Ontario Review Board
Re: Guled Yusuf
ORB File No: 7040
Hearing held on: Tuesday, January 6, 2026
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Section 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Dr. K. Connidis
Members: Hon. N. Kozloff
Dr. K. Hand
Dr. G. Kerry
Mr. S. Duffy
Parties Appearing:
Accused: Guled Yusuf
Counsel: Ms. M. Perez
The person in charge of hospital: Counsel: Mr. D. Blumenkrans
Attorney General of Ontario: Counsel: Ms. V. Culp
REASONS FOR DISPOSITION
(Dated March 19, 2026)
Overview
On October 3, 2016, Guled Yusuf was found not criminally responsible on account of mental disorder (“NCR”) on a charge of first-degree murder, arising out of events that culminated in Mr. Yusuf stabbing his uncle to death. Since the finding of NCR and the initial disposition, Mr. Yusuf has remained subject to Dispositions of the Ontario Review Board, most recently a Disposition dated January 8, 2025, discharging him on conditions.
On January 6, 2026, this panel of the Review Board convened at the Centre for Addiction and Mental Health (“CAMH” or “the Hospital”) to hold a hearing and review that Disposition. Mr. Yusuf was present and was represented by counsel, Ms. M. Perez.
The issues to be decided at this hearing were whether Mr. Yusuf continues to meet the threshold test for significant threat and, if so, what is the necessary and appropriate disposition, considering the four factors in s. 672.54 of the Criminal Code.
None of the parties contested a finding of significant threat. The parties were generally in agreement that the current conditional discharge disposition should continue with a change to the travel condition and the removal of the condition requiring abstinence from alcohol and drugs and the condition prohibiting him from possessing weapons. We agree. These are our reasons.
The following information concerning Mr. Yusuf, all of which is contained in the current Hospital Report dated December 14, 2025 (Exhibit 1) is reproduced from last year’s Reasons for Disposition:
"Background, Index Offence and Clinical Course
Mr. Yusuf is 32 years of age, having been born in Toronto in May 1992. His childhood was difficult. His mother was a war refugee from Somalia who came to Canada at the age of 22. When he was two years old, Mr. Yusuf’s father left his mother and moved to England. When Mr. Yusuf was five years old, his mother died by suicide. She was 27 years old at the time. He later learned from his family that she suffered from depression. His father died from Covid in May 2020.
After his mother’s death, Mr. Yusuf was raised by an uncle in Minnesota until the age of 11. He then returned to Toronto and lived with his maternal uncle (Musa Yusuf, the victim of the index offence) and his family. He completed high school in Toronto.
Mr. Yusuf worked as a salesman from October 2011 to March 2012. He visited family in Arizona for a few months, then returned to work as a salesman at a different company from October 2012 to November 2014. Around the time that he stopped working, he began to experience mental health difficulties. It is notable, however, that each of the individuals interviewed by police regarding Mr. Yusuf’s presentation in the weeks leading up to the index offence described that they were shocked that he had been involved in such a violent offence. Prior to the index offence, Mr. Yusuf had no criminal record and no known psychiatric contacts or admissions. Available information suggests that the index offence occurred during his first episode of psychosis.
The circumstances surrounding the index offence are well summarized in the hospital report. Briefly, sometime in early December 2014, Mr. Yusuf came to believe that his uncle had something to do with his mother’s suicide. He asked his uncle about this and his uncle reacted angrily to the suggestion and was verbally abusive in response.
On December 4, 2014, Mr. Yusuf spent one last night in the apartment. He thought he heard his uncle sharpening a knife and that his uncle would harm him. He decided to leave the apartment. His uncle tried to stop him. He spent the next four nights at a motel. During this time he became increasingly fearful of his uncle. He sent several messages to family members stating that he feared that his uncle would kill him. He also ate and slept very little, smoked cigarettes excessively and attended two different mosques. He decided that he wanted to go to Saudi Arabia to escape from his uncle but was unable to obtain a ticket, despite attending at Pearson Airport to try to do so.
After checking out of the hotel on December 9th, Mr. Yusuf returned to the airport to again inquire about getting an airline ticket. Frustrated, he left his suitcase with most of his belongings at the airport, abandoning it in a public area. He returned to Toronto by TTC and rode the subway for a while. He heard voices in his head that he believed were from God, telling him that his uncle was the anti-Christ and a false prophet. The voices also told him he would have to kill his uncle.
