Ontario Review Board
Re: Ahmed Ahmed
ORB File No: 7942
Hearing held on: Thursday, July 24, 2025
Place of Hearing: Brockville Mental Health Centre
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Mr. M. Segal
Members: Dr. W. Johnston
Dr. G. Stones
Ms. N. Nathanson
Mr. A. Mete
Parties Appearing:
Accused: Ahmed Ahmed
Counsel: Ms. C. Richards
Person in charge of hospital: Representative: Dr. E. Carefoot
Attorney-General of Ontario: Counsel: Ms. M. Dufort
REASONS FOR DISPOSITION
(Dated August 26, 2025)
Introduction
1Ahmed Ahmed, age 36 according to his government issued identification (his true birthdate of May 7, 1991, would make him 34) was found not criminally responsible on account of mental disorder on September 10th, 2021 in relation to charges of expose genitals to a person under 16 years of age for a sexual purpose, fail to comply with an undertaking, cause a disturbance by fighting/shouting/swearing and assault with a weapon or imitation weapon, all committed in the period March to May 2021, contrary to the Criminal Code.
2On July 24th, 2025, Mr. Ahmed appeared at the Brockville Mental Health Centre (BMHC) (the hospital) for his annual hearing and in relation to a Rule 13 transfer sought by the hospital to the Waypoint Centre (Waypoint).
3In initial positions, the hospital advanced that significant threat to the public continued to exist and that a transfer to Waypoint was justified, and the least restrictive and least onerous option that protected the patient, staff and other patients, and the best suited option to respond to Mr. Ahmed’s particular needs, bearing in mind the treatment impasse that was present at the hospital.
4Crown counsel agreed that the significant threat threshold was met but had concerns respecting the advisability of the current conditions of Mr. Ahmed’s detention order, especially as they related to possible access to the community, and had reservations regarding paragraphs 2(e), 2(f), 4(d), 5(e) and 5(f) of the current Disposition.
5Counsel for the patient agreed that significant threat was present, opposed the transfer and indicated she would have submissions regarding the conditions of the current detention order.
6Ms. J. Lefebvre, counsel for Waypoint, was granted party status on the transfer issue, all parties supporting her participation. Ms. Lefebvre indicated that she was not taking any firm position at the outset regarding transfer but intended to call evidence from Dr. A. Mishra, Clinical Director of Waypoint.
7At the conclusion of the evidence, the Board determined that a transfer to Waypoint was justified and appropriate. The Board also held that while the patient remained at the hospital, clauses 2(e), 2(f), 4(d), 5(e) and 5(f) should be removed from the disposition relating to his continuing time at the hospital.
8The hearing was set for one half day but exceed that estimate somewhat.
9Exhibits filed at the hearing included:
Updated hospital Report dated July 10th, 2025, including a Psychological Risk Assessment dated July 7th, 2025. Ms. A. Leeming, who authored the risk assessment, was in attendance.
Exhibit 2 – Notice of Motion from Waypoint seeking standing
Notes from Token Economy Program
Map of Waypoint Grounds
Excerpt from Waypoint Internet site describing Forensic Programs
Transfer correspondence, including March 25, 2025, letter relating to the Royal Ottawa Hospital, and April 10th, 2025, letter from Waypoint,
Note – July 8th, 2025, regarding soccer ball incident
Note – March 5th, 2025, regarding interaction with a peer
10The Board also had before it the most recent Disposition and most recent Reasons for Disposition, and notes from a pre-hearing conference.
Index Offences
11These are found in the Reasons for Decision dated October 15th, 2024:
“On December 17, 2019, Mr. Ahmed was officially trespassed from the Greenboro Community Centre located on 363 Lorry Greenberg Drive
On June 29, 2020, he was observed peering through the front and back doors. On July 6 and 9, he was seen looking through various windows. On July 15 he was reported to be on the premises filming children. On July 21, staff observed him walking by the park with his phone up and facing children playing in the park. They believed he was filming as when Mr. Ahmed noticed staff, he put the phone down immediately. On July 21 he was seen sitting on a bench on the pathway. He was issued a 2nd trespassing notice. On July 22, he was at the same bench smoking cannabis. On July 23, he asked staff, “What do you think is worse? Supporting the troops or trusting the cops?” On July 27, Mr. Ahmed followed Ms. Mouton and her child, walking very close to the child, “cursing and being inappropriate.” Later that day he remained on a park bench and was loud and swearing. He left when he was asked to. On July 31, Mr. Ahmed appeared to be in a verbal altercation with another individual who appeared to be gesturing to Mr. Ahmed to stay away. He was pointing at Ms. Moulton and yelling loudly. Day camp for the children was cancelled.
