Re: Masoud Esmaili
ORB File No: 5849
Hearing held on: Tuesday, November 25, 2025
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Finley
Members: The Hon. B. Allen Dr. Y. Alatishe Dr. L. O. Lightfoot Mr. J. Cyr
Parties Appearing:
Accused: Masoud Esmaili Counsel: Mr. J. DiCecca
The person in charge of hospital: Counsel: Mr. D. Blumenkrans
Attorney General of Ontario: Counsel: Ms. V. Culp
REASONS FOR DISPOSITION
(Dated January 21, 2026)
Introduction
On April 14, 2011 Mr. Masoud Esmaili was found not criminally responsible by reason of mental disorder on a charge of aggravated assault, contrary to the Criminal Code.
Under s. 672.81(1) of the Criminal Code, a panel of the Ontario Review Board (“the Board”) was convened on November 25, 2025, at the Centre for Addiction and Mental Health (“CAMH or the Hospital”) to review Mr. Esmaili’s threat to public safety and the appropriate disposition under s. 672.54 of the Criminal Code.
Mr. Esmaili’s existing disposition dated November 19, 2024, orders detention at the General Forensic Service at CAMH with privileges including community living in approved accommodation.
The parties adopt a joint position on significant threat on the view that Mr. Esmaili continues to pose a significant threat to public safety and requires detention at the General Forensic Service at CAMH with the privileges up to residing in approved community accommodation. Mr. Esmaili’s counsel disagreed about the frequency of the reporting requirement.
The current reporting clause at paragraph 4(d) of the disposition provides that Mr. Esmaili report to the person in charge of the Hospital or his or her designate not less than once per week. The abstention clause at paragraph 4(a) requires Mr. Esmaili abstain absolutely from non-medical use of alcohol or drugs or any other intoxicant.
At the start of the hearing the Hospital and Crown adopted a joint position on the reporting and abstention clauses seeking no change to the existing conditions. Mr. Esmaili’s counsel sought a reduction in the frequency of reporting.
At the close of evidence, the three parties agreed that reporting not less than every two weeks is an appropriate reporting condition.
Disposition
For the reasons set out below the Board concludes, under s. 672.54 of the Criminal Code, that Mr. Esmaili continues to pose a significant threat to public safety and that the necessary and appropriate disposition is detention at the General Forensic Service at CAMH with privileges up to community living in approved accommodation.
Regarding the reporting clause the Board finds that it should be amended to require Mr. Esmaili to report to the person in charge of the Hospital not less than every two weeks. The Board also finds that the abstention clause should remain in place.
Current Diagnoses
- Mr. Esmaili is diagnosed with schizophrenia, residual type, substance use disorder involving cannabis, cocaine and alcohol and is diagnosed with anti-social personality disorder.
The Evidence
- The Board has before it the Hospital Report dated November 8, 2025, which contains an account of Mr. Esmaili’s personal and psychiatric background which need not be repeated in detail here. The Board also has the oral evidence of Dr. Padraig Darby, author of the Hospital Report.
Index Offence
- On January 24, 2011, Mr. Masoud Esmaili and his mother, the victim, were in their residence in Toronto. Mr. Esmaili and his mother were having financial difficulties. Mr. Esmaili was yelling and screaming at his mother and was very angry. For unknown reasons Mr. Esmaili stabbed his mother several times in the back with a pair of scissors. Police attended the residence and with the assistance of the Emergency Task Force, located Mr. Esmaili and placed him under arrest. He was read his rights to counsel and transported to 54 Division where he was held for a show cause hearing. The mother sustained two collapsed lungs and deep puncture wounds to her back.
Criminal History
- Mr. Esmaili has previous convictions in 2004 for uttering threats, robbery, and failure to comply with a recognizance as well as a further charge of robbery in 2009.
Substance Use
- Mr. Esmaili began smoking marijuana in 2001 at the age of 17 and has admitted to “smoking up” just before the index offence. He continues to smoke cannabis.
