Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER
Case No: UI-2022-003851

First-tier Tribunal No: HU/51190/2021

THE IMMIGRATION ACTS

Decision & Reasons Issued:

On 9th of July 2025

Before

UPPER TRIBUNAL JUDGE HOFFMAN
DEPUTY UPPER TRIBUNAL JUDGE RAE-REEVES

Between

IA (Bangladesh)
(ANONYMITY ORDER MADE)
Appellant
and

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the Appellant: Mr S Karim, Counsel instructed by City Heights Solicitors
For the Respondent: Mr Tufan, Senior Presenting Officer

Heard at Field House on 30 June 2025

DECISION AND REASONS

Order Regarding Anonymity

Pursuant to rule 14 of the Tribunal Procedure (Upper Tribunal) Rules 2008, the appellant is granted anonymity.

No-one shall publish or reveal any information, including the name or address of the appellant, likely to lead members of the public to identify the appellant. Failure to comply with this order could amount to a contempt of court.
1. The appellant, a citizen of Bangladesh, appeals on human rights grounds against the respondent’s decision dated 01/04/2021 refusing his application for leave to remain on the basis of his private life dated 10/03/2020.
2. For the reasons given below this appeal is allowed.
3. The parties rely on an appeal bundle comprising 463 pages. All page references in this determination refer to the pdf numbering in that bundle.
ANONYMITY
4. The appellant has requested an anonymity order and this was not objected to by Mr Tufan. We have considered the public interest in open justice, but we consider it is outweighed by the need to protect the appellant’s fragile mental health as he is a vulnerable witness.
BACKGROUND
5. The appellant entered the United Kingdom on 10/10/2009 with entry clearance as a student. He completed a foundation course and undergraduate degree. He applied for further leave to remain on 30/12/2013 but the respondent had written to him on 17/12/2014 telling him that his college’s licence had been revoked and inviting him to find another college within 60 days. His application was refused because he had not provided a new CAS.
6. The appellant appealed against that decision and his appeal was heard by First-tier Tribunal Judge Bennett on 02/12/2015 who promulgated his decision on 08/01/2016. The appellant did not appear before him and was unrepresented. We detail below the judge’s conclusions.
7. The appellant made a human rights claim for leave to remain based on his private life in the UK in 2020 which was refused on 01/04/2021. The appellant appealed against that decision and his appeal was refused by First-tier Tribunal Judge Fergusson but in doing so he overlooked a supplementary bundle, and this decision was appealed to the Upper Tribunal. At a hearing before the Upper Tribunal on 12/01/2023 both parties agreed that it was a material error of law to overlook the supplementary bundle. The decision was set aside and was re-made by Upper Tribunal Judge Gleeson in a decision dated 19/05/2023 promulgated on 28/05/2023 in which she dismissed the appellant’s appeal.
8. That decision was appealed and permission to appeal was granted by Falk LJ on 22/04/2024. By consent, Upper Tribunal Judge Gleeson’s decision was set aside, and the appeal was remitted to the Upper Tribunal for a fresh de novo determination which we now provide.
HEARING
Preliminary issues
9. In view of the appellant’s health conditions, we are satisfied that he is a vulnerable witness, applying the Joint Presidential Guidance L No 2 of 2010: Child, Vulnerable Adult Sensitive Appellant Guidance.
10. At the beginning of the hearing, we clarified with Mr Tufan what the respondent’s position was in relation to the medical evidence. He confirmed that the respondent accepts the diagnoses provided by the experts and that they record that he has a suicidal ideation. He confirmed that the expertise of the experts is accepted. However, he will be making submissions that the appellant had done nothing about his mental health between 2022 and 2025.
Issues in dispute
11. As agreed by the parties, the three issues are as follows:
a) Whether refusal would result in a breach of Article 3 of the ECHR on medical grounds?
b) Pursuant to section 276ADE(1)(vi) of the Immigration Rules, would the appellant face “very significant obstacles” to his integration into Bangladesh?
c) Is the decision of the respondent proportionate to the aims of Article 8(2) of the ECHR in the refusal would result in unjustifiably harsh consequences?
12. The appellant relies on three witness statements dated 23/11/2021 (65), 08/03/2023 (43) and 13/06/2025 (11). He relies on and adopts all his statements. The appellant expresses despair that he lost his college place through no fault of his own and states that he made every effort to enrol on a new course but was unable to in time.
