Ontario Review Board
Re: Kwajoe Boachie Adomako
ORB File No: 8238
Hearing held on: Tuesday, June 17, 2025
Place of hearing: Southwest Centre for Forensic Mental Health Care 401 Sunset Drive, St. Thomas
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. S. Kert Members: Dr. T. Verny Dr. J.C. Rose Ms. K. Tomaszewski Ms. C. Plyley
Parties Appearing:
Accused: Kwajoe B. Adomako Counsel: Ms. N.C. Circelli
The person in charge of hospital: Counsel: Ms. J. Zamprogna
Attorney General of Ontario: Counsel: Mr. D. Rows
REASONS FOR DISPOSITION
(Dated July 21, 2025)
Introduction
Kwajoe Boachie Adomako was found not criminally responsible on account of mental disorder on charges of sexual assault (x2), contrary to the Criminal Code, on February 15, 2023.
Mr. Adomako is currently subject to a Disposition of the Ontario Review Board (“ORB” or the “Board”) dated June 28, 2024, which detains him at the Southwest Centre for Forensic Mental Health Care (“SCFMHC” or the “Hospital”) with a variety of privileges up to entering the community of Elgin, Middlesex or Essex, indirectly supervised, and to “attend the sexual behaviours clinic at either the Centre for Addiction and Mental Health, Toronto, or the Royal Ottawa Hospital, Ottawa for a sexological assessment, if indicated.”
On June 17, 2025, a panel of the Board convened to review Mr. Adomako’s Disposition pursuant to s. 672.81(1) of the Criminal Code. He was present for his hearing and represented by his counsel, Ms. N.C. Circelli, throughout.
The issues to be determined at the hearing were whether Mr. Adomako represents a significant threat to the safety of the public, and if so, the necessary and appropriate Disposition to manage that risk having regard to the criteria set out in s. 672.54 of the Criminal Code.
When parties were canvassed for their initial, tentative positions at the commencement of the hearing, counsel for the Hospital submitted that Mr. Adomako remains a significant threat to the safety of the public and that the necessary and appropriate Disposition is a Detention Order, with the inclusion of the privilege of living in the community of Elgin County in approved accommodation, and reporting not less than four times per month when living in the community. Counsel for the Attorney General and counsel for Mr. Adomako both supported the Hospital’s position.
All parties maintained their respective positions at the conclusion of the evidence, and the Board was thus presented with a joint submission on all issues.
Following deliberations, the panel unanimously agreed with the joint submission and concluded that Mr. Adomako is a significant threat to the safety of the public as that term is defined in s. 672.5401 of the Criminal Code and explained in the governing authorities. The panel further found that the necessary and appropriate Disposition for the management of Mr. Adomako’s risk is a Detention Order on the terms jointly recommended by the parties.
Index Offences
- The circumstances of the index offences are: “#1: Sexual Assault, Sec. 217 CCC
On Wednesday, May 18, 2022, the victim, was working as a Mental Health Nurse at Southwest Detention Centre, in Windsor, Ontario. While waiting for a door to open so that she could exit a secure area, the accused came out of the shower area and lunged toward the victim and proceeded to grab her breasts with his two hands.
#2: Sexual Assault, Sec. 217 CCC
On Friday, August 26, 2022, at about 1:00 am, the victim was walking along Ouellette Avenue, in the City of Windsor, after finishing work at a downtown establishment. At about that time, she was approached quickly by a male she recognized from attending High School together, as the accused. They engaged in a short conversation, but as the victim was about to continue on her way, the accused pulled her close and began touching her breasts over the top of her shirt. She screamed and pushed him away.
Background and History
Mr. Adomako’s personal background is set forth in detail in the Hospital Report and need not be repeated here. The following summary is excerpted from the Board’s latest Reasons for Disposition, dated July 23, 2024.
Mr. Adomako and his mother both described him as a good student in elementary school and early high school. He was an honour roll student. He was never diagnosed with attentional or a learning disability. However, something changed when he was around 16 years of age. He was told he was not allowed to return to school. His mother was unsure why and felt it was discrimination because he had converted to Islam. His medical records indicated some problems with drugs at school around this time. His mother said she was unaware of any behavioural problems in childhood or adolescence although she expressed vague concerns about certain peer groups.
