORB File No. 6501
Hearing Date: Thursday, May 8, 2025
Hearing Location: Centre for Addiction and Mental Health, Toronto
Pursuant to: Section 672.81(1) of the Criminal Code;
Before:
Alternate Chairperson: Ms. L. Banks
Members: Dr. T. Verny Dr. G. Nexhipi Mr. W. Apted Mr. K. McKenna
Parties Appearing:
Accused: Roble Adam Counsel: Mr. D. North
The Person in charge of Hospital: Counsel: Mr. K. Dow
Attorney General of Ontario: Counsel: Ms. M. Feindel
REASONS FOR DISPOSITION
(Dated June 19, 2025)
Introduction
Mr. Adam was found not criminally responsible on March 24, 2014, for the criminal code offence of first-degree murder.
He is currently subject to a detention order under a Disposition dated June 17, 2024, with privileges that extend to living in the community in 24 hour supervised accommodation approved by the person in charge, and entering the community of Toronto escorted by staff.
A panel of the Ontario Review Board (the panel) convened this annual hearing on May 8, 2025, at the Centre for Addiction and Mental Health (CAMH) to review the current Disposition pursuant to s. 672.81(1) of the Criminal Code of Canada.
After considering the evidence, the panel concluded that a continuation of the current detention order with the same terms and conditions was appropriate.
Index Offence
- The following is a synopsis of the facts pertaining to the index offence as produced in last year’s Reasons for Disposition.
“According to the police report, Mr. Adam was charged with First Degree Murder of 51 year-old Larisa Belekova on Wednesday February 3, 2010 at 13 Homewood Avenue, Toronto (DARA Residence). This was Mr. Adam’s residence. Ms. Belekova was the house manager. Police were called about a stabbing at 13 Homewood Avenue. They located the victim’s traumatized body. She was transported to St. Michael’s hospital where she succumbed to her injuries. Staff at the house advised that Mr. Adam had been in Ms. Belekova’s office, where an argument ensued; staff observed Mr. Adam leaving the office and found the victim suffering from a traumatic injury. Mr. Adam was located in an upstairs bedroom with blood on his body.
Hospital Report dated April 28, 2025
The Hospital Report dated April 28, 2025, was prepared for this hearing and contains a detailed review of Mr. Adam’s personal and mental health history.
Mr. Adam was born in Ethiopia, married a woman in Somalia, and moved to Italy. Mr. Adam, his wife and son moved to Vancouver in 1991. It was at this time that he began to experience mental health issues. Mr. Adam and his wife were divorced in 1993.
Mr. Adam is diagnosed with:
Schizophrenia;
Substance Use in Full Remission in a controlled environment (cannabis, cocaine, alcohol)
Idiopathic Progressive Neuropathy;
Degenerative Disease of the Nervous System, unspecified.
At the time he moved to Canada Mr. Adam began to experience symptoms of schizophrenia. He developed beliefs that people were exercising sorcery on him and controlling his life. In 2009, he was evicted from a housing shelter and became homeless.
The Hospital Report indicates that Mr. Adam has a lengthy history of schizophrenia with poor psychosocial functioning. He has had intermittent compliance with antipsychotic medication and community treatment. Mr. Adam reported that he had not taken his medication for approximately one month prior to the index offence.
Mr. Adam continues to reside in transitional housing at White Squirrel Way. He was discharged from the Hospital to White Squirrel Way on April 27, 2021. This housing provides onsite support and supervision 24 hours per day. He has been on a wait-list for long-term care housing since 2019. Prior to Mr. Adam’s discharge to White Squirrel Way, he had resided on a secure forensic unit the entirety of his time at CAMH.
Records indicate that Mr. Adam has criminal convictions for an assault in 1992, an assault in 1997, and public intoxication in 2008.
The Hospital Report indicates that Mr. Adam did not have any contact with family this past year, and had minimal contact with other residents. He met with his case manger from the outpatient treatment team every 2 weeks, and with Dr. Choptiany, his psychiatrist or Dr. Chan, his resident, monthly.
Mr. Adam had no understanding of his diagnosis or the reason he took medication. He could not suggest a consequence for him of discontinuing his medication. Mr. Adam could not recall his psychiatric history, details regarding the index offence, or the reason he was under the jurisdiction of the ORB.
In July 2024, Mr. Adam expressed paranoid concerns of “sorcery”, and worried that another tenant in the building was targeting him. Mr. Adam paid the other tenant $500.00 to prevent the sorcery from happening.
Mr. Adam was cooperative with the treatment team, and has not consumed substances or alcohol. His mental state has remained stable, and there has not been any violent behaviour.