Mr. Ahmed in total has been advised of his Trespass and asked not to return to the premise three times since June 29, 2020.
Mr. Ahmed was described as sometimes aggressively confronting staff about his trespass order. Other times, Mr. Ahmed is nice to staff and greets them and wants to talk to them.
On August 5, 2020, Mr. Ahmed was observed outside the front doors of the community centre using their bicycle tire pump. Staff were confronted by Mr. Ahmed off property asking, “Why are they always calling the police on me?” and requesting a letter of Recognition for his Trespass (in writing- a reason why).
There were reports that Mr. Ahmed was seen peering into the pool windows where children were swimming in bathing suits and that at one time, he was believed to be videotaping children. He was also noted to act “suspiciously” around the children and seemed to be “focused on them.”
Mr. Ahmed rarely came directly onto the property but could be seen soaking his hat in the splash pad or sitting on the park bench further south on the path. When Mr. Ahmed was approached by officers, he acknowledged that he received an extended trespass form and that he knows not to go on the property. He said he would walk the path but not enter the premise and that once or twice, he rinsed his had under a splash pad due to the heat but quickly leaves afterward. Mr. Ahmed stated that as far he knew, sitting on the bench was allowed because it was not part of the community centre. Mr. Ahmed was noted to have made “odd comments about butterflies attacking him and that he is always recording people to protect himself.”
Mr. Ahmed went against warnings from officers many times and was seen walking on the fields, parks, and up to the doors of the community centre. He began showing aggressive behaviour toward staff about his trespass order and this interfered with the use of the camp for children.
On August 5, 2020, Mr. Ahmed was approached again with a Notice of Intent with a copy of the original Trespass Notice. He said he remembered the paper and was rude when speaking with the officer, stating “I listened to you now; you need to listen to me.” He said he did not do anything and had never been to the community centre. He accused the officer of being “out to get him” and trying to “ruin his life.” He wanted an apology from the Community Centre. He spoke over the officer and demanded that the officer leave his house.
In an email from Ms. Moulton to the Ottawa Police on August 5, 2020, it is indicated that Mr. Ahmed approached her in the neighbourhood a week prior and asked, “Why do the staff at Greenboro hate me so much? Why are they always calling the police on me?”
March 14, 2021: Expose genitals to a person under 16 years of age for a sexual purpose
Mr. Ahmed was described as known to frequent the parks, community centre, and businesses in the Lorry Greenberg/Conroy area of Ottawa, from where he had been trespassed for harassment and indecent acts. On March 14, 2021, two children, ages ten and seven, were walking their dog Eastbound near the intersection of Lorry Greenberg Dr. and Finland Pr. The children saw a man near a fire hydrant, facing East, who turned as the children got closer. One of the children noticed him pull down his pants and expose his penis to them. The children stopped walking and the accused said “Hi guys” to them. One of the children told police he said “hi” in a friendly voice. The children were frightened and ran home, telling their mother, who then called the police. The incident occurred almost directly in front of Mr. Ahmed’s address (81 Finland Drive).
When police arrived at Mr. Ahmed’s address, he was sitting on his step having a cigarette.
The statement police obtained a statement from Mr. Ahmed was dated May 17, 2021. When Mr. Ahmed was asked if he understood what the file meant, Mr. Ahmed stated “inappropriate behaviour.” Mr. Ahmed told the officer “I am mentally ill. I don’t like to be stressed out. I feel like hurting myself when I am. Not on medication right now. Working. Do pressure washing.”
Officers asked if he recalled what occurred on March 14 and Mr. Ahmed said, “Not really.” When the alleged offence was recounted to Mr. Ahmed, he replied, “Don’t know the little girl and would never do anything like that. Being harassed by police up and down left to right. Bikers. Trying to survive in the city and not get in trouble. I would not do that Miss.” The officer referred to a day that police brought him into hospital, but he could not recall when this was. When asked if Mr. Ahmed saw kids on his way that on March 14, he said, “No. Harassed by a group of girls.” Mr. Ahmed described his routine as, “Wake up early in the morning, walk, coffee, same routine, people try to bully me. Swallow the type or manor they put me in. Sometimes I get told not to come in that store or anything like that. Usually grab my coffee and grab my weed. If don’t work I walk around. Don’t go looking for girls but maybe if I see a beautiful girl I may try to say hi because I am a shy person.”
