Ontario Review Board
Re: Shahid Alam
ORB File No: 5765
Hearing held on: Thursday, August 14, 2025
Place of hearing: Centre for Addiction and Mental Health 1001 Queen Street West, Toronto
Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Mr. P. Capelle Members: Dr. P.E. Cook Dr. A. Park Mr. J. Goldenberg Ms. B. Little
Parties Appearing: Accused: Shahid Alam Counsel: Mr. B.T. Hurst The person in charge of hospital: Representative: Dr. M. Choptiany Attorney General of Ontario: Counsel: Ms. V. Culp
REASONS FOR DISPOSITION
(Dated September 19, 2025)
Introduction
On December 10, 2010, Shahid Alam was found unfit to stand trial on account of mental disorder (“NCR”) on a charge of assault causing bodily harm, contrary to the Criminal Code of Canada (the "Criminal Code"). Mr. Alam is currently subject to a Disposition of the Ontario Review Board (the "Board") dated May 29, 2024, detaining him at the Forensic Service of the Centre for Addiction and Mental Health, Toronto (“CAMH”), with privileges up to living in the community in supervised accommodation approved by the person in charge.
On August 14, 2025, a panel of the Ontario Review Board (the "ORB" or the "Board") convened a hearing pursuant to ss. 672.48(1) and 672.81(1) of the Criminal Code of Canada. Mr. Alam was in attendance and was represented by his counsel, Mr. Hurst.
Preliminary Matters
Mr. Alam was not in attendance. Dr. Choptiany advised that his patient has not attended the last number of annual hearings, adding that bringing Mr. Alam to the hospital for a hearing would be detrimental to Mr. Alam, in addition to putting others at risk. Mr. Hurst advised that he had no instructions from Mr. Alam, but that presence of counsel was required for a fitness hearing. Given the foregoing, the patient’s presence was excused per 672.5(10) of the Criminal Code.
Without Prejudice Position of the Parties
Dr. Choptiany advised that there were no proposed changes to the current disposition which entails detention at the Forensic Service at CAMH together with the privilege of community living. That position was supported by Ms. Culp, on behalf of the Attorney General. Mr. Hurst added that his client is likely permanently unfit and continues to pose a significant risk to public safety. The hearing therefore proceeded by way of a joint position that was maintained in the course of Closing Observations.
Background and Index Offences
Mr. Alam is a 56-year-old male who came to Canada from Pakistan in 2005. He has never married and has no children. He lives alone and receives financial support from the Ontario Disability Support Plan (ODSP). Because of his mental health conditions, he cannot make decisions about his medical or psychiatric treatment or manage his money. His older brother makes medical and psychiatric decisions for him as his SDM, and the Ontario Public Guardian handles his finances as his SDM.
Mr. Alam was diagnosed with two serious mental health conditions when he was 11 years old in and living in Pakistan: Obsessive-Compulsive Disorder and Schizophrenia.
Since his arrival to Canada, Mr. Alam has lived mostly in hospitals and care facilities because his conditions make it very hard for him to live safely in the community. In June 2005, he spent a month at William Osler Hospital where doctors confirmed his diagnoses However, he was admitted to hospitals several more times thereafter because he stopped taking his medication and his ability to care for himself deteriorated.
In March 2006, he was moved to a special care home but had to be re-admitted to hospital six weeks later. He was then placed at Brucefield Manor, a private care home. In December 2006, he was charged with assaulting another resident. The court found he was not mentally fit to stand trial, so he was sent to St. Joseph's Healthcare Hamilton (SJHC).
In February 2008, Mr. Alam was found guilty of assault but given a suspended sentence with 12 months’ probation. By March 2009 his probation had ended but he continued living at SJHC as both a voluntary and involuntary patient pursuant to the Mental Health Act (MHA).
In July 2010, while still at SJHC, he was charged with assault causing bodily harm. In December 2010, he was again found unfit to stand trial and remained in hospital. Between December 2010 and April 2011, he was involved in several violent incidents. In June 2011, he was moved to a secure unit at the Centre for Addiction and Mental Health (CAMH) after a Review Board hearing.
