Re: S. (A.)
ORB File No: 7291
Hearing held on: Wednesday, April 8, 2026
Place of hearing: Centre for Addiction and Mental Health
Pursuant to: Sections 672.48(1) and 672.81(1) of the Criminal Code
Before:
Alternate Chairperson: Ms. C. Fromstein
Members: Dr. J. Kis
Dr. A. Kerry
Hon. N. Kozloff
Mr. S. Doherty
Parties Appearing:
Accused: S. (A.)
Counsel: Mr. J. McCulligh
The person in charge of hospital: Counsel: Ms. G. Meaney, Articling Student
Attorney General of Ontario: Counsel: Mr. M. Feindel
*Pursuant to s. 672.501(1) of the Criminal Code, the Ontario Review Board prohibits the publication, broadcasting, or other transmission of any information that could identify a victim in this matter or a witness who is under 18 years of age.
REASONS FOR DISPOSITION
(Dated May 13, 2026)
Introduction
On January 9, 2018, S. (A.) was found unfit to stand trial on charges of sexual assault (x3), all contrary to the Criminal Code of Canada. He is currently subject to a Disposition dated April 9, 2025, detaining him at the Forensic Service of the Centre for Addiction and Mental Health, Toronto (“CAMH”), with privileges extending to living in the community of the Greater Toronto Area in supervised accommodation approved by the person in charge.
On April 8, 2026, this panel of the Board convened at CAMH to conduct the annual review of S. (A.)’s Disposition. S. (A.) was present for his hearing along with his counsel, Mr. J. McCulligh. S. (A.) was assisted at the hearing by an Arabic language interpreter who initially provided consecutive translation. S. (A.) repeatedly requested that the interpreter not speak to him. Interpretation was subsequently discontinued, subject to request for assistance, as he appeared visibly frustrated during the process.
Position of the Parties
- At the outset of the hearing the parties were canvassed as to their initial positions. All parties joined in the submission that S. (A.) is permanently Unfit to stand trial, that he remains a significant threat to the safety of the public and that his current Disposition should be continued without change.
All parties maintained their position in final submissions at the conclusion of the evidence.
Alleged Index Offences
- The circumstances of the alleged index offences are set out in last year’s Reasons for Disposition as follows:
“The first incident took place on September 22, 2017, and allegedly involved an assault on a female patient at the Credit Valley Hospital in Mississauga. The victim of the assault was in hospital pursuant to an order under the Mental Health Act. While in the ward, the accused entered the victim’s room, forced himself on her, as she struggled to resist, he pinned her down, lifted his gown, he positioned his body between her legs and began to perform pelvic thrusts on top of her body. Staff observed the male leaving the victim’s room and contacted the police. Due to the diminished capacity of the victim, she was unable to provide a statement.
The second alleged offence took place on September 28, 2017, and involved another inpatient of the Credit Valley Hospital Psychiatric Unit. The accused approach the victim who was in a female-only area. When the victim advised the accused, he was not permitted on the unit, the accused grabbed the victim’s breast and crotch area over her clothes. The victim yelled for help and a duty nurse escorted the accused away. The victim provided a video statement; police attended and arrested the accused for sexual assault on December 7, 2017.
A second count of alleged sexual assault against the same victim involved touching of the victim by the accused in the area of her hips, buttocks and stomach. After the victim told the accused to stop touching her and he continued to do so, the victim informed a duty nurse. There were no reported physical injuries as a result of the assault.”
Evidence at the Hearing
- The evidence at the hearing included the Hospital Report dated March 23, 2026, Exhibit 1 and the testimony of Dr. Swayze.
Background History
S. (A.)'s personal, legal, and psychiatric history are set out in detail in the Hospital Report. Briefly summarized, S. (A.) is currently 61 years of age and was born and raised in Iraq, the youngest of 11 children. He immigrated to Canada with his family and is a permanent resident. His parents are deceased. He has four sisters and one brother living in Canada.
S. (A.) has no prior criminal history.
S. (A.) has a long history of mental health struggles, even prior to immigrating to Canada. His psychiatric history in Canada commencing in 2011 and course since being found unfit to stand trial are set out in great detail in the Hospital Report.
S. (A.)’s current mental health diagnoses are:
a) Schizophrenia
b) Alcohol Use Disorder, in remission in a controlled setting
c) Mild Neurocognitive Disorder and
d) Mild Intellectual Disability with a Differential Diagnosis of Schizoaffective Disorder
S. (A.) is incapable of consenting to psychiatric treatment and his sister, R., continues to be his substitute decision maker (“SDM”). He is also incapable of managing his financial affairs for which the Office of the Public Guardian and Trustee is his SDM.
He is currently treated with long-acting injectable antipsychotic medication every 4 weeks and oral antipsychotic medication twice daily, augmented by a mood stabilizer medication twice daily. S. (A.), despite his belief that treatment is not necessary or beneficial, is generally compliant with medication administration.
