Re: Ali Kiamarz-Milani
ORB File No: 3766
Hearing held on: Wednesday, January 21, 2026
Place of hearing: Waypoint Centre for Mental Health Care
Pursuant to: Section 672.81(2.1) of the Criminal Code
Before:
Alternate Chairperson: Mr. R. Bigelow
Members: Dr. P. Darby
Dr. K. Patel
Ms. C. Murray
Ms. D. Smith
Parties Appearing:
Accused: Ali Kiamarz-Milani
Counsel: Ms. J. Boissonneault (via Zoom)
The person in charge of hospital: Counsel: Mr. J. Thomson (via Zoom)
Attorney General of Ontario: Counsel: Ms. S. Curry
REASONS FOR DECISION
(Dated February 3, 2026)
Introduction:
On April 29, 2003, Mr. Ali Kiamarz-Milani was found not criminally responsible on account of mental disorder (“NCR”) on a charge of assault with a weapon contrary to the Criminal Code of Canada (the "Criminal Code").
Mr. Kiamarz-Milani is currently subject to a Detention Disposition of the Ontario Review Board (the “Board” or “the panel”), dated August 21, 2025, detaining him at the Forensic Service of the Centre for Addiction and Mental Health (“CAMH”) with residual authority to the High Secure Provincial Forensic Programs of the Waypoint Centre for Mental Health Care (“Waypoint” or the “hospital”) until such time as he is transferred to CAMH.
By letter dated November 17, 2025, the hospital notified the Board pursuant to section 672.56(2) of the Criminal Code of a restriction of Mr. Kiamarz-Milani’s liberties, which had lasted over seven days due to his placement in seclusion on November 9, 2025. On January 21, 2026, a panel of the Board convened a hearing to review the restriction of Mr. Kiamarz-Milani’s liberty.
Mr. Kiamarz-Milani was not present at the hearing. His lawyer, Ms. Jocelyne Boissonneault, requested an order pursuant to s. 672.5(10) as Mr. Kiamarz-Milani did not wish to attend. She confirmed that she had clear instructions to proceed in his absence. Therefore, an order was granted pursuant to s.672.5(10).
A Restriction of Liberty (“ROL”) report dated December 2, 2025, was entered as Exhibit 1. A Hospital Report dated May 27, 2025, was entered as Exhibit 2.
The issue at the hearing was whether the hospital’s decision to increase the restrictions on Mr. Kiamarz-Milani’s liberty was necessary and appropriate and represented the least restrictive and least onerous intervention available in the circumstances both at the time of its onset on November 9, 2025, and throughout its duration up to November 17, 2025.
For the reasons outlined below, the Board finds that the restriction of Mr. Kiamarz-Milani’s liberty from November 9, 2025, through to November 17, 2025, was necessary and appropriate, and represented the least onerous and least restrictive measure.
Positions of the Parties
As a preliminary matter, the parties all confirmed that, as this is solely a restriction of liberty hearing with no request to a change in the terms of the Disposition, there was no objection to Dr. Patel and Dr. Darby sitting as members of this panel, notwithstanding their connection to the Centre for Addiction and Mental Health (“CAMH”), Mr. Kiamarz-Milani’s pending transfer to CAMH, and Dr. Patel’s involvement with Mr. Kiamarz-Milani as his outpatient psychiatrist in 2014 and 2015 and other clinical involvement with Mr. Kiamarz-Milani in 2016 and 2017 at CAMH.
At the outset of the hearing the parties were canvassed as to their positions. Counsel for the hospital, supported by counsel for the Attorney General, submitted that the initial restriction of liberty commencing November 9, 2025, was necessary and appropriate; it represented the least onerous and least restrictive measure at the time it was imposed, and it continued to be so up to the date it was discontinued, being November 17, 2025.
Ms. Boissonneault took the position that the initial restriction of liberty on November 9, 2025, and the ongoing restriction of liberty up to November 17, 2025, was not necessary and appropriate and did not represent the least onerous and least restrictive measure.
Restriction of Liberty
The ROL report stated that Mr. Kiamarz-Milani had become “extremely agitated” in the context of reminders of the unit’s policy on headphone use. Mr. Kiamarz-Milani swore and raised his voice. He continued to use abusive language and invade the staff’s personal space when told he would need to return to his room if he could not comply with the headphone policy. He was again encouraged by staff to return to his room but refused while continuing to be dismissive and use confrontational behaviour. Additional staff were called to assist and while attempting to escort him to his room Mr. Kiamarz-Milani physically resisted, including attempts to kick and swing at staff. He pressed his leg against the wall in an effort to resist movement. He was eventually returned to his room. A seclusion order was thereafter obtained.
