[2023] UKUT 00164 (IAC)

The appellant reported to the 2021 FTT mental health panel that he had flashbacks to his time as member of the Zanu-PF youth in Zimbabwe (summarised as being a child soldier) and these occurred when he was serving his prison sentence. He was in contact with mental health services whilst in prison.

The appellant was released from prison on licence on 21 February 2020. He has been known to secondary psychiatric services since March 2020 when he was referred to psychological therapy due to symptoms of PTSD related to his time as a child soldier. Before this could be provided the appellant was detained under s.2 in June 2020 following an incident in which a neighbour and an emergency worker were assaulted. He was sectioned between July and September 2020 when he exhibited signs of acute mania. He was diagnosed with bipolar affective disorder with psychotic features.

The reports note that the appellant’s bipolar disorder follows a clear pattern of typical relapse and remission. When unwell he presents with formal thought disorder, grandiose delusional beliefs, bizarre behaviours, serious violence to others and aggression. This means that he is at increased risk of retaliatory violence due to his provocative behaviours and chaotic presentation.

The reports also describe the appellant as experiencing symptoms of trauma including hyper-arousal, hypervigilance nightmares and flashbacks, with an extensive trauma history starting in childhood, including his experience of being forced to work as a child solider and being exposed to atrocities and highly traumatic experiences.

Upon his release the appellant was compliant with prescribed medication (Olanzapine and Sodium Valproate) and community treatment.

The appellant’s mental health deteriorated in October 2021 when was asked to travel to Kenya for the funeral of his partner’s mother. He was concerned about its proximity to Zimbabwe and the risk of being apprehended by security service.

He was assessed and reassessed following incidents of criminal damage and shortly after suffered a very severe relapse which led to him being sectioned again between December 2021 and January 2022. The reports note that the relapse occurred shortly after he was asked to travel to Kenya and despite compliance with antipsychotic medication.

Such was the extent of his delusional mind at the time that he was recorded as having been involved in over 28 aggressive and at times assaultive behaviour that involved intervention by nursing staff, including seclusion, to preserve his welfare and that of other patients.

The appellant needs considerable support in the community. This includes:

Ms Joliffe’s report describes an increase in the appellant’s paranoid thinking, nightmares, flashbacks and distress. Mr Evans also refers to the appellant experiencing regular flashbacks and nightmares relating to multiple traumas including his experiences as a child soldier.

Mr Evans concludes that if the appellant “were to stop his medication or be unable to access his treatment then it is highly probable that he would relapse”.

Mr Gregory’s report links the more severe impact upon the appellant’s mental health to when he is confronted with issues that trigger a sense of existential threat, primarily associated with being placed at the mercy of organisations in Zimbabwe. He concludes that the appellant “is very afraid of the prospect of being deported to Zimbabwe…and this has previously led to the onset of acute episodes of mania accompanied by erratic and aggressive behaviour which have only be successfully managed in hospital… there is a very high likelihood of relapse should he be informed at that he will be deported”.

Ms Joliffe concludes that returning the appellant to Zimbabwe would be “enormously triggering…and would lead to further exacerbation of psychotic symptoms and a significant relapse” and without the intensive care the appellant receives and the support of his immediate family, he is “at a high risk of relapse of a serious episode of psychosis if deported”.