13. He explains that his father was keen to support his son studying abroad and sold land to pay for the costs. Sadly, his father suffered long term cancer and died in May 2017 and it was during the course of his three-year treatment that the appellant’s family funds were exhausted by the medical costs. The appellant says that he carries a constant sense of guilt and grief having been unable to visit his father while he was ill or attend his funeral.
14. He sets out aspects of his private life and in particular his social network which he states that he is dependent on. He describes how his mental health has deteriorated particularly following his father’s death and that he has suffered from depression and contemplated suicide.
15. He expresses his feelings of being a failure having not completed his education in the UK and this has also resulted in his fiancé leaving him. He explains how difficult it would be for him to return to Bangladesh. He says that his family hate him because they blame him for his father’s death and for squandering the money his father put towards his education.
LEGAL FRAMEWORK
17. Firstly, consideration must also be given to whether the decision of the respondent would amount to a breach of Article 3 of the European Convention on Human Rights (“ECHR”). This Article is not qualified. Both parties agree that the case of AM Zimbabwe (2020) UK SC 1 applies.
18. Under paragraph 276ADE(1)(vi) of the Immigration Rules, the requirements to be met by an adult applicant who has lived continuously in the UK for less than 20 years at the date of application are that “there would be very significant obstacles to the applicant’s integration into the country to which he would have to go if required to leave the UK.” The parties agree that this is the applicable law at the time of the application, although 276ADE has now been replaced by Appendix Private Life.
19. Outside of the rules, the question is whether the refusal breaches the appellant’s right to respect for private life under Article 8 ECHR. That right is qualified. The appellant must establish on a balance of probabilities the factual circumstances on which he relies and that Article 8 (1) is engaged. If it is, then we must decide whether the interference with the appellant’s right is justified under Article 8 (2). If an appellant does not meet the immigration rules, the public interest is normally in refusing leave to enter or remain. The exception is where refusal results in unjustifiably harsh consequences for the appellant or a family member such that refusal is not proportionate. We take into account the factors set out in s.117B Nationality Immigration and Asylum Act 2002 and balance the public interest considerations against the factors relied upon by the appellant.
20. As set out below, we are rely on the guidance in Devaseelan (2002) UKIAT 00702.
FINDINGS
22. We direct ourselves that following Devaseelan, Judge Bennett’s determination provides an assessment of the claim that the appellant was making at that time. It is not binding on ourselves and can be built upon, particularly by the provision of new evidence. For this reason the outcome of a hearing before a second judge may be quite different from that of Judge Bennett.
23. We turn to the assessment made by Judge Bennett. The appellant did not attend the hearing and in the absence of any arguments before him, his analysis is brief. At paragraph 11 he does not consider there would be very significant obstacles to the appellant’s integration because he was born and lived in Bangladesh. He maintains a bank account there and gave no reasons why there would be obstacles.
24. Whilst the judge considered that he had established a private life in the UK he was not satisfied that removal would be a sufficiently serious interference with it because he could continue his private life there. He places little weight on the appellant’s precarious presence in the UK and makes no reference to any factors that would outweigh the need for effective immigration control.
25. The sparsity of Judge Bennett’s findings are not a criticism as he had no skeleton argument and no submissions were made to him. Moreover, there was no Article 3 medical claim before him. Whilst we are mindful of the guidance in Devaseelan, we agree with Mr Karim’s submission that there needs to be a wholesale fresh consideration of the appellant’s circumstances (appellant’s Skeleton Argument paragraph 14 “ASA”).
