Case No. ZC21P00327

18.These proceedings and the dispute over relocation have clearly taken a substantial toll on both parents. Shortly before this application was issued, the mother sought assistance from a consultant psychiatrist, Dr McPhillips. He diagnosed depression and reports from him were filed by the mother in support of her application. Very sadly, Dr McPhillips died earlier this year. The mother is now under the care of a different consultant psychiatrist, Dr Sally Braithwaite who has diagnosed her as having severe depressive episode without psychotic symptoms. In October 2021 the father too sought assistance from a consultant psychiatrist, Dr Niall Campbell, and was diagnosed with major depressive disorder. As I have already indicated the introduction of this late evidence from Dr Campbell caused the adjournment of an earlier hearing in this matter.19.I heard oral evidence from both Dr Braithwaite and Dr Campbell. They were, of course, giving evidence as treating doctors, rather than as expert witnesses pursuant to Part 25 FPR. That said, subject to the points that I mention below, I accept their evidence of their respective patient’s condition and the likely effect that the outcome of these proceedings may have upon them.20.As a tool to assist in the diagnosis of their condition and the assessment of its severity, both parents have undertaken the Beck Depression Inventory on several occasions. This involves the patient self-reporting their feelings on a number of matters. A higher score is indicative of a more severe depression. When first seen by Dr McPhillips in March 2021, the mother’s reported score was 36/63. On the most recent occasion when the test was administered, in late March 2022, the mother’s score had risen to 51/63. The father scored 32/63 when first seen by Dr Campbell in October 2021; his most recent score was 52/63. 21.Dr Braithwaite confirmed that the mother was on high doses of medication and sleeping aids. She considered that the mother was severely depressed and that the overall recent trajectory of her condition had been a “marked deterioration” since her first assessment in March 2021. She described the mother as feeling “trapped” in the UK. The mother had a number of depressive symptoms including “overwhelming fatigue, lack of enjoyment in anything, poor concentration and tearfulness”. She had reported difficulties in self-care, finding it harder to get out of bed or to shower. She was no longer able to hide her distress from the children, snapping at VB and was no longer emotionally available to the children. Whilst the mother had not reported any suicidal thoughts, Dr Braithwaite indicated that she “would be extremely concerned” for the mother’s health and safety if any further deterioration in her depressive condition occurred and in her oral evidence she indicated that she considered that “something catastrophic” could happen if the mother was not permitted to relocate22.Dr Braithwaite emphasised that in her view the mother’s depression was linked to her wish to relocate to the USA, reporting that:“I have little doubt that her depression would be significantly improved by gaining leave to return to the US, and without that, she would struggle ever to recover fully from her depressive condition.”23.Under cross-examination from Ms Guha, Dr Braithwaite conceded that there were likely to be a number of factors contributing to the mother’s depression of which her frustrated wish to relocate to the USA was but one, and that these also included the breakdown of her relationship with the father, the very difficult circumstances under which the family were currently living and the stress of proceedings. Although Dr Braithwaite could not say with certainty the extent to which each of these factors was contributing to the mother’s condition, she emphasised that she considered the mother’s desire to return to the USA to be the longest standing issue.24.Dr Campbell’s evidence in relation to the father to a large degree mirrored that of Dr Braithwaite in relation to the mother. Dr Campbell reported that the father presented with significant depressive thought processes including feelings of sadness, failure and worthlessness. His physical features of depression included loss of sleep, reduced concentration and fatigue. The father has also described suicidal ideation (although he has said that he would not act on these feelings). Dr Campbell described there having been a gradual deterioration in the father’s mental state since he had first seen him in October 2021. He too was concerned as to the potential impact on father’s condition if relocation was permitted.25.In cross-examination by Ms Eaton, Dr Campbell was asked about a comment in his report that if the mother and children were to move permanently to the USA, “access will be difficult and [the father] will inevitably lose contact with them”. Ms Eaton referred to the mother’s significant proposals for contact between the father and the children and the possibility that the father might himself move to the USA. Dr Campbell accepted that his comment that, in the event of relocation, a loss of contact was an inevitability was an exaggeration of the position.26.In cross-examination Ms Guha asked Dr Braithwaite some questions about the Beck Depression Inventory and the possibility that it can be manipulated by a subject reporting feelings with a view to achieving a high score. Whilst Dr Braithwaite accepted this potential vulnerability, she made clear that it was one element of the diagnosis of depression which rested on other symptoms and observations as well. Whilst Ms Guha, in her closing submissions, highlighted the fact that the Beck Depression Inventory may be vulnerable to manipulation this is, of course, is a point that potentially cuts both ways as both parents have reported increasingly high scores on the Inventory as proceedings have progressed. 27.For the mother, Ms Eaton sought to make a point about the father having reported his symptoms very shortly before a hearing that had been listed in the case after being referred to Dr Campbell by his solicitors. A similar point was also made in cross examination by Ms Guha on behalf of the father – the mother having first consulted Dr McPhillips around the time that these proceedings were issued (although she had previously been seeing a therapist since August 2020). It seems to me likely that these proceedings and the feelings that they engendered in both parties have brought matters to a head and have provided a reason for them each to seek professional help in respect of the symptoms which they have experienced. However, that does not mean that those symptoms are not genuine or have been manufactured for the purposes of adding weight to their respective cases.28.I had the opportunity to observe both parents throughout the hearing. The mother, in particular, exhibited significant and visible distress throughout the hearing; not only during her time in the witness box, but whilst listening to the other evidence and to my exchanges with counsel. This presentation was consistent with the account that Dr Braithwaite gave of the mother’s state of mind and also with the observations of other third parties such as her employer who has placed her on medical leave. I accept that her obvious distress which continued throughout the three days that she spent in court was indeed genuine and was not (as Ms Guha suggested in her closing submissions) an attempt to evade questions asked of her in cross-examination. The father appeared outwardly less emotional in his presentation both in the courtroom generally and during the course of his evidence.29.Having considered matters carefully, I accept the evidence of both Dr Braithwaite and Dr Campbell as to their respective patient’s conditions. Although their outward symptoms vary, both parents are clearly suffering from a severe depression and I take extremely seriously the evidence of both Dr Braithwaite and Dr Campbell as to the likely impact of an adverse ruling on each parent.