Tribunal decisions

The decision

IN THE UPPER TRIBUNAL
IMMIGRATION AND ASYLUM CHAMBER
Case No: UI-2025-002615

First-tier Tribunal No: HU/01590/2022

THE IMMIGRATION ACTS

Decision & Reasons Issued:

On 13th of January 2026

Before

UPPER TRIBUNAL JUDGE LANDES

Between

SECRETARY OF STATE FOR THE HOME DEPARTMENT
Appellant
and

OAA
(BY HIS LITIGATION FRIEND RAA)
(ANONYMITY ORDER MADE)
Respondent

Representation:
For the Secretary of State: Ms A Ahmed, Senior Home Office Presenting Officer
For OAA: Mr A Gilbert, counsel instructed by Lighthouse Solicitors

Heard at Field House on 15 October 2025

Order Regarding Anonymity

Pursuant to rule 14 of the Tribunal Procedure (Upper Tribunal) Rules 2008, OAA and his litigation friend are granted anonymity.

No-one shall publish or reveal any information, including the name or address of OAA or his litigation friend, likely to lead members of the public to identify OAA. Failure to comply with this order could amount to a contempt of court.

DECISION AND REASONS
For ease of reference, in the decision below I refer to the parties as they were before the First-Tier Tribunal, that is to OAA as the appellant, and to the Secretary of State for the Home Department as the respondent.

Anonymity
1. An order for anonymity was made in the First-Tier Tribunal by the judge hearing the case (“the FTJ”). The FTJ considered that the appellant’s vulnerability and mental health conditions outweighed the principles of open justice.
2. The respondent applied in written submissions dated 23 September 2025 to lift the anonymity order. The respondent in that argument referred to the strong public interest in open justice, submitting in summary that the index offence of robbery was against a background of past offending and that the appellant’s rights, even bearing in mind his vulnerability and mental health, did not outweigh that strong interest in open justice given his serious offending.
3. Mr Gilbert submitted at the hearing that there was no evidence that the appellant’s name was already in the public domain by reason of his convictions; there had not been reporting in the past. The medical evidence indicated, he submitted, that the appellant had schizophrenia and the disorder was characterised by persecutory and paranoid beliefs; the publication of material about the appellant therefore carried with it a significant risk of aggravating the appellant’s condition. The appellant had been released from detention without a fixed address and without support.
4. Ms Ahmed responded that there was no evidence that the appellant had been released without a care package. She submitted that there was no real likelihood of harm to the appellant when there was no updating medical evidence, particularly when considering the evidence that the appellant’s condition had improved. There was a high threshold when an anonymity order was made, and her submission was that threshold had not been met.
5. Both the Upper Tribunal Guidance Note 2022 no 2: Anonymity orders and hearings in Private and the corresponding First-Tier Tribunal guidance emphasise the strong public interest in open justice and that exceptions to that rule must be justified by some more important principle. The relationship between open justice and the need to protect the rights of individuals who may be harmed by disclosure of personal details was examined in A v British Broadcasting Corporation (Scotland) [2014] UKSC 25 which emphasised that the court has to carry out a fact-specific balancing exercise and central to that evaluation is the purpose of the open justice principle, the potential value of the information in question in advancing that purpose and conversely any risk of harm which the disclosure may cause to the maintenance of an effective judicial process or to the legitimate interests of others.
6. As Ms Ahmed emphasised not only is the default position open justice, but there is also a strong public interest in the naming of foreign national offenders who have committed criminal offending.
7. Nevertheless, I consider there is material which indicates that the appellant could be at real risk of harm if his identity is disclosed. The First-Tier Tribunal considered that he was so vulnerable that a litigation friend needed to be appointed to protect his interests. I appreciate the appeal turns on whether the FTJ adequately considered the recent evidence relating to the appellant’s mental health. However the 2023 report of Dr Reid concluded that the appellant suffered from schizophrenia, presenting with persistent auditory hallucinations and significant negative symptoms (even though he was on medication), and that if released from immigration detention he would require support and supervision by the community mental health team as well as a social care assessment to determine his suitability for independent living. The psychiatrist concluded that the appellant required ongoing and assertive healthcare as he did not have the volition to manage his condition himself and required supervision to ensure his concordance with treatment. Dr Reid describes the appellant’s past, including his detention under the Mental Health Act after presenting with paranoid ideation and aggression; indeed he was found unfit to plead before treatment with anti-psychotic medication. He has a relapsing/remitting condition.
8. It is right that the latest medical records I have show that the appellant has not been taking medication without any obvious return to psychotic symptoms. The most up-to-date information in medical records from the IRC (November 2024) concludes that he presents a low risk of harm to self or others (p 950 – 951). They noted however a low threshold for hospital referral and whilst the appellant may seem “better” in that he is not exhibiting florid symptoms of schizophrenia despite not being on medication, he refused engagement with the doctor and did not maintain eye contact (p 950) and the day before became very dismissive and somewhat aggressive when the nurse tried to engage with him, looking at her angrily when she tried to talk to him, had matted hair and had not covered the top half of his body (entry of 21 November p 950). The history earlier in the month indicated that the appellant did not engage well in reviews, allowed only brief conversations from his cell door, smelt bad and did not often leave his room except for meals (p 949).
9. The appellant was in the very structured environment of detention where his needs were provided for when he appeared “better”. It is right that there is no up to date medical evidence but, I repeat, schizophrenia is a relapsing/remitting condition which is sensitive to stressors (I observe Dr Reid considered the appellant’s mental state would worsen under the stress of a court hearing). Bearing in mind that the appellant has been released from immigration detention without a package of support and has no fixed address (I appreciate Ms Ahmed says there is no evidence of this other than Mr Gilbert’s assertions, but I have an email from the appellant’s solicitors of 8 August explaining that they cannot give the tribunal an address for the appellant as he has no fixed address) and has a very serious relapsing/remitting condition, with a history of paranoia, I agree with Mr Gilbert that there is a significant risk that publicity will be seriously detrimental to the appellant’s mental health and I consider that risk given the appellant’s history and his undoubted past vulnerabilities outweighs the strong public interest in open justice.
10. I therefore explained to the representatives at the beginning of the hearing after hearing submissions that I would be maintaining the anonymity direction. I bear in mind of course that an anonymity order can be lifted but I consider it sensible at this stage, as [15] of the Upper Tribunal Practice Direction suggests, to err on the side of caution given how unwell the appellant has been in the past and that it was necessary to appoint a litigation friend. I anonymise the litigation friend as well as the appellant to prevent the risk of jigsaw identification.