In response, Mr. Yusuf threw his cell phone and laptop into a garbage bin at a subway station. He went to a Dollarama store, bought a cheap knife with a 10-inch blade, and took the subway to the Keele station. He did not get off at High Park, the nearest station to the apartment, because he thought his uncle might have that station under surveillance. He walked to the apartment and knocked on the door. When his uncle came into the hallway, Mr. Yusuf stabbed him, then fled down the stairs. He ran to a nearby park where he left his duffle bag and the knife. He then stripped naked and ran approximately two km on a cold night before being apprehended by the police. The police gave him a sedative by needle in order to restrain and arrest him.
Following his arrest in respect of the index offence, Mr. Yusuf was detained in custody. He was treated with psychotropic medication in jail, and by the time of his admission to CAMH in October 2016 (following the finding of NCR), he had already been receiving the oral antipsychotic olanzapine and an antidepressant.
At his initial Review Board hearing, Mr. Yusuf was ordered detained on a secure forensic unit at CAMH. Once there, he participated in several treatment programs, as well as various recreational programming. When granted passes he was able to use these without incident. In late November 2017, he was transferred to a general forensic unit at CAMH.
In December 2018, Mr. Yusuf experienced an acute psychotic decompensation. He described paranoia towards a stranger who worked at a nearby shop, suspected his psychiatrist of not liking him, expressed odd ideation about the world being good or evil, and displayed mild disorganized thinking. A clozapine work up was initiated, requested by Mr. Yusuf and supported by his psychiatrist. A week later, Mr. Yusuf was started on clozapine. After a series of adjustments to the medication, his mental state stabilized.
In May 2019, Mr. Yusuf decided to discontinue clozapine due to his experience of sedation and sexual side effects. He was capable to make treatment decisions and, after extensive discussions with the treatment team about risks and alternatives, clozapine was stopped and olanzapine was started.
This medication change triggered a rapid decompensation. Within one week, Mr. Yusuf experienced poor sleep and was possibly responding to internal stimuli. By the following week he showed increased suspiciousness and depression. He also began hearing the voice of God. While he denied that the voice was command in nature, he said he would defend himself if necessary. He refused to resume clozapine, but agreed to increase the dosage of olanzapine. When that approach was unsuccessful, Mr. Yusuf ultimately agreed to restart treatment with clozapine. Soon after, his mental state stabilized back to baseline. He has remained on clozapine since that time.
Mr. Yusuf continued to reside on a general forensic unit at CAMH until November 2020, when he was discharged to THRP-2, a 24-hour high support housing program close to CAMH with supports that included, among other things, onsite medication administration, staff support and substance use monitoring through urine drug screens. Mr. Yusuf settled in well and liked where he was living."
- Dr. Robert McMaster, Mr. Yusuf’s attending psychiatrist and one of the authors of the current Hospital Report, provided evidence at last year’s annual review both in the form of a hospital report and oral testimony. In order to give context to Mr. Yusuf’s Course Since the Last Hearing, which is set out below, the following is quoted from last year’s Reasons for Disposition, at paragraphs 19 to 23:
"At the current hearing, we received evidence in the form of an updated hospital report, as well as the oral testimony of Dr. McMaster. That evidence revealed as follows: The most recent clinical year was a positive one for Mr. Yusuf. He resided at THRP-2 housing until February 26, 2024, when he moved to an independent apartment through Forensic Supportive Housing, where he remains to date.
Despite the move to more independent living, Mr. Yusuf’s mental state remained stable throughout the year. He demonstrated fair insight and judgment into his mental illness, need for treatment and level of risk. Similarly, he demonstrated fair insight into his need for medication, the importance of taking his medication and his potential for experiencing psychotic symptoms if he was nonadherent with medication. He was fully independent managing his medication through the use of blister packs, which were monitored through the year to ensure his compliance.
In August 2024, Mr. Yusuf requested that his clozapine be changed or lowered. After discussions with the team regarding his history of experiencing psychosis when his clozapine was lowered (notably in May 2019), Mr. Yusuf agreed to lower the medication by a small amount. According to Dr. McMaster, this was done in cooperation with the team, and Mr. Yusuf has reported less of a side effect burden with the change.