26. We first consider the medical evidence. We have been provided with the up-to-date evidence of Dr Georgia Costa dated 06/06/2025. She is a qualified psychologist and psychotherapist with considerable workplace experience and is accredited as an expert witness. Her CV is provided (35). Based on this unchallenged expertise, we accept her opinions and diagnosis. Based on standard testing, her opinion is that the appellant suffers from severe depression and severe anxiety (31). This includes suicidal ideation (30). He also scores very highly for severe hopelessness. She notes that he is on medication and is seeing a psychiatrist, Dr Gina Waters who she refers to; “I totally agree with Dr Gina Waters in that, while he is living in fear and uncertainty, his mental health will not improve. Furthermore, it is very important that Mr A continues to have the support of his social network. This network is clearly a protective factor in the absence of his immediate family who he is estranged from” (33).
27. She goes on to say “if he is not allowed to remain in the UK, I fear that this will be another huge loss for him and I do not think that he would be emotionally equipped to cope with it. I have no doubt that it would have a devastating effect on his mental health as it would be an additional stress. The risk of him having a mental health crisis and becoming a danger to himself would significantly increase. His suicidality would increase and he may attempt to take his own life” (33).
28. Dr Waters provides a recent letter dated 22/05/2025 (40). She confirms that the appellant has been referred back to the Kentish Town Core Team and that he has recurrent depressive disorder. She confirms that when she reviewed him in 2022, he had poor sleep, appetite, low mood and suicidal ideation as well as anxiety and panic attacks. His symptoms appear to be treatment resistant although he is currently on medication. She states that he has frequent suicidal ideation. She notes he has no support network in Bangladesh and the death of his father led to further deterioration in his mental health. She states, “returning to Bangladesh would cause serious harm to his mental health and disrupt his treatment and the stability he has found here”.
29. His diagnosis of anxiety and depression with suicidal thoughts is echoed by his GP in a letter dated 19/05/2025 (39). The appellant has previously relied on reports from Dr Christine Nallet who is a very experienced GP with a special interest in chronic conditions. She provides reports dated 20/05/2019, 27/12/2020 and 13/03/2022. These reports are independent medico-legal reports with the latter based on an interview and psychiatric assessment undertaken in March 2022. Across the three reports her diagnoses remain constant, namely depression and anxiety which had been treated since 2019. She notes that he had been prescribed Sertraline in December 2021 and was started on Citalopram in March 2022, although he had been self-medicating with Amitriptyline. She states that he considers that he has not been able to bring any pride to his family due to his failures and if he returns, he would be dependent on them who are already living with difficulties. He scored the maximum on the GAD score for anxiety and his score for depression is very high too (257).
30. She concludes that he needs to engage with long term psychological and medical treatment and returning would reinforce his feeling of total failure and could “strengthen the impulses he has that his life has become a burden” (259).
31. There was no challenge by the respondent to the diagnoses, and based on these authoritative experts, we find that the appellant suffers from the disorders they describe and has suicidal ideations.
32. Based on the consistency and quality of the evidence we find that the appellant’s problems as described are serious, long standing and coincide with the onset of his father’s cancer in 2014 and resulting death in 2017 alongside the change in his immigration status.
33. We next turn to the availability of support the appellant may encounter on return to Bangladesh because findings on this topic impact our consideration of the relevant legal tests described below.
34. Mr Tufan submits that there is no reason why the appellant’s family would not assist him if he needed help. He also emphasised that he didn’t consider the appellant would need help. He based this submission on lack of credibility. We listened carefully to the appellant’s evidence and at times it was vague and difficult to understand because of the appellant’s very quiet manner. At times he was visibly upset, necessitating a pause to his cross-examination. However, we are mindful of the appellant’s vulnerable state and his serious mental health issues and do not consider that he lacked credibility.
35. He was asked about his family and confirmed that he has four brothers and two sisters. He said he did not know what they did but confirmed that they used to work in construction, as a garment inspector and school teacher. When asked about his family his answer was clear and emotional that “they don’t like me, they hate me”. He went on to say that they blame him for his father’s death because he is a failure. He later emphasised that his siblings “do not care about me”.
