Preston Hill’s back story before he fatally stabbed a Toronto pastor included a serious brain injury, a London court heard Wednesday.

The former elite local hockey player reported during a psychiatric assessment to determine whether he might be sentenced as a dangerous offender that he suffered a serious brain injury in 2020, a year before a violent spree near Western University.

But forensic psychiatrist Alina Iosif testified she “didn’t see a great departure” in Hill’s criminal history after the head injury.

While a defence psychiatrist had diagnosed Hill with a neuro-cognitive disorder due to the injury, Iosif said she couldn’t establish that diagnosis because none of the three Ontario specialists who do neuropsychological testing was available.

While there was some cognitive decline after the injury, Hill improved in some cognitive testing scores during treatment, she noted.

Iosif testified Wednesday in the Ontario Court of Justice, where Justice George Orsini is assessing this week whether Hill will be designated a dangerous offender, which could keep him incarcerated indefinitely.

She agreed under questioning by assistant Crown attorney Konrad de Koning that Hill reported he’d been a victim of childhood sexual abuse.

“It was bad, it made me angry and get into trouble. I wish it never happened,” Hill told Iosif during 2023 interviews.

Hill, 26, pleaded guilty two years ago to manslaughter, assault causing bodily harm and attempted robbery after a violent crime spree in a north London neighbourhood on May 15, 2021.

When he pleaded guilty, the Crown said it would ask the attorney general’s permission to seek a dangerous offender designation for Hill. As part of that application, a 60-day psychiatric assessment was ordered.

Consent for the application came a year ago. Orsini began hearing evidence this week at a hearing to determine Hill’s sentence, including a possible dangerous offender tag.

The hearing began with testimony from corrections officials who described programming and procedures for the dangerous offender population. The focus shifted to Hill and his troubling background on Wednesday.

His criminal record began as a young adult with convictions for assaults, robberies, threats and attempted robbery, court heard. He also has a history of drug addiction issues.

Iosif, of Toronto’s Centre of Addiction and Mental Health, began to review her 56-page report on Hill, based on interviews with him and a review of his background. The June 6, 2023, report included court records, a specialized Gladue pre-sentence report for Indigenous offenders, and records of his mental health and head injury treatment.

In her report, she noted Hill said he didn’t disclose the sexual abuse by a female community member that began when he was about four, until he was about 17. He said he told his parents, but not police, because he didn’t want to be “a rat.”

But there was confusion in the records about when the abuse occurred and when he told people. The abuse was disclosed in other court records shown to Orsini, including one in which Hill said he understood he was abused at 12.

Iosif said she factored in the abuse when assessing Hill, but it was difficult because it was not clear when or how it occurred.

Within minutes on May 15, 2021, Hill fatally stabbed Sufurani (Samuel) Bakare, a pastor and father of four in his 50s, at a Patricia Street address, then ran to Richmond Street, where he stabbed a man walking his dog and attempted a carjacking near Western University’s gates.

Bakare, a Nigerian native, ran Christ the Redeemer Ministries and a cleaning business. He’d befriended Hill at the Salvation Army’s Centre of Hope the day before he was killed, offering help finding work and a place to live.

Bakare had lived at a Patricia Street rooming house and he and Hill drove there to pick up Bakare’s belongings. The landlord knew he was coming, but went back to sleep before they arrived. Bakare called police to help him get his belongings and was waiting in the driveway when Hill attacked.

A parking enforcement officer found Bakare slumped against the garage with a fatal stab wound to his neck just as Hill was being arrested on Richmond Street for the other two attacks.

The dog walker was taken to hospital with a stab wound to the abdomen. Hill left deep scratch marks on the car he tried to carjack after the driver rolled up his windows.

Hill was arrested in a bank parking lot, where he was subdued with pepper spray after encouraging police to shoot him.

Hill had blood on his hands, one of Bakare’s two cellphones and a folding knife on him when he was arrested. He told police he hadn’t taken illegal drugs, then admitted taking crystal meth the night before.

In a later interview, he told police he’d launched the attacks as part of “a war against goofs.”

The hearing is expected to continue all week.

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