During the year, urine drug screens were conducted randomly on a weekly basis. Mr. Yusuf largely complied with the UDS requests without issue, including once he moved to independent living. All of the samples returned as negative for substances of abuse.
Mr. Yusuf continued his employment with CMHA's Extreme Clean team. He also spent many of his days going out for short walks, watching movies and television and, more recently, attending more frequently at the mosque. There have been no reports of any difficulties at his new housing where Mr. Yusuf appears to have settled well."
- The following relevant update appears in the current Hospital Report, at pages 28 to 30:
"Course Since the Last Hearing
Mr. Yusuf had another positive reporting year. He remained in the community without interruption. He has a good rapport with his case worker and team. He attended meetings regularly; however, on occasion was quite late.
Mental Health
Mr. Yusuf’s mental state was unchanged. His restricted affect was consistent with his prior reporting periods. He denies experiencing perceptual abnormalities, nor does he appear to respond to internally generated stimuli. He denies persecutory, paranoid, religious, or referential delusions. He does not endorse suicidal, violent, or homicidal ideation. His sleep and appetite is consistent, as is his energy level, which he describes as being low.
Medication
Mr. Yusuf adheres with his medication regimen. This is supported by random blister pack checks during the reporting period. He acknowledges the importance of taking medication consistently, and that if he does not, he is at risk of psychotic relapse. While he is aware of the potential for relapse, this reporting period he requested that his clozapine dose be lowered. He is aware that this could destabilize him; however, he valued the potential benefit of a decreased side-effect burden, as being worth the potential risk. A decrease was done, to 250 mg, in a measured fashion, with monitoring of his mental state, and clozapine levels. Other medications include metformin, levothyroxine, and peglyte.
Physical Health
Mr. Yusuf continues to see Dr. Lipari at Parkdale Community Health Centre Queen West. Overall, his physical health is good, although he struggles with constipation. He requests support in addressing weight gain and low energy, which he attributes to low testosterone levels. He met with a dietician at Parkdale Community Health Centre in person this year and also by phone. He demonstrates some insight into his physical health needs, and understands healthy eating and the need for exercise, although has some difficulty implementing his goals. He previously purchased unhealthy meals through Uber Eats, although switched to a halal meal delivery service. At times he seeks quick fixes. He enjoys walking.
Mr. Yusuf attended the emergency department throughout this reporting period for complaints of pain, beginning in February 2025 in which he was seen at St. Joseph Hospital. Mr. Yusuf received a prescription for Hydromorphone at his initial visit. After Testing and bloodwork at the second emergency visit the physician determined it to be a gastrointestinal virus that will pass naturally and can be treated with Tylenol. Mr. Yusuf continued to seek a renewal for his hydromorphone prescription but was denied and educated on addictions related to pain medication. Continuing to visit the hospital at different times within the reporting period, Mr. Yusuf was presented with a prescription for pain medication such as Percocet. Mr. Yusuf was encouraged by his treatment team to follow up with his family doctor Dr. Lipari to further investigate the root cause of his pain. Mr. Yusuf was diagnosed with asthma after having breathing difficulties.
Mr. Yusuf continues to walk daily and spends time in his building’s gym.
Substance Use
Mr. Yusuf has expressed a desire to quit smoking and was offered various supports. He purchased nicotine gum and was able to quit smoking in the summer. There were no indications of substance misuse during the reporting period. As such, the team did not ask Mr. Yusuf to provide a urine drug screen, nor was he required to by his disposition.
Independent Living Skills and Employment
Mr. Yusuf continues to reside independently. He benefits from reminders to maintain the cleanliness of his unit. He experienced rodent infestation, such as cockroaches. It was thought that the lack of proper cleaning, and maintenance, was contributory.
Mr. Yusuf maintains employment with the Extreme Clean team. He more recently took a break, given his diagnosis of asthma, and the associated risk of his job. His employer is trying to find him work that is less risky to his health.
Social Supports
Mr. Yusuf is generally an isolative individual. He spoke with some family members, and socialized with friends, in-person and online. He visits the mosque on a regular basis.
Professional Supports
Mr. Yusuf maintains a good relationship with his treatment team. Due to the requested changes in his medication, and also some physical concerns related to his medication, the team was reticent to transition him to a non-forensic team. However, the team is in the process of doing so.