Mr. Adomako himself advised of a history of behavioural problems in childhood and adolescence. He claimed to be suspended from school after setting fire on the stage in the school gym in grade 7. He reported using drugs at school in grade 8 and the same year he was suspended for inappropriate conduct with a female student in the boys’ bathroom.
Mr. Adomako’s employment history is limited. He worked for a short time as a security guard in 2018. In recent years, Mr. Adomako has received funding through the Ontario Disability Support Program (ODSP). He has not been employed.
Mr. Adomako has a psychiatric history which is detailed in the Hospital Report. In summary, Mr. Adomako was first admitted to hospital in Windsor in June 2012 when he was 16 years of age. According to the NCR report dated December 1, 2022, Mr. Adomako was brought to the hospital by his family because of bizarre and paranoid behaviour. He had joined a religious group and became religiously preoccupied and was not attending school. There was also conflict with the school involving issues of drugs. It appears around this time that Mr. Adomako either stopped attending school or was expelled.
Mr. Adomako was admitted to the hospital for psychiatric treatment at the age of 20 in 2016. He was throwing books in the men’s prayer room in a mosque. His behaviour was described as aggressive and bizarre. By-standers called the police and EMS brought Mr. Adomako to hospital. He had been using cannabis which was confirmed with urine drug screens on admission. His discharge diagnoses on these admissions were acute psychosis, rule out bipolar disorder and psychosis NOS.
Mr. Adomako has a history of cannabis use, which has contributed to psychotic episodes. Police reports indicate he was found with cannabis paraphernalia in his possession during his arrest in August 2022. It is also reported that he used methamphetamine in 2016.
Mr. Adomako’s criminal offending history includes convictions for offences similar to the index offences. He was convicted of a sexual assault in 2021 and indecent act in 2022. He received short jail sentences and probation for these offences. He was also convicted of assault (original charge was sexual assault) in 2022. The Hospital Report details the circumstances around the criminal offending history as well as the index offences.
Mr. Adomako also received a jail sentence of four months for a conviction for assault and three years’ probation. The victim was a female unknown to Mr. Adomako who he encountered in a retail store in Windsor. Mr. Adomako is on the sex offender registry and is required to comply with reporting requirements for life.
In the 2023-2024 report period, Dr. N. Mokhber, Mr. Adomako’s attending psychiatrist, diagnosed Mr. Adomako with Personality Change Due to Traumatic Brain Injury. This diagnosis opened up important, new avenues to treatment. Prior to age 16, Mr. Adomako was a model student. He appeared talented with little behavioural issues. Following a serious accident when a vehicle hit his bicycle, resort to substance abuse and sexually inappropriate behaviours started.
In April 2024, an MRI revealed that Mr. Adomako suffered injuries to a part of the brain that results in behavioural changes, including violence and inappropriate sexual behaviours. To address his sexual issues and with his consent, in 2024 Mr. Adomako was started on Lupron by injection. Lithium was also added to Mr. Adomako’s treatment regime to address damage.
Evidence at the Hearing
The Board received documentary evidence in the form of a Hospital Report dated May 13, 2025. The Board also heard oral evidence from Dr. N. Mokhber, Mr. Adomako’s attending psychiatrist.
Dr. Mokhber confirmed the following diagnoses: Schizophrenia; Substance Use Disorder, in remission in a controlled Environment; Personality Change Due to Traumatic Brain Injury; Rule Out Paraphilic Disorder.
Dr. Mokhber also confirmed that when he is treated by injection with long-acting antipsychotic medications and Lupron (a hormone suppressant), Mr. Adomako’s symptoms of psychosis and inappropriate sexual behaviours are controlled. With these treatments, Mr. Adomako is not a management issue. For this reason, Dr. Mokhber and the Treatment Team recommend that a community living clause be included in the Disposition. In the doctor’s opinion, if Mr. Adomako is treated with these medications, community living is realistic during the upcoming report periods.
