Re Adeola Bakenne, 2025 CanLII 62953

Re: Adeola Bakenne

ORB File No: 7706

Hearing held on: Wednesday, June 18, 2025

Place of hearing: St. Joseph’s Healthcare, Hamilton, West 5th Campus

Before:

Alternate Chairperson: Mr. J. Goldenberg

Members: K. Brisson Dr. P. Prendergast Ms. K. Weisbaum

Parties Appearing:

Accused: Mr. Adeola Bakenne Amicus: Mr. A. Rai Person-in-charge of the hospital: Counsel: Mr. S. O’Brien Attorney General of Ontario: Counsel: Ms. C. Gzik

REASONS FOR DECISION

(Dated July 4, 2025)

I. Decision

1. A panel of the Ontario Review Board (the “Board”) met on June 18, 2025 to review the restriction on Mr. Bakenne’s liberties as a result of his admission to hospital on March 27, 2025 through to May 20, 2025. The Board’s task was to determine if the Restriction of Liberty (“ROL”) imposed on Mr. Bakenne was necessary and appropriate, as well as the least restrictive and least onerous intervention in the circumstances, both at the time it was imposed and throughout its duration.

2. For the reasons set out below, the Board concluded that the restriction on Mr. Bakenne’s liberties when he was admitted to hospital was necessary and appropriate, as well as the least restrictive and least onerous intervention in the circumstances, both at the time it was imposed and throughout its duration. In other words, the panel decided it was necessary and appropriate for Mr. Bakenne to be admitted to hospital because his behaviour at his annual hearing on March 26 and the content of a letter he wrote to the Board for the purpose of his hearing indicated an increase in his risk to the safety of the public. When it was decied that a change in medication was needed, his safety and wellbeing required slow and careful titration of his medication and close monitoring of his existing medical conditions. His admission to hospital was and continued throughout his stay to be the least restrictive and least onerous intervention for Mr. Bakenne.

II. Overview

3. On March 12, 2020, Mr. Adeola Bakenne was found not criminally responsible on account of mental disorder (“NCR”) on charges of Assault with Intent to Resist Arrest and Assault Peace Officer Causing Bodily Harm, contrary to the Criminal Code of Canada (the “Criminal Code”). He is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated March 26, 2025, detaining him at the Forensic Psychiatry Program of St. Joseph’s Healthcare Hamilton (“SJHH”, or the “hospital”), subject to a number of terms, conditions and privileges, including the privilege of living in the community in accommodation approved by the Person-in-Charge of the hospital.

4. Mr. Bakenne was readmitted to SJHH on March 27, 2025. When he attended his Board hearing the previous day, his presentation was noted to be off his baseline. He presented as bizarre and grandiose. When his attending psychiatrist and case manager met with him the day after his hearing, his presentation remained off baseline. His brother, Mr. A. Bakenne, Mr. Bakenne’s substitute decision maker (“SDM”), consented to the admission to hospital, and Mr. Bakenne agreed to be admitted.

5. By letter dated April 4, 2025, the Person-in-Charge of the hospital provided notice pursuant to s. 672.56 (2) of the Criminal Code that the duration of the increased restriction on Mr. Bakenne’s liberties had exceeded 7 days.

6. On June 18, 2025, a panel of the ORB convened a hearing via Zoom videoconference to conduct a review of restrictions on Mr. Bakenne’s liberties pursuant to s. 672.81(2.1) of the Criminal Code. Mr. Bakenne was in attendance at the hearing and represented himself. Mr. Rai acted as amicus.

III. Positions of the Parties

7. At the commencement of the hearing all parties were canvassed as to their initial recommendations to the Board.

8. Counsel for the hospital, Mr. O’Brien, stated the position that the Restriction of Liberty (“ROL”) imposed on Mr. Bakenne from March 27 to May 20, 2025, was necessary and appropriate and in the circumstances of the case represented the least onerous and least restrictive decision available. It remained so from the date of the initial restriction on March 27 up to the date of the restriction being no longer in place on May 20.