Mr. Esmaili’s Personal and Psychiatric History
Before the Current Reporting Year
Personal History
- Mr. Esmaili is 41 years of age and born in Kurdistan (Iran). He and his parents immigrated to Canada in 1991 when Mr. Esmaili was seven years of age. His parents separated in 1994. He resided with his mother until he committed the index offence in 2011. He did not finish high school as he found schoolwork difficult. Mr. Esmaili worked briefly as a labourer doing landscaping work with his uncle. But he did not enjoy that work and did not pursue other employment.
Psychiatric History
Before the Current Reporting Year
Mr. Esmaili had no prior psychiatric admissions or treatment before the index offence.
After the not criminally responsible finding in 2011, Mr. Esmaili was detained on a secure forensic unit at CAMH. From November 2012 he agreed to be treated with clozapine which resulted in significant improvements in his mental state. He ceased being a behavioural and management problem and in late 2014 Mr. Esmaili was transferred to a general forensic unit at CAMH.
Over the years Mr. Esmaili continued to experience negative symptoms of schizophrenia despite medication compliance. A barrier to Mr. Esmaili’s discharge from Hospital was his use of cannabis and spice at times when he was not directly supervised by Hospital staff. His cannabis use both on and off the unit led to frequent restrictions of his privileges. Mr. Esmaili has had limited insight that at the time of the index offence, substance use contributed to his psychotic symptoms and aggressive behaviour.
Initially Mr. Esmaili was reluctant to use his passes and to participate in groups. His focus was on release from the Hospital and a return to his mother’s home as part of a discharge plan. But both he and his mother lacked insight into the nature of his illness, his need for treatment, the role of the Board and the risk posed to her when he is less stable. The treatment team therefore did not support Mr. Esmaili returning to live with his mother and the mother was not regarded as suitable to be an approved person.
By September 2021, Mr. Esmaili was reportedly able to engage with structured relapse prevention and drug avoidance programming to aid in preventing drug misuse during indirectly supervised passes. He began to appreciate that his cannabis use was a barrier to gaining more privileges including his hope of living in the community. Between September 2020 and September 2021, despite acknowledging his cravings, Mr. Esmaili was able to maintain abstinence.
Mr. Esmaili began to demonstrate an understanding of the infeasbility of a discharge to his mother’s home and to appreciate his need for a high support and structured setting to ensure his successful transition from the Hospital to the community. Although he continued to express doubt about his psychiatric illness, he was medication compliant and willing to take his medications as recommended by his treatment team and while under the jurisdiction of the Board.
In March 2022, Mr. Esmaili was discharged to live in an all-male residence with 24-hour support on site. This residence has an 11:00 pm curfew and provides medication supervision on site. The thinking behind the discharge decision was that this level of support combined with intensive Forensic Outpatient Service (“FOPS”) follow up, and individual sessions with a team social worker, would provide a suitable level of support for Mr. Esmaili notwithstanding his substance use issues, limited insight, and poor motivation.
Mr. Esmaili’s accommodation to his housing was satisfactory and his mental health was relatively stable. But he returned to using of cannabis on a regular basis. Very problematic was the fact that all 72 of Mr. Esmaili’s drug screens were positive for cannabis. Symptoms of his mental illness such as auditory hallucinations fluctuated in intensity with his ongoing cannabis use. Sometimes he stated that he did not have a mental illness and at other times conceded that cannabis use may worsen his mental illness.
Previous Reporting Year – 2023 to 2024
During the 2023/2024 reporting year Mr. Esmaili continued to reside in the same high support housing in the community with follow up care provided by FOPS. There were no incidents of aggression or threatening behaviour and no significant deterioration in his mental health. However, that year was marked by persistent problems of poor self care, ongoing cannabis use and resistance to change.
While Mr. Esmaili’s mental health was relatively stable over the year, he continued to present with negative and positive symptoms of schizophrenia. Similar to the previous year the symptoms of auditory hallucinations and the intensity of hallucinations fluctuated with his ongoing cannabis use. Of great concern was that from September 2023 all 97 of Mr. Esmaili’s drug screens were positive for cannabis. His insight into the benefit of medication remained limited but he did continue to consent to the use of antipsychotic medications and to show a significant positive response to his medications.