At CAMH, Mr. Alam exhibited frequent aggressive behavior, Catatonia and continued OCD behaviors. In June 2018, he was moved to a Salvation Army residence with 24-hour supervision and one-on-one staff support. In early 2020, he had to return to the hospital because his mental health got worse and he became more aggressive at the residence.
At the time of this hearing, Mr. Alam was living in the community pursuant to a Detention Disposition.
The circumstances of the index offences are taken from last year’s Reasons for Disposition as follows:
“On July 11, 2010, there was an incident at the Secure Forensic Unit, St. Joseph’s Healthcare which resulted in an injury to a staff member. His nurse was attempting to convince him to get ready for bed when he became angered with these attempts, grabbed a chair and held it over his head in an aggressive stance towards both his nurse and security officer. The security officer grabbed the chair and attempted to disarm Mr. Alam. The nurse, the victim, ran into the room to assist the security officer. After a brief struggle between Mr. Alam and the security officer, Mr. Alam dropped the chair, turned and punched the victim in the face with a closed fist. The victim was knocked to the ground and momentarily unconscious. Mr. Alam was subdued, and the victim was taken to the Emergency Department for her injuries. She suffered damage to her teeth as her bridge was broken. On September 21, 2010, Mr. Alam was charged with Assault Causing Bodily Harm. At the time he was an involuntary patient under the authority of the Mental Health Act of Ontario.”
Current Diagnoses
Pervasive Developmental Disorder
Unspecified Schizophrenia Spectrum Disorder
Intellectual Disability
Obsessive Compulsive Disorder
Evidence at Hearing
Dr. Choptiany gave evidence on behalf of the hospital and adopted the contents of the Hospital Report, entered as Exhibit 1. He has treated Mr. Alam for the past decade over the course of admissions and discharges to the community. Dr. Choptiany noted that all of Mr. Alam’s diagnoses are quite complex and together result in aggressive behaviours. These are summarized at page 45 of the Hospital Report and reproduced below for ease of reference:
June 2024 – spat at and attempted to strike staff when they attempted to change his briefs
July 2024 – when accompanied to shopping mall for haircut, became stuck, agitated and irritable. Police were called but Mr. Alam returned to the house without police intervention
November 2024 – chased a staff outside to another house; staff escaped and were not injured
January 2025 – chased a staff upstairs and physically assaulted them (“slapped with a close fist”) – presented as agitated and was responding to internal stimuli prior to the incident
March 2025 – assaulted staff by hitting them in face; attempted to kick two additional staff
March 2025 – chased a behavioural therapy student upstairs
April 2025 – chased a staff outside and picked up shovel in threatening manner
May 2025 – chased his brother and nephews upstairs
June 2025 – assaulted staff by hitting in the face when introduced to new co-resident
June 2025 – assaulted staff by grabbing their sweater and hair, causing them to fall to the floor, resulting in soreness, redness and pain to scalp
Dr. Choptiany last assessed Mr. Alam’s fitness to stand trial on August 7. On that date he could not meaningfully answer any Taylor test questions. The doctor added that Mr. Alam could not communicate in either Urdu or in English to instruct counsel. Further, this inability has worsened.
Dr. Choptiany advised that Mr. Alam continues to represent a significant threat as set out at page 49 of the Hospital Report, reproduced below ease of reference:
“Mr. Alam continues to present as a significant threat to the safety of the public as defined in Section 672.5401. He has been assaultive to both staff and co-patients in the context of his placement on a secure forensic unit and high-support housing. His assaults are often unprovoked but typically involve lashing out at those in his environment, including caregivers and other patients.”
Dr. Choptiany noted that he only assesses Mr. Alam at his community residence. Mobile blood services also attend there to take samples as required.
Closing Observations
Dr. Choptiany stated that no changes were recommended to the current disposition as the hospital requires the ability to quickly readmit and determine the suitability of housing for this patient.