9. On behalf of the Attorney General, Ms. Gzik stated agreement with the position of the Hospital.

10. As he had no instructions from Mr. Bakenne, who had conveyed that he wanted to represent himself, Mr. Rai stated that he took no position.

11. When asked by the Chair what he wanted from the Board at the hearing, Mr. Bakenne stated, “I’m not asking the board for anything.”

IV. Issues

12. The Board’s task was to determine if the Restriction of Liberty (“ROL”) imposed on Mr. Bakenne as a result of his readmission to the hospital was necessary and appropriate, as well as the least restrictive and least onerous intervention in the circumstances, both at the time it was imposed and throughout its duration. Pursuant to the decision of the Ontario Court of Appeal in Regina vs. M.L.C. (2010 ONCA 843), the Board must consider not only the reason for the restriction and the initial decision to impose a restriction but also the ongoing circumstances of the accused for the period of time that the restriction remains in place including up to the time of review. The initial restriction of liberty and ongoing restriction of liberty must be the least onerous and least restrictive necessary for public safety and for the accused.

13. In other words, regarding Mr. Bakenne’s rehospitalization and continued stay at the hospital, the precise issues are:

i) Was the initial restriction of Mr. Bakenne’s liberty by virtue of his rehospitalization on March 27, 2025, necessary and appropriate, as well as the least restrictive and the least onerous intervention?

ii) If so, was the ongoing restriction on Mr. Bakenne’s liberty by virtue of maintaining him at the hospital from March 27 until May 20, 2025, necessary and appropriate, as well as the least restrictive and the least onerous intervention?

V. Background

Index Offences

14. The following is a synopsis of the index offences, which occurred on September 25, 2018, excerpted from the Reasons for Disposition dated April 17, 2025:

“On September 25, 2018 Mr. Bakenne became aggressive and hostile, yelling and screaming, causing a disturbance when the bank manager at the bank refused to open a new account for him. Police were called and Mr. Bakenne told them he was not leaving as the bank staff were being racist in refusing to open an account for him. He was told he was trespassing and had to leave but refused. He was arrested under the Trespass to Property Act. When the police attempted to effect the arrest, Mr. Bakenne became combative and punched and kicked at the officers. He punched one of the officers twice in the side of the face and she tasered him. He continued to try to hit the other officer and he was tasered again."

15. The following is a summary of Mr. Bakenne’s personal and mental health history based on the history included in the most recent Reasons for Disposition dated April 17, 2025.

16. Mr. Bakenne was admitted to hospital on March 12, 2020 following the NCR finding. On May 29, 2023, he was discharged to live in the community. He was readmitted to the hospital from December 27, 2023 to January 17, 2024. He did not have a criminal record prior to the index offence.

17. Prior to the index offences, Mr. Bakenne lived in St. Catharines and received support from the Canadian Mental Health Association. He was often non-compliant with his medication, which resulted in frequent hospitalizations for his symptomatic bizarre behaviour. He was evicted from his apartment and began accessing the shelter system. Between 2018 and 2019, he was transported to hospital by police on at least four occasions for ongoing bizarre and threatening behaviour in the community and increased psychotic symptoms. He has a history of substance use including cannabis, crystal methamphetamine and heroin. He often presented in hospital with auditory hallucinations, paranoid thoughts, and delusional beliefs.

18. Following the index offence, Mr. Bakenne was charged with various offences on February 26, 2019, September 22, 2019, and September 23, 2019, including two counts of mischief, sexual assault, indecent act, mischief, and fail to comply with recognizance and two further counts of mischief and an assault.

19. On admission to the hospital following the index offence, Mr. Bakenne acknowledged experiencing command auditory hallucinations. His insight and judgment were limited due to the ongoing psychotic symptoms. He was experiencing delusional beliefs, and his behaviour was described as unpredictable. By the end of November 2019, prior to the NCR finding, he was refusing his antipsychotic medication. In early December 2019, he assaulted a staff member. By mid-December he accepted his antipsychotic medication, and his behaviour improved.