Mr. Adam generally spent his time alone in his room, but would go into the community with staff and other patients daily. Mr. Adam was always accompanied by staff when in the community.
Mr. Adam is not capable to make treatment decisions or manage his financial affairs.
The Hospital Report indicates that his risk to public safety, although having been reduced over the years with medication, remains primarily as a result of lack of insight. Without close supervision he would discontinue his medication and his mental condition would deteriorate. The Report states that Mr. Adam’s clinical trajectory suggests that he will require intensive external supervision.
Mr. Adam has a severe and rare form of schizophrenia, and his cognitive limitations have limited his ability to progress. He is unable to manage indirectly supervised passes into the community. The Hospital Report also refers to the Hospital needing the ability to readmit Mr. Adam to the Hospital should there be indications of decompensation or medication refusal, and the ability to approve housing.
Testimony of Dr. Chan
Dr. Chan testified at these proceedings. He is a resident working with Dr. Choptiany, and they have been treating Mr. Adam.
Dr, Chan highlighted some of the salient information contained in the Hospital Report. He referred to Mr. Adam being mentally stable this past year and doing well. Mr. Adam endorsed delusional beliefs earlier in the year, but they resolved on their own.
Dr. Chan summarized Mr. Adam’s condition as treatment resistant schizophrenia, history of substance abuse, together with cognitive impairment that has not been fully diagnosed. Mr. Adam is being followed by a neurologist for the cognitive impairment.
Dr. Chan believes that the cognitive impairment affects Mr. Adam’s insight and memory. Mr. Adam also experiences breakthrough psychotic symptoms and delusions. He described the symptoms as short lived and not persistent.
Dr. Chan stated that Mr. Adam is compliant with his medication with strong supervision and support. The onset of periodic psychotic symptoms are unpredictable. Mr. Adam’s very poor insight into his illness would affect his ability to be compliant with medication.
Dr. Chan indicated that Mr. Adam requires a residence with 24-hour supervision to assist him with his daily needs, and to ensure medication compliance.
Without this supervision and support, Mr. Adam’s mental condition would decompensate, and he would very likely react violently to people in his vicinity.
Dr. Chan indicated that the focus of the treatment team is to locate permanent housing with 24-hour supervision.
Dr, Chan confirmed with the Crown that White Squirrel Way will not terminate his residency even though it is transitional housing. The Crown also referred to the July 2024 incident when Mr. Adam was exhibiting paranoia and believed that someone was targeting him. Dr. Chan confirmed that Mr. Adam has no recollection of the index offence.
In answer to questions from the panel, Dr. Chan advised that Mr. Adam is unable to exercise indirectly supervised passes into the community for mental health reasons. Mr. Adam requires supervision to assist him with his cognitive deficits. Mr. Adam would be a risk to abscond and use substances if he were indirectly supervised in the community. This would result in a reemergence of his psychotic symptoms.
Submissions
- The parties agreed that a continuation of the current Disposition with the same terms and conditions was necessary and appropriate.
Analysis
Mr. Adam is diagnosed with treatment resistant schizophrenia, and suffers from cognitive impairment for which he is being seen by a neurologist.
The cognitive impairment prevents Mr. Adam from having any insight into his condition and the need for treatment. He does not recall the index offence, does not understand his illness or the reason he is taking medication. He does not comprehend the reason he is under the jurisdiction of the ORB.
Mr. Adam has remained mentally stable this past year, with the exception of an onset of paranoia in July. His stability in the community is maintained with strong supervision and monitoring. He requires a residence that provides 24-hour supervision to ensure his medication compliance and to be aware of any decline in his condition.
Without this supervision, Mr. Adam would discontinue his medication, there would be a reemergence of his psychotic symptoms, including paranoia, which would result in Mr. Adam being highly likely to lash out violently to protect himself from a perceived threat.
Since his admission to CAMH following the index offence, Mr. Adam resided in a secure forensic unit until he moved to White Squirrel Way. It is also the evidence that Mr. Adam is incapable of exercising indirectly supervised passes into the community, and must always be accompanied by a staff member.
It is necessary for the Hospital to have the ability to readmit Mr. Adam to the hospital quickly if there are indications of mental decline, and to approve Mr. Adam’s housing to ensure it provides the required support and supervision.
It is, therefore, necessary and appropriate that this Disposition will impose a detention order with the same terms and conditions as in the previous Disposition.
In coming to this conclusion, the panel has applied the principles provided in s. 672.5401 of the Criminal Code.
DATED this 19th day of June, 2025, at the City of Toronto, in the Toronto Region.
Mr. K. McKenna
Legal Member
Office of the Registrar
Ontario Review Board