He reiterated to officers that he is “mentally ill” and said he was willing to “put an anklet on if that works for you guys.” He did not want “the incarceration of the prison system” on his mind and he just wanted to be “respected and left alone a bit.” When asked about his mental illness he stated, “To be honest I don’t really understand it. Can’t fully comprehend or grasp it.” When asked again about the alleged offence, Mr. Ahmed stated, “Never have and no reason for me to do that. Honest to God I have never done anything like that in my life. Problem I have is yesterday I talked to a girl but now we are here. Kendra.” The officers told him that he went for a walk, and his mother called the police, and he went to the hospital. He said, “This little girl should not be treated like that. No reason for me to do that. Those police officers came to me for a different reason.”
March 21, 2021: Cause a disturbance by fighting/shouting/swearing
The police attended Mr. Ahmed’s residence after a phone call from his mother. Mr. Ahmed was causing a disturbance on the public sidewalk by yelling and using insulting language and yelling at people in the area.
When Cst. Kendrick was finally able to attend Mr. Ahmed’s residence and speak with his mother, she advised that she was concerned Mr. Ahmed was going to yell at people and cause a disruption as he has abruptly left the residence in anger. Mr. Ahmed’s behaviour was increasingly disruptive and erratic, and police were increasingly called to the area. Some of the behaviour included yelling and chasing people throughout the area.
Cst Kendrick was flagged down by a woman who told her that Mr. Ahmed had just yelled at her and her fifteen -year -old daughter, telling her to kill herself. She later learned from the victim that the accused prevented her from walking around him while he yelled at her on the sidewalk and called her a pervert as well as to go kill herself. He was wearing a white jacket, hat and pajama pants. Other neighbours said he was yelling and screaming at people while running through their housing complex on Siren private, a common and escalating occurrence according to neighbours.
Cst. Kendrick was very familiar with Mr. Ahmed due to multiple dealings with him. She knew him to be suffering from “mental health related issues” and was often brought to hospital by family and quickly released and he also rarely met the threshold for a Section 17. She noted he was often mistakenly reported as “jumping into traffic” but when police attend, he is simply yelling at cars and people who pass by him. She noted that Mr. Ahmed often has difficulty staying focused and explaining himself. There was an escalation and change with Mr. Ahmed’s behaviours, to the point that when Cst Kendrick arrived on Finland Private, many residents approached her cruiser and explained that “Ahmed is crazy he just left.” People kept stopping her to explain his disturbance. Many residents were aware of him, knew him by name and did not engage with him, but this did not stop Mr. Ahmed from yelling and screaming at them unprovoked.
It was apparent that Mr. Ahmed had just been released from hospital after being apprehended by police on March 14, 2021. He was not prescribed any medication. Mr. Ahmed’s mother believed his behaviour to be escalating.
Another male approached Cst Kendrick and stated Mr. Ahmed had just thrown a yellow yard stick at him as they passed each other on the sidewalk. This male was angry, but did not wish to provide a statement, he only explained that Ahmed causes havoc in the neighbourhood and that "he's getting worse, more angry now.”
When Mr. Ahmed was assessed by Cst Kendrick he was compliant with police and was oriented. He “would not stop talking” and was “continuously rambling about the kids in the area and people disturbing him.”
Cst. Kendrick noted “In 2021 alone, police have submitted reports in regard to Ahmed on 7 separate occasions (#21-1596, #21-21182, #21-36800, #21-53704, #21- 58419, #21-58694, #21-58733). These reports do not include calls to service where Ahmed was the subject and no report was submitted. The reports entail Ahmed chasing people down the street, yelling profanities, trespassing, as well as is the suspect of indecent exposure to two children. Since these incidents Ahmed has been apprehended and released from the hospital. This situation shows Ahmed again, approaching a youth, yelling and scarring them. In addition, he is terrorizing the area to the point that while I was conducting my investigation, I was bombarded with people approaching me about his past behaviour, and his disturbing behaviour on this date. Ahmed currently has many conditions but was not breaching any on this date. After speaking with my NCO, I decided to lay the charge for cause disturbance contrary to the Criminal Code of Canada.”