There were other areas of progress. Mr. Esmaili’s self-care gradually improved. He increased his interaction with staff and other tenants of the residence and increased his attendance at peer led groups at the housing for education and recreational activities.
The pressing issue for Mr. Esmaili continued to be his cannabis use which he did not want to reduce because it “relaxed him.” His problems with cannabis use continued and he remained resistant to the clinical team’s attempts to address his ongoing use. The clinical team’s view was that they were unlikely to agree to Mr. Esmaili returning to live with his mother as long as he continued his cannabis use. The team explained to him that its view was based on his ongoing substance use and the resulting increase in his paranoid symptoms and the risk of decompensation and violence. Mr. Esmaili was advised that the team would be prepared to talk about the possibility of him returning home if his cannabis use were to be successfully addressed.
The Current Reporting Period – 2024 to 2025
For the entire reporting period of 2024/2025 Mr. Esmaili continued to reside in the same high support housing with 24/7 staff support. Residents are provided medication oversight and on-site socio-recreational programs. A curfew policy requires all residents to be at the residence from 10:00 pm to 6:00 am.
Several factors bode in Mr. Esmaili’s favour during this reporting year. He continued to see his FOPS psychiatrist weekly in person at the FOPS clinic and to see his case manager twice a week mainly at his residence. His contacts increased in relation to his level of wellness and extra support needs. Mr. Esmaili attended his appointments with his clinical team without any issues and was compliant with his treatment regimen.
Throughout the current reporting year Mr. Esmaili declined the clinical team’s support in dealing with his cannabis problem saying he will not stop using because he is addicted to cannabis and cannot stop. Mr. Esmaili’s urine tests presented with negative and positive indicators. While the results revealed he was compliant with all of his prescribed medications, all 93 urine samples tested positive for cannabis.
There were no reported issues regarding medication non-compliance. However, Mr. Esmaili presents with persistent negative symptoms of his illness, poor self care, ongoing low-grade paranoia, and hallucinations. He fails to understand the correlation between his cannabis use and the positive symptoms of his mental illness. Mr. Esmaili also displays limited insight into his index offence blaming his behaviour during the offence on the “devil” and “on his parents’ divorce.” Moreover, he also demonstrated limited knowledge and insight regarding the Board system and what part he plays in ensuring his progress.
Mr. Esmaili has maintained contact with his family. His mother visits him at least once a week, at times joining him for a meal. In July 2025 Mr. Esmaili’s mother attended one of the appointments with the clinical team. During that meeting she voiced the hope for her son to live with her. The team explained the elevation of his risk and the barrier to his recovery that cannabis use presents. And it was explained that Mr. Esmaili is unprepared to address this issue at this time.
There were some other improvements during this reporting year worth noting. There has been some slight progress with Mr. Esmaili being open to suggestions and support from the housing staff with his self-care. For instance, the housing staff are working on ensuring that he showers at least twice a week. His sleep has become more regular although he does wake up during the night at times. As well Mr. Esmaili’s socialization and interacting with co- residents in the common areas have increased.
Summarizing a potential risk scenario the Hospital Report at page 39 states:
If Mr. Esmaili is to reoffend, it will likely transpire in the following way: Mr. Esmaili would resume cannabis use with an escalation in his level of use. He would become more actively psychotic, disorganized, and likely non-adherent with his psychiatric medications. It is not expected that his mother (whom he would presumably live with if granted an absolute discharge) would be able to intervene in a timely and appropriate manner and his mental state would continue to deteriorate. He would likely develop a resurgence of paranoid thoughts and could become agitated and emotionally aroused, increasing the likelihood of violent behaviour. His mother would be expected to be at the highest risk, assuming he would live with her.
Mr. Esmaili’s largest risk is captured by dynamic factors, namely psychosis and substance use. It is thought that his relapse in cannabis use is contributing to a low-grade increase in symptoms and poorer self care, but no evidence of behavioural deterioration at this point.
Oral Evidence of Dr. Sandy Simpson
Dr. Sandy Simpson provided no added information for the period since the November 8, 2025, Hospital Report.