20. In May 2023, Mr. Bakenne was discharged to live at the Perkins Centre, Indwell Housing, a facility that offers independent apartments with staff on site during weekday business hours. His condition and behaviour had improved, but he still experienced symptoms of psychosis, such as paranoid delusions. He could be rude, argumentative and defiant. Numerous drug screens returned positive for cannabis.

21. Mr. Bakenne was readmitted to the hospital on December 27, 2023. His psychotic symptoms had intensified and he tested positive for ephedrine/pseudoephedrine, which is known to trigger manic or psychotic symptoms. With improvement in his symptoms, he was discharged to his residence on January 17, 2024. His mental status fluctuated in the community and his insight into his illness and need for medication was limited.

22. Mr. Bakenne’s clinical presentation had not changed appreciably over the year prior to his disposition hearing on March 26, 2025. He had continued to experience grandiosity and delusions. He had occasionally gone beyond the boundary of his disposition. He often resisted or denied the suggestions of his treatment team and stated that he would use substances if granted an absolute discharge.

Current Diagnoses

23. Mr. Bakenne’s current diagnoses are Schizophrenia and Cannabis Use Disorder, in sustained remission in a controlled environment.

VI. Evidence

24. Dr. Shariati has been Mr. Bakenne’s attending psychiatrist since 2022. He attended Mr. Bakenne’s annual hearing on March 26, 2025. He is the author of the ROL Report and adopted its contents. He was aware of the letter written by Mr. Bakenne, which was mentioned in the ROL Report. At the time of his annual hearing in March 2025, Mr. Bakenne was incapable with respect to treatment, and continues to be incapable. His brother, Mr. A Bakenne, is his substitute decision maker (“SDM”).

25. Dr. Shariati stated that he saw Mr. Bakenne within the month prior to the March 26 hearing. Mr. Bakenne has treatment resistant schizophrenia spectrum disorder. During the hearing, Dr. Shariati noticed that Mr. Bakenne appeared stressed and when speaking, Mr. Bakenne displayed thought disorganization, grandiosity and persecutory thoughts. Throughout the last few years, there had been no clear issue of risk detected in Mr. Bakenne. For example, Mr. Bakenne had not mentioned any sexual content during meetings with Dr. Shariati. However, Mr. Bakenne’s behaviour at the March 26 hearing showed the team that there was the potential and possibility that that indicators of risk could come out in Mr. Bakenne’s behaviour in a stressful situation. It also showed that Mr. Bakenne might continue to have residual symptoms and not be fully treated with antipsychotic medication and, as such, his medication needed to be strongly reconsidered. For that purpose, Mr. Bakenne was admitted to hospital.

26. With respect to Mr. Bakenne’s letter of March 24, 2025, Dr. Shariati stated that the letter reflected Mr. Bakenne’s mental state: it was disorganized and showed thought disorganization, contained elements of grandiosity and, in particular, inappropriate sexually explicit references to his genitalia. While not overtly aggressive or threatening in nature, the content of the letter was incongruent with the legal and social context of the Board hearing and indicated poor boundaries and lack of awareness of the outcomes for those who would read the letter.

27. Dr. Shariati stated that prior to Mr. Bakenne’s annual hearing on March 26, the team was considering initiating Clozapine as a treatment for Mr. Bakenne. When he was admitted to hospital on March 27, Mr. Bakenne did not appear to be an immediate risk to the safety of the public, rather, his behaviour indicated inadequate treatment for his schizophrenia, possibly impacting his social interactions, which in turn indicated risk to the safety of the public, which indicated the need for prompt review of his treatment.

28. With respect to Mr. Bakenne’s course of treatment while in hospital, Dr. Shariati stated that further assessment of Mr. Bakenne’s mental state was required. A change in treatment also appeared warranted. The process for initiating clozapine requires contacting the manufacturer, consultation with a pharmacist and preliminary bloodwork. Mr. Bakenne’s substitute decision maker consented, and Mr. Bakenne also agreed. Mr. Bakenne acknowledged that a change was needed and was cooperative. Because Clozapine can have significant and serious side effects, slow titration is necessary to minimize side effects. The team took the same approach in initiating Chlozapine for Mr. Bakenne. In particular, in Mr. Bakenne’s case, and especially given he has Benign Ethnic Neutropenia (“BNE”, a condition that lowers white blood cell counts), it was necessary to monitor for cardiac risks and white blood cell counts. This type of close monitoring can only be done in hospital.