Application to amend
11. Ms Ahmed had also applied, in the written submissions of 23 September 2025, to amend the grounds of appeal to argue procedural unfairness in refusing the application to adjourn the hearing. She explained that when she had reviewed the decision. she had investigated all the circumstances and discussed the case with colleagues and that led her to consider that there may be an additional arguable error of law in refusing the adjournment. She explained that the appeal had been ongoing for some time and it was not on the myHMCTS case system so locating the relevant papers was not the easiest task. However, she submitted there was no prejudice to the appellant; the proposed amendment had been served well in advance of the hearing.
12. Mr Gilbert invited me to consider the case of R (on the application of Onowu) v First-tier Tribunal (Immigration and Asylum Chamber) (extension of time for appealing; principles) IJR [2016] UKUT 00185 (IAC). He said when I was considering all the circumstances of the case, I should consider in particular the need for the tribunal to enforce compliance with the procedural rules; it was in the public interest to enforce compliance with the rules; the grounds were in fact very weak. He proceeded to explain to me why he said the grounds were very weak.
13. When considering whether to extend time, I considered the factors set out in Onowu. Firstly, there has been a significant breach. The original grounds were filed on 14 May (the last possible day to be in time). Permission was granted by the Upper Tribunal by decision issued on 29 July 2025, so there was a delay of more than four months from the expiry of time and almost two months from the date permission was granted before applying to amend. There is simply no good reason for the delay. I appreciate the fact that because the appeal was not on the online case management system it made it more difficult for the respondent, but the respondent must have reviewed the papers for grounds to be prepared in the first place. I therefore continue to the next stage, to evaluate all the circumstances of the case. The need for compliance with rules and practice directions is particularly important. However, in this case although the amendment was late, it was advanced in good time before the hearing, the appellant has had sufficient notice, and I do not consider the late application prejudices him. I was invited by Mr Gilbert to take into account when extending time that the proposed ground was weak, but I do not consider that I can, without full investigation. Bearing in mind that the appellant has had through Mr Gilbert time to consider the respondent’s arguments, and I do not consider him to be prejudiced thereby, I extend time for making the application. Before hearing full argument and considering the matter, I consider that it appears arguable, given the volume of material, that it was unfair (in the Nwaigwe sense) for the judge to refuse the adjournment application and accordingly I permitted Ms Ahmed to advance that argument.

