Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER
Case No: UI-2024-004845

First-tier Tribunal No: RP/00008/2020

THE IMMIGRATION ACTS

Decision & Reasons Issued:

On 25th of March 2025

Before

DEPUTY UPPER TRIBUNAL JUDGE JARVIS

Between

AM
(ANONYMITY ORDER MADE)
Appellant
and

THE SECRETARY OF STATE FOR THE HOME DEPARTMENT
Respondent

Representation:
For the Appellant: Mr A. Eaton, Counsel instructed by Southwark Law Centre
For the Respondent: Ms S. Nwachuku, Senior Home Office Presenting Officer

Heard at Field House on 4 March 2025

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 him. Failure to comply with this order could amount to a contempt of court. This order has been made on the basis of the international protection issues in the appeal which outweigh the public interest in open justice.

DECISION AND REASONS

Introduction
1. This decision should be read alongside the Upper Tribunal’s (“the UT’s”) error of law decision dated 23 January 2025.
Procedural history
2. As laid out in the earlier decision, the Appellant is a Somali national born in 1970 who the Respondent has historically accepted is a member of the minority Reer Hamar group – the Bandhabow.
3. The effect of the UT’s findings in the error of law decision (at §45) is that the Appellant has rebutted the section 72 (of the Nationality, Immigration and Asylum Act 2002) presumption, but his appeal against the refusal of his Refugee Convention claim has been lawfully dismissed.
4. The remaining live issue relates to whether the Appellant’s deportation to Somalia would breach the UK’s obligations under Article 3 ECHR.
The remaking hearing
5. The remaking hearing was heard in-person at Field House. The Appellant attended accompanied by his support worker but was not required to give evidence: both representatives were in agreement that the appeal should proceed by way of submissions only.
6. Preliminarily Ms Nwachuku asked permission to adduce two further country reports: ‘Response to an information request - Somalia: Mental health treatment’ (4 October 2024) (“the 2024 report”) and ‘Response to an Information Request - Somalia: Mental healthcare in Mogadishu’ (16 June 2021) (“the 2021 report”). After discussion Mr Eaton indicated that he had no objection to the evidence being admitted and I therefore accepted the reports into evidence. I also admitted the Appellant’s updated skeleton argument dated 28 February 2025.
7. In her submissions Ms Nwachuku relied upon the refusal letter from 2019, the Respondent’s Humanitarian Situation Country Policy Information Note (“CPIN”) (May 2022) and the two reports adduced on the day of the hearing. She asserted that OA (Somalia) (CG) [2022] UKUT 33 (IAC) (“OA”) and the CPIN at section 2.4.1 confirmed that the humanitarian conditions in Somalia did not generally reach the threshold of serious harm. Ms Nwachuku averred that OA established that it would be rare for a person from the Reer Hamar group to be compelled to reside in an Internally Displaced Person (“IDP”) camp.
8. Ms Nwachuku further argued that the Appellant’s mother had only left Somalia recently and in line with OA it was likely that the family would still have specific relationships in Somalia to call upon. She also contended that the Appellant had spoken of his desire to work in his witness statement and that he could do this on return with initial reliance upon the money provided under the Facilitated Return Scheme (“FRS”) and clan support. It was also asserted that the country guidance tended to show that members of the diaspora were favoured by employers in Somalia. Ms Nwachuku overall submitted that the evidence did not establish that the Appellant would be forced to reside in an IDP camp on return.
9. In respect of the Article 3 ECHR medical threshold Ms Nwachuku relied upon the 2024 report which indicates that schizophrenia is recognised as a mental disorder in Somalia and that there are some psychiatrists in Somalia. I was also asked to have regard to the 2021 report which indicates that risperidone is available from four hospitals in Somalia.
10. Ms Nwachuku contended that the evidence provided suggested that the Appellant would be able to access his medication and relevant psychiatric healthcare and that coupled with the financial package offered through the Facilitated Return Scheme, as well as relevant support from clan members, the Appellant would be able to access the required medication and support. She also added that OA established that a guarantor would not be required if the Appellant took up self-employed work in Mogadishu.
11. I was therefore asked to dismiss the Article 3 ECHR destitution and Article 3 ECHR medical appeals.
12. In his response Mr Eaton emphasised the preserved findings from the decision of the First-tier Tribunal including the Appellant’s high level of vulnerability, his complex needs and the 24/7 multi agency support which he has received in recent times.
13. He argued that the Appellant’s desire to work was contingent upon his ability to recover from his long-standing health problems and that there was no real prospect of the Appellant being able to earn a living for himself in Mogadishu.