Ms. Culp noted that Mr. Alam’s housing is permanent. There is a plan to reassess his medications which include potentially adding Lithium to address ongoing aggression.
Mr. Hurst submitted that this has been a relatively positive year for Mr. Alam. He has not required readmission to hospital and staff at his group home are able to support him to go outside on occasion for fresh air. He has been able to tolerate a nurse practitioner attending to his physical needs at his group home. Further, Passport funding has been reinstated.
Analysis and Decision
Earlier this year the Supreme Court of Canada released its decision in R. Bharwani, 2025 SCC 26, which provides the decisive interpretation of the definition of “unfit to stand trial” within the Criminal Code as well as the application of the “fitness test”.
Before the Supreme Court of Canada, Counsel for Mr. Bharwani argued that the fitness test required an accused:
to have analytical capacity, meaning that the accused must possess the ability to make rational decisions in the conduct of their defence
The Supreme Court of Canada dismissed the above noted argument, stating the following at paragraph 6, vis-à-vis “fitness to stand trial”:
… an accused is fit to stand trial when they are able to make and communicate reality-based decisions in the conduct of their defence or instruct counsel to do so. Conducting a defence includes making decisions that an accused must always make personally and those which relate to the exercise of their right to full answer and defence, such as decisions about pleas, the mode of trial, selection of counsel, whether to testify, whether to call or cross-examine witnesses, and closing submissions, among others. The capacity required to make those decisions is a reality-based understanding of the nature or object of the proceedings and their possible consequences, an ability to understand the available options and their consequences, and an ability to select between those options when making decisions. Fitness to stand trial does not require an accused to make decisions in their best interests. Rather, it requires making decisions based on an understanding of reality that is not overwhelmed by delusions, hallucinations, or other symptoms of their mental disorder. Transient mental health symptoms do not necessarily compromise an accused’s ability to conduct a defence. The focus is always on assessing the extent to which an accused’s mental disorder impairs their understanding of reality when making and communicating decisions in their defence.
Mr. Alam’s fitness to stand trial was last assessed by Dr. Choptiany a week before this hearing. On August 7, 2025, Mr. Alam was unable to meaningfully answer any Taylor test questions. As a result, Mr. Alam remains unable to instruct counsel or meaningfully participate in his defence at trial. This is the case either in the English language or his native Urdu with the assistance of an interpreter. The evidence before us is that this inability has worsened. In previous years, Mr. Alam could be fitness coached to be rendered fit, but this is no longer possible. Clearly, as at the date of this hearing, Mr. Alam lacked a reality-based understanding of the elements prescribed by the Supreme Court of Canada in Bharwani required to satisfy the threshold of fitness to stand trial.
The Panel therefore unanimously accepts Dr. Choptiany’s uncontroverted evidence that Mr. Alam remains unfit and further notes Mr. Hurst’s comments that his client is likely permanently unfit and continues to pose a significant risk to public safety. Given the foregoing and the earlier finding that Mr. Alam continues to present as a significant threat, this Panel will not make a recommendation for the Court to consider a stay of the outstanding charges pursuant to s.672.851(1).
The propriety of a Conditional Discharge was considered but ultimately rejected due to the instability of Mr. Alam’s mental state. In the event of early signs of mental decompensation, Mr. Alam continues to require expeditious readmission to CAMH, a forensic psychiatric facility where he is known, as opposed to a Schedule 1 Hospital. A Detention Disposition continues to be necessary and appropriate in order to oversee and approve his housing in the community.
In making this Disposition, the Board carefully considered the joint position and submissions of the parties and the evidence of Dr. Choptiany and is satisfied that this determination is both necessary and appropriate. The Board reviewed the provisions of s. 672.54 of the Criminal Code and carefully considered the need to protect the public from dangerous persons, Mr. Alam’s mental condition, his reintegration into society and other needs.
DATED this 19th day of September, 2025, at the City of Toronto, in the Toronto Region.
Mr. P. Capelle Alternate Chairperson
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Office of the Registrar Ontario Review Board