Re: Alfredo Forte
ORB File No: 4898
Hearing held on: Wednesday, March 25, 2026
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Section 672.81(1) of the Criminal Code
Before: Alternate Chairperson: Ms. L. Banks Members: Dr. S. Lessard Dr. J. Cheston Ms. A. La Viola Mr. J. Cyr
Parties Appearing: Accused: Alfredo Forte Counsel: Mr. D. Embry
The person in charge of hospital: Counsel: Mr. K. Dow
Attorney General of Ontario: Counsel: Ms. J. Graham
REASONS FOR DISPOSITION
(Dated April 15, 2026)
Introduction:
On September 27, 2007, Mr. Alfredo Forte was found not criminally responsible on account of a mental disorder (“NCR”) on one count each of assault with a weapon, assault, and possession of weapon for a purpose dangerous to the public peace, all contrary to the Criminal Code of Canada (the “Criminal Code”).
Since his NCR finding, Mr. Forte has been subject to Dispositions of the Ontario Review Board (“ORB” or the “Board”), most recently a Disposition dated April 15, 2025, which orders him discharged subject to a variety of terms and conditions, including that he reside at a specified address, report to the person in charge (“PIC”) of the Centre for Addiction and Mental Health, Toronto (“CAMH” or the “hospital”) not less than once a week, and consent to treatment as prescribed by the PIC of CAMH, or his or her designate, in accordance with s.672.55(1) of the Criminal Code.
On March 25, 2026, a panel of the ORB convened to hold a hearing to conduct an annual review of Mr. Forte’s existing Disposition pursuant to s. 672.81(1) of the Criminal Code. Mr. Forte attended the hearing and was represented by his counsel, Mr. Embry.
The issues to be considered at this hearing are whether Mr. Forte is a significant threat to public safety as now defined in s. 672.5401 of the Criminal Code and, if he is found to be a significant risk to the community, the determination of the necessary and appropriate Disposition in the circumstances bearing in mind the factors enunciated in s. 672.54 of the Criminal Code.
For the reasons set out below, this Board has concluded that Mr. Forte continues to pose a significant threat to public safety. It is our view that the necessary and appropriate Disposition in the circumstances is that he continue to be subject to the terms of his existing Conditional Discharge Disposition.
Index Offences:
- The circumstances giving rise to the index offences are set forth in detail in the Hospital Report to the ORB dated February 17, 2026 (the “Hospital Report”) and may be summarized as follows:
“In October of 2006, Mr. Forte, while armed with a knife, attacked a fellow resident of a home for persons with mental health issues. The complainant suffered minor injuries.”
Positions of the Parties:
All parties were canvassed as to their initial recommendations to the Board. Counsel for the hospital submitted that Mr. Forte met the significant threat test and that the necessary and appropriate Disposition was a continuation of his existing Conditional Discharge Disposition.
Crown counsel indicated support for the hospital’s recommendations.
Mr. Embry indicated his client was requesting an Absolute Discharge but that if the Board were to make a finding of significant threat, then he was supportive of the hospital’s recommendation for a Conditional Discharge and counsel affirmed that his client consented to the inclusion of the treatment condition.
All parties maintained their initial positions in closing submissions. With regard to the inclusion of a weapons’ prohibition, the hospital took no position. The Crown indicated its support for such a prohibition. Mr. Embry recommended that if the Board were to determine that a Conditional Discharge was warranted then the Disposition should not include a weapons’ prohibition as it was not necessary or appropriate given the many years that had passed since the commission of the index offence and the absence of any further incidents involving Mr. Forte using a weapon or engaging in assaultive behaviours.
Personal Background:
The Hospital Report and the ORB Reasons of May 6, 2025, contain the details of Mr. Forte’s personal background, legal and psychiatric history and need not be repeated in detail here as these documents were entered in the Record and/or Exhibits at the hearing. Briefly stated, Mr. Forte is a 48-year-old single man who was born and raised in Toronto. His parents separated when Mr. Forte was about 10 years old. Mr. Forte does not have any children.
Mr. Forte completed Grade 13 and then attended the University of Waterloo pursuing a computer science degree. He completed one semester before dropping out. He attended Humber College for one semester, but began to experience panic attacks and did not complete the program. He had no further schooling after the age of 20 due to the onset of his psychiatric illness. He has not been employed since age 20.
Mr. Forte does not have a history of problematic alcohol or drug use.
Legal History:
At the age 21, Mr. Forte was charged with assault cause bodily harm, after an incident at the College Street Site of CAMH. The victim was a female nurse. The charge was ultimately managed by a court diversion.
Mr. Forte was charged with assault at age 22, involving a nurse at the Mississauga Hospital. He was suffering from psychotic symptoms at that time, and he received court diversion once again. His CPIC indicates no prior convictions.