Mr. Adomako has not yet attended the sexual behaviours clinic at either the Centre for Addiction and Mental Health, Toronto (“CAMH”), or the Royal Ottawa Hospital “ROH”), Ottawa, due to no fault of Mr. Adomako. The Hospital continues to check on the progress of the waitlist at each clinic, and was advised on June 10, 2025, that an update would be provided by the ROH ‘as soon as possible’.
Dr. Mokhber described the difficulties resulting from waiting for an appointment with a sexual behaviours clinic. To attend a sexual behaviours clinic for phallometric testing, Mr. Adomako must be free of all hormone suppressant medication. He had been receiving a Lupron injection every three months. To prepare for a possible assessment by the sexual behaviours clinic at the ROH, this was discontinued in February 2025.
Mr. Adomako was offered oral sex suppressant, which he initially refused. His substitute decision maker declined to force Mr. Adomako to take the oral form of the medication. Oral medications clear the body within two to three days, making preparation for an appointment at a sexual behaviours clinic easier to accommodate.
When not receiving any hormone suppressant, Mr. Adomako’s psychotic symptoms worsened, and he began to engage in impulsive behaviours and inappropriate sexual behaviours, including stalking and chasing one of the Hospital’s female security staff. Additional sexually inappropriate behaviours are described in the Hospital Report.
While unmedicated, Mr. Adomako had no insight into the inappropriate nature of his sexual behaviours and denied or justified his behaviours.
On May 22, 2025, Mr. Adomako agreed to take oral hormone suppressant medication. Dr. Mokhber told the panel that as of the date of the hearing, Mr. Adomako’s inappropriate behaviour is under control, and improving.
Dr. Mokhber explained that the purpose of the sexual behaviours test is to determine what type of psychological programs Mr. Adomako needs. The doctor emphasized that the pharmacological aspect of Mr. Adomako’s treatment has been identified.
The plan is that with identification of Mr. Adomako’s psychological treatment needs, the long-acting Lupron injection can be re-initiated, and Mr. Adomako can be transitioned to the rehabilitation unit in preparation for community living.
The uncertainty of how long Mr. Adomako will need to wait to be assessed by a sexual behaviours clinic is causing a delay in the implementation of this plan.
After some discussion about how long the Hospital would wait for the ROH sexual behaviours clinic assessment before re-initiating the long-acting Lupron injection, Dr. Mokhber indicated that she would need to discuss this with the Treatment Team, but that she anticipated that an additional wait of three months might be appropriate.
Dr. Mokhber testified that before Mr. Adomako can transition to community living, the Treatment Team will need to assess his coping strategies as he deals with real life stressors. This will be done in a stepwise fashion, beginning with gradually increasing privileges and the use of passes.
While his insight is improving it is still limited. Mr. Adomako is unable to describe or recognize the symptoms of his diagnoses. Unfortunately, Mr. Adomako has not shown any positive response to the psychological programs provided to him to date. Dr. Mokhber cautioned that while Mr. Adomako has not acted violently or with sexually inappropriate behaviour in the Hospital when properly medicated, this was in the context of a structured setting supervised by well trained staff who know him and know his early warning signs. His transition to the community will require close supervision.
Dr. Mokhber indicated that the rehabilitation unit Treatment Team will determine when Mr. Adomako is ready for community living. She expects that this Treatment Team will likely seek 24/7 supervised accommodation for Mr. Adomako, to enable the Treatment Team to closely assess his adjustment to community living, and to minimize the risk to the public.
On a positive note, the doctor highlighted that apart from when he was not receiving an optimal dose of hormone suppressant medication, Mr. Adomako did not engage in physical aggression or sexually inappropriate behaviour. He is willing to take long-acting Lupron. He is compliant with his medications, although he needs to be reminded to take them. He can name his diagnoses. He has been attending AA programs in the Hospital.
Because Mr. Adomako was so high functioning prior to the brain injury when he was 16, Dr. Mokhber expressed hope that with proper treatment, both pharmacological and psychological, Mr. Adomako will be able to learn healthy strategies to cope with stressors in the future.