36. He confirmed that his sisters are married and look after his mother who has difficulties with her vision and hearing. His mother is still in the family home but stays with his sisters. He emphasised again that his family had sold their land and that the family had spent their money on his education in the UK and he would only be a burden if he returned now. When specifically asked why he could not return to live with his mother, he said that he did not have the capability to survive and that she would be a burden on him or he would be a burden on her.
37. We are mindful of the fact that it is very simple for an appellant to make an assertion that they have no contact or support in their country of origin. In the present appeal we find the appellant’s evidence on this point to be credible because it has been consistent across the witness evidence, all of the expert reports and his oral evidence.
38. The experts all comment on this point. Dr Costa refers to him as being estranged (33) and his family hating him (30). Dr Walters states that he has no support (52), as does Dr Nallet (259). His NHS peer coach Mr Leiritz comments that he has no active support in his country of origin (54). His nurse suggests the same (55). This is consistent with the lay witness evidence including the appellant’s (Witness statement dated 13/06/2025 paragraphs 22 and 24) and that of Mr SI who attended to give oral evidence (statement paragraph 12; page 76).
39. We note that Mr Tufan did not submit that the appellant’s witness, Mr SI, who is his mother’s cousin, lacked credibility. We place weight on this witnesses evidence as he attended to provide oral evidence. Other witnesses also state that he has no support, and we note that their evidence goes back as far as 2021, for example, Mr M A (81), Mr J A (84). We attach little weight to the evidence of witnesses who have not attended the tribunal but nevertheless note that the consistency of the evidence.
40. In summary, based on the consistency of evidence across multiple years and in oral testimony, we accept that the appellant cannot rely on family or other support in Bangladesh. This will have an impact on the tests that we apply below.
Article 3 claim
41. The genesis of the law relating to Article 3 cases is comprehensively set out in the decision of the Upper Tribunal in MY (suicide risk after Paposhvili) (2021) UKUT 232 (IAC) at paragraph 12 onwards. The well-known test in AM (Zimbabwe) (2020) UKSC 17 was helpfully broken down by the Upper Tribunal in AM (Article 3 health cases) Zimbabwe 2022 UKUT 00131.
42. The decision in MY confirms that the risk of suicide can trigger an Article 3 case, a fact previously established RA (Sri Lanka) v SSHD (2008) EWCA civ 1210. The point was also considered in Y (Sri Lanka) v SSHD (2009) EWCA civ 362 and J v SSHD (2005) EWCA civ 629. We refer to the test in AM below but following Mr Tufan’s submissions relying on the factors in J, we analyse those factors, or tests, set out in J as reformulated in Y and which were considered in MY.
43. The first factor requires an assessment to be made of the severity of the treatment which is said that the applicant will suffer if removed. Mr Tufan submits that there would be no serious risk of harm because the appellant’s ill health is predicated on the threat of removal and removing such threat would reduce the risk of suicide. He notes in this regard that the appellant has not tried to commit suicide. We reject this submission. We consider that the appellant has discharged the burden of establishing that he is a seriously ill person. Based on the medical evidence we find that the appellant is a seriously ill person due to his mental health and suicidal ideation and is undergoing treatment. Both his treating GP and psychiatrist together with Dr Costa are clear in their opinion and diagnoses and conclude that he has suicidal ideations, very poor mental health and is at risk of harming himself, particularly if removed. We specifically rely on the conclusions of the most recent medical evidence quoted above (paragraph 27) that removal would have a devastating effect with a subsequent significant increase to becoming a danger to himself.
44. Secondly, a causal link must be shown to exist between the act of removal and the inhuman treatment complained of. Mr Tufan suggests there is no causal link because if the threat of removal is taken away the risk lessens. We disagree because we find that the link does exist between removal and the potential suicide that may be caused by that removal. We comment below on available treatment. The third and fourth factors need not be commented on as we acknowledge that the Article 3 threshold is particularly high and that it can succeed in suicide cases.
45. The third and fourth factors of the test in are uncontroversial.
