COURT OF APPEAL (CIVIL DIVISION)
ON APPEAL FROM THE ASYLUM AND IMMIGRATIUON TRIBUNAL
Strand, London, WC2A 2LL
B e f o r e :
LORD JUSTICE MAURICE KAY
LORD JUSTICE HUGHES
| AJ (Liberia)
|- and -
|Secretary of State for the Home Department
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for the Appellant
Mr R Palmer (instructed by Treasury Solicitor)
for the Respondent
Crown Copyright ©
Lord Justice Hughes :
i) The appellant had been referred by his general practitioner to a consultant psychiatrist and on by the latter to Dr Dodgson for therapy. That was in Summer 2004, viz after the failure in front of the first adjudicator in March of that year. Since July 2004, Dr Dodgson has seen the appellant regularly, some 38 consultations by January 2006. He is thus a treating psychologist with a close knowledge of his patient, and not a consultant preparing a report solely for legal purposes.
ii) Dr Dodgson had found the appellant to be suffering from post traumatic stress disorder and an adjustment disorder. Flashbacks to violent incidents witnessed had been successfully treated and he had responded well to therapy, plus (in the early stages) medication. The stressor was regarded as a fear of return to Liberia and of suffering violence if that were to occur. As therapy had proceeded, he had identified also in the appellant a sense of shame and guilt at what he had done or witnessed. He was currently attending college and the prognosis was good if he remained in the UK with ongoing counselling. He had not needed medication for some time; indeed Dr Dodgson as a psychologist was not in a position to prescribe it. If he were to be returned to Liberia there was a significant risk of deterioration. He would lack counselling. There were likely to be external cues which triggered painful memories. He might develop psychosis and there was a significant risk of suicide. The level of that risk was described in different terms at different stages of the reporting. By the time Dr Dodgson was giving oral evidence before the AIT, he described it as a "very high risk".
iii) There had been no sign of suicidal ideas in the three year period when the appellant was actually living in Monrovia. Dr Dodgson suggested that that might be because at that time he would have had hope, whereas now the prospect of return loomed.
iv) There had been no attempt at suicide. There had however been an increase in anxiety since the likelihood of return increased. At some stage, the appellant had cut himself deliberately; it was not clear exactly when this had been.
v) The assessment of suicide risk was not wholly dependent on the appellant's (rejected) account of being targeted as a former child soldier in Monrovia. Dr Dodgson had in the past proceeded in part on the basis that that was true, but his opinion was that even if the appellant's subjective fears were ill-founded, as they had been found to be, they were nevertheless real to him and, with his sense of shame and guilt, created the risk of suicide which he described.
vi) If the appellant were to deteriorate in the manner Dr Dodgson anticipated, he would need either therapy or medication; without either there would be serious deterioration.
"…does not disclose the exceptional circumstances of the D case (cited above) where the applicant was in the final stage of a terminal illness, AIDS, and had no prospect of medical care or family support on expulsion to St Kitts."
The AIT decision
"Taking all the appellant's circumstances into account, we do not think that the severity of the treatment he would suffer on return would attain a minimum level so as to reach the high threshold set by Article 3."
"But it is not suggested that the medication the appellant would need would be unavailable for purchase on the private market in Monrovia and in any event, so far as we are aware, there is nothing to stop the appellant, or those acting on his behalf, for [sic] arranging for him to take supplies of medication with him. We consider it reasonably likely, once back in Monrovia, that he could obtain the necessary medication there."
It went on to say that whilst it accepted that the appellant would experience intrusive flashbacks and suicidal thoughts, which would be triggered by his return to his country of origin, it did not think that these would result in his being at real risk of committing suicide or of undergoing severe psychological deterioration or severe mental illness.
"However, the strength of her claim under article 3 does not depend upon the history, no matter how deserving or undeserving of our compassion, but upon her present situation and her immediate or very near future. "
Lord Justice Maurice Kay: I agree
Sir Mark Potter P. I also agree.