After Cst Kendrick explained her concerns to Mr. Ahmed he said, “but she’s a pervert” and then began “rambling nonsense about her father also being his father.”
May 2, 2021: Fail to comply with undertaking, Cause a disturbance by fighting/shouting/swearing, Assault with weapon or imitation weapon
On August 6, 2020, Mr. Ahmed was released on an undertaking at his residence of 81 Finland Private with the condition “not attend any soccer fields-splash pads- parking lots- connecting”
On May 2, 2021, at approximately 0918, Mr. Ahmed breached his release conditions by attending a park and the connecting walking paths located at 250 Lorry Greenberg Drive in the City of Ottawa. While breaching this condition, he caused a disturbance by yelling insulting language towards a person walking their dog and subsequently committed assault with weapon by throwing rocks at them.
The victim was walking their dog through the park when the accused began yelling and screaming at them. The accused continue to yell that the victim was a pedophile. The victim did not personally know Mr. Ahmed but was aware of him due to disturbances in the area. Mr. Ahmed, unprovoked, began to throw large rocks directly at the victim and their dog. The victim fled the part and called police.
Multiple people approached police, mentioning Mr. Ahmed by name, and noting that he was walking around yelling at people.
When the officer approached Mr. Ahmed to arrest him, he was noted as: “Ahmed was irrational and was not allowing me to speak. He kept asking me why I was arresting a child. I informed him many times why he was under arrest, and he continued to be adamant that he was not breaching anything and had done nothing wrong.”
When Mr. Ahmed was being read his rights and cautions, he often answered, “yes miss” and then he began “rambling nonsense about the Crown being a drug dealer.” When he was informed that he would be transported downtown for Show Cause Court, he immediately became enraged and began yelling and screaming, then he cried and pleased to not be brought to jail.
May 17, 2021: Sexual assault, Harassment by repeated following another person
On May 17, 2021, the victim, Ms. Stevens, attend the OC Transpo transit station at 50 Rideau Street. At the station, she was approached by Mr. Ahmed who was unknown to her except for a conversation they had before Ms. Stevens departed on her bicycle. 45 minutes later, Ms. Stevens returned to the station and encountered Mr. Ahmed again.
Information on the call that police received at approximately 0226 included that Mr. Ahmed approached Ms. Stevens at the transit station on 50 Rideau Street and that she encountered him again when she returned after delivering medications to a friend. When Ms. Stevens returned, Mr. Ahmed became physical, grabbing her buttocks. Ms. Stevens said “no” several times and pushed Mr. Ahmed away. She then got onto the 97 OC Transpo bus to avoid Mr. Ahmed, even though this was not her bus and he followed her onto the bus, sitting next to her. Mr. Ahmed allegedly continued to try to pull Ms. Stevens toward him and poked her several times in the thigh with his finger. Mr. Ahmed tried to convince Ms. Stevens to bring him to her house to have sex and then tried to convince her to have sex with him at the Hurdman bus station. Mr. Ahmed then offered Ms. Stevens money for sex. When Ms. Stevens got off the bus at Hurdman station, Mr. Ahmed initially stayed on the bus and then got off and chased after her. A bus driver alerted Ms. Stevens that Mr. Ahmed was chasing her, and Mr. Ahmed caught up to her. He told her he was looking for his phone. Ms. Stevens became upset and told him to get back on the bus to Rideau to find his phone. She then fled the scene.
When police interviewed Mr. Ahmed later that morning, Mr. Ahmed admitted to speaking with Ms. Stevens but denied the sexual assault. His account was not consistent. He admitted that he was attracted to Stevens but at Hurdman station he felt that she was not interested. He also admitted to “friendly touches.”
Mr. Ahmed told officers that he was “with her all night” and “we were having a good time.”
Current Diagnoses
Antisocial personality disorder
Substance-induced psychosis, in remission
Amphetamine type substance use disorder, in remission in a controlled environment; Cannabis use disorder, in remission in a controlled environment
Background
12Mr. Ahmed was admitted to the hospital on October 7th, 2024, following a transfer from the Royal Ottawa. He is single, has no children and is financially supported by ODSP. He can make treatment decisions and of managing property and finances.
