Re Noah Ferko, 2026 CanLII 29950

Ontario Review Board

Re: Noah Ferko

ORB Files No: 8641

Hearing held on: Thursday March 5, 2026

Place of Hearing: St. Joseph’s Healthcare Hamilton

Pursuant to: Section 672.81(1) of the Criminal Code

Before:

Alternate Chairperson: Mr. R. Bigelow

Members: Dr. K. Hand Dr. T. Stirpe Mr. K. McKenna Ms. M. McKinnon

Parties Appearing:

Accused: Noah Ferko Amicus: Mr. A. Confente The Person in charge of Hospital: Counsel: Mr. S. O’Brien Attorney General of Ontario: Counsel: Mr. B. Adsett

REASONS FOR DISPOSITION

(Dated March 30, 2026)

Introduction

1. On October 8, 2024, Mr. Ferko was found not criminally responsible on account of mental disorder on charges of break and enter, assault, forcible confinement and fail to comply with probation (x2), all contrary to the Criminal Code. Mr. Ferko is currently subject to a disposition of the Ontario Review Board (the Board) dated March 26 2025 ordering that he be detained at the Forensic Psychiatry Program of St. Joseph’s Healthcare Hamilton (the Hospital) with privileges up to and including residence in the community in accommodation approved by the person in charge.

2. On Thursday, March 5, 2026, the Board convened a hearing to review Mr. Ferko‘s disposition pursuant to section 672.81(1) of the Criminal Code. Mr. Ferko was present at the hearing, self-represented. Also present at the hearing was Amicus appointed by the Board as well as Mr. Ferko’s mother and father.

3. The issues to be determined at the hearing were whether Mr. Ferko continued to represent a significant threat to the safety of the public as defined in section 672.5401 of the criminal code and, if so, what was the necessary and appropriate disposition that was also the least onerous and least restrictive, taking into account the factors set out in 672.54 of the Criminal Code.

Initial Positions of the Parties

4. At the commencement of the hearing the parties were requested to provide their initial without prejudice positions with respect to the issues before the Board. Counsel for the Hospital submitted that Mr. Ferko continued to represent a significant threat to the public and that the necessary and appropriate disposition was a continuation of the current detention order with the same terms and conditions save and except that the references to “the community of Hamilton” in the current conditions 2 (e), 2(f), 2(g) and 2(i) be replaced with reference to “the community of Southern Ontario” and the term 2(h) and the current decision be amended to require reporting a minimum of once per week.

5. Counsel for the Attorney General supported the Hospital’s position.

6. Mr. Ferko indicated that he took no issue with the recommendation of the Hospital save and except that he questioned the rationale for increasing reporting from a minimum of once per month to a minimum of once per week while residing in the community.

Evidence at the hearing

7. The evidence at the hearing consisted of the Hospital Report dated February 12, 2026, and the oral evidence of Dr. Naidoo, Mr. Ferko’s most responsible physician.

Findings:

8. For the Reasons that follow, the Board finds that Mr. Ferko continues to represent a significant threat to the safety of the public and that the necessary and appropriate disposition was a continuation of the current detention order with the amendments as requested by the hospital.

Index Offences:

9. The circumstances surrounding the alleged index offences, as summarized in last year’s reasons for disposition with minor amendments deleting information identifying the victim and specific location of the incident are as follows:

On September 28, 2023, police received multiple calls from tenants at an apartment building in Stoney Creek, concerning a tenant in unit 303, Mr. G., being assaulted by Mr. Ferko, a tenant in unit 203. The police learned that the previous night Mr. Ferko entered Mr. G’s unit and damaged all of his property. Mr. G advised the police that the previous evening his unit was entered by a person wearing a black balaclava and black cape. This person threw furniture and various personal items off the balcony. Mr. G. arranged for a new lock to be installed, and he spent the night at his mother’s home. Mr. G. and his mother returned to his unit on September 28 and discovered that the new lock was broken and there was fresh damage to his door. Mr. Ferko barged into the unit, grabbed a large wooden stick, and engaged in a brief struggle with Mr. G.’s mother. He then fled the residence. A short time later, Mr. Ferko returned to Mr. G.’s unit with personal items belonging to Mr. G., which he said he found outside. Mr. G. told Mr. Ferko to leave, and Mr. Ferko responded by lunging at Mr. G., and proceeded to punch and kick him for over 2 minutes. Mr. Ferko was apprehended under the Mental Health Act and taken to St. Joseph’s Hospital.