The grounds; discussion, conclusions
Procedural unfairness in refusing the adjournment application?
14. Ms Ahmed did not advance more than faintly the argument that there was apparent bias on the part of the judge. That is an argument that should have been made from the beginning if it were to be advanced and there is simply no merit in it and no material to begin to justify it. There is a bare assertion of an approach hostile to the respondent because the respondent considers that the judge was overly lenient to the appellant and unfairly criticised the respondent. However the fact that the test for refusing an adjournment is whether there was any deprivation of a party’s right to a fair hearing does not mean, even if it is found that the judge was wrong to refuse an adjournment, that there was bias on the part of the judge. A fair-minded and informed observer does not conclude that there is a real possibility of bias simply because a judge makes a decision which turns out to be wrong. The FTJ expressed himself in perfectly appropriate moderate terms and considered both parties’ cases.
15. Ms Ahmed referred to her written submissions from [18] onwards which explained why she said it was unfair of the judge to refuse the adjournment application. She explained and reinforced the written submissions in her oral submissions. There are six points relied on in the written submissions which are to be taken individually and cumulatively, which I summarise below. The additional points made in oral submissions are in italics:
(i) There was a very tight deadline given by the duty judge for the appellant to re-serve a bundle and skeleton argument on the respondent by 15 January and the respondent to carry out her review by 29 January given the hearing was 3 February. It gave no scope for an extension of time;
(ii) It was relevant that the duty judge had directed re-service on the respondent because it seemed the papers had been sent to an address which was no longer in use. It was not clear that service to the right address had been effected on 9 January. In any event the relevant date in the FTJ’s mind should have been 29 January which was the time allowed. The breach was not significant and serious bearing in mind the period between 29 January – 3 February is not a significant period;
(iii) The respondent had previously sought actively to chase the appeal bundle and skeleton argument, hence the chasing email to the tribunal on 31 December 2024. The judge did not consider that the respondent had taken active steps to pursue the review of the appeal;
(iv) The FTJ did not factor in the volume of papers – two bundles (one of over 700 pages including witness statements and expert evidence, a medicolegal report and a country expert report and medical evidence, one of 174 pages including an addendum to the country report, further witness statements and medical records) and a skeleton argument. On the day of the hearing there was a further statement from the appellant’s sister which was accepted. The material had not been seen before. The FTJ noted the “very significant further medical evidence provided” and given the short timeline between 29 January and the date of the hearing the application for an adjournment was not unreasonable, although of course the test was fairness. If an application had been made for an extension of time it would have been made very close to the hearing date. The matter had not been reviewed since 2022;
(v) The FTJ criticised the respondent but failed to consider that plainly the respondent was not in a position to proceed. She needed time to review the evidence, respond to it adequately and put forward her position. That was what a review was so that the presenting officer was not ready to proceed with her case. It was held against the respondent that the presenting officer could not give a timeframe for review of the case. The FTJ could have set directions for when a review was due for example giving 3 weeks for the case to be reviewed. It was unfair for the FTJ not to do so and then to criticise the respondent for not providing a timeframe;
(vi) The FTJ’s reasoning that the appellant would be seriously prejudiced given his “severe mental health” did not consider the lack of updated medical evidence or that the appellant’s condition was relatively stable, nor did it consider the sentencing judge’s remarks. Characterising the appellant’s mental health as “severe” was overly generous to the appellant.
16. Mr Gilbert responded that the adjournment application had been presented as the respondent needing to carry out a review. The respondent had not said through her presenting officer that she was not ready, and the presenting officer had not said she was unable to present the appeal and could not proceed. The respondent had 19 days to consider the material and so it was not obvious that the case would not be ready to be presented. A review would have set out what if any matters were agreed and what were not, but it was not a necessary step. The respondent could have been ready to proceed without a review being carried out. It was perfectly reasonable for the FTJ not to give the respondent an opportunity to comply with a direction she had already breached. The fact is the respondent had offered 14 days and had more than 14 days. The appellant was ready to proceed and the FTJ had properly directed himself to what was fair in the circumstances; the appellant was impecunious.
17. I observe that the test as made clear in Nwaigwe (adjournment: fairness) [2014] UKUT 00418 (IAC) is one of fairness, the question not being whether the FTJ acted reasonably, but whether he acted fairly, whether there was any deprivation of the affected party’s right to a fair hearing.
18. So far as Ms Ahmed’s points (i) to (iii) are concerned, it is right that there was a tight deadline but the respondent had said in an email on 31 December that they would require 2 weeks to review the case once documents had been submitted (p 45 bundle). In fact there was more than 3 weeks between the date of service of the documents to the proper email address (which I see no reason to doubt was 9 January as the FTJ explains he saw confirmation that was the date of compliance [8]) and the date of the hearing. At no time did the respondent contact the tribunal to ask for an extension of time or even to say that there were difficulties with compliance because of the number of documents. The FTJ sent an email chasing the review on 31 January (the working day before the hearing) and seeking confirmation that the hearing was effective and would go ahead. The respondent did not inform him that there were any difficulties. Despite the fact that the respondent had earlier chased the appellant’s documents, I consider that the judge was entitled to find that there was a serious and significant breach of directions, in circumstances where the respondent could give no explanation as to why the review had not been carried out and could give no timescale for when it would be carried out.