46. In relation to the fifth factor, namely whether the risk is objectively well founded, we disagree with Mr Tufan. He suggests that it is not, because the risk of suicide is brought about by the shame that the appellant feels in relation to his family. Such a factor is usually more relevant where appellants fear, wrongly or rightly, actions by the state so as to breach Article 3. However, as the Court of Appeal held in Y (Sri Lanka) at paragraph 16 when looking at the test in J, even where there is no objective foundation to a person’s fear on return, a genuine subjective fear can lead to a real risk of suicide. That, we find, is the case here. In particular, Dr Costa writes, the “risk of him having a mental health crisis and becoming a danger to himself would significantly increase” and the appellant’s “suicidality would increase and he may attempt to take his own life as an impulsive, desperate measure”.
47. The next and final issue is whether Bangladesh has effective mechanisms to reduce the risk of suicide, as the presence of such mechanisms will naturally weigh against the appellants claim of a breach of Article 3 rights. We therefore go on to consider what treatment is available and would be accessible to the appellant.
48. It is relevant to note that we first find that the appellant is currently undertaking treatment. He has regular contact with his GP and has access to talking therapy through the Camden Mental Health Core Team. In particular he is under the care of a consultant psychiatrist, Dr Waters. He is currently on medication; Mirtazapine. Prior to this medication he was on Sertraline in November 2024 and prior to that, Citalopram. As noted by Dr Costa his mental health has not responded to medication and we agree with Mr Karim that this is more likely to be the reason why he has changed medications.
49. We are directed to the Country Policy and Information Note Bangladesh: Medical Treatment and Health Care dated July 2022 (“CPIN”) which both parties rely on. It notes that many people experiencing poor mental health do not access health care, and this may be due to widespread stigma but also restricted access. It notes that only 270 psychiatrists and 500 clinical psychologists operate in Bangladesh. It quotes the US State Department finding that government facilities for treating persons with mental disabilities were inadequate (10.1.1).
50. Mr Tufan submits that the appellant’s village where he would return is some 84 kilometres from Dhaka (approximately). He notes that he has at least one brother in Dhaka and that treatment is available at public facilities such as a National Institute of Mental Health in Dhaka, including for those who have attempted suicide, and that his current medication is available at the Dhaka Medical College Hospital (paragraph 10.1.5, 10.1.4 respectively). These facilities have in-patient and out-patient provision, including psychiatric crisis intervention in case of suicide attempts.
51. Mr Karim relies on the fact that the experts suggest that the appellant needs long term support (257) and that his treatment is currently resistant to the various medications he has tried (52). In addition, he notes that the appellant appears to have physical consequences as a result of his mental health issues, including affecting his memory. He submits that the holistic treatment identified by the experts is not the same as access to a single drug and relies on the references to inadequate treatment and the fact that the Institute referred to by Mr Tufan only has 200 beds (identified in the previous CPIN from 2019). The objective evidence appears to show that there are other beds or facilities available but he argues that it is still very small in a country of 170 million people.
48. The appellant also relies on objective material quoted in his previous skeleton argument, namely an article entitled "The current state of mental health care in Bangladesh: part 1 – an updated country profile” from the Royal College of Psychiatrists dated August 2021. It notes that psychotropic drugs are not widely available and few patients visiting government healthcare facilities have access to them. Of some concern it notes that referrals to mental health specialists are “near non-existent” (ASA paragraph 33). We do note, however, that this report suggests that there are far more hospital beds available in Dhaka than is suggested by the CPIN, although Mr Karim submitted that is irrelevant so long as there is an insufficient number of trained medical staff to care for the patients.
49. Mr Karim emphasises that it is not theoretical availability of treatment but actual access that we must consider. We agree with this approach.
50. We note that the CPIN states that Mirtazapine is available at the Dhaka Medical College Hospital (10.1.4), which is a state-run facility, but this single reference does not indicate or demonstrate that psychotropic drugs are generally available. In this regard we rely on the Royal College of Psychiatrists assessment as being experts in this field, especially when their report post-dates the sources quoted in the CPIN.