Background Information Regarding the Accused:

10. As of the date of the hearing, Mr. Ferko was 27 years of age. He was born in Hamilton, the second in a sibline of three with an older and a younger sister. He did reasonably well in school until grade 10 when his marks deteriorated because of cannabis use. In grade 11, he began to skip many classes to spend time with friends and smoke cannabis. However, he did graduate high school and began a program at Humber College in 2020 but left the program. In 2021 he enrolled in Algonquin College’s arborist program and graduated from the program in the spring of 2022.

11. Mr. Ferko began an apprenticeship as an arborist but left to try and establish his own landscaping company. However, he has been financially supported by the Ontario Works program initially since March 2023 and currently the Ontario Disability Support Program.

Substance Use History

12. Mr. Ferko began drinking alcohol when he was in grade 8, which escalated to binge drinking during his teenage years. He has a history of becoming aggressive when consuming alcohol including one incident where he assaulted his father while under the influence of alcohol. He reports that he tried attending Alcoholics Anonymous for a year but did not find the program helpful.

13. Mr. Ferko began using cannabis when he was in grade 10 and smoked cannabis on a daily basis until he reached grade 13. However, he reported at the time of his NCR assessment that he had not “used cannabis for the last couple of years”. He began using CBD oil in 2023 and last used in October 2024.

14. Mr. Ferko also has used IV steroids, methamphetamine, psilocybin and Xanax.

Legal History:

15. Although the Hospital report states that Mr. Ferko does not have a criminal record, it also states that he was placed on probation for a driving offence, but no particulars of that matter are provided.

Psychiatric History

16. In October 2020 Mr. Ferko presented at a hospital emergency department and reported experiencing visual and auditory hallucinations of “snakes threatening his safety”. He was preoccupied with internal stimuli and admitted having consumed alcohol and cocaine the previous day. He was referred to a concurrent disorders outpatient program and at his intake to the program in January 2021 he denied paranoia, auditory hallucinations or thought broadcasting although he indicated he sometimes felt like he was getting messages through license plates.

17. In January 2023 Mr. Ferko attended a hospital emergency department with his family who indicated that Mr. Ferko

had purchased a one-way ticket to Europe in early January because he believed his dreams were instructing him to embark on a journey of self-discovery. While there, he perceived abstract paintings in a hostel as calling to him and serving as a map to a specific presence in Egypt. His family reported that he then traveled to Egypt, where he trespassed and slipped on one of the pyramids, resulting in abrasions to his foot. While in Egypt, there was another incident where he stripped naked, ran across the highway, jumped into the Nile River, and swam 400 meters across the river with two open wounds on his foot. He was apprehended by authorities in Egypt and subsequently brought back to Canada. During his initial assessment, Mr. Ferko reported delusional content regarding Egypt, the pyramids, and his beliefs about reincarnation. He denied having any suicidal or homicidal ideation. He declined the medication offered for sleep and anxiety. Mr. Ferko's urine drug screen tested negative for substance use. He consented to attend the hospital to treat the wounds on his foot but did not believe he had any psychiatric issues. Mr. Ferko was placed on a Form 1 for diagnostic clarification and stabilization. He was transferred to the Charlton Campus Mental Health inpatient unit for ongoing care.

18. Mr. Ferko’s discharge diagnosis in March 2023 was schizophreniform disorder/schizophrenia, polysubstance use disorder with alcohol, cannabis, psilocybin and cocaine in early remission.