29. Dr. Shariati testified that prior to readmission to hospital, Mr. Bakenne’s had been taking Olanzapine, however, because there was redundancy between Olanzapine and Clozapine, Olanzapine was discontinued. Clozapine is superior for psychosis, however, the change to Clozapine needed to be monitored carefully. As of the date of the ROL hearing, Mr. Bakenne continued to take Clozapine.

30. When asked if Mr. Bakenne could have been introduced to Clozapine as an outpatient, Dr. Shariati stated that it was necessary and a priority to first further assess Mr. Bakenne’s risk to the safety of the public. While it is possible to start a patient on Clozapine as an outpatient, it was necessary and beneficial to start Mr. Bakenne as an inpatient because of his particular medical conditions, including BNE, which required monitoring his vitals (e.g., blood samples needed to be taken twice a day), as well as side effects.

31. Dr. Shariati stated that at the time of his discharge from hospital on May 20, 2025, Mr. Bakenne appeared well and was calm and cooperative, with no obvious positive signs of psychosis. His case manager said that Mr. Bakenne’s thoughts seemed clearer. As of the date of the ROL hearing, he had not shown any troubling signs and continues with his usual routine. Because of the concerns around risk to the safety of the public, the potentially serious side effects requiring intense monitoring and Mr. Bakenne’s needs related to his particular medical conditions, there was no better, least restrictive and as effective course of treatment in hospital.

32. In response to the question from Ms. Gzik as to whether or not Mr. Bakenne is “optimally” treated, Dr. Shariati stated that Mr. Bakenne is reasonably treated with the current dose of Clozapine. While the team will need more time to monitor Mr. Bakenne, the current dose is adequate. Dr. Shariati added that while it would be “tricky” to determine how quickly he might decompensate, if Mr. Bakenne was to stop taking Clozapine, a decrease in its benefits would be seen within a matter of days.

33. Mr. Bakenne had no questions for Dr. Shariati.

34. In response to a question from Mr. Rai, Dr. Shariati stated that during Mr. Bakenne’s course as an inpatient, Mr. Bakenne had been stable and generally cooperative, without incidents.

35. In response to questions from the panel, Dr. Shariati stated that at the time of the initial admission, he inferred from Mr. Bakenne’s behaviour that Mr. Bakenne seemed to understand that things were not going as well as they had been. For example, Mr. Bakenne had refused Chlozapine last year, but he readily accepted of it upon admission. While Mr. Bakenne did not show full insight, he did realize something was wrong. He did not see why his letter was problematic and during hospitalization, his insight into the letter did not improve.

36. Dr. Shariati testified that the decision to admit Mr. Bakenne was based on the need to perform a more thorough assessment of his risk. The letter he submitted was inappropriate in the context of the ORB hearing. Dr. Shariati inferred from the letter that Mr. Bakenne’s behavior could become socially inappropriate, and when combined with his grandiosity, could pose a risk to the public. The team decided admission was necessary to better assess and manage the situation. They then considered starting Clozapine. Regarding the indicators of risk—disinhibited, grandiose, and inappropriate behavior—Mr. Bakenne was not considered safe to return to the community until he was on a therapeutic dose of Clozapine. Other interventions, such as CBT consults, were not effective. Once his dose reached 200 mg, which is at the lower end of a potentially therapeutic dose, Dr. Shariati judged that the risk was likely mitigated. While Mr. Bakenne can adjust to context, not all of his social interactions while in the community can be observed, so Dr. Shariati’s decision was based largely on reaching that dose. Mr. Bakenne was then discharged back to the community. There had been a bed bug infestation in Mr. Bakenne’s apartment, which can be distressing, that delayed his discharge from hospital for a few days, however, he seemed able to manage that stress once he returned home.