19. The appellant did serve a large volume of documents (point (iv)). However much of the material had already been served on, or already known to the respondent. The psychiatric reports of 2021 were included in the respondent’s bundle. The most recent medical report of Dr Reid in February 2023 was sent to the respondent under cover of a letter of 7 July 2023 in which the appellant’s representatives sought adjournment of the full hearing (then fixed for the middle of July 2023) because the appellant had disappeared and there were serious concerns over his mental health (see p 801 bundle). Further CMRHs were then also postponed in the autumn of 2023 because the appellant had been recalled to prison for failing to report but was so unwell that the prison were seeking to transfer him to hospital under a section and it was impossible for the psychiatrist to carry out a capacity assessment (see p 805). The respondent was copied into those letters which included disclosure of medical information. The respondent may not have seen all the medical records, but the only medical records of relevance were those that post-dated Dr Reid’s report, and particularly the April - November 2024 records. It is not clear whether the respondent had seen the witness statements before they appeared in the final bundle, but letters from the family witnesses were sent with the further submissions and appear in the respondent’s bundle so the respondent would have been aware what they were likely to say. A witness statement was served on the day of the hearing, but it was extremely brief and only explained why the relevant witness could not attend the hearing. It is not clear whether the respondent had previously been served with Dr Aguilar’s country expert reports. In conclusion, although the volume of material served was large, the volume of relevant material which the respondent had not previously seen was much more modest.
20. The adjournment application was not presented before the FTJ as the respondent being unable to proceed (point (v)). The Practice Direction of November 2024 section 7.11 (referring to rule 24A (3) of the First-Tier Tribunal Procedure Rules) states that a review must explain whether the respondent agrees that the schedule of disputed issues is correct and if not, the correct list of disputed issues, including whether there are any further issues that the respondent wishes to raise, the respondent’s brief submissions on the disputed issues including whether they oppose or accept the appellant’s position, which of the witnesses they intend to cross-examine and whether the appeal should be allowed on any ground if the appellant and or their witnesses are found to be broadly credible. A review is therefore in very broad terms, the respondent’s position statement in response to the appellant’s skeleton argument. I do not agree with Ms Ahmed that the failure to serve such a statement meant that the respondent was unable to proceed. It is well-known that the respondent does not always serve a review particularly in cases which are not on the myHMCTS platform. The respondent’s presenting officer did not suggest to the FTJ that they had not had sufficient time to read and digest the documents or to prepare any necessary cross-examination. In that sense the respondent was in a position to proceed, in the sense of challenging any positive case put forward by the appellant. However by asking for time to serve a review, the respondent wanted time to put forward a collective position statement, which would have enabled them for example to raise any further issues or to put forward a positive case of their own beyond what had already been set out in the reasons for refusal letter. I am not told however (and neither was the FTJ) what positive case the respondent wished to put forward that they were unable to, or what matters the respondent wished to challenge that they felt they were unable to absent a review.
21. I do not consider it realistic to say that the FTJ could have set a short timetable of his own for a review to be provided. Of course he could in theory, but that would be pointless in practice if the respondent could not complete a review within that time. In circumstances where the presenting officer could give no explanation as to why the review had not been carried out [8] and no timescale could be given for such a review [6], the FTJ could not possibly have had any confidence that the respondent would be able to carry out a review within a relatively short period, and that therefore if he adjourned, the position would be any different in say three weeks’ time.
22. It was open to the FTJ (point vi) to describe the appellant’s mental health as “severe”. Whatever the precise state of the appellant’s mental health at the time of the hearing (which obviously the FTJ had not determined at that point), the appellant had an enduring serious mental health condition, namely schizophrenia and he had been sufficiently unwell during proceedings that a litigation friend had been appointed. The proceedings had been delayed coming to final hearing because at various stages the appellant had disappeared, failed to co-operate with medical professionals or simply been very unwell. I do not consider the sentencing judge’s remarks relevant in this context. It is evident that in 2022, after the appellant was taken into custody and received appropriate medication, he became fit to plead and his mental health improved (see sentencing remarks at p 1125). Nevertheless it deteriorated subsequently in 2023 as the correspondence suggesting the prison were considering a section for the appellant showed. It is obviously well known and not surprising that the condition of a person with schizophrenia might fluctuate over time and might be influenced by life events or stresses they were experiencing. The FTJ also accepted the appellant’s counsel’s submission that there was a real risk the appellant would not be able to afford further representation at a further hearing. It was therefore open to the FTJ to conclude that an adjournment would seriously prejudice the appellant.
23. I conclude therefore that the FTJ took into account relevant considerations when considering the application for an adjournment and that there is nothing to indicate that there was any deprivation of the respondent’s right to a fair hearing. Against the background of a vulnerable appellant with funding difficulties, the respondent had had the time they asked for to review the case, there was no explanation of why that had not been sufficient or of the timescale in which the case could be reviewed, and the presenting officer had not indicated that they themselves had insufficient time to familiarise themselves with the papers so as to be able to conduct the appeal on behalf of the respondent. There was no procedural unfairness therefore.
Article 3