Mr. Yusuf recently mentioned that he would like to visit Saudi Arabia during Ramadan, with the friend who owes him money. This was not deemed to be similar to the time of the index offence when he attempted to travel to Saudi Arabia, given that it was not associated with psychotic beliefs.
Mental Status Examination
Mr. Yusuf was adequately kempt. He was consistently calm and polite. He was cooperative during interviews. At times, as in the past, he had some trouble answering questions or elaborating on his answers; this was felt to be related to his limited self-awareness rather than a lack of cooperation. His affect was restricted in range, with limited reactivity. His stated mood was “good”. His answers were slightly delayed, and at times he paused while speaking, seemingly to think. Otherwise, his speech was normal for pitch and tone. His thought process was coherent. In terms of content, no paranoid, referential, religious, nor grandiose delusions were identified. He denied any suicidality, violent, or homicidal ideation. He denied experiencing hallucinations and did not appear to be responding to internal stimuli. His insight into his illness and need for medication was good. As well, he identified the major role of his mental illness in his index offence, and was able to identify some signs of relapse into psychosis. He did seem to underestimate the risk of lowering clozapine, as compared to the team’s opinion. There were no critical lapses in judgement throughout the reporting year."
- With respect to the issue of significant threat, the following is excerpted from the current Hospital Report at pages 31 to 34:
"The Psychopathy Checklist and Violence Risk Appraisal Guide were scored in January 2018 by Mr. Bronwyn MacKenzie, psychometrist, and Dr. Brian Pauls, psychologist, for the purpose of risk assessment.
Psychopathy Checklist – Revised Version (PCL-R)
Mr. Yusuf received a score of 8 out of 40 on the PCL-R. This score places him at the 4th percentile of male forensic patients in the PCL-R standardization sample; that is 96% of individuals in the standardization sample received a higher score. Or, alternatively, that 3% of individuals in the standardization sample received a lower score. Given the standard error of measurement of this instrument, it can be said with 95% confidence that Mr. Yusuf’s true score on the PCL-R is between the .2nd and 16th percentile of the male forensic psychiatric patients in the standardization sample. Mr. Yusuf’s score on Factor 1 (personality component) fell at the 17th percentile and his Factor 2 score (lifestyle component) fell at the 3rd percentile, compared to the male forensic psychiatric patient population. These results indicate that Mr. Yusuf possesses a very low level of psychopathic traits.
Violence Risk Appraisal Guide, (VRAG)
On the VRAG, Mr. Yusuf’s score placed him at the 32nd percentile compared to the standardization sample. Given the standard error of measurement of this instrument, it can be said with 95% confidence that Mr. Yusuf’s true score on the VRAG is between the 13th and 54th percentiles of the standardization sample. Mr. Yusuf’s score on the VRAG places him in bin 4, where bin 1 represents the lowest risk group and bin 9 the highest. Among individuals of the standardization sample who were in the same bin/risk category as Mr. Yusuf, 17% reoffended violently within an average of 7 years of opportunity and 31% reoffended within an average of 10 years after release. Mr. Yusuf’s score on the VRAG places him in a moderate risk category.
Structured Clinical Judgment
In order to provide a risk assessment, using structured clinical judgment, the HCR-20 Structured Guide for the Assessment of Violence Risk was scored. The HCR-20 is intended for use with civil psychiatric, forensic, and criminal justice populations. There are 10 historical (H) variables, 5 clinical (C) variables, and 5 risk management (R) factors. Each item is scored as not present, partially present or definitely present to aid a composite assessment of risk. It includes variables that capture relevant past, present, and future considerations.
Mr. Yusuf was scored on the HCR-20: Version 3 on the basis of an ongoing detention order, or if receiving a conditional discharge
The first portion of the HCR-20 is the Historical section, which includes ten lifetime or static factors related to future violence risk potential. Mr. Yusuf possesses numerous historical risk factors, including a history of problems with: violence (retaliation to bullying, index offence), relationships (i.e. lack of intimate and non-intimate relationships), substance use (i.e. cannabis, cocaine, and ecstasy use), major mental disorder (symptoms of Schizophrenia), and traumatic experiences (i.e. being witness to his mother’s suicide).
