Re: Salar Aghdasi
ORB File No: 4818/5209
Hearing held on: Friday, May 9, 2025
Place of hearing: Waypoint Centre for Mental Health Care 500 Church Street, Penetanguishene
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Finley Members: Dr. K. Hand Dr. L.O. Lightfoot Ms. M. Chamberlain Mr. J. Cyr
Parties Appearing:
Accused: Salar Aghdasi Counsel: Mr. A. Stasny (via Zoom)
The person in charge of hospital: Representative: Ms. T. Newman
Attorney General of Ontario: Counsel: Ms. S. Curry
REASONS FOR DISPOSITION
(Dated August 7, 2025)
Introduction
On June 11, 2007, Salar Aghdasi was found not criminally responsible on account of a mental disorder (NCR) on a count of aggravated assault, contrary to the Criminal Code of Canada. On November 12, 2008, he was found NCR on a count of assault causing bodily harm, contrary to the Criminal Code. He is currently subject to a disposition of the Ontario Review Board (ORB/the Board), dated February 12, 2024, detaining him at Waypoint Centre for Mental Health Care (Waypoint/the hospital) in the High Secure Provincial Forensic Program, with hospital and grounds privileges, escorted by staff.
On May 9, 2025, the Board convened to conduct the annual hearing of Mr. Aghdasi’s disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Aghdasi was present and represented by Mr. Stasny.
At the outset of the proceedings, all parties were canvassed as to their positions on the two issues to be determined by the Board: whether Mr. Aghdasi continues to represent a significant threat to the safety of the public, and if so, the necessary and appropriate disposition, including the appropriate hospital, having regard to the criteria set out in s. 672.54 of the Criminal Code.
Ms. Newman, on behalf of the hospital, submitted that Mr. Aghdasi remains a significant threat to the safety of the public and the necessary and appropriate disposition is the continuation of the current detention order. Ms. Curry, on behalf of the Ministry of the Attorney General, concurred in the hospital’s positions.
Mr. Stasny conceded that Mr. Aghdasi continues to represent a significant threat to the safety of the public. He agreed that a detention order was appropriate. However, he submitted that Mr. Aghdasi’s risk could be managed in a less secure setting such as the Centre for Addiction and Mental Health (CAMH) in Toronto or St. Joseph’s Healthcare in Hamilton (St. Joseph’s).
Findings
- For the reasons that follow, the Board finds that Mr. Aghdasi continues to represent a significant threat to the safety of the public and the necessary and appropriate disposition is a continuation of the current detention order with the same terms and conditions.
The Evidence
- The evidence at the hearing consisted of the Hospital Report, dated December 17, 2024 (ex. 1), an Update to the Hospital Report, dated April 10, 2025 (ex. 2), responses to the Rule 13 request from St. Joseph’s, CAMH and Ontario Shores Centre for Mental Health Sciences (Ontario Shores) (exs. 3-5), and the viva voce evidence of Dr Mishra, Mr. Aghdasi’s treating psychiatrist.
The Index Offences
- A summary of the two index offences has been taken from the information provided in the Hospital Report.
On February 5, 2007, Mr. Aghdasi called his uncle to come over to the apartment that Mr. Aghdasi shared with his mother. When his uncle arrived, Mr. Aghdasi met him at the door and stabbed him in the chest. When police arrived on scene, they located the accused standing over the victim in the second floor hallway. He was still brandishing the knife. The victim was transported to Sunnybrook Hospital by ambulance. The victim suffered four stab wounds to the chest area that required stitches.
In March 2008, Mr. Aghdasi was detained at CAMH pursuant to a disposition of the Ontario Review Board. Mr. Aghdasi’s escalating assaultive behaviours while an inpatient there culminated on March 18, 2008, when he went to a co-patient’s room and stabbed the co-patient several times in the face with a pen.
Background Information
The Hospital Reports include detailed information about Mr. Aghdasi’s background and psychiatric history and need not be reviewed here beyond the following material points. Mr. Aghdasi is a 42-year-old man who was born in Iraq. He and his family fled Iraq due to fear of religious persecution and arrived in Canada in 1992. Mr. Aghdasi was 11 years old at the time.
Mr. Aghdasi’s father reported noting changes in his son’s behaviour after he left school in Grade 12. He described finding his son sleeping on the balcony of their apartment in cold weather, wearing only pajamas, having thrown his clothes onto the street. On another occasion, his father found him trying to slash himself with a razor blade. When his father tried to speak with him, Mr. Aghdasi stated, “I am God…ordering you to stay alive”, “don’t come close, there is deep water…you will die”.
Mr. Aghdasi had brief admissions to various general hospitals, beginning in 2004 and leading up to the first index offence. He acknowledged experiencing auditory hallucinations and exhibited paranoia and disorganization. With antipsychotic medication, his presentation improved.