51. Based on this objective evidence we find that it is unlikely that the appellant would have access to suitable healthcare and this would increase his mental illness and risk of suicide. Using the terms articulated in J we do not consider that Bangladesh has effective mechanisms to reduce the risk to this appellant. As submitted by Mr Karim, we have applied a real-world perspective on this evidence. We accept that there are facilities in Dhaka which is some two hours away from the appellant’s village. Based on the medical evidence we find that the appellant requires ongoing treatment and even with such treatment he currently has suicidal ideations. It therefore seems clear to us that he will require what Mr Karim describes as a holistic approach to his care in order to support his mental health and prevent crises, including suicide.
52. We have been careful to set out our reasons why we have found that the appellant would not have support in his country of origin. The real-world scenario is therefore that he would return to his home village with an elderly and infirm mother who suffers from hearing and vision loss. We find from 10.1.2 of the CPIN that it is highly unlikely that the appellant would have access to mental healthcare facilities in a rural area as they are concentrated in the major cities, particularly Dhaka. We have accepted his evidence as credible that his family, including his brother in Dhaka, have either been estranged from him or in his words “hate me”. Even if they do not hate him, we accept that the appellant has a genuinely held subjective belief that they do and, coupled with the evidence that stigma surrounds mental health issues in Bangladesh, that the appellant would not seek out his family in any event. Without such support we do not consider it realistic that the appellant would have access to the very limited healthcare provision in Dhaka. The experts emphasise the need for him to have access to his support network which would be lacking and would, based on the experts result in a deterioration of his mental health and without such support we find he would not have access to available psychiatric care.
52. The onus is on the appellant to adduce evidence capable of demonstrating that substantial grounds have been shown for believing that as a seriously ill person he would face a real risk:
(i) On account of the absence of appropriate treatment in the receiving country or the lack of access to such treatment,
(ii) Of being exposed to a serious, rapid and irreversible decline in his or her state of health resulting in intense suffering, or to a significant reduction in life expectancy.
53. In considering the effect of removal on the appellant we focus on the “foreseeable consequences of the removal” as stated in J [28]. In doing so we are mindful of the assessment set out in J that the ill treatment must “necessarily be serious such that it is an affront to fundamental humanitarian principles to remove an individual to a country where he is at risk of serious ill treatment” [26]. We have taken into account that it is a particularly high threshold in foreign cases and the fact that it is “even higher where the alleged inhuman treatment is not the direct or indirect responsibility of the public authorities of the receiving state, but results from some naturally occurring illness, whether physical or mental”.
54. Based on the findings set out above, we conclude that the lack of appropriate treatment (and support) would expose the appellant to a significant reduction in life expectancy or a serious rapid and irreversible decline in his state of health resulting in intense suffering. Based on the medical evidence we have found that the appellant suffers from severe depression and suicidal ideation. Dr Costa considers that removal would have “a devastating effect on his mental health” and “his suicidality would increase and he may attempt to take his own life”. Based on the expert’s opinion, we find that without access to treatment or medication in Bangladesh would result in the likelihood of suicide which would fulfil the test. The risk is also made greater due to the appellant’s real or perceived rejection by his family and sense of shame at having failed both his family and in particular his deceased father.
55. For all the above reasons we find that removal of the appellant to Bangladesh would breach the UK’s obligations under Article 3 on both medical and suicide grounds.
Article 8 claim
56. It follows that we find that removal would also amount to a breach of the appellant’s private life under Article 8.

NOTICE OF DECISION
The appeal is allowed on human rights grounds.

V Rae-Reeves

Deputy Judge of the Upper Tribunal
Immigration and Asylum Chamber

04/07/2025