Psychiatric History:
Mr. Forte has a significant psychiatric history and was first diagnosed with depression at age seventeen. His first psychiatric admission occurred in 1998. He presented at CAMH as he had been experiencing paranoid delusions believing that government agents were following, poisoning and controlling him. As a result of same, he was experiencing severe anxiety and intermittent suicidal and homicidal ideation. He was admitted as a voluntary patient but was ultimately placed on a Form 3 under the Mental Health Act (“MHA”). While in hospital, he seriously assaulted a member of the nursing staff, punching her in the face and head and was charged with assault, causing bodily harm. He also engaged in other acts of property aggression and attempted to assault another staff member with a sharp end of a piece of wood, prompting his transfer to Mental Health Centre Penetanguishene, Oak Ridge Division (now known as “Waypoint”) for treatment in a more secure setting. He remained there for months.
In 1999, he was admitted to hospital on several occasions when suffering from hallucinations. He engaged in self-harm.
Mr. Forte had a lengthy admission at CAMH between March 2000 and December 2002. There were numerous instances of aggression against staff. He was admitted to hospital several more times between then and 2006. He was also receiving out-patient care. Mr. Forte suffered hallucinations. The Hospital Report sets out many instances of both self-harm and significant assaults on others.
After the index offences, Mr. Forte remained detained in hospital. He remained psychotic, delusional and violent. It was necessary to place him in seclusion on multiple occasions. When medicated, he was able to show some improvement.
After being found NCR in 2007, he remained in hospital for approximately one year, until he was able to be discharged into the community. He remained delusional but was not violent.
Over the years, there have been many hospital readmittances of various durations prompted by noncompliance with medication and episodes of behavioural dysregulation. He continued to experience active symptoms of his illness but did not engage in violence.
His mental condition improved with medication compliance and in November 2020, he was able to move out of hospital to high support community housing. In 2021/2022, he remained in housing but for a re-admission to hospital of just over two weeks. However, Mr. Forte continued to suffer from significant symptoms of psychosis, consistent with ultra-treatment-resistant Schizophrenia. He experienced auditory hallucinations on a daily basis. He engaged in obsessive-compulsive behaviours.
His mental status largely remained unchanged, with a diagnosis of ultra-treatment resistant schizophrenia. He is treated with antipsychotic medications, primarily Clozapine.
Current Diagnosis:
- Mr. Forte’s current diagnoses are:
Schizophrenia; and
Obsessive Compulsive Disorder (“OCD”).
Evidence at the Hearing:
Dr. B. Chan, a PGY6 psychiatric fellow under the supervision of Dr. Eid, testified at the hearing to supplement the documentary evidence before the Board. Dr. Chan adopted the contents of the Hospital Report and indicated there were no significant updates thereto. Dr. Chan advised that Mr. Forte had been under the care of Dr. L. Van until October 2025, when his care was transferred to Dr. L. Eid and Dr. B. Chan.
Mr. Forte continues to reside in the community at Oakwood ARCH residence, where he was initially discharged in November 2020. This is a high-support residence with staff on site 24 hours a day and supervised medication administration. Mr. Forte has his own bachelor apartment with a washroom and kitchen. The facility provides daily meals, some programming and assistance with laundry and keeping residents’ units clean. Mr. Forte is amenable to remaining in his current housing.
Mr. Forte is assessed as incapable to consent to psychiatric treatment. His father is his substitute decision maker (“SDM”) and under his SDM’s consent Mr. Forte’s medications included daily oral doses of the antipsychotic medications Clozapine (500 mg daily) and Aripiprazole/Abilify (15 mg daily) together with the antidepressant medication, Fluoxetine (oral solution 80 mg daily). Mr. Forte reported sedation as a side effect of the medication. At the present time, Mr. Forte’s treatment is considered to be optimized; however, the doctor testified that new treatment modalities may be considered in the future given his ongoing chronic psychotic symptoms.
In terms of his mental state, the Hospital Report indicates that: “Despite optimize medication treatment, he continued to experience auditory hallucinations. He described the voices and his commentary and said they originated from multiple recognizable sources, such as “Sheilah”. He denied any commanding or violent auditory hallucinations. He also described ongoing delusional sentiments, stating that he had psychic abilities, and could read the minds of others and put thoughts into the minds of others. He remained paranoid about the government, CIA, and CSIS, with worries that those government agencies were targeting him. He continued to have grandiose beliefs about being mortal. He also displayed ongoing negative symptoms, and has limited attention to his personal hygiene.”
The doctor stated that Mr. Forte acknowledges experiencing commentary voices that can be command in nature instructing him to do mundane things throughout the day. He acknowledges that these voices help him to make what the doctor described as “benign decisions;” however, he has stated that these command hallucinations do not instruct him to act violently. He also denied thoughts of self-harm or suicide.