24. The grounds aver that the FTJ failed to explain how the appellant’s evidence met the test set out in AM (Zimbabwe) [2020] UKSC 17 as the judge relied on the expert evidence from 2023 and made no reference to the medical records of April – November 2024 from Gatwick IRC suggesting the appellant’s condition was reasonably stable, that he had been assessed as low risk of harm to himself or others and although non-compliant with medication or further psychiatric assessments had shown no indication of self-harm or suicidal tendencies.
25. Ms Ahmed added that the FTJ had not explained how the appellant was a seriously ill person. She submitted that the Upper Tribunal in AM (article 3; health cases) Zimbabwe [2022] UKUT 131 had explained that whether someone was a “seriously ill person” generally required clear and cogent medical evidence from treating physicians in the UK. She submitted that included updating evidence. Furthermore when the recent medical records were considered pages 948 – 950 showed that the appellant’s risk of suicidality/self-harm was assessed as low and the risk to others as low. His condition was reasonably stable. She submitted that in those circumstances, adequate reasons had not been given for the judge’s conclusion that there was a real risk of serious, rapid and irreversible decline in the appellant’s state of health resulting in intense suffering or a significant reduction in life expectancy. She referred to Bensaid v United Kingdom (application no 44599/98) and submitted there were analogies with paragraphs [38] – [40] of that decision; she submitted that like that applicant, this appellant faced the risk of relapse even if he stayed in the UK and, like that applicant, the risk that the appellant would suffer deterioration in his condition if returned to Somalia was to a large extent speculative.
26. In the rule 24 response, Mr Gilbert submitted that it was not right to say that the FTJ had made no reference or failed to give reasoned consideration to the medical records from the IRC suggesting the appellant’s condition was reasonably stable. The judge had referred to the entry of 8 November 2024 to the effect that the appellant was not currently taking any medication and found this to be consistent with the evidence that he was not compliant with his medication. It was not, it was submitted, a material error to provide no further reasoned analysis of the IRC records which disclosed no assessment by a doctor until 22 November 2024 and was then limited to a brief conversation because the appellant did not engage. It was submitted that there was nothing capable of displacing the expert diagnosis of a relapsing/remitting condition which the appellant could not manage alone and which would not remain stable. The expert diagnosis was that the appellant had a permanent condition with violent relapses in the absence of careful management. The respondent had effectively accepted in the refusal letter that Somalian medical treatment was inhuman and degrading.
27. In submissions, Mr Gilbert took me further through the medical records. On 2 October 2024 the appellant had been admitted to the segregation unit because he had slapped another resident (p 944). On 6 October, he was described as not wanting any medication, appearing guarded and paranoid, exhibiting poor hygiene and only engaging minimally with staff (p 945). He was described as having stopped his medication in January 2024 when he was in prison and presenting negative symptoms of psychosis, guarded, isolative, self-neglect and expressing reluctancy to treatment – he would be referred to the psychiatrist to assess (p 946). Mr Gilbert submitted that the appellant did not attend his psychiatric assessment on 14 October and it was evident he did not want to engage (p 947 – the doctor found him lying in bed with the curtains closed and the appellant said he was fine and just wanted to be left alone). The appellant then refused further engagement, whether for his VACP (vulnerable adult care plan) or for mental health reviews; the pattern was having brief conversations at his cell door (ps 947, 950). The fact remained, he submitted, that there was nothing to displace Dr Reid’s conclusion that the appellant required ongoing and assertive healthcare and lacked the volition to manage his condition himself, requiring supervision to ensure concordance with drug treatment.
28. Moreover, Mr Gilbert submitted that even if, contrary to his submissions the FTJ’s reasoning was inadequate, it was not a material error. The judge found that there was no realistic prospect of any family support in Somalia, that there would be no meaningful support in Somalia from the appellant’s clan members, that he would not have any financial support of any meaningful nature in Somalia, that he would not be able to work, and that there was a high risk that he would immediately be destitute [35] and likely to end up in an IDP camp. In other words, on the FTJ’s other findings, which he submitted had not been challenged, Article 3 would be breached in any event.
29. Ms Ahmed accepted that the respondent had not challenged the findings set out at paragraph 3a) of the rule 24 response (no prospect of remittances or other financial support, not able to work, mental health treatment institutions being productive of a real risk of inhuman or degrading treatment, relapses lead to threatening others, no prospect of clan support and immediate destitution, likelihood of ending up in an IDP camp and being extremely vulnerable to violence). She accepted that the grounds raised limited matters of challenge, but she said that this was a reasoning challenge; if the FTJ had not looked at the appellant’s mental health in the right way then holistically he had not approached the decision in the right way.
30. I note that Dr Reid assessed the appellant on 25 January 2023. At the time, Dr Reid’s summary of the healthcare records from the appellant’s transfer to Brook House IRC on 2 November 2022 was that the records noted persistent symptoms of psychosis, reporting ongoing auditory hallucinations. There were frequent episodes of low mood and social withdrawal but no concerns about a risk of deliberate self-harm (see paragraph 5.17). The appellant was taking psychotropic medication although the plan had been to change his medication to reduce his psychotic symptoms (5.18). On examination, Dr Reid noted no signs of self-neglect, but limited engagement as the appellant was at times uninterested and preoccupied with his own thoughts, but there was no formal thought disorder. He reported continuing to hear voices although he denied that they gave him commands (7.5) and he was aware that he had mental health problems, believing that he was better on medication (7.7). Dr Reid’s conclusion was that the appellant’s symptoms were clinically in keeping with schizophrenia, that his history indicated recurrent psychotic episodes, currently presenting with persistent auditory hallucinations and negative symptoms, notably affective flattening, paucity of speech and avolition (8.1) (8.2). I observe that the healthcare records from the time of the appellant’s transfer to Brook House IRC in the autumn and winter of 2022 showed that the appellant’s risk assessment was low (p 176) and that he appeared settled, and heard voices “sometimes” (p 875), that there were issues regarding his compliance with medication (for example p 880, p 881), and that he was reluctant to engage and would only allow brief assessments (p 884).
