Case No. EWFC-93

Dr Nadeem gave evidence at length on the second day via CVP videolink. The father had prepared a set of questions, most of which the court put to the expert on behalf of the father and the court also asked further questions for clarification and to assist the father. Further time for the father to consider extra questions and to ask them directly. Dr Nadeem confirmed that he had read all of the up to date documentation and there were no changes to his recommendations. 61.He was challenged at length by the father but his opinion did not deviate from the report. He clarified that the specific psychological treatment required by the father would be DBT: Dialectical Behavioural Therapy. Father had severe and protracted substance misuse problems needing to be treated. Father should become abstinent from drugs before commencing DBT therapy as it does not work as well if drugs are taken. The therapy would most likely be 12 months from commencement.62.When challenged, he confirmed that he had prepared his assessment fully in line with industry professional standards and denied that it was unfair or biased. 2.5 hours was taken for the interview and usually this was 1-1.5 hours so rather than being too short as father stated, it had been much longer. It had been carried out in a standard manner with use of the medical records and full history and fact gathering with routine questions – before deciding what would or would not ultimately be relevant to the assessment.63.He considered the fathers history to be particularly relevant, including his comments about his own parents, as although they were made when father was in an addiction state, the reality was that he had a very long history of substance abuse and father had never been abstinent for a long period. It was all relevant in a wider context. He had gathered evidence for his opinions and recommendations from the medical records and also based upon his interview with the father as well as the court bundle. He considered that his assessment was fair; he had highlighted the father’s achievements and not ignored them as suggested. 64.Father submitted that “Dr Nadeem had not acknowledged that his mental health issues were a by-product of the substance abuse in the past”, effectively that the drugs caused or significantly contributed to the mental health issues. Dr Nadeem denied this strongly and stated that the contrary was correct. He had noted that a diagnosis of Emotionally Unstable Personality Disorder had been suggested in the past but he expressed concerns about labelling. It was difficult to give a diagnosis where there was substance misuse, but he was convinced that there were underlying mental health issues and personality traits, not merely linked to substance abuse.65.When asked about his opinion as to whether if addicted once, you were always addicted even if you free yourself, Dr Nadeem said that there were various school of thought. AA for example considers that you cannot be cured and complete abstinence is necessary. He preferred to focus on the individual person, as everyone had a unique journey to improve, achieve and sustain total abstinence. In the case of the father, given the severe and protracted nature of his substance abuse, this meant that total abstinence would be required. The father had previously switched from one substance to another, one addiction to another but had never achieved total abstinence, neither had he dealt with the underlying psychological issues.66.He was concerned at the father’s reference to his “recreational use” of Ketamine He would not call it “recreational” with the father’s protracted history. Standard practice for people with the father’s history was to recommend no “recreational use” at all it as it was simply too risky.67.Mother asked one question which was whether the hypnotherapy which the father was undertaking now would be sufficient. He replied that it was not something he would prescribe, not within the guidelines and there was no specific evidence backing it.68.I am satisfied that Dr Nadeem’s assessment was balanced and fair. I accept his oral and written evidence, it was cohesive and detailed. His oral evidence reflected his written evidence and he was reflective and insightful when giving evidence. He was happy to praise the father for the improvements made but it was clear that he was concerned about the underlying issues and the risk of relapse without professional support. There are many more aspects of the report which I could address in this judgment but I do not need to do so. The report is accepted by the court and cross examination did not damage it’s credibility. It can be referred to and disclosed to any professional therapist/support worker who assists the father in due course. Dr Nadeem agreed to set out in a letter the precise information about the therapy, ideally with suggested therapists and father agreed to accept and utilise this.69.I prefer the opinions of the professional expert on issues of mental health and substance abuse to those of the father. I do not do this simply because he is an expert appointed by the court, but as a result of the very clear and persuasive way he presented his evidence, both in the report and orally. It is also important to note that he is a very experienced and practising expert and a specialist in general adult and substance misuse psychiatry. There is no evidence, save for the father’s opinions, to challenge his conclusions and I accept them. The same is true for the Guardian, another experienced professional.