In terms of his OCD diagnosis, Mr. Forte continues to present with ritualistic behaviours, including excessive handwashing and pacing. He continued to decline psychotherapy or treatment optimization.
Over the past reporting year, Mr. Forte remained compliant with his medications, did not engage in any assaultive incident and did not abscond from his residence. Other than the three notable incidents identified below, he did not present as a management problem.
On April 2, 2025, Mr. Forte had an argument with a co-client at his housing, and the co-resident attempted to hit Mr. Forte. No injuries were sustained but the police were called. There have been no further issues with this co-resident or any other co-residents since that time. With staff intervention, Mr. Forte was able to self-regulate.
In June 2025, Mr. Forte became angry and yelled at staff about some minor housing repairs. When staff walked away and shut the door, Mr. Forte banged on the door, but the incident did not escalate further. There was no reported property destruction or physical violence.
Finally, on December 19, 2025, Mr. Forte missed his psychiatric follow-up appointment because he claimed he slept in. When informed that he needed to report as required, he attended hospital immediately that same day, and was apologetic about the missed appointment.
Mr. Forte is also supported in the community by the Extended Forensic Out-patient Service (“EFOPS”) team which includes Dr. Chan and his case manager. He meets with his case worker on a weekly basis, and she assists him in navigating and addressing many of the concerns of his housing provider. He meets with Dr. Chan approximately once a month. Mr. Forte has complied with all follow-up appointments with members of the EFOPS, but he rarely engages in outings or other programming.
Mr. Forte is primarily independent with his self-care but, as has been the case in past years, Mr. Forte’s personal hygiene has remained an issue and he often unkempt and malodorous. He continues to require prompting and regular reminders to shower and change his clothes at least weekly. He does his laundry every two weeks with the help from his out-patient team. His relationship with housing staff has been challenged at times due to his resistance to attend to his personal hygiene. On three occasions over the past reporting period, he refused to allow housing staff to enter his unit for safety checks, as per housing policy. He agreed after intervention from his EFOPS case manager. He can also become dismissive and/or irritable when questions are raised regarding his hygiene.
Mr. Forte’s parents continue to have regular contact with him, and they are important supports for him. He typically sees them separately on a weekly basis and they have reported to the EFOPS team that they believe Mr. Forte is doing well and is much improved.
As has been the case in past years, Mr. Forte has minimal social interaction with his co-residents, and he primarily keeps to himself. He spends most of his days inside his apartment, often working on his “manifesto”. He continues to refuse to show the contents of his manifesto to his team members; however, he has advised that the manifesto does not contain any threats to others.
Dr. Chan testified that Mr. Forte has declined engagement in structured programming and activities, but he goes out several times a week to run errands, buy groceries, or go for walks. The team will continue to encourage him to engage in community activities and programs.
Going forward, Dr. Chan stated that the team would like to see Mr. Forte improve his therapeutic rapport with team members and engage in recommended programming to target his limited insight across all relevant domains.
Mr. Forte has not engaged in physical violence since 2015. He was discharged to the community in 2020 and has not acted out violently; however, the doctor stated that this stability was in the context of his compliance with prescribed medication and close monitoring by his out-patient treatment team and his housing staff. Since his transition to community living, he has only required one brief re-admission to hospital from February 20, 2021, to March 8, 2021.
In terms of his insight, Dr. Chan testified that Mr. Forte does not believe he actually suffers from a major mental illness. He continues to be unable to connect his experience of psychotic symptoms to his mental illness.
Mr. Forte continues to question whether his medications help attenuate his symptoms. Dr. Chan stated that Mr. Forte has repeated on many occasions that he will discontinue his prescribed medications when he is no longer under the jurisdiction of the ORB.
Dr. Chan stated that a consent to treatment condition is still considered necessary due to the fact that Mr. Forte has impaired insight with regard to the importance of treatment and he has a history of non-adherence to treatment. The doctor commented that Mr. Forte has been compliant with his treatment over the past 10 years and he attributes his compliance as being a result of the external “legal” requirements imposed upon him while under the Board’s jurisdiction.
The re-offence scenario included in the Hospital Report concludes that Mr. Forte suffers from an “ultra-treatment resistant form of schizophrenia” which has been the driver of his past violence when he has impulsively acted out on persecutory and grandiose delusions, causing harm to others. Dr. Chan testified that were Mr. Forte to become non-compliant with his medications, he would be prone to exacerbation in his psychotic symptoms, and he would likely present with heightened paranoia, persecutory delusions and/or command hallucinations, disorganized thinking and isolative behaviour. In that context, he would be likely to present as distrustful and aggressive and, over time, act out with violence.