31. By contrast, in the summer of 2023 when the appellant’s tribunal case was delayed because of his ill-health, the records show that the appellant was very mentally unwell. For example, when his prison health record began at HMP Lewes in August 2023 he was seen following concerns regarding his behaviour. He was wearing his trousers very low with a red scarf on his head, unkempt with dirty fingernails, hunched body language and limited eye contact, appeared thought blocked and distracted and occasionally agitated, muttering but with no sound as if responding to stimuli and looking into the corner of the room, anxiously (p 846). In the following days he was described as responding to unseen stimuli (p 847) and presenting as thought disordered with perceptual abnormalities and psychotic (p 853). He was described as lacking capacity and the conclusion (p 854) was that he needed hospital admission and meanwhile was monitored on hourly checks. His behaviour worsened and he was described as acutely psychotic despite an increase in medication (p 858).
32. The appellant had improved from that relapse when admitted to the IRC again in April 2024. Thereafter his behaviour and observations are summarised as per Mr Gilbert’s submissions at [27] above.
33. I set that out to show that although the appellant was not floridly unwell in the autumn of 2024, it is not as if he has steadily improved from the time he was examined by Dr Reid. Indeed at the time the appellant was seen by Dr Reid in 2023 he was also described by prison staff as “low risk” and the only real difference from the observations in the autumn of 2024 was that in the autumn of 2024 the appellant was not reporting to staff that he was hearing voices. His condition had however worsened in the summer of 2023 and then obviously improved again in that despite not taking medication in the autumn of 2024 and not having taken medication for 10 months or so, he was not exhibiting florid symptoms of psychosis.
34. I disagree with Ms Ahmed’s submission that the FTJ’s conclusion that the appellant was a seriously ill person was not adequately reasoned. The FTJ considered all the medical reports, highlighting the appellant’s diagnosis with serious mental health conditions. He accepted the summary in the skeleton at paragraphs 11 – 12 [27] which set out a long quote from Dr Reid’s report explaining that schizophrenia was a relapsing and remitting condition requiring ongoing mental health care and where monitoring compliance with medication, medical, occupational and social support was needed and without such management there was a significant risk that the appellant’s mental health would deteriorate which would lead to an exacerbation of his symptoms. It does not obviously change the position that the appellant had not been taking medication and was described as “low risk”. As I have explained, he was also described as “low risk” at the time of Dr Reid’s report. The fact remains that he was not a person who had been stable for some years, he had experienced a serious relapse during the proceedings and if he was not taking medication or accepting support, then his condition was not being adequately managed. The FTJ made no error of law in concluding that the appellant had discharged the burden of establishing that he was a seriously ill person.
35. The Upper Tribunal have explained in AM (Art 3; health cases) Zimbabwe [2022] UKUT 131 (IAC) considering the authorities of AM (Zimbabwe) v Secretary of State for the Home Department [2020] UKSC 17 and Savran v Denmark (application no. 57467/15), that once an appellant has established he is a seriously ill person, the second part of the test is:
“Has P adduced evidence “capable of demonstrating” that “substantial grounds have been shown for believing” that as “a seriously ill person”, he or she “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
[a] to a serious, rapid and irreversible decline in his or her state of health resulting in intense suffering, or
[b] to a significant reduction in life expectancy”?”
36. The FTJ found that the appellant would not be able to access such treatment as there was in Somalia without support. I consider this conclusion was one it was perfectly open to him to reach. There was ample evidence, even on the recent medical records, of the appellant refusing to engage with the nurses and doctors in the IRC and of course not taking his medication [26], which latter point was expressly referred to by the FTJ. The FTJ also accepted the witness evidence which set out that the appellant was not engaging with family members either, even though they were trying to assist him.
37. The real question is whether the appellant would face a real risk as a result, of being exposed to a serious, rapid and irreversible decline in his state of health resulting in intense suffering or to a significant reduction in life expectancy.
38. The appellant’s skeleton argument put the appellant’s Article 3 case on two alternative bases – on the AM (Zimbabwe) basis of the real risk set out at [37] above, or alternatively on the basis of Ainte (material deprivation – Art 3 – AM (Zimbabwe) [2021] UKUY 203 (IAC) that Article 3 ECHR could be engaged by conditions of extreme material deprivation, and that the AM (Zimbabwe) test applied such that the question would be whether conditions were such that there was a real risk that the individual concerned would be exposed to intense suffering or a significant reduction in life expectancy.