The primary clinical items that were deemed partially present, and relevant, are difficulties with insight.
In the context of an ongoing conditional discharge the Risk Management factors that were deemed present, and relevant, were future problems with personal support, and stress or coping. The additional items that would be present, and relevant, in the context of an absolute discharge include future problems with treatment or supervision response.
Overall, he was assessed as being low risk under the current recommendation of a conditional discharge. His risk of imminent violent was low. If he were to reoffend violently, his risk of serious physical harm would be high.
Mr. Yusuf‘s key protective factors include medication use/effectiveness, professional care and self-control. Possible areas/ goals for improvement/treatment targets include leisure activities, and medication insight. His overall level of protection is considered moderate.
Strengths
Mr. Yusuf has several strengths. He is polite and pleasant. He has numerous pro-social values. He is generally rule-abiding. His insight into his mental illness is good. He is adherent to medication and attends his appointments on time. He considers staff suggestions. He made efforts in completing tasks that were required of him. With support, he shared some of his experiences with the team.
Criminogenic Risk Factors
Schizophrenia: Mr. Yusuf has a major mental disorder which requires long-term treatment with antipsychotic medication. It was an important factor in his index offence. He presented with a rapid reappearance of psychotic symptoms when medication changes were made in hospital at his request (due to unwanted side effects). Mr. Yusuf has asked about reducing or changing his medication during the reporting year. To his credit, he was receptive to the recommendations of his psychiatrist to continue clozapine given his historical and ongoing response to this medication. As previously noted, he has been compliant with medication while under the ORB, in hospital and in supervised housing. He has expressed reasonable insight into his need to continue to take such medication in the future.
Poor coping and problem-solving skills: Mr. Yusuf has difficulties coping with stressors, problem solving, and prioritizing goals. He continues to require support and structure to assist him in consistently making decisions, in the face of conflict, stress, and competing interests, that are healthy and in-line with his recovery goals. In spite of having participated in numerous psychoeducational programs, Mr. Yusuf has evidenced difficulties with concept acquisition and application of concepts to his daily life as pertains to problem solving and coping skills. This has improved during his tenure in the community.
Substance use: Mr. Yusuf has a history of substance use. He consumed alcohol once during the 2017-2018 review period, while in company of peers that were drinking. He used alcohol on at least one occasion in the past year. His insight into the potential effects of substances on his mental and behaviour was partial. He requires ongoing psychoeducation support and supervision in applying relapse prevention principles to his daily life.
Limited insight: As previously noted, Mr. Yusuf does have a fair insight into his past psychotic symptoms, his need for medication, and several areas of his recovery process. However, his understanding of his risk factors associated with decreasing clozapine could be improved. To his credit, he is generally accepting of the management plans put in place to address his risk.
Personality Structure: While Mr. Yusuf does not suffer from a formal personality disorder per se, he does exhibit characteristics that will be challenging for him to overcome in order to independently manage his risk. His rigid cognitive style, poor reflective capacity, procrastination tendencies, externalization of responsibility for issues, search for “quick fixes” to problems, have been areas that the team has been working with him around. Mr. Yusuf tends to do better with high levels of structured activities and support. To his credit, he is generally receptive to feedback and discussions around these issues.
Lack of structure: Mr. Yusuf had limited structure to his days and weeks over the course of the reporting period other than his work. Several factors were contributive to this situation, including Mr. Yusuf’s cognitive style and personality structure, negative symptoms of schizophrenia, possible elements of social anxiety, poor self-esteem and performance anxiety. To his credit, he has been consistent in his goal to obtain employment, and some delays in this domain were out of his control.
Limited Personal Support/Social isolation Mr. Yusuf has little support in the community other than his treatment team. Though he is in contact with extended family members, the support they can provide is limited by their living abroad. Otherwise, he has some contact with friends. Mr. Yusuf has endorsed wanting to increase his social interactions. Mr. Yusuf has historically had difficulties in social communications with others, particularly women, which has led to a pattern of illicit drug use and the solicitation of prostitutes. Prior to the index offence, he was involved with an antisocial peer whom he stated was his closest friend.