Analysis and Conclusions
The panel agrees with the parties’ joint submission and is also independently satisfied on the evidence that Mr. Adomako is a significant threat to the safety of the public. Mr. Adomako has been diagnosed with a major mental illness, Schizophrenia as well as Personality Change Due to Traumatic Brain Injury, which appears to have resulted in behavioural changes, including violence and inappropriate sexual behaviours. Mr. Adomako's score on the STATIC-99R placed him well above the average risk of being charged or convicted of another sexual offence, about three to four times the average rate of reoffending for the overall population of individuals convicted of sexually motivated offences. Mr. Adomako’s insight across all domains is underdeveloped.
The panel adopts the Re-Offence Scenario set out on page 49 of the Hospital Report:
Absent forensic support and supervision, Mr. Adomako would likely discontinue psychiatric treatments and begin using substances, which would exacerbate his psychotic symptoms such as command hallucinations and disinhibition related to sexual urges. He would most likely act out similarly to the time of the index offence.
The panel also adopts the Overall Clinical Assessment of Risk set out on page 50 of the Hospital Report:
Mr. Adomako has been diagnosed with a major mental illness, namely Schizophrenia. Although his psychotic symptoms are now fairly well controlled with antipsychotic medications, he was occasionally observed responding to internal stimuli and expressed some mild paranoia;
Although Mr. Adomako demonstrated some improvement with his interactions with females after being started on the anti-androgen medication, this was required to be discontinued in order to complete the phallometric testing and these behaviours have increased as a result;
Mr. Adomako has a history of repeated episodes of sexual violence, which seem to be driven in part by symptoms of Schizophrenia, as well as impulsive disinhibited behaviour potentially due to a traumatic brain injury. Results of the phallometric testing will be helpful to clarify whether an underlying paraphilic disorder also contributes to his risk, as the ones conducted previously were inconclusive;
Mr. Adomako’s insight into his mental illness, need for treatment and violence risk remain underdeveloped.
Mr. Adomako has a lengthy history of nonadherence to medications. He has made various attempts to have his medications discontinued i.e. complaining of side effects but has remained adherent overall. Outside of the hospital setting, it is probable that he would not adhere to treatment or follow-up recommendations;
Mr. Adomako has a history of substance use. Although he has indicated that he will not use in the future, this appears externally motivated in that he will only not use because his disposition prohibits him. He does not believe that substance use negatively impacts his mental state and has not completed adequate substance use programming while in hospital. Mr. Adomako’s psychiatric history indicates a link between substance use, mental health status decompensation and sexual violence; and,
Although Mr. Adomako has reasonable support from his mother and brothers, they would not be able to mitigate his level of risk. As well, he has no professional mental health supports outside of the forensic system and no stable housing.
The panel is further satisfied that the necessary and appropriate Disposition is a Detention Order. A Conditional Discharge is not realistic at this time, and no parties suggested it. As expressed in the Hospital Report on page 51:
Mr. Adomako is not being considered for an alternative disposition because he requires close supervision and monitoring to ensure his ongoing treatment, manage his symptoms, and prevent his reoffending. He lacks insight into his mental illness, need for treatment and violence risk. He has not completed adequate substance use programming and does not appreciate the negative impacts substance use has on his mental health. He requires further assessment, medication optimization and psychoeducation. Mr. Adomako has yet to progress to a rehabilitation unit that would further test his ability to cope with greater liberties (e.g., community readiness). Should Mr. Adomako progress to community living the upcoming reporting period, it will be necessary to be able to return him to hospital expediently should he decompensate and to detain him if required. The hospital also requires the ability to approve his accommodations in order to ensure appropriate structure, supervision and support to manage his risk.
The panel is satisfied that it is necessary and appropriate to include community living and reporting clauses in the Disposition. The evidence supports a conclusion that with optimized pharmacological treatment, and adequate structure and supervision, community living is a realistic possibility in the upcoming reporting periods. The Hospital needs to be able to identify appropriate housing and place Mr. Adomako on the applicable waitlists during the upcoming reporting period.
The panel expresses its sincere hope that Mr. Adomako will continue to progress during the upcoming reporting period.
In coming to these conclusions, the panel has considered the paramount factor of public safety, along with the objectives of addressing Mr. Adomako’s mental condition, his other needs, and his reintegration into the community.
DATED this 21st day of July 2025, at the City of Toronto, in the Region of Toronto.
Ms. K. Tomaszewski Legal Member
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Office of the Registrar Ontario Review Board