39. The FTJ melded together those two aspects when coming to his decision and focussed on whether there was overall a real risk of a serious, rapid and irreversible decline in the appellant’s state of health. However, the grounds challenge only the FTJ’s reasoning on the medical aspects. The FTJ although coming to the all-encompassing conclusion at [43] “I find that there is a real risk of serious, rapid and irreversible decline in their state of health resulting in intense suffering or a significant reduction in life expectancy” does not focus on life expectancy or explain why the lack of access to medical treatment would mean that the appellant was at real risk of harming himself or otherwise having his life shortened (as opposed to for example having his life shortened by the result of destitution or the risk of violence). The appellant’s current risk of harm to himself was assessed as “low” and it was also “low” at the time of Dr Reid’s report. Dr Reid was specifically asked in his instructions (see 4 (b) under the heading “instructions”) to comment on the risk of suicide and/or self-harm if the appellant were removed to Somalia. He did not do so. The only direct comments on suicide I can trace are the comment about the detention environment not being conducive to the appellant’s treatment based on the position statement of the Royal College of Psychiatrists (paragraph 8.7) that “detention centres are likely to precipitate a significant deterioration of mental health in most cases, greatly increasing suffering and the risk of suicide” and the comment that “schizophrenia is also associated with mood disorders, such as depression, and an increased risk of self-harm or suicide” (paragraph 8.5). There is nothing in Dr Reid’s report which sets out whether the appellant in his specific circumstances would be at real risk of self-harm or suicide if returned to Somalia. If the FTJ intended to find that there were substantial grounds for concluding that there was a real risk of a significant reduction in life expectancy based on the appellant’s lack of access to medical treatment, that was simply unreasoned.
40. The FTJ summarised at [41] Dr Reid’s conclusions on the effect on the appellant’s mental health of removal to Somalia and his consequent inability to access healthcare. The relevant comments specific to the appellant (as opposed to general comments about schizophrenia) were that without management there was a significant risk that the appellant’s mental state would deteriorate which would lead to an exacerbation of his symptoms, notably his abnormal beliefs and behaviour, with consequent unpredictability or aggression (8.5) and that it was highly likely that the stressor of removal to Somalia would lead to depressed mood and an increase in his level of anxiety and arousal meaning his psychotic symptoms would worsen and he would be at considerable risk of relapse which may necessitate an inpatient hospital admission (9.1).
41. Although, as I have explained, the risk the appellant posed was described as “low” both at the time of the hearing before the FTJ and at the time of Dr Reid’s report, and in some ways his condition was similar, a significant difference was that at the time of Dr Reid’s report the appellant was on medication, but still reporting hearing voices, whereas by the time of the hearing he was not on medication but not reporting hearing voices. An absence of medication had, over a period of 10 months or so (from January 2024 when he was reported not to be taking medication to the latest records in November 2024), not led to a full relapse with florid symptoms. Dr Reid’s conclusion that without monitoring compliance with medication there was a significant risk that the appellant’s mental state would deteriorate leading to an exacerbation of abnormal beliefs and behaviour had therefore not obviously been borne out at least as far as psychotic symptoms were concerned. The FTJ should therefore have evaluated this aspect.
42. In addition, the FTJ said “there is sufficient evidence that there is a real risk of being exposed to a serious, rapid and irreversible decline in the Appellant’s state of health. I accept that this is likely to result in intense suffering – as per the medical evidence and my findings” [45]. The difficulty is that if the FTJ intended to find that the serious rapid and irreversible decline was as a result of the lack of appropriate treatment or of access to such treatment, he needed to explain given the recent medical records evidencing the appellant’s current symptoms and behaviour when unmedicated, why the lack of access to treatment would result in a rapid decline or why a rapid decline would result in intense suffering. As explained in Savran v Denmark, a relapse which is likely to result in aggressive behaviour and a significantly higher risk of offences against the person as a result of the worsening of psychotic symptoms would cause very serious detrimental effects but could not be described as “resulting in intense suffering” for the applicant himself ([143] – my underlining). The Grand Chamber in Savran found it unnecessary to decide in the abstract whether a person suffering from a severe form of schizophrenia might be subjected to “intense suffering” within the meaning of the threshold test, and this is not self-evident on the facts of this case such that no further explanation by the FTJ was required. Whilst the FTJ was entitled to accept Dr Reid’s conclusions that as a person with schizophrenia vulnerable to stressors, removal to Somalia would be a stressor for the appellant leading to depressed mood and an increase in his level of anxiety and arousal,
43. I appreciate that the FTJ found that the mental health treatment in Somalia was such that the respondent’s own evidence suggested a very real risk of inhumane and degrading treatment such as the appellant being chained. Whilst this might be said to be “the absence of appropriate treatment” leading to “intense suffering” or otherwise a breach of Article 3 ECHR, the FTJ does not explain why there was a real risk of the appellant being subjected to such treatment, given that his clear findings were that the appellant would not seek out treatment for his mental health, and his findings were also that the appellant would have no family or clan support who would seek out treatment for him (or try to treat him themselves). Of course, it might be that a person was so obviously mentally unwell that passers-by or the authorities would take him for treatment but if the FTJ meant this to be his finding it would require further reasoning to be more than speculation.
44. I therefore agree with the respondent that if the FTJ’s conclusions are taken as referrable to the Article 3 medical risk alone then they are inadequately reasoned.
45. However, as I have noted above, the appellant’s case was also presented on the basis that he would be at risk of destitution exposing him to intense suffering or a significant reduction in life expectancy (compare Ainte) (see paragraph 9 a ii of the skeleton argument before the FTJ). The FTJ made findings on lack of family support in Somalia and destitution in Somalia and said that he had accepted the submissions in the skeleton argument [45].
46. The FTJ’s conclusions relevant to this point that are not obviously affected by the lack of reasoning I have set out above are:
(i) That the appellant had no-one in Somalia who could provide him with any meaningful support [22];
(ii) That the family in the UK would not be able to provide any meaningful support [23];
(iii) That the ties the appellant had with Somalia were limited given the very young age at which he came to the UK (10) and his mental health conditions [24];
(iv) The prospects of the appellant working were negligible [24];
(v) There would be no meaningful support from clan members as per the expert report [35];
(vi) There was a high risk that the appellant would be immediately destitute [35];