Current Diagnosis

19. Mr. Ferko’s current diagnoses are schizophrenia and substance use disorder, in early remission.

Evidence of Dr. Naidoo

20. Dr. Naidoo indicated that:

• He had been Mr. Ferko’s most responsible physician since his arrival at the Hospital in March 2025 and had reviewed and adopted the contents of the Hospital Report. Mr. Ferko suffers from a major mental illness, schizophrenia, as well as a substance use disorder.
• Mr. Ferko had been residing in the community on judicial interim release prior to his admission to hospital after the NCR finding. Once he arrived in Hospital it took him some time to get used to the rules and accept feedback from staff. However, he is engaged with the treatment team and uses the staff for support.
• Mr. Ferko has progressed well and has been using passes into the community regularly with passes now up to 72 hours duration. There had been a few instances where he returned late from passes and was somewhat oppositional but in general, he has done quite well. He has completed the first part of the Cognitive Behavioural Therapy for psychosis (CBTp) program and needs to involve himself in a substance use program in order to develop his insight into the impact of substance use on his mental health. The basis for the treatment team’s opinion with respect to significant threat is his lack of insight into both the impact of substance use on his mental health and the importance of treatment in maintaining his mental health. Mr. Ferko has a long history of not prioritizing treatment and would certainly deteriorate quickly should he resume consumption of alcohol. When unwell he constituted a significant flight risk due to his impulsive behaviours such as his trip to Europe and Egypt.
• With respect to why the treatment team was recommending that the reporting when residing in the community in the current disposition should be increased, he indicated that he did not understand why the previous year the Hospital had recommended reporting only once per month. Although his use of passes in the community had been without significant incident, given his risk assessment, lack of insight and potential for rapid decompensation if he returned to the use of substances or ceased taking medication, he required close supervision when initially released into the community.
• The plan for the upcoming year was to have him involve himself in relapse prevention programming, expand his social support network and social skills, obtain gainful employment and continue with education with respect to his illness and the importance of treatment.
• Mr. Ferko would not likely return to hospital voluntarily if he began to decompensate and the Mental Health Act provisions were insufficient to protect the public.

Final Positions of the Parties

21. Counsel for the Hospital and counsel for the Attorney General maintained their initial positions. Mr. Ferko indicated that, having heard Dr. Naidoo’s explanation for the recommendation of more frequent reporting when residing in the community, he now believed that the increase was appropriate.

Analysis and Conclusion, Significant Threat:

22. Although Mr. Ferko did not contest the issue of significant threat, the Board carefully considered the evidence and independently concludes that it clearly supports a finding of significant threat. Mr. Ferko suffers from a major mental illness, schizophrenia, as well as a substance use disorder, although in early remission. He has a history of aggression both in the community and within his family primarily while under the influence of alcohol. He has little insight into the impact of alcohol on his mental health and intends to resume use when no longer under the Board’s jurisdiction.

23. Absent the supervision of the Board, it is highly likely that Mr. Ferko will return to the use of alcohol exacerbating his mental illness with a return of the symptoms he experienced at the time of the index offences thereby putting the public at risk.

Analysis and Conclusion Necessary and Appropriate Disposition

24. Given Mr. Ferko’s lack of insight into his illness and particularly the impact of alcohol consumption on it, he requires close supervision when in the community and the Hospital needs the authority to approve accommodation in order to ensure the necessary supervision as well as residence in a location conducive to medication adherence and abstinence. In addition, given the risk of rapid decompensation, the Hospital needs the ability to return him to Hospital rapidly at early stages of decompensation. The Board accepts the evidence of Dr. Naidoo that the provisions of the Mental Health Act would not be sufficient to protect the public, therefore, a conditional discharge would not be an appropriate disposition.

DATED this 30th day of March 2026, at the City of Toronto, in the Toronto Region.

Robert Bigelow Alternate Chairperson

Office of the Registrar Ontario Review Board