37. When asked whether Mr. Bakenne would likely seek support in the future, Dr. Shariati testified that at the time of his hospital admission, Mr. Bakenne was aware that something was wrong and needed to change. He agreed to the hospital admission, but this seemed to reflect more his acceptance of the Board’s legal authority and the consent of his substitute decision-maker than a willingness to seek help. Mr. Bakenne’s SDM consented to treatment with Chlozapine and Mr. Bakenne agreed to take it. In hospital, was he able to exercise passes, which he used without difficulty.

38. When asked if he wished to give any evidence, Mr. Bakenne stated he believed he was being bullied by his doctor and by his SDM. He believed his opinion and his civil rights should be respected. He said he is not grandiose or persecutorial. He admitted to being stressed.

VII. Analysis

39. In considering each issue, the Board reviewed the hospital record (March 10, 2025), the Reasons for Disposition (April 17, 2025), the ROL Report (April 10, 2025) and related letter from Mr. Bakenne (March 24, 2025), as well as the viva voce evidence of Dr. Shariati, Mr. Bakenne’s psychiatrist, and of Mr. Bakenne himself.

40. The Board accepts the testimony of Dr. Shariati, the Hospital Report and the ROL Report and finds merit in the recommendation of Counsel for the hospital, Mr. O’Brien, and Counsel for the Attorney General, Ms. Gzik.

The initial restriction of Mr. Bakenne’s liberty by virtue of his hospitalization on March 27, 2025, was necessary and appropriate, as well as the least restrictive and the least onerous intervention.

41. The Board accepted the testimony of Dr. Shariati regarding the reason for the initial admission of Mr. Bakenne. The purpose of the admission was multifactorial. The decision to admit Mr. Bakenne was based on observations of Mr. Bakenne’s behaviour at the disposition hearing on March 26, 2025, and his letter dated March 24, 2025, which was inappropriate in the context of the Board hearing, indicating that his behavior could become socially inappropriate. When combined with his grandiose and persecutory behaviours, he could pose a risk to the safety of the public. His admission was necessary in order to better manage his situation, perform a more thorough assessment of his risk and reexamine the efficacy his antipsychotic medication.

The ongoing restriction on Mr Bakenne’s liberty by virtue of maintaining him at the hospital from March 27 to May 20, 2025, was necessary and appropriate, as well as the least restrictive and the least onerous intervention?

42. The Board accepted the testimony of Dr. Shariati with respect to Mr. Bakenne’s ongoing stay in hospital and the length of time required. Regarding the indicators of risk—disinhibited, grandiose, and inappropriate behavior—Mr. Bakenne was not considered safe to return to the community until he was on a therapeutic dose of Clozapine, a drug considered to be superior for psychosis. Dr. Shariati had discussed Chlozapine as a possible treatment with Mr. Bakenne in the past, but it had not been previously prescribed. Standard practice with respect to staring Clozapine is to titrate up slowly in order to identify and manage possible side effects, which can be significant and serious. This approach was particularly important for Mr. Bakenne, given his medical conditions, which required close monitoring by the team. By the end of his hospital stay on May 20, Mr. Bakenne had reached a reasonable therapeutic dose of Clozapine and was then discharged back to the community. As noted in the ROL Report, at his baseline, Mr. Bakenne can still exhibit some features of grandiose and persecutory behaviours, however, he did not pose a risk to the safety of the public.

43. The Board acknowledges the contributions made by Mr. Bakenne during the hearing and wishes him well as he moves forward.

Conclusion

44. Considering the foregoing, the panel finds that the restriction placed on Mr. Bakenne’s liberties occasioned by his admission to hospital on March 27 to May 20, 2025, was necessary and appropriate, as well as the least onerous and least restrictive intervention available to the hospital in the circumstances, both at the time it was imposed and throughout its duration.

45. In making this decision, the panel has taken into account the need to protect the public from dangerous persons, Mr. Bakenne’s current mental state, his reintegration into society and his other needs.

DATED this 4^th^ day of July 2025, at the City of Toronto, in the Toronto Region.

Ms. K. Weisbaum Legal Member

Office of the Registrar Ontario Review Board