Mr. Kiamarz-Milani participated in seclusion relief on November 10, 2025. Over the next two days he was deemed not appropriate for seclusion relief because he was demanding, argumentative, agitated, shouting and swearing at staff, and banging on his door. He was assessed by the duty doctor on November 12, 2025, for a 72-hour assessment. He was not willing to cooperate with the assessment. The seclusion order was renewed.
On November 13, 2025, Mr. Kiamarz-Milani settled as the day progressed and was offered seclusion relief after dinner. Mr. Kiamarz-Milani declined seclusion relief.
On November 14, 2025, Mr. Kiamarz-Milani was not offered seclusion relief due to “time constraints”. He was described as anxious and easily angered.
On November 15, 2025, Mr. Kiamarz-Milani participated well in a 70 minute seclusion relief period.
On November 16, 2025, Mr. Kiamarz-Milani was assessed by the duty doctor, and it was reported that seclusion would likely be discontinued following one more successful relief period. He was not offered seclusion relief on November 16, again due to “time constraints”.
On November 17, 2025, Mr. Kiamarz-Milani was offered and accepted seclusion relief. He was described as “appropriate and followed directions”. His seclusion was thereafter discontinued.
The Hospital Report notes that Mr. Kiamarz-Milani’s security levels fluctuated regularly in 2025 and were periodically placed on hold through the review period, consistent with his unstable mental status. He occasionally reached level C3 privileges, which allowed him to go off the unit independently for up to one hour at a time. In August 2025, prior to his pre-board conference, Mr. Kiamarz-Milani was exercising level C2 privileges, which permitted accompanied access off the unit.
Mr. Kiamarz-Milani’s diagnoses include Schizoaffective Disorder, Bipolar Type; Other (or unknown) Substance Use Disorder, moderate, in early remission; Antisocial Personality Disorder; Borderline Intellectual Functioning.
Oral Evidence at the Hearing
Dr. Ismail, Mr. Kiamarz-Milani’s most responsible physician since January 2024, provided viva voce evidence at the hearing. Dr. Ismail testified that Mr. Kiamarz-Milani was transferred from CAMH to Waypoint on August 22, 2022, because he had become increasingly unmanageable at CAMH requiring persistent need for seclusion due to his risk to co-patients (including repetitive aggression towards an elderly co-patient that resulted in injury to the co-patient).
Dr. Ismail stated that since his transfer to Waypoint his aggression lessened but he occasionally required seclusion.
Dr. Ismail said that, lately, Mr. Kiamarz-Milani has been more compliant with his medication regimen. He is optimally treated.
Dr. Ismail said that Mr. Kiamarz-Milani appeared to be having a rough few weeks prior to the hearing and the staff did their best not to seclude him during that time. However, on November 9, 2025, there were no warning signs prior to the escalation of Mr. Kiamarz-Milani’s behaviour.
Dr. Ismail testified that there is a Crisis Prevention Plan (“CPP”) in place to provide a consistent approach in staff’s management of Mr. Kiamarz-Milani’s high-risk behaviours, which include non-compliance with direction, sexual inappropriateness, threats, verbal aggression, and environmental aggression. The CPP offers recommendations as to how staff might prevent escalation of high-risk behaviours, and should such behaviours require it, the CPP recommends that staff seek a seclusion order. Pursuant to the CPP, when Mr. Kiamarz-Milani is hard to redirect the staff are to terminate the interaction with him to determine if he will calm down. They also are to offer prn medication and provide an environment where he can deescalate. Regarding the incident of November 9, 2025, seclusion was required as per the CPP. He was placed in his own room with a locked door.
Dr. Ismail agreed that seclusion was a significant restriction of Mr. Kiamarz-Milani’s liberty. He testified that seclusion was discontinued once Mr. Kiamarz-Milani was able to demonstrate that he was able to function in a “normal ward environment”.
Dr. Ismail said that the on-call physician was contacted when seclusion was initiated. Mr. Kiamarz-Milani was uncooperative with an assessment. Therefore, seclusion continued based on the staff’s description of Mr. Kiamarz-Milani’s behaviour. A PRN was not offered to Mr. Kiamarz-Milani when he first went into seclusion because he had already taken a prn earlier in the day at 11:00 a.m. It would be too soon after the 11:00 a.m. prn to offer another prn.