14. In respect of the FRS funding, Mr Eaton emphasised that the financial support was limited and in any event the Appellant had a history of being financially exploited. It was argued that the Appellant would face a greater risk having received financial support and that he did not have the capacity to use the money positively.
15. In respect of potential clan support, Mr Eaton contended that the type of clan support envisaged in the guidance provided in OA related to measures such as standing as a reference or guarantor for accommodation/work and did not constitute the kind of 24-hour support and monitoring required by the Appellant in order to meet his core vulnerabilities.
16. In respect of potential healthcare support in Mogadishu, Mr Eaton contended that OA gave case-specific guidance about potential healthcare available in Mogadishu. Mr Eaton relied upon the 2024 report at sections 1.1.2, 1.1.3 and 1.1.4 to show that there was significant evidence of engrained stigma in respect of mental health disorders with only very rudimentary health provisions in existence.
17. Mr Eaton also relied upon section 1.2.2 and argued that the Respondent’s own evidence indicated that free medication was only available for basic conditions and that the Appellant would be compelled to pay for his antipsychotic medication. Mr Eaton made the same point in respect of the 2021 report by reference to section 5.
18. In respect of the 2021 report, Mr Eaton also submitted that only the Forlanini Hospital provided free mental healthcare but in that case only in the context of outpatient treatment which was manifestly insufficient for the appellant’s own particular needs.
19. Overall Mr Eaton submitted that the Appellant’s mental health would very quickly decline on return and that he would fall into destitution or would otherwise meet the Article 3 ECHR medical threshold. Mr Eaton also added that the Appellant would very likely end up residing in an IDP camp featuring dire conditions because of a lack of support and that an associated risk of violence was a possibility.
Findings and reasons
20. In coming to my conclusions I have had careful regard to the composite bundle of 286 PDF pages provided by the Appellant for the error of law proceedings, Mr Eaton’s most recent skeleton argument and the two country reports provided by Ms Nwachuku.
21. In respect of the assessment of Article 3 ECHR, I have applied the lower standard of proof and considered all the evidence, in the round, at the date of the hearing. I have reminded myself that the burden of proof falls upon the Appellant.
22. The UT’s starting point is guided by the preserved findings from the First-tier Tribunal: that the Appellant has complex needs and receives significant, multiagency support; that he does not have direct family in Mogadishu and would not receive remittances from the diaspora on return.
Article 3 ECHR - destitution
23. It is important to begin with reference to the detailed findings of the UT in OA (Somalia) (CG) [2022] UKUT 33 (IAC) (“OA”) and the Appellant’s accepted membership of the Reer Hamar group.
24. At §247 the UT concluded: “…We prefer the evidence of the Appellant's own expert, Ms Harper, taken with the summary in the 2019 Landinfo report, that the Reer Hamar may be distinguished from other minority clans in this respect. The Reer Hamar live in their own districts, among their own people. The evidence does not demonstrate that they are forced to resort to IDP camps. A returning member of the Reer Hamar would be highly unlikely to resort to an IDP camp; instead, they will find accommodation in one of the Reer Hamar districts.”
25. And at §248: “…being a member of a clan such as the Reer Hamar has the potential to place an individual returnee in a relatively advantageous position upon their return when compared to other, less senior minority clans, or at least go some way to mitigating the otherwise harsh conditions they would encounter. The Reer Hamar will be better placed to exploit network links than some other minority clans in Mogadishu; they will be more familiar with the city through the concentrated residential focus of the clan, and are less likely to be residing in IDP camps. They have made some gains in placing their clan on the trajectory to resumed influence and significance.”
26. A further factor is the relevance of the potential FRS grant of £750 for the Appellant, at §274: “…The initial FRS grant of 750GBP amounts to approximately 1000USD at current rates. It will accordingly be sufficient to secure a returnee's accommodation and subsistence for two weeks (assuming all food is purchased at the hotel) and up to four weeks (assuming cheaper food is purchased elsewhere, or some work is secured to provide an additional income in the meantime).”
27. In respect of the risk of international serious harm in IDP camps, at §309: “…We have not been taken to any evidence that human rights abuses are sufficiently widespread to merit a finding that there are presently "substantial grounds" to conclude that such abuses continue to take place in a significant number of IDP camps, nor that such conduct takes place as the result of a policy or system, or official indifference on the part of the relevant authorities.