Dr. Chan reiterated that Mr. Forte suffers from a marked lack of insight which render it highly likely that, if not closely monitored by housing staff, his treatment team and ORB oversight, he would discontinue his medications over time. This would, over time, result in an intensification of his paranoia and affective instability, and further exacerbate his risk of harm to members of the public.
Dr. Chan advised that in the treatment team’s assessment, Mr. Forte is able to be safely managed under a Conditional Discharge which mandates he resides at his current residence where he is well supervised, provided that he continues to adhere to his prescribed treatment. Should Mr. Forte become non-compliant with his treatment, the team could request assistance from the police to bring Mr. Forte to hospital, where he will likely be certifiable under Box B of the Mental Health Act.
Dr. Chan stated that Mr. Forte’s most salient protective factors in the management of his risk are the external oversight provided by his residence staff, his forensic EFOP clinical team, and the authority of the ORB Disposition.
In response to a question posed by a member of the Board, Dr. Chan agreed that given Mr. Forte’s history of assaultive behaviours and the fact that the index offence involved the use of a weapon, the inclusion of a weapons’ prohibition was reasonable.
The doctor stated that Mr. Forte has done well over the past year in the context of the external control of the ORB and the EFOPS team together with the support of the housing team.
No further evidence was called by the parties.
Analysis and Conclusions:
The Board accepts that Mr. Forte remains a significant threat to public safety based upon the evidence of Dr. Chan and the evidence contained in the Hospital Report. When non-compliant and acutely unwell, Mr. Forte has become paranoid and agitated and has acted out with significant violence which has seriously compromised public safety. He has a history of noncompliance with medication, and it is our view that his risk would significantly increase if treatment were discontinued. Mr. Forte continues to state that if no longer under the Board’s jurisdiction, he will discontinue treatment with Clozapine. The expert evidence before us indicates that discontinuation of this medication would be highly likely to result in an intensification of his psychotic symptoms with the likely result of an escalation in his risk of violence.
In addressing the issue of significant threat, the panel has also carefully considered the decision of the Supreme Court in Winko v. British Columbia. In that case, the Court identified a significant risk as “a real risk of physical or psychological harm to members of the public that is serious in the sense of going beyond the merely trivial or annoying. The conduct giving rise to the harm must be criminal in nature." In Winko, the Supreme Court also outlined that in coming to a conclusion on the issue of significant risk, a Review Board should closely examine a range of evidence including: the circumstances of the original offence, the past and expected course of the accused's circumstances and treatment, the present state of the NCR accused's medical condition, the NCR accused's own plans for the future, the support services existing for the NCR accused in the community and, perhaps most importantly, the recommendations provided by experts who have examined the NCR accused. According to the doctor’s testimony, the clinical team unanimously agrees that Mr. Forte continues to represent a significant threat to public safety.
In light of our finding of significant threat, we must shape a Disposition that is necessary and appropriate, as well as least onerous and least restrictive in the circumstances for the coming year.
The Board has concluded that Mr. Forte can continue to be safely managed under his existing Conditional Discharge Disposition. The terms of his Disposition stipulate that he continues to reside at his current staff-supported residence and that he consents to a treatment condition.
Mr. Forte has done well over the past several years. We are cognizant that he has not engaged in any physical aggression since 2015 and, despite his limited understanding of the importance of his adherence with his Clozapine treatment, he has remained compliant, albeit under direct staff supervision and while subject to an ORB Disposition. To his credit, Mr. Forte has continued to consent to the inclusion of a treatment condition and has expressed an understanding that he would be required to be readmitted to hospital should his current accommodation not be appropriate for him in the future. In the panel’s assessment, the Box B criteria of the Mental Health Act would be sufficient to safely manage Mr. Forte’s risk should he evidence signs of any decompensation in his mental state while residing in the community.
Accordingly, based on all of the evidence and the submissions of the parties, the Board finds that the necessary and appropriate Disposition is a Conditional Discharge on the same terms as his existing Disposition.
In terms of the inclusion of a weapons’ prohibition, the panel considered this carefully but determined that it is not necessary or appropriate at this juncture, nor is it least onerous or least restrictive. Although Mr. Forte used a knife in the commission of the index offence, that occurred approximately two decades ago when Mr. Forte was unmedicated and experiencing psychotic symptoms. He has not been assaultive since 2015, and his Disposition has not included a weapons’ prohibition for many years. The inclusion of a weapons’ prohibition at this juncture is not least restrictive or least onerous, nor does it seem necessary or appropriate in the interests of public safety.
In reaching our decision, we have considered the paramount need to protect the public from dangerous persons, the mental condition of Mr. Forte, his reintegration into society and his other needs.
DATED this 15th day of April, 2026, at the City of Toronto, in the Toronto Region.
Ms. L. Banks Alternate Chairperson
Office of the Registrar Ontario Review Board