In January 2006, Mr. Aghdasi was taken to hospital as a result of an overdose of his prescribed medication. He had been violent in the home, punching walls and throwing furniture. Treatment with antipsychotic medication was initiated. A referral to the Assertive Community Treatment Team (ACTT) was made but he refused. He was discharged against medical advice with a diagnosis of Chronic Paranoid Schizophrenia.
Following his initial hearing under the ORB, Mr. Aghdasi was admitted to CAMH. At the time, he admitted to “probably” suffering from a mental illness and had very little insight into the need for medication. He acknowledged experiencing command hallucinations that made him angry and anxious, although did not want to discuss the content of the hallucinations with the treatment team.
Between November 2007 and the second index offence, Mr. Aghdasi engaged in problematic behaviour. On November 29, 2007, he became involved in a verbal altercation with a co-patient. Staff were able to prevent it from escalating by intervening. At the time, Mr. Aghdasi told staff that the person had been teasing him, and he felt threatened.
In December 2007, Mr. Aghdasi became quite agitated and angry, and required a brief period in seclusion. He reported that the voices were bothering him but, once again, declined to discuss the nature of the voices. On December 7, 2007, Mr. Aghdasi was escorted by two staff to a medical appointment in the community. Upon exiting the taxi, he ran from the staff. He spent the night in a bus shelter and called his father in the morning. He was returned to the hospital by his father.
On February 7, 2008, Mr. Aghdasi assaulted two co-patients who were “bothering” him. He also was verbally aggressive with staff. While on the way to seclusion, he punched a co-patient in the mouth. On February 26, 2008, one of the victims of the February 7th assault reported that Mr. Aghdasi had threatened to kill him and rape his mother. On March 18, 2008, he assaulted this same co-patient (the second index offence). At the time, Mr. Aghdasi told staff that the victim “was saying things about my sister…my mother…he made me angry”. A maximum-security setting was deemed necessary to manage Mr. Aghdasi’s risk. He was transferred to Oak Ridge (now Waypoint) on March 20, 2008.
Mr. Aghdasi remained an inpatient at Waypoint until April 15, 2015, when it was determined that he no longer required a maximum-security facility. He was transferred to a secure forensic unit at St. Joseph's Healthcare Hamilton.
While an inpatient at St. Joseph’s, Mr. Aghdasi continued to experience hallucinations, paranoia, and grandiose ideations. He denied having a mental illness and was frequently non-compliant with medication, “cheeking” his medication or disposing of it in the garbage. There were multiple occasions when he was verbally aggressive and threatening towards staff and co-patients and was angry, glaring and yelling. He also submitted multiple urine drug screen samples which were presumptive positive for cannabis.
In 2018, Mr. Aghdasi was transferred to a secure forensic unit due to his behaviour. Of particular concern given the nature of the index offences, is that he was found to be hiding sharp objects in his room. Ten small sharp pieces of broken plastic spoons and four flex pens were found.
Mr. Aghdasi’s threats included sexual violence. In August 2018, he exposed his genitals and advanced towards a female nurse who was alone with him in his room, saying, “I am going to fuck you.” This incident was quite frightening and caused significant emotional trauma to the nurse involved. This was followed by multiple and frequent incidents of inappropriate sexual behaviour over the course of the next year. This behaviour was directed towards both male and female staff, and included touching female staff in the crotch area, and co-patients.
St Joseph’s requested an early hearing. The clinical team was concerned that Mr. Aghdasi’s quality of life was significantly restricted given the need to safely manage the risk that he posed to both staff and co-patients. There would be more constructive activities available to Mr. Aghdasi within the High Secure Provincial Forensic Program at Waypoint. The Board agreed and Mr. Aghdasi was transferred back to Waypoint in November 2019.
In November 2020, the Board ordered that Mr. Aghdasi’s care be transferred to Ontario Shores. The Board found that being close to his family was a significant factor for Mr. Aghdasi and his risk to the public could be safely managed on a secure forensic unit.1
Pending his transfer to Ontario Shores, Mr. Aghdasi remained on the High Secure Provincial Forensic Program. In November 2020, Mr. Aghdasi began periodically to refuse, spit out or overtly cheek his clozapine. On December 11, 2020, his Clozapine was discontinued due to noncompliance. His mental status and his behaviour began to deteriorate. Mr. Aghdasi required five separate periods of seclusions during that clinical year. As in the past, he was verbally threatening and abusive towards staff and co-patients, sexually inappropriate, engaged in environmental aggression, and created weapons in his room. On September 8, 2021, he punched a staff member in the face.
At his next annual hearing, he was ordered detained at the High Secure Provincial Forensic Program at Waypoint.
Course Since the Last Disposition.