13Mr. Ahmed was born in Yemen. Mr. Ahmed, his mother and brother, came to Canada when he was eleven. Mr. Ahmed was in an Ethiopian Refugee Camp before coming to Canada. Prior to immigrating, the lives of Mr. Ahmed and his mother were exposed to considerable psychological trauma. Mr. Ahmed graduated high school in Ottawa and lived with his mother and brother.
14In 2005, he was convicted of robbery(x2), Robbery with violence, fail to comply and obstruct peace officer. He received four years in penitentiary for the three counts of robbery. In 2010, Mr. Ahmed was convicted of sexual assault, break and enter, theft under and fail to comply. He was also convicted of assault causing bodily harm, uttering and forgery. He lost his permanent residency by reason of his criminal behaviour but was not deported to Yemen due to it being deemed an unsafe destination.
15Mr. Ahmed’s mother reported her son fighting in school and contacts with police arising out of assaultive behaviour. Mr. Ahmed started using cannabis in 2016. After release from prison in 2015, Mr. Ahmed became isolative. He went seven months without a shower, and cannabis use increased. Mental health challenges were observed in jail in 2010, by the Ottawa Hospital in 2017 and subsequently. Concerning behaviours were described by his mother and physicians and police. Included were observations regarding paranoia, bizarre behaviour in the community, increasing complaints from police and neighbours. He endorsed delusional, grandiose themes.
16In 2021, Mr. Ahmed was diagnosed with Schizophrenia and Cannabis Use Disorder. Mr. Ahmed engaged in self-harm.
17In jail in 2021, and during a hospital admission he exhibited bizarre ideas and delusions of reference.
18While at the Royal Ottawa, he was sexually inappropriate with female staff and female co-patients. There were many incidents. His use of Cannabis was significant. In June 2022 he exposed his penis. Diverting medication was an issue. His sexual behaviours were assessed.
19Mr. Ahmed lived at home in 2023 but ongoing issues, including positive drug screens for cocaine, cannabis and bizarre behaviour. Sexual misbehaviour continued.
20There was a Restriction of Liberty hearing held September 2023. Drug screens continued to be problematic. On October 10th, 2023, Mr. Ahmed eloped from hospital but returned later that day intoxicated from cocaine. The hospital noted misbehaviour in the period September to November 2023, including substances.
21In February 2024, he was discharged to the family home. After continued substance use and behavioural issues he was readmitted in June of 2024. A summary of concerning incidents is found at pages 81 to 82 of the hospital report. Eventually, the Royal Ottawa found itself in a treatment impasse.
22Mr. Ahmed was admitted to Brockville October 7th, 2024. There was a Restriction of Liberty hearing on April 10th, 2025, arising from a physical assault on a peer, an assault on staff including threats of bodily harm. Eventually, the Royal Ottawa found itself in a treatment impasse. Threats, substance use, and aggressive behaviors are noted at page 92 of the hospital report.
23For the last few years, psychotic symptoms have been minimal. The hospital report notes that Mr. Ahmed continues to decline antipsychotic medication and has no observable symptoms of schizophrenia. The hospital does not view him as meeting the diagnostic criteria for schizophrenia. Previously observed psychotic symptoms may be more properly related to substance-induced psychosis. He continues to present with significant symptoms of antisocial personality disorder. The risk assessment prepared by Ms. Leeming under the supervision of Dr. Seto also meets criteria for the clinical construct of psychopathy. His behaviour since admission to Brockville has led to several behavioral challenges, and includes aggression, threats, intimidation, difficulty following direction, hoarding of medication, diversion of medication.
24Mr. Ahmed has expressed a desire to leave Canada.
25He believes that nursing staff are only against him.
26Since admission to his current hospital, there have been 35 incidents or rule violations and 11 aggressive incidents noted at page 98 of the hospital report.
27Mr. Ahmed has targeted those less vulnerable. His risk for violence is high. On March 5th, 2025, the police charged Mr. Ahmed with two counts of assault with a weapon and two counts of uttering threats. He threatened staff with bodily harm and threw feces at them. Those charges remain before the courts.
Evidence at the Hearing
28Dr. E. Carefoot, the patient’s psychiatrist since last October, testified. Dr. Carefoot confirmed that her current diagnosis is antisocial personality disorder, substance use disorder Dr. Carefoot noted that Mr. Ahmed had previously been diagnosed with schizophrenia but there has been no evidence of that observed by her.