The main focus of Dr. Simpson’s oral evidence was concentrated on the reporting requirement and the drug abstinence clause with particular regard to Mr. Esmaili’s cannabis use. The existing reporting term stipulates reporting not less than once a week. The drug abstinence term requires absolute abstention from non-medical use of alcohol or drugs or any other intoxicant. Mr. Esmaili must also submit samples of his urine for analysis of whether drugs have been consumed.
Dr. Simpson described a good relationship with Mr. Esmaili and has recommended he meet one or two times a week with the outpatient team, about once a week with him as Mr. Esmaili’s treating psychiatrist. Dr. Simpson testified that his impression is that Mr. Esmaili’s contacts with the clinical team both at home and at the Hospital are enjoyable to Mr. Esmaili and for that reason have been more of a voluntary than an imperative experience. The doctor distinguished the nature of Mr. Esmaili’s contacts from mandatory reporting contacts carried out principally for monitoring purposes.
Dr. Simpson initially proposed that the reporting requirement would continue as reporting at a minimum “at least once a week” because of the therapeutic value to him of the contacts. It was proposed to Dr. Simpson by a member of the Board that reporting “not less that every two weeks” might be an appropriate reporting requirement under the circumstances. Dr. Simpson did accept that suggestion.
On the question of cannabis abstention Dr. Simpson testified that the clause should remain in the disposition because of the clear nexus between cannabis use and decompensation. As Dr. Simpson explained, this has been demonstrated by declines in Mr. Esmaili’s mental status when he uses cannabis and has been an ongoing concern in Mr. Esmaili’s ongoing psychiatric picture. Dr. Simpson confirmed the evidence in the Hospital Report that Mr. Esmaili has resisted advice on the importance to his mental health of abstention from cannabis.
Dr. Simpson testified that after residing in high support housing for over three years Mr. Esmaili continues to have problems abstaining from cannabis. He vacillates on his understanding of the adverse effects cannabis has on his mental status and his chance of residing with his mother. His urine samples up to the present regularly test positive for cannabis. Mr. Esmaili acknowledges that he smokes two or three joints a week although he indicates that he would like to stop using cannabis. But Mr. Esmaili resists the clinical team’s attempts to assist him with this.
Dr. Simpson testified that there have been some positive features in Mr. Esmaili’s case during the current reporting year. He referred to Mr. Esmaili’s positive adjustment to his housing, self-care and participation in various programs and activities offered by his housing. The doctor cited Mr. Esmaili’s experiences with ongoing low-grade paranoia and hallucinations that have not given rise to any major behavioural issues. And Mr. Esmaili gets along well with housing staff and co-residents. Dr. Simpson concluded from this progress that smoking two or three joints per week with no decompensation would not require a return to the Hospital.
Mr. Esmaili’s counsel asked about how accommodating, or as he put it, “putting up with,” Mr. Esmaili’s cannabis use accords with the mandatory requirement to abstain from using non-prescribed drugs. Dr. Simpson explained that the fact is that Mr. Esmaili’s mental status in the community, notwithstanding his cannabis use, has not been such that he has required hospitalization. Dr. Simpson’s view however is that the abstention clause is necessary given the clear nexus between cannabis use and decompensation. He explained that the clause should be maintained in the event Mr. Esmaili increases his cannabis use and his mental status declines in which case he could be hospitalized.
The Parties’ Positions
As noted earlier the Crown and Mr. Esmaili adopted a joint position with the Hospital on significant threat. Mr. Esmaili disagrees with the frequency of reporting in the existing disposition. Counsel for Mr. Esmaili referred to the progress Mr. Esmaili has made during the current reporting year despite his cannabis use, being that he remained mentally stable, has been medication compliant, did not engage in any violent or aggressive behaviour and developed a friendly and cooperative disposition with housing staff and others and consistently reported to the treatment team.
At the close of evidence, the three parties agreed with the reporting clause requiring reporting not less that once every two weeks and agreed with retaining the abstinence clause.