310. We do not consider the evidence relating to the overall prevalence of crime and human rights abuses in Mogadishu to demonstrate that there are substantial grounds for concluding that IDPs are at a real risk of being subjected to mistreatment of this nature beyond the risk faced by an 'ordinary' citizen of Mogadishu.”
“312. It follows that, absent some special factor which renders a returnee residing in an IDP camp particularly vulnerable to human rights abuses, there is no real risk of being exposed to such treatment merely over and above the risk faced by an 'ordinary citizen' of Mogadishu residing elsewhere in the city.”
28. This led the Tribunal to the overall conclusion at §339: “If there are particular features of an individual returnee's circumstances or characteristics that mean that there are substantial grounds to conclude that there will be a real risk that, notwithstanding the availability of the FRS and the other means available to a returnee of establishing themselves in Mogadishu, residence in an IDP camp or informal settlement will be reasonably likely, a careful consideration of all the circumstances will be required in order to determine whether their return will entail a real risk of Article 3 being breached. Such cases are likely to be rare, in light of the evidence that very few, if any, returning members of the diaspora are forced to resort to IDP camps.”
29. In respect of mental health services in Mogadishu the UT concluded that there is limited but nonetheless meaningful provision of mental health medication in Mogadishu. The panel went on to accept that the country evidence demonstrated that mental health medication had been available for some time and that some, albeit limited, provision is available for those with mental health conditions (§350). At §351 the Tribunal placed material weight on a report by the organisation TANA (from 2020) which recorded that the medication risperidone is available in at least four hospitals and that patients who cannot afford consultation fees are treated free of charge (including drug abusers referred by police) by the Forlanini Hospital.
30. In respect of cannabis and alcohol, the evidence cited by the UT panel at §354 suggests that both are potentially available in Mogadishu albeit this would have to be acquired on the black market.
31. In light of the UT’s overall conclusions in OA as summarised at §405, I must apply §407(h) of MOJ & Ors (Return to Mogadishu) Somalia CG [2014] UKUT 442 (IAC) and the conclusions at §356 of OA.
32. In respect of §407(h)(i), I note that the Appellant is a member of the Bandhabow subgroup of the Reer Hamar which is a senior minority clan with deep historical roots in Mogadishu. The Appellant worked with his father in a shop before he left Somalia at the age of 29 in 1999 before later arriving in the United Kingdom on 2 January 2000. The Appellant and his family previously faced persecution on the basis of their clan membership.
33. By reference to §407(h)(ii) I find that the Appellant has been absent from Mogadishu for approximately 25 years; I also conclude that the Appellant does not have any known immediate family or direct clan associations to call upon on return to Mogadishu (§407(h)(iii)).
34. In regard to §407(h)(iv) I note the preserved finding that the Appellant would be able to apply for (and I find reasonably likely to receive) £750 under the Respondent’s Facilitated Return Scheme.
35. In respect of the Appellant’s prospects of securing a livelihood (whether through employment or self-employment) I conclude overall that those prospects are extremely low. I start by recognising that the Appellant has previously worked in Somalia and, according to the medical notes before the UT, also worked whilst in prison.
36. The important context however is that during both periods of work the Appellant was not consuming alcohol which he has been significantly dependent upon since around 2006 (and so post-dating his work in Somalia) and which he was not able to access whilst in prison.
37. The evidence postdating the Appellant’s release from his most recent sentence indicates that he continues to drink alcohol and has a tendency to minimise his levels of consumption (see for instance the National Probation Service letter dated 16 July 2024).
38. The Appellant’s misuse of alcohol compounds his mental health problems which is spoken to in much of the medical evidence and is the subject of findings by the First-tier Tribunal. I find that, overall, the evidence indicates that the Appellant has previously been diagnosed with schizophrenia and has been receiving venlafaxine and risperidone for his mental health problems for a number of years. It is suggested that the Appellant may have been sectioned on two occasions in the past but I have no further information about that before me.