29Dr. Carefoot noted Mr. Ahmed’s behaviours have varied. Various behavioural plans, including a reward plan, have been put in place. There have been brief periods of improvement but notable incidents, including aggression and violence and rule-breaking always re-emerge.
30There were two incidents of aggression the weekend before the current hearing. Mr. Ahmed is in Brockville’s highest security unit, and he is not eligible to return to a less restrictive setting at the hospital.
31Mr. Ahmed’s incidents, including aggressive behaviours, are directed at staff and peers. He has targeted vulnerable patients. He has persuaded persons to agree to his needs regarding TV and phone usage.
32To his credit, he has been attending various groups. He has worked through a dialectical therapy workbook, but Dr. Carefoot emphasized he has difficulties applying the lessons. His insight regarding concerning behaviours is very poor. Dr. Carefoot is of the opinion that use of the workbook and attendance at groups is externally motivated. He had to be moved to the most restrictive unit because of various issues including diverting nicotine and other patients’ medications.
33At present he is allowed to attend to the secure yard with staff, and the treatment mall where there is a library and a pool table.
34In one concerning incident he kicked a ball with force near the head of a vulnerable patient who was playing goaltender against a wall. The ball hit the patient’s head after hitting the wall. Staff asked him to desist, but he did hit it again, and the ball was removed. Threatening remarks to staff and peers are frequent.
35The hospital has no programming for antisocial personality disorder, group or individual, and no programming for Concurrent Disorders.
36Mr. Ahmed’s family is permitted to visit once a week. They reside in Ottawa. He has received three visits with his brother. On two of those his mother was also present. His mother is in Ethiopia at present.
37In Dr. Carefoot’s view, a transfer is necessary and appropriate. The hospital has not been able to see forward progress. There are concerns about staff and peers’ safety, even in the hospital’s most secure unit. Mr. Ahmed is now facing new criminal charges.
38The hospital has no concerns regarding the present Disposition although Mr. Ahmed has not been granted any of the privileges that Crown Counsel has identified as not being justified. Dr. Carefoot does not see Mr. Ahmed being granted those privileges any time soon. Within the next year, it was possible to envisage Mr. Ahmed being granted privileges while supervised on hospital grounds, but that would be many months away. The hospital is not fenced in.
39The Token Economy Program replaced an earlier behavioural plan.
40As part of his Antisocial Personality Disorder, Mr. Ahmed displays a pervasive disregard for the rights of others. He struggles with impulsivity. He is perpetually deceitful.
41It is difficult to build a rapport with him. Mr. Ahmed does not see his behaviours as problematic.
42Mr. Ahmed is on a wait list for group therapy, but those groups do not deal with antisocial personality disorder. Group therapy is prompted by a recognition of the trauma he experienced as a youngster. The wait list at the hospital is at least six months.
43Dr. Carefoot acknowledged the history of inappropriate interaction with females, and manipulation and physical aggression with some vulnerable patients.
44Mr. Ahmed asked the hospital not to speak to his mother about a possible transfer. That was probably due to Mr. Ahmed’s desire not to cause her stress.
45Mr. Ahmed attends Narcotics Anonymous but is not interested in any hospital groups relating to substances.
46Mr. Ahmed eloped from the Royal Ottawa for a day. When living with his mother, there were some elopements.
47A neuropsychological assessment in October 2021 showed extremely low global intellectual functioning. Dr. Carefoot agrees that a re-testing of intellectual level would be in order now that Schizophrenia is no longer an active diagnosis.
48For Mr. Ahmed to be moved to a less restrictive unit, there would need to be at least a month of incident-free behaviour. The key is lowering the negative incidents.
49Dr. Carefoot noted that Mr. Ahmed has not been able to move forward at the hospital. She observed that this was the second medium security hospital where things have not worked out.
50There is an Imam who visits the hospital, but Mr. Ahmed has a difference of opinion with him regarding certain aspects of Islam, so there are no visits between the two. If Mr. Ahmed put forward an alternative Imam, the hospital would try to accommodate.
51The use of a workbook in participation in groups is likely externally motivated to obtain more privileges.
52The crux of the impasse relates to Mr. Ahmed’s lack of confidence in his team and a lack of resources. Notwithstanding Mr. Ahmed’s concerns about his team, the team is professional and committed to working with him. The larger challenge is a lack of resources to respond to the antisocial personality disorder.