Re-offence Scenario
In risk assessment, one of the best predictors is a patient’s history of violence. Mr. Yusuf has acted violently when psychotic. If he were to re-offend, this would likely occur in the context of psychotic exacerbation, either driven by him falling away from psychiatric treatment, substance use, and/or stress. His limited coping abilities, poor problem-solving abilities, tendency to externalize responsibility for his actions, immaturity, and external motivation to comply with expectations, and previous association with antisocial peers place him at high risk of poor psychosocial functioning, stress, substance use and discontinuation of psychiatric care, absent sufficient support and structure."
- Dr. McMaster sets out the conclusion of the clinical team on the issue of significant threat at page 35 of his current report:
“4. Composite Assessment of Risk
Mr. Yusuf has a history of severe violence in the context of untreated mental illness, potentially exacerbated by substance use. While he has progressed throughout his tenure under the ORB, he continues to have numerous risk factors that increase his risk of psychotic relapse, and substance use, and in turn, his risk of violence. He has lowered his clozapine this year in the context of side-effects. Historically, this is of concern. Taken in totality, the clinical team opines that Mr. Yusuf represents a significant threat to the safety of the public as defined in Section 672.5401.”
- Finally, the Hospital Report sets out the unanimous opinion of the clinical team regarding their recommended disposition for the coming year:
“5. Team Proposed Order
The clinical team is of the unanimous opinion that Mr. Yusuf’s risk is most appropriately addressed at this time within the context of a conditional discharge. The proposed disposition would both protect the public and represent the necessary and appropriate disposition. Mr. Yusuf’s mental state has remained stable, and he has demonstrated an ability to continue to adhere with his medication. As well, he has gained insight into the need to abstain from substance use. The team is of the opinion that the Mental Health Act could be utilized should he decompensate.
In regard to housing, Mr. Yusuf has agreed to stay at FSH. He has limited community support, although is amenable to working with his case manager. The team supports Mr. Yusuf in his goal to visit with family members.
While Mr. Yusuf benefits from the support of his team, the team proposes a loosening of reporting to facilitate increasing independence while under the auspice of the ORB.
The treatment team proposes the following conditions:
□ Reporting frequency: report to the person in charge of CAMH, Toronto, or his or her designate, not less than once every four weeks.
□ Travel restrictions: not to leave Canada except upon obtaining prior approval of his/her itinerary and with the consent of the person in charge of CAMH or his or her designate.
The treatment team proposes removal of the following conditions:
□ Abstinence from alcohol and drugs: abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant.
□ Weapons: refrain from having in his possession any firearm, ammunition or other offensive weapon, or being in the company of any person possessing a firearm other than a peace officer.”
Evidence at the Hearing
In response to questions from counsel for the Hospital, Dr. McMaster addressed the recommendations of the clinical team, particularly the proposed conditions.
He advised that Mr. Yusuf wants to be able to travel to Saudi Arabia during Ramadan. If so, the clinical team wants to be able to consider Mr. Yusuf’s proposed itinerary (including who he is travelling with and where he is staying) as well as contingency planning should there be a deterioration in Mr. Yusuf's mental state.
He explained that the condition in the previous disposition ordering that Mr. Yusuf abstain absolutely from the non-medical use of drugs or any other intoxicant is no longer necessary given that he does not use drugs or alcohol. Similarly, a weapons prohibition is no longer required consistent with imposing “the least onerous and least restrictive” disposition in the current circumstances. Dr. McMaster concluded on that point that Mr. Yusuf is progressing towards an Absolute Discharge “so it makes sense to trial this.”
In response to questions from counsel for the Attorney General, Dr. McMaster reiterated that Mr. Yusuf had a good year, adding that he had developed insight into his illness and that he is largely independent at present. He opined that Mr. Yusuf is able to travel independently subject to his proposed itinerary and the contingencies in the event of a decompensation, and subject to his mental state.
Looking forward, Dr. McMaster will monitor Mr. Yusuf’s mental state as he transitions. He said that “so far” Mr. Yusuf has made “very successful progress”, and that he had a good relationship with his clinical team including his psychiatrist and his case worker.
In response to questions from counsel for Mr. Yusuf, Dr. McMaster stated that Mr. Yusuf has good insight into his medication and takes it independently, albeit his Clozapine dose was reduced in August 2025 due to its adverse side effects and is now at the floor of what is necessary for therapeutic effect.