(vii) The expert’s report was accepted in full namely that the appellant was likely to end up in an IDP camp and would be extremely vulnerable to violence [37].
47. As Mr Gilbert points out, those conclusions were not challenged by the respondent in the grounds of appeal or indeed the amended grounds of appeal. I need however, as Ms Ahmed submits, to consider matters holistically and to consider whether the gaps I have identified in the FTJ’s reasoning affect the FTJ’s conclusions on this point.
48. The conclusions at (i) and (ii) above are based on the judge’s acceptance of the witness evidence. The conclusion at (iii) above is a perfectly valid conclusion which the judge explains. The appellant’s ties to Somalia have been affected by his past mental health, whatever the position of his current mental health. I observe that it is apparent from the witness statements and the expert report, both of which the judge accepted, that Mogadishu, where the appellant would be returned, is not the appellant’s home area, his home area being subject to the ongoing presence and operations of Al-Shabab which would themselves put the appellant at risk (see expert’s conclusion 3). Accordingly, the appellant would have to remain in Mogadishu rather than return to his home area.
49. Whilst the FTJ did not expressly discuss the appellant’s recent medical condition when concluding that the prospects of his working were negligible (iv), he had evidently considered the evidence in full including the recent medical records [26] and [28]. Those described as set out above, guarded behaviour, paranoia, lack of engagement and some self-neglect. It is indeed difficult to see how the appellant could possibly work in an unfamiliar environment where he would be without any practical, emotional, or institutional support. I consider that even though the appellant was not obviously suffering from psychotic symptoms, the FTJ was entitled to conclude that the appellant was not compliant with medication, had a lack of volition and needed assertive health care. Dr Reid’s conclusion, which the FTJ accepted, about those with schizophrenia requiring their compliance with medication to be monitored and requiring medical, occupational and social support was not a conclusion specific to the appellant; it was a conclusion generally relevant to schizophrenia sufferers (see [41]).
50. The conclusion at (v) that there would be no meaningful support from clan members comes from the expert report. That conclusion is based on the expert analysing the country guidance case of OA (Somalia) Somalia CG [2022] UKUT 00033 and explaining why the appellant in his specific circumstances would not have clan support (see paragraph 66 onwards of the main report and paragraph 12 onwards of the addendum report). It does not depend on the FTJ’s conclusions in respect of the appellant’s mental health condition.
51. The conclusion (vi) that the appellant would be immediately destitute naturally follows from the FTJ’s conclusions that the appellant would not have support in Somalia from anyone and would not be able to work. This finding was not challenged by the respondent. Whilst the appellant’s ability to work relates to his mental health, as I have explained above, the FTJ’s finding in this respect was adequately reasoned and not in error.
52. The finding that the appellant would end up in an IDP camp and be vulnerable to violence was accepted by the FTJ based on the expert report. Again this was dependent on the expert’s reasoning as to country conditions in Somalia and the IDP camps in particular, rather than the way the appellant would be treated because he would be displaying obviously psychotic symptoms for example.
53. Even bearing in mind the FTJ’s lack of reasoning in respect of specifically medical risk, I can see no error in his agreement with the appellant’s counsel that the appellant faced destitution such that there was a real risk that he would be exposed to intense suffering or a significant reduction in life expectancy. As I have repeatedly said, the FTJ’s findings on destitution and the appellant finding himself in an IDP camp and at risk of violence (from which he would not be protected by the state) have not been specifically challenged.
54. The Upper Tribunal in the country guidance case of OA (Somalia) explained that whilst for most returnees, the prospect of their having to resort to accommodation in an IDP camp was too remote [338], there might be particular features of an individual returnee’s circumstances which meant that there would be a real risk that residence in an IDP camp would be reasonably likely, in which case a careful consideration of all the circumstances would be required in order to determine whether their return would entail a real risk of Article 3 being breached [339].
55. When the FTJ’s adequately reasoned findings are put together: - a high risk of immediate destitution, resort to an IDP camp (described by the expert whose evidence was accepted by the FTJ as “very dangerous places where gangs operate” and “life-threatening” with “lack of food, order and ongoing fights common”) where the appellant would be extremely vulnerable to violence (the expert concluding that the treatment would be especially harsh for the appellant, a minority clan member, because he would be expected to have resources having come from Europe) that the appellant lacked the volition to manage his mental health condition himself and as a person with schizophrenia needed medical, social and occupational support, and was returning, not to his home area, but to the capital of a country he had left as a 10-year old, there is no error in the FTJ’s overall acceptance of the arguments in the appellant’s skeleton argument that removal would be a breach of the appellant’s Article 3 rights. On the FTJ’s adequately reasoned findings, the conditions the appellant would face on return are such that he would be at real risk of immediate exposure to intense suffering or a significant reduction in life expectancy. There is therefore no material error in the FTJ’s overall conclusion on Article 3 ECHR.
Ground 2
56. Ground 2 suggests that it was an error of law for the FTJ not to consider section 117 C of the 2002 Act and give the public interest greater regard. As Mr Gilbert noted in his rule 24 response, article 3 protection is absolute, and an appellant’s interests are not to be balanced against the public interest. If all that was meant by the ground was that the FTJ omitted to consider Article 8 ECHR in the alternative, ideally the FTJ should have considered all bases of the appellant’s case, but it is not material given the appellant succeeded on Article 3 ECHR and I have found there to be no material error in that overall conclusion.

Notice of Decision
The judge’s decision contains no material error of law and stands. The Secretary of State’s appeal is dismissed.

A-R Landes

Judge of the Upper Tribunal
Immigration and Asylum Chamber

30 December 2025