Mr. Aghdasi’s current diagnoses are Schizophrenia, multiple episodes, currently in partial remission and Cannabis Use Disorder, in sustained remission in a controlled environment. He continues to be incapable of making treatment decisions and his mother is his Substitute Decision Maker. His current regular medications are olanzapine, benztropine and lorazepam. Mr. Aghdasi continues to reside on the Beausoleil A unit. Dr. Mishra took over Mr. Aghdasi’s care following the departure of Dr. Muraven in late December 2024.
Notwithstanding treatment with two antipsychotic medications, Mr. Aghdasi continues to experience psychotic symptoms, including delusions and auditory hallucinations that cause him to become agitated and angry. He continues to resist discussing the contents of his delusions and hallucinations. Mr. Aghdasi remains on a post-administration medication watch. He has refused medications, saying he does not “trust them”, spat them out, and evaded his medication watch. Given the limited improvements noted with Olanzapine, a trial of clozapine was suggested to which Mr. Aghdasi refused.
Mr. Aghdasi was found to be in possession of more than the permitted number of pens and several plastic spoons that had been broken into pieces. After considerable encouragement, Mr. Aghdasi complied with the staff member’s request to hand the broken pieces over. This is particularly concerning given second the index offence and his history of similar behaviour while at St. Joseph’s. Mr. Aghdasi has continued to display inappropriate sexual behaviour.
Mr. Aghdasi has participated in some of the unit programming, such as Music Appreciation and one-on-one computer time. However, he has not engaged in any program designed to address his criminogenic risk factors, such as anger management or relapse prevention groups.
Mr. Aghdasi's security levels were placed on hold eight times from January 21, 2024 to November 20th, 2024. During this time, his security levels were dropped on several occasions in the context of difficulty following direction, responding to internal stimuli, irritability and conflict with peers. Mr. Aghdasi remains on a medication watch protocol which has been ordered to support medication adherence.
Mr. Aghdasi’s insight remains extremely poor. He minimizes the presence of his mental disorder and his psychotic symptoms, which he continues to experience. He actively resists taking his medication and has refused to engage in programming that would address some of his problematic behaviours. He fails to appreciate the seriousness of his past violent behaviour and the impact that it has had on others. He has stated that he will cease treatment, including medication, the day that he is discharged.
The clinical team concluded that Mr. Aghdasi continues to require the highly structured and supervised unit that his current disposition provides, as noted in the Hospital Report at p. 163:
The clinical team acknowledged that Mr. Aghdasi has not required seclusion and resides on the least structured program yet felt that his risk was too great for a less secure setting at this time. Mr. Aghdasi will continue to be encouraged to participate in programs and groups to benefit him over the coming year in an effort to reduce his risk such that he could transition to a less secure hospital, ideally closer to his family.
Mr. Aghdasi’s family continues to be a support to him. They maintain regular telephone contact and Mr. Aghdasi’s father and mother have each visited him this year.
Dr. Mishra testified before the Board. He reported that Mr. Aghdasi’s illness is treatment refractory. The medications that he is receiving are helping, in that there have been no episodes of violence. However, the concerning behaviours continue. This includes his hoarding of sharp objects, and sexually inappropriate behaviour.
Dr. Mishra testified that Mr. Aghdasi has no insight into his mental illness and no insight into the ongoing need for medication. Mr. Aghdasi remains on medication watch to ensure compliance with medication.
Before considering a recommendation for a less secure environment, Dr Mishra testified that he would like to see Mr. Aghdasi agree to another trial of clozapine, and attending groups and programs, or vocational services that would be structuring his time in a useful way. Even if Mr. Aghdasi’s medication regime were to remain the same, Dr. Mishra would like to see Mr. Aghdasi demonstrate some motivation or some understanding of his criminogenic risk factors and be open to discussing them with his treatment team. To date, Mr. Aghdasi has not engaged in any counselling.
In response to questions from Ms. Armenise, Dr. Mishra indicated that, should Mr. Aghdasi be transferred to a less secure unit, a male-only unit would be preferable. Such a unit is only available at CAMH.
In response to questions from Mr. Stasny, Dr. Mishra agreed that Mr. Aghdasi has not acted out aggressively, and there has been no violence and no seclusions over the past year in review. Dr. Mishra reiterated that the concern is Mr. Aghdasi’s ongoing symptoms and unwillingness to engage with this treatment team. His fashioning of weapons and his inappropriate behaviour towards staff and co-patients has remained persistent. Mr. Aghdasi’s flat out denial of his behaviour makes it difficult to deal with.