39. The consistent medical evidence also shows that the Appellant tends to suffer with auditory hallucinations (hearing voices) which is exacerbated when he is stressed, and that the severity of his mental health problems is closely linked to his stress levels and use of alcohol.
40. It appears that the Appellant was also able to access synthetic cannabinoids whilst in prison albeit it is not suggested that he is still using cannabis in the most recent documentary evidence.
41. I accept that the Appellant is therefore suffering with remitting-relapsing mental health problems which are compounded by his longstanding alcohol abuse and that this also seriously impacts upon his compliance with his medication regime. The doctor’s letter from 1 March 2023 indicates that the Appellant could become well if he was abstinent and compliant with his medication, but it is also clear that the Appellant continues to consume alcohol despite being within the supportive care of St Mungo’s.
42. In respect of that care, I reiterate the findings of the First-tier Tribunal that the Appellant is subject to 24/7 multi agency support. The National Probation Service letter indicates a strong link between the Appellant’s reduction of alcohol intake since his release from prison and his regular access to a visiting psychiatrist in the supported accommodation he resides in.
43. Much of the medical evidence speaks to the Appellant’s inherent vulnerability not only to exacerbations of his mental health problems (for instance the overdose attempted in 2022) but also his vulnerability to being subject to exploitation. The National Probation Service letter details, to some extent, that the Appellant was targeted for money by other residents in the accommodation as it had become known that he was receiving disability benefit.
44. The letter from St Mungo’s dated 16 August 2024 confirms that the hostel staff dispense the Appellant’s medication to him on a daily basis and provides a further comment that the Appellant’s mental health would relapse very quickly if he was unsupervised.
45. In respect of the Appellant’s historical circumstances, taking into account his alcohol abuse from at least 2006, the National Probation Service letter also refers to periods of time in which the Appellant was street homeless.
46. On the basis of the findings made by the UT in OA at §274 I conclude that it is reasonably likely that the Appellant would receive the FRS package of £750 meaning that he would be able to reside in a hotel in Mogadishu for up to 4 weeks after his return.
47. In respect of the availability of medication in Mogadishu I take into account the general observations made by the UT in OA, as well as the 2021 and 2024 reports expressly relied upon by the Respondent in this hearing and find that risperidone is available in Mogadishu but is not free. I also find that the current evidence before me does not show that venlafaxine is available but if it is, the 2024 report indicates that it would also need to be paid for as it is plainly not a basic form of medication (see 1.2.2 of the report).
48. There is no good reason to think that the Appellant could not take some medication with him from the UK but it is also apparent that any medication brought from the UK would be finite in quantity and therefore the Appellant would reasonably likely have to pay for these medications (if available) within a foreseeable period after his return.
49. In any event I conclude that the weight of the evidence before the Tribunal (which I have referred to above) indicates that the Appellant will very quickly become non-compliant with his medication (whether brought from the UK or acquired in Somalia) without the 24/7 support and monitoring which he currently receives in the United Kingdom.
50. Whilst alcohol is not easy to obtain it is nonetheless available to some extent in Mogadishu – this is shown not only in some of the evidence cited by the UT in OA (and the headnote at 16) but also by the Tribunal in AAW (expert evidence - weight) Somalia [2015] UKUT 673 (IAC) (§63). I recognise that the latter decision is not reported in respect of the availability of alcohol, but it is nonetheless consistent with the later evidence in OA.
51. I therefore find it is reasonably likely that the Appellant would seek to obtain alcohol on his return to Mogadishu and would be able to find some on the black market. In any event the medical evidence also indicates that the Appellant’s mental health is sensitive to increased stress which would no doubt be a highly relevant factor on his return to a country which he has not resided in for over 25 years and where he has no immediate family.
52. I therefore find that the Appellant’s mental health will reasonably likely materially deteriorate on his return to Mogadishu and that he will not be compliant with his medication. I find that it is highly likely that the Appellant will not have the agency to seek assistance from a relevant health provider in Mogadishu and the 2024 report provided by the Respondent confirms that none of the hospitals in Somalia provide special housing or assisted living for people suffering from long-term mental disease (section 1.1.1).