He maintains the view that alcohol and other psychoactive substances would not negatively impact him but the degree of supervision he receives has precluded access.
The Hospital Report sets out that S. (A.) has had a variable clinical year, similar to past years. He was able to be transferred from the Forensic Secure unit to the Forensic General Unit on May 8, 2025, where he remains under the care of Dr. Ian Swayze. He has engaged in ongoing episodic verbal aggression, sexually disinhibited behaviours, and profanity, He has been variably compliant with the expectations of the clinical team including a detailed, evolving behavioural plan.
The language barrier, as he speaks primarily Arabic, requires the use of an interpreter. An interpreter was present every weekday morning as required but his responses were often nonsensical.
S. (A.) is eligible for Disability Services Ontario (“DSO”) support, funding, and housing. He is currently being assessed for a treatment bed at Lumenus Community Services and remains on the DSO wait list.
His family remains a strong support. His brother is an approved person, and S. (A.) was able to have staff escorted home visits over the year, which went well.
Fitness to Stand Trial
S. (A.) has consistently been assessed as unfit to stand trial. He remains unaware of the outstanding charges, the nature and object of the proceedings, the participants and their functions, the pleas available to him, and the possible outcomes. He presented as unable to instruct counsel.
S. (A.) is unfit to stand trial as the result of a persistent psychotic disorder coupled with his cognitive deficits. His fitness will not be restored through psychiatric treatment or education. The hospital report sets out the opinion that S. (A.) is permanently unfit to stand trial. It is also the opinion that he remains a significant threat to the safety of the public.
Testimony of Dr. Swayze
Dr. Swayze updated the panel with the information of a recent sexual assault committed by S. (A.) on a female nursing student in which he grabbed her breasts and staff had to intervene to stop the assault. No charge was laid. Apart from this incident, his transition to the General Forensic unit has gone relatively well. These episodic physical violations occur but not frequently. There is a behavioural plan in place. The General FU on which he is currently placed works well – it is a small unit with more staff availability to monitor him than is available on the Secure FU.
S. (A.) remains consistently and grossly unfit. He has absolutely no awareness of the charges, the allegations, could not describe possible outcomes of proceedings nor instruct counsel, He is permanently unfit due to his neurocognitive and dementing process with treatment refractory schizophrenia. This has been the case for several years. He is not amenable to treatment and has residual psychotic symptoms despite medication. His medication regimen contains some of his symptoms, but he still experiences auditory hallucinations and paranoia.
S. (A.) requires a high level of supervision. Without same he would approach and sexually assault persons in the community. He is able to use level 4 passes for accompanied outings into the community, i.e., Tim Hortsons or activities. His brother is an approved person (“AP”) who can take him onto hospital grounds for an hour or into the community. He has been on staff escorted passes to visit his family home. He cannot be given indirectly supervised passes.
Community housing must be something that closely replicates the hospital, using similar behavioural planning and offering 24/7 supervision. He is being considered for accommodation at a Lumenus Community Services residence.
Analysis and Conclusion
Fitness
The Supreme Court of Canada in R. v. Bharwani 2025 SCC 26 has recently held that to be fit to stand trial an accused must be able to make reality-based decisions in the conduct of their defence and intelligibly communicate these decisions to counsel or the court. This requires a reality-based understanding of the nature or object and possible consequences of the proceedings, as well as an ability to understand the available options and their consequences, and to select between those options when making decisions. The accused is not required to make decisions in their best interests, but cannot be overwhelmed by delusions, hallucinations, or other symptoms of their mental disorder when making and communicating these decisions (para 77). The Court further stated that the key issue in most fitness hearings before the Board is whether the accused’s mental disorder prevents them from conducting a defence (para 33).
The “capacity” required to make these decisions includes “a reality-based understanding of the nature or object of the proceedings and their possible consequences, an ability to understand the available options and their consequences, and an ability to select between those options when making decision (para 61).
On the evidence before us, which we accept, S. (A.) is unable to make reality-based decisions as he is not, as a result of his mental disorder, aware of the charges, the nature of the proceedings or the pleas available to him. He is not able to instruct counsel. His mental disorder prevents him from conducting a defence. We find that he is unfit to stand trial. On the evidence, he is permanently unfit.
Significant Threat and Necessary and Appropriate Disposition
S. (A.) meets the threshold of significant threat. He recently sexually assaulted a female nursing students and episodic physical violations continue. Without the high level of support he is receiving he would approach and sexually assault person(s) in the community. The hospital continues to investigate the possibility that there might be options for his further integration into the community at housing that replicates the close supervision and behavioural plan currently in place. S. (A.)’s current disposition provides for this possibility.
For these reasons the Board orders that the Disposition, be continued without change. We make this order in consideration of the primary factor, protection of public safety, S. (A.)’s mental condition, his reintegration into society and his other needs.
DATED this 13th day of May, 2026, at the City of Toronto, in the Toronto Region.
Ms. C. Fromstein
Alternate Chairperson
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Office of the Registrar
Ontario Review Board