53The female patient that Mr. Ahmed last targeted has been moved. The hospital is co-ed. There is no treatment available in Brockville to deal with sexual behaviours.
54While the hospital does not have groups or individual therapy to address some of Mr. Ahmed’s more obvious needs, it does make use of behavioral plans, self-directed study and medication. Mr. Ahmed has no interest in procuring assistance to address anger. The hospital’s therapist has no training in dealing with trauma.
55Dr. Carefoot is of the view that Mr. Ahmed requires a higher level of security to deal with his aggressive behaviours.
56Dr. A. Mishra, a staff psychiatrist at Waypoint, testified. He is the Director of Forensic Programs at Waypoint. Dr. Mishra gave a general description of Waypoint’s operation. There are 160 beds divided into four blocks. Incoming patients can expect to remain in the assessment unit at least three to four months. Dr. Mishra’s letter, Exhibit 1, was to be taken as his evidence-in-chief. Waypoint does not have specific programs for antisocial personality disorder but has several patients with that disorder, some of whom only have that disorder.
57At Waypoint, there is a shortage of psychological therapists. There is no behavioural therapist at Waypoint. However, Waypoint has occupational therapists, recreational therapists and a CBT therapist. There is a part-time therapist who specializes in trauma.
58Dr. Mishra noted that Waypoint’s main mandate is the avoidance of violence. A higher level of structure is employed. Elopement is well managed. There is a higher ratio of staff to patient coverage than at a medium secure hospital. There are all male units, however staff include females. Many psychoeducational and therapeutic groups are available.
59Climbing the privilege ladder involves the ability to move off the assessment unit. While on the unit, access to an outside yard is available once or twice a day. There is also a big yard that can be accessed a couple of times per week in good weather. After a few weeks on the assessment unit there would be opportunities to use the leisure centre, engage in leisure type groups, attend the canteen and have computer time.
60Family visits involve pre-planned two-hour slots. If family is traveling a distance, visitation on two consecutive days can be arranged. Waypoint assists families travelling with financial assistance or at least accommodations. Families can access audio-visual access of their loved ones once a week. Telephone calls are permitted daily.
61There is an Imam who attends in person and on-line.
62Patients come to Waypoint when their risk cannot be managed, when violence or a risk of violence has become incompatible with their current placement.
63It is possible that an incoming patient may have to stay on the assessment unit up to six to eight months, depending on staffing issues and bed availability in other units.
64If Mr. Ahmed was admitted to Waypoint, he would be placed on an all-male unit with much more structure than he is currently provided with at Brockville. There may be a preliminary setback, but after a few months, access to a full range of groups would be available.
65What Waypoint is good at, is mitigating the risk of violence.
66An incoming patient can aspire to the Beausoleil unit that has less structure and is designed to accommodate those who have no episodes of aggression or violence.
67There are a few therapeutic groups on the assessment unit. That unit often has court-ordered assessments for 30-90 days.
Submissions
68In final submissions significant risk was not contested.
69The hospital reiterated how Mr. Ahmed was not working with staff, that this was the second medium secure forensic hospital where he had experienced challenges, that he takes advantage of vulnerable patients. The hospital noted that he cannot get off the secure unit. There has been no progress in hospital. A transfer to Waypoint would provide more opportunities and possibly more progress. There is no ward suitable at the hospital for antisocial personality disorder patients and Brockville does not have the tools to deal with them.
70In the alterative, paragraphs 2(e), 2(f), 4(d)5(e) and 5(f) were not reasonably foreseeable. Hospital grounds access might be available in some months but will require the patient to be accompanied at no less than a 1:4 staff ratio.
71Crown Counsel noted that in Mr. Ahmed’s case, the move to Waypoint may involve more liberties than was his norm in Brockville. In any event, Brockville is no longer appropriate given that it is co-educational, and the risk to vulnerable co-patients and staff. Mr. Ahmed’s counsel indicated her client was very much opposed to the transfer. She noted that Mr. Ahmed had only been at Brockville since October. There had been a major change in his diagnosis which could reasonably result in adjustment issues. There was no treatment impasse in her view. For example, there were periods of improved behaviour. The incident with the soccer ball was overblown. Her client was engaging in group therapy sessions and working though workbooks. In counsel’s view, Waypoint offerings were not necessarily better. Elopements was not a large concern. Access to family was a highly relevant consideration. Mr. Ahmed’s counsel opposed removal of any conditions in the current disposition. Waypoint continued to remain neutral in its final submissions
Analysis
72The principal issue before the Board was whether a transfer from Brockville to Waypoint was justified. Was it the least restrictive and least onerous path that could be taken at this juncture? Would a transfer have a potential to control the patient’s aggression and risk of violence while addressing prospects of rehabilitation.