53. Equally there is no country evidence at all to indicate that the Appellant could seek 24/7 support from any governmental or non-governmental body in Mogadishu or anywhere else in southern Somalia. Furthermore the Respondent has not provided any bespoke evidence to indicate that specific arrangements could be made for this Appellant after his immediate return to Mogadishu.
54. I therefore conclude that it is reasonably likely that the Appellant’s mental health will seriously deteriorate within a short period of time after return even if he is not able to access alcohol.
55. This means that I find that it is reasonably likely that the Appellant would not be able to secure a livelihood (whether employed or self-employed) even with some initial assistance from his own extended clan family. The conclusions of the UT in OA show the importance of an association with a family grouping like the Reer Hamar but I accept that the evidence does not go so far as to show that they would (or could) seek to provide the Appellant with the kind of 24/7 support that he needs. I also take into account that much of the support received by the Appellant in the United Kingdom is provided by professional services such as a visiting psychiatrist and so on. There is again no evidence that the Appellant’s clan in Mogadishu could or would be able to provide the Appellant with such bespoke, specialised assistance.
56. In respect of §407(h)(vi) I find, in accordance with the preserved finding from the First-tier Tribunal, that the Appellant does not have access to remittances from outside of Somalia.
57. Applying §407(h)(vii) I note that the Appellant has experienced periods of time when he has had no support at all in the United Kingdom meaning that he became homeless. This is compounded by the Appellant’s own abuse of alcohol and cannabis which has also affected his relationships with family members in the UK.
58. The Appellant’s journey to the United Kingdom in 2000 is not relevant to his current financial circumstances for the reasons which I have already laid out in detail, applying (§407(h)(viii)).
59. I therefore find that the Appellant does reasonably likely face the prospect of living in an IDP camp (or informal settlement) despite the fact that he is a member of the Reer Hamar diaspora.
60. The Tribunal must not however apply the UT’s further guidance about the humanitarian conditions in MOJ for the reasons explained by the UT in OA.
61. Therefore turning to OA, I take into account the panel’s guidance that there continues to be a spectrum of conditions across the IDP camps in Mogadishu and that there has been durable positive change in a significant number of such camps since 2014 (the time MOJ was decided).
62. In respect of the granular assessment of the conditions in an IDP camp (or indeed an informal settlement) which the Appellant is reasonably likely to encounter, I must take into account the fact that the Appellant will display as a person with serious mental health difficulties including an increased manifestation of auditory hallucinations and the potential for aggressive behaviour towards others.
63. I find that the Appellant will also reasonably likely not be in receipt of the medication which he requires because of the impact upon him of increased stress, an exacerbation of his mental health problems and the associated costs.
64. It is also reasonably likely that he would be able to obtain, and therefore abuse, alcohol which would exacerbate his vulnerability.
65. I therefore conclude that the Appellant is a seriously ill person who has shown a causal link between the proposed removal and the intense suffering which I find he has established is reasonably likely to follow his removal to Mogadishu.
66. At §112 of OA the UT concluded that: “…The living conditions must be so dire so as to fall within the 'other very exceptional cases' criterion. The level below which such conditions must fall is to be calibrated by reference to the Paposhvili requirement that the returnee must be 'seriously ill'. They must face immediate, serious and intense suffering that reaches the Article 3 threshold.”
67. I find that the intense suffering arises from the likely conditions in which he would be living. I find that it is reasonably likely that, within a short period of time, he will find himself residing in an IDP camp at the lowest end of the spectrum (amounting to dire conditions) or in an informal settlement where there is also a reasonable likelihood that he would be subject to human rights abuses due to his vulnerabilities.
68. I remind myself that the Appellant’s particular vulnerability has also been shown by the fact that support staff previously had to intervene to prevent the Appellant being financially exploited by other residents of the supported accommodation. Whilst this clearly does not amount to serious harm for the purposes of Article 3 ECHR it is nonetheless indicative of the Appellant’s vulnerability even in circumstances in which he is being provided with professional 24/7 support.

Notice of Decision
The Article 3 ECHR appeal is allowed.

I P Jarvis

Deputy Judge of the Upper Tribunal
Immigration and Asylum Chamber

18 March 2025