Dr. Ismail clarified that the diagnosis of Borderline Intellectual Functioning was queried. It is suspected that he may have this diagnosis but all attempts to conduct a neuropsychological assessment have been unsuccessful due to Mr. Kiamarz-Milani’s lack of cooperation. Even at his baseline mental state he is argumentative, which could be related to Borderline Intellectual Functioning.
Based on Mr. Kiamarz-Milani’s CPP, he must be able to participate successfully in seclusion relief on two consecutive days prior to discontinuation of seclusion. In response to questions from Ms. Boissonneault, Dr. Ismail agreed that there was a possibility that Mr. Kiamarz-Milani’s seclusion was prolonged by not receiving an offer of seclusion relief on November 14 or 16, 2025, due to time constraints.
In response to questions from the Board, Dr. Ismail testified that ward rules for Mr. Kiamarz-Milani have been simplified because of his suspected Borderline Intellectual Functioning.
Submissions
Mr. Thomson submitted that the evidence supports that seclusion of Mr. Kiamarz-Milani was necessary on November 9, 2025, and steps were taken to ensure the discontinuation of seclusion at the earliest possible time. His restriction of liberty was necessary and appropriate and the least onerous and least restrictive measure from November 9, 2025, throughout the restriction. Ms. Curry supported and relied on Mr. Thomson’s submissions.
Ms. Boissonneault submitted that Mr. Kiamarz-Milani’s liberty was significantly restricted as a result of the seclusion. Ms. Boissonneault submitted that the initial restriction was not necessary and appropriate and did not represent the least onerous and least restrictive measure. She directed the Board to paragraph 29 of the Reasons for Disposition dated August 21, 2025, which states, “…The evidence suggests that his reactive behaviours are often triggered by excessive structure…”. The hospital needed to be careful in restricting Mr. Kiamarz-Milani’s liberty as he is vulnerable. She submitted that the staff safely escorted Mr. Kiamarz-Milani to his room after the incident and did not allow time for all the other interventions described in his CPP before secluding Mr. Kiamarz-Milani without the benefit of an assessment.
Ms. Boissonneault submitted that the ongoing restriction also was not necessary and appropriate and did not represent the least onerous and least restrictive measure. She submitted that had Mr. Kiamarz-Milani been offered seclusion relief on November 14 and November 16 he may have had seclusion discontinued if he had two consecutive successful days of seclusion relief. She submitted that seclusion can not be prolonged due to a lack of resources.
Analysis and Conclusion
The Board finds that a significant increase in the restriction on Mr. Kiamarz-Milani’s liberty has taken place, pursuant to the factors set out in the decision of the Ontario Court of Appeal in R v MLC (2010 ONCA 843), as well as Regina v Campbell (2018 ONCA 141). The parties did not contest that the seclusion was a significant departure from the liberty norm to which Mr. Kiamarz-Milani had become accustomed.
The restriction of liberty arose as a result of Mr. Kiamarz-Milani’s refusal to follow ward policy, which ultimately lead to aggressiveness toward staff. The Board accepts the evidence in the ROL Report that Mr. Kiamarz-Milani attempted to kick and swing at staff as he was being escorted to his room. Mr. Kiamarz-Milani was uncooperative with an assessment by the duty doctor. Unable to rely on an assessment, it was reasonable that the duty doctor continued seclusion based on the staff’s description of Mr. Kiamarz-Milani’s behaviour, which posed a risk of serious harm to the staff and other patients. The restriction of liberty, at the time it was imposed, was necessary and appropriate for the safety of the public. It represented the least onerous and least restrictive measure.
Dr. Ismail agreed that seclusion could have been discontinued earlier if Mr. Kiamarz-Milani had been offered the opportunity for seclusion relief on November 14 and / or November 16. The Board finds that this is speculative. Mr. Kiamarz-Milani declined seclusion relief a number of days. He declined an assessment. It is more than possible that he could have declined an offer for seclusion relief on November 14 and / or November 16. Therefore, it is not known if seclusion was extended by not offering seclusion relief. However, the Board is mindful that there was a potential lost opportunity for a truncated period of seclusion.
Considering all the circumstances, the Board finds that the restriction of Mr. Kiamarz-Milani’s liberty, throughout, was necessary and appropriate for the safety of the public. It represented the least onerous and least restrictive measure at the time it was imposed up to November 17, 2025.
DATED this 3rd day of February 2026, at the City of Toronto, in the Region of Toronto.
Ms. C. Murray
Legal Member
Office of the Registrar
Ontario Review Board