73For some time, Mr. Ahmed was diagnosed with Schizophrenia. The hospital now views the patient’s primary diagnosis as antisocial personality disorder. Any psychosis is now believed to have been induced by substance use disorder. In any event, since the transfer to Brockville, no indicia of psychosis have been observed.
74The behaviours at Brockville resemble the behaviours at the Royal Ottawa. These behaviors include a real risk to staff, co-patients, female peers and vulnerable peers. A picture emerges from the stays at the Royal Ottawa and Brockville of an individual who consistently, with minor variations, defies rules, is engaged in aggression, violence and sexually inappropriate behaviours. While he gets along with some staff, he generally is mistrustful of them. This past March he was charged with serious assault and threatening conduct against staff. The criminal charges remain outstanding.
75Brockville is not equipped to address Mr. Ahmed’s risk of violence and aggression. The units are co-educational. There is no programming that is designed to assist with personality disorders. The hospital has employed behavioural plans and therapies but with poor results. There have been brief periods of improved behaviour that appear to coincide with external events such as a pending Restriction of Liberty hearing. The improvements are transient and are prompted by external motivation.
76The fact is Mr. Ahmed is not progressing at Brockville. His behaviours continue to be very concerning. This is the second medium secure hospital where he has hit a dead end. Mr. Ahmed is not agreeable regarding treatment for anger or substances. He can make treatment decisions. Notwithstanding advice to stay on antipsychotic medication for ameliorative impacts on mood, he has decided, as his right, to stop them.
77While clarity in his diagnosis is context, the reality is that his behaviour cannot be adequately managed in Brockville in such a way as to provide for staff and co-patients’ safety.
78Waypoint is designed and mandated to manage those at high risk of violence or the risk of violence. While there is no clear pathway to treating, let alone curing antisocial personality disorder, it has much more experience with the management of persons with such a diagnosis. A transfer to Waypoint does not mean the end of the line. Waypoint’s goal is to address the patient’s needs and to permit readmission to a medium secure forensic hospital.
79It was indicated that there may be a short temporal setback if Mr. Ahmed is transferred to permit him to be assessed and placed on one of Waypoint’s other units. However, even in the assessment unit there are programs available, of a non-therapeutic variety, and yard privileges and the ability, within a reasonable period, to secure off-unit privileges. Notably, the units are all male which is important given Mr. Ahmed’s risk toward female co-patients. Waypoint’s approach to structure and earning privileges will provide clarity to patient’s expectations.
80If Mr. Ahmed is transferred, the issue of access to family must be considered. His family lives in Ottawa. His mother does not drive and is dependent on her other son, Mr. Ahmed’s brother to drive. It appears that the family does not have much in the way of assets. But Waypoint compensates families for overnight accommodations. Certainly, telephone contact is encouraged and available daily. Audio visual slots are available weekly. Recognizing that the family is further away from their son, overall, the benefits of a transfer outweigh this particular concern which can be mitigated by the various means of access and supports available to family at Waypoint.
81Something must change. It went poorly at the Royal Ottawa. It has not gone well at Brockville. Brockville cannot manage Mr. Ahmed. The pattern of violence including threats of violence, aggression, taking advantage of vulnerable patients, sexually inappropriate conduct, all require a more rigorous structure. The recent criminal charges are very concerning. Waypoint has the experience with persons with Mr. Ahmed’s diagnoses.
82In all the circumstances, the Board finds that a transfer is justified and the least onerous, least restrictive course of action that is firmly available, that both protects the public and taking into account the patient’s rehabilitation.
83While at Brockville the patient has not received the privileges noted by Crown counsel and is unlikely to earn them in the upcoming year. The Board agrees that the provisions in question are not realistic in Brockville, including pending a transfer, and they are removed. We wish Mr. Ahmed well.
DATED this 26th day of August, 2025, at the City of Toronto, in the Toronto Region.
Mr. M. Segal Alternate Chairperson
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Office of the Registrar
Ontario Review Board