With regard to the travel restriction, he suggested a change in the wording of paragraph 1(d) in the previous disposition from “the Province of Ontario” to “Canada”.
He advised that Mr. Yusuf has been reporting every two weeks although the current reporting condition stipulated “not less than once every four weeks”, and that he was displaying good control. He said that Mr. Yusuf had been employed as a cleaner part time but that he had stopped about a month ago due to difficulties with breathing when masked, and that he might be reassigned to another job by his employer.
He stated that Mr. Yusuf is now able to identify some signs of relapse into psychosis.
In response to questions from the panel, Dr. McMaster advised that in the absence of employment Mr. Yusuf goes for walks, visits friends, engages in various activities, and visits his mosque. He opined that Mr. Yusuf “has been gravitating to positive peer groups.”
Dr. McMaster said he thought that if Mr. Yusuf was stressed, he has good rapport with the team and would go to the Emergency or speak with his case worker.
Regarding “unstructured time” he said that Mr. Yusuf informs his case worker about some of his friends including co-patients he socializes with, and that he does not gravitate towards those with anti-social traits. Dr. McMaster stressed the positivity of Mr. Yusuf’s association with his mosque.
He stated that Mr. Yusuf has good insight into his need for medication and takes it independently, albeit his Clozapine dose was reduced in August 2025 due to its adverse side effects and is now at the floor of what is necessary for therapeutic effect.
Submissions of the Parties:
Counsel for the Hospital submitted that Mr. Yusuf had another good year, that he had better insight into his illness and medication, and that the proposed elevation of his privileges was not a concern.
Counsel for the Attorney General reiterated that this was a joint submission.
Counsel for the Accused likewise reiterated that it was a joint submission. She added that her client had a “very good year”, that his insight had improved, that the reduction in his medication was due to its side effects and that Mr. Yusuf knows he needs it. She said that he has a good relationship with his team and is transitioning towards an Absolute Discharge.
Analysis and Conclusions:
The parties did not place significant threat in issue at this hearing, and we find that on the basis of Mr. Yusuf’s history, the nature of the index offence and his current mental health status that he remains a significant threat.
It is apparent from the evidence that Mr. Yusuf tends to do better with structured activities and support, such as that which is available to him under a Review Board disposition. While he does not suffer from a formal personality disorder, he does “exhibit characteristics that will be challenging for him to overcome in order to independently manage his risk.” His rigid cognitive style, poor reflective capacity, procrastination tendencies, externalization of responsibility for issues, and tendency to search for ‘quick fixes’ to problems have been areas that the team has been addressing with him. To further mitigate his risk, that work should also continue.
We also agree that with the changes recommended by the Hospital and supported by the other parties, a conditional discharge disposition remains the necessary and appropriate disposition. The hospital report and oral testimony demonstrate that Mr. Yusuf had another good clinical year. He remained compliant with medication, which he took independently, and there were no instances of violent or aggressive behaviour. In fact, Mr. Yusuf has not engaged in any incident of physical violence since coming under the jurisdiction of the Review Board. He has insight into his mental illness and its link to the index offence, for which he remorseful.
The mainstay of Mr. Yusuf’s treatment is his antipsychotic medication and support from the treatment team. As noted, he continues to do well under treatment with clozapine and has remained adherent with medication, including since moving to more independent living in February 2024.
For the reasons articulated by Dr, McMaster, we agree that condition 1(b) in the previous disposition ordering that Mr. Yusuf “abstain absolutely from the non-medical use of alcohol or drugs or any other intoxicant” is no longer necessary. Likewise, we agree that condition 1(c) in the previous disposition ordering that he “refrain from having in his possession any firearm, ammunition or other offensive weapon, or being in the company of any other person possessing a firearm other than a peace officer” is no longer necessary.
In the result, after due consideration of public safety (which is paramount), as well as Mr. Yusuf’s mental condition, his reintegration into the community and his other needs, we find that the necessary and appropriate disposition, which is also the least onerous and least restrictive in the circumstances, is the continuation of the current conditional discharge with changes to include removal of the above-mentioned conditions.
DATED this 19^th^ day of March, 2026, at the City of Toronto, in the Toronto Region.
Hon. N. Kozloff
Legal Member
__________________
Office of the Registrar
Ontario Review Board