The Board’s Conclusion
Based on the evidence before us, the Board unanimously accepts the opinion as stated in the Hospital Report that Mr. Esmail remains a significant threat to public safety within the criteria outlined in Winko v. British Columbia, 1999 CanLII 694 (SCC), [1999] 2 SCR 625, and as defined in s. 672.5401 of the Criminal Code. The Board considered the criteria, as set out in s. 672.54, namely, the paramount criterion of the safety of the public and Mr. Esmaili’s community re- integration, his mental condition, and his other needs.
We accept, in accordance with s. 672.54 of the Criminal Code, that the least onerous and least restrictive disposition, that is necessary and appropriate in the circumstances, is to maintain detention at the General Forensic Service at CAMH on the existing conditions, except that the condition for Mr. Esmaili to report to the person in charge of the Hospital should be amended to reporting “not less than every two weeks”. The Board finds that the abstention clause should be maintained.
The Board arrives at its decision for the following reasons.
On the question of significant threat, the Board considered both the favourable and unfavourable aspects of Mr. Esmail’s experiences during the current reporting year.
On the positive side, housing staff have reported that there has been improvement in Mr. Esmaili’s receptiveness to suggestions and assistance with self-care from the housing staff. Mr. Esmaili’s participation in activities and socialization has increased. There have been no major behavioural issues despite his cannabis use and he has not required any hospitalizations. His demeanour with staff has been amenable.
Although Ms. Esmaili has not decompensated over this year while continuing to smoke limited amounts of cannabis, the spectre of instability still looms because smoking cannabis underlay his actions in the index offence and has been an aggravating factor in his mental instability. As well Mr. Esmaili’s insight into the adverse effects of cannabis on his mental status fluctuates. And the majority of his urine samples up to the present regularly test positive for cannabis.
The Board finds the adverse factors outweigh the positive in terms of pointing to risk and as such the Board agrees that Mr. Esmaili remains a significant threat to the public and that detention in a general forensic unit with the privilege of approved community living is an appropriate disposition at this juncture.
During our deliberations, the Board discussed at some length Mr. Esmaili’s cannabis use. We considered the concern with the reporting requirement being amended from “at least once a week” to “not less than every two weeks.” The disquiet on this was that with the amendment there is no real guarantee that Mr. Esmaili will report regularly if the disposition term allows the leniency of reporting not less than every two weeks.
The question was whether the Board could be assured that Mr. Esmaili shares, in same or similar measure, Dr. Simpson’s enthusiasm about his visits with the treatment team. The concern was that with the more lenient requirement Mr. Esmaili would be within his right to decide not to attend appointments regularly.
There was another aspect to this area of deliberation. It involved considering the view whether the amended clause is appropriate as supportable by Dr. Simpson’s account of Mr. Esmaili’s notable progress in the current reporting year, in areas that had been previously of some concern. Ultimately the Board accepted Dr. Simpson’s opinion. The Board’s decision is based on accepting that Mr. Esmaili is positively disposed and enthusiastic about making contact with the team, as described by Dr. Simpson, and on accepting that Mr. Esmaili will continue in that practice.
On the view that Mr. Esmaili continues to use cannabis in smaller quantities than he previously did, using two or three joints a week, the Board agrees that reporting not less than every two weeks is appropriate in that circumstance. The abstinence clause should be maintained so in the event that Mr. Esmaili’s use of cannabis results in decompensation, he can be returned to Hospital.
Based on the Hospital Report and the evidence added in Dr. Simpson’s testimony the Board concludes, under s. 672.54 of the Criminal Code, that Mr. Esmaili remains a significant threat to public safety and that currently the necessary and appropriate disposition, that is the least onerous and the least restrictive to mitigate threat to public safety, is to maintain the existing disposition with an amendment to the reporting clause requiring Mr. Esmaili to report to the person in charge of the Hospital not less than every two weeks. The Board finds the abstinence clause should be maintained.
The existing disposition satisfies the paramount criterion under s. 672.54 of protecting the safety of the public and further meets Mr. Esmaili’s interests in community re-integration and supports his mental health and his other needs.
DATED this 21^st^ day of January, 2026, at the City of Toronto, in the Toronto Region.
The Hon. B. Allen
Legal Member
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Office of the Registrar
Ontario Review Board