Dr. Mishra agreed that some patients never develop insight. However, it may not be of material importance if the person’s risk and symptoms can be mitigated. Insight is just one factor in a risk assessment. Dr. Mishra testified that he will discuss the possibility of making changes to Mr. Aghdasi’s medication with his SDM. He also is considering asking for a consultation. In the doctor’s opinion, clozapine would be the option, but because it involves blood tests and the taking of vitals, the patient’s cooperation is required.
Dr. Mishra agreed that it would be beneficial for Mr. Aghdasi to be closer to his family. However, it may not help manage Mr. Aghdasi’s symptoms or address his risk factors.
Dr. Mishra indicated that over the next year, the treatment team would focus on small steps. Mr. Aghdasi has demonstrated little interest in rehabilitative programming. However, there could be improvements in utilizing his day in a more productive manner. He needs to demonstrate a willingness to take a more active role in his recovery.
In response to questions from the panel, Dr. Mishra agreed that pharmacogenetic testing could assist in considering further options for treatment.
In the response to the Rule 13 request dated January 20, 2025, De. Chaimowitz pointed out that Mr. Aghdasi remains symptomatic, is actively responding to internal stimuli and remains reluctant to share the contents of his delusions and auditory hallucinations. He specifically agreed with Dr. Muraven’s clinical assessment of risk as found on p. 163 of the Hospital Report:
It is my opinion, within a reasonable degree of medical certainty, that detention in a maximum secure forensic facility is the appropriate and necessary disposition for Mr. Aghdasi at this time. It is also my opinion that a maximum secure forensic facility is the least onerous and least restrictive setting in which to address his risk.
In a response on behalf of CAMH on February 7, 2025, Dr. Darby took the same position. Further, he indicated that the units at CAMH are much smaller and patients are put in much more frequent and close contact with one another. As a result, Mr. Aghdasi’s behaviour would be much more difficult to manage.
In the response on behalf of Ontario Shores, dated April 28, 2025, Dr. Coleman agreed that Mr. Aghdasi continues to require the high level of support and supervision that can only be provided at Waypoint.
Submissions
Ms. Newman submitted that Mr. Aghdasi remains a significant threat to the safety of the public and that the necessary and appropriate disposition is a continuation of his current detention order with the same terms and conditions. Both Dr. Muraven and Dr. Mishra have found that the risk is too great to move Mr. Aghdasi to a less secure facility at this time. Mr. Aghdasi continues to be symptomatic, his insight is poor, and he does not discuss his delusions or minimizes them. He has not engaged in treatment and, this past year, his medication compliance has been of concern, requiring post administration monitoring. In her submission, the risk to the safety of the public is too great.
Ms. Armenise concurred in the hospital’s submissions.
Mr. Stasny submitted that Mr. Aghdasi would like to be closer to his family. There has been some progress over the past year, in that there have been no seclusions. Mr. Stasny acknowledged that there were ongoing concerns with respect to Mr. Aghdasi’s stability and obviously, there was still work to be done. He reiterated Mr. Aghdasi’s request for a move, ideally to CAMH, which is closest to his family.
Analysis and Conclusion
The Board carefully considered the two Hospital Reports, the three Rule 13 responses and the evidence of Dr. Mishra and unanimously concludes that Mr. Aghdasi continues to represent a significant threat to the safety of the public. Mr. Aghdasi continues to experience symptoms of his schizophrenia, including delusions and auditory hallucinations that have caused him to become agitated and angry. He has continued to exhibit concerning behaviours even while on two antipsychotic medications and in a highly structured and highly supportive environment. He has continued to be verbally aggressive towards staff and co-patients. He has continued to exhibit sexually inappropriate behaviour. He has continued to collect sharp objects that are capable of causing harm. Given the nature of the index offences, these behaviours are extremely concerning.
Mr. Aghdasi has made it clear that, should he no longer be subject to the jurisdiction of the Board, he would cease treatment, including his medication. Without treatment, Mr. Aghdasi would suffer a deterioration in his mental status and his psychotic symptoms would become more pronounced. As in the past, he would become aggressive and violent towards those in his immediate vicinity. As such, he remains a significant threat to the safety of the public.
The Board unanimously finds that the necessary and appropriate disposition is a continuation of the current detention order. We agree that, given the verbal aggression, sexually inappropriate behaviour, medication compliance issues and hoarding of potential weapons, a maximum secure forensic facility is required at this time to safely manage Mr. Agdhasi’s risk to the public. Nothing else currently suffices.
In concluding that the necessary and appropriate disposition is a detention order in the High Secure Provincial Forensic Program at Waypoint, the Board considered the criteria set out in s. 672.54 of the Criminal Code, which includes the need to protect the public from dangerous persons, the mental condition of the accused, the integration of the accused into society and the other needs of the accused.
DATED this 7th day of August 2025, at the City of Toronto, in the Toronto Region.
Ms. C. Finley Alternate Chairperson Office of the Registrar Ontario Review Board