“The Claimant and Defendant shall each obtain an independent psychiatric report addressing (a) the Claimant’s mental health; (b) the Claimant’s treatment needs; (c) the Claimant’s suitability for detention; and (d) any other matters considered to be of relevance. For the avoidance of doubt, such reports are in addition to any report provided by Dr Brown.”
“4. As soon as the Defendant received Dr Slater’s report and had considered the contents of the same, advice was received from Tsol the same day after they had considered the report. On Thursday19th April 2012 AS was referred to the Three Bridges Mental Health Unit by Dr Brown in the prison health care team in light of Dr Slater’s report. At the time of doing so, Dr Brown advised that the Three Bridges Mental Health Unit do not have a bed available at the current moment in time and it could take between 1-6 weeks for Three Bridges to accept AS depending on the severity of his condition and after all risk issues have been considered. In the early afternoon of Thursday19th April 2012 the Claimant’s solicitors were informed of this. 5. However later in the afternoon of Thursday 19th April the Home Office caseworker telephoned Three Bridges to check on what the current state of affairs was. The caseworker spoke to a Dr Kemal of the Three Bridges Mental Health Unit. Dr Kemal is a consultant psychiatrist who had discussed AS’s case with his registrar, a Dr Sharda, who had assessed and completed the report dated16th March 2012 . Dr Kemal asserted to the caseworker that the Claimant does not meet the criteria for referral to the unit and can be suitably managed in the Healthcare Wing of the prison. The caseworker asked Dr Kemal to confirm this opinion in writing; however Dr Kemal said that in order to get something in writing the caseworker should contact the admissions manager Mr Maguire. 6. The caseworker duly spoke to Mr Maguire who advised him that AS is not suited for Three Bridges due to his personality disorder and mentioned that there is a hospital in Mill Hill that deals with patients with personality disorder. However, the difficulty with this is that I understand that Dr Brown has stated that AS can only be transferred to a facility within the current NHS Trust area. … 8. The court will be aware that the UKBA’s obligation to identify the need for any proposed transfer and the required supporting evidence and a referral is made on that basis, however transfer decisions are made by the Secretary of State for Justice, who I note are not currently a party to these proceedings. … 10. The Defendant continues to monitor and assess the Claimant’s detention and ongoing health care within prison while alternative and appropriate care is identified. As such, it is the Defendant’s belief that detention continues to be the most appropriate way of providing the Claimant with appropriate health care and preventing him from self-harm. As well as protecting the public, and particularly his former partner, from the risk of harm and reoffending which the Claimant is considered to pose.”
“We are aware of the expert opinions provided on behalf of the Claimant and Defendant, but we are of the view that Dr Brown is best placed to assess your client’s suitability for hospitalisation as she is your client’s treating psychiatrist who sees your client on a regular basis. Our client is, however, happy to review his decision should your client’s mental health deteriorate or change in any way. Further, our client was informed by Dr Brown in the last few weeks that AS’s mental health appears to be improving and this further strengthens our view that he does not require treatment in hospital at the current time.”
“I can confirm that under DH Responsible Commissioner Guidance NHS Brent are the Responsible Commissioner for AS’s health and Westminster Council are responsible for his Social Care. Should the Courts determine a mental health need requiring acute in-patient treatment he will be reassessed either at Park Royal or St Charles’ Hospital (both mental health units are under CNWL-Central and North West NHS Trust who cover our commissioned m/h services). This is on the basis that West London Mental Health Trust as the expert forensic provider that we commission to provide high and medium secure provision have assessed him and their clinical recommendation was that he was not appropriate for this service. Park Royal or St Charles will still need to do their own assessment to meet any m/h needs and manage any related risks. This assessment will also inform what package of health and/or social care or other support may be required to insure that his needs are adequately met.”
“in terms of admission to a medium secure unit, he does not meet our criteria for admission at present as he is not presenting as a significant immediate risk to others, his primary diagnosis is of borderline personality disorder.”
“6.1 Since his arrival into Wandsworth, AS has made numerous threats to harm himself and on several occasions has engaged in significant acts of self-harm. His risk to himself in this regard is due to his emotional instability and poor coping skills in relation to stress. On release he is likely to seek prescription medication or use illicit drugs which may serve to increase his risk to himself. His risk to himself at present remains significant; it could be lowered by supportive and specific treatment for those with personality disorder as provided by local secondary psychiatric services. 6.2 AS was previously charged with the common assault of his partner, it is my understanding that this charge was dropped at court some months later. He has twelve previous convictions for sixteen offences. He was first convicted of theft in 2008, he went on to commit eight further thefts over the next two years. He was convicted of battery in 2011, however I do not have details of this offence. He has admitted to previously fighting with a Hezbollah militant group while in the Lebanon and carrying a gun in his mid-late teenage years. Since his arrival here he has made intermittent albeit serious threats to harm me and threats to kill himself and ‘take someone with him’, implying a prison officer or another inmate. He has also made threats to harm the arresting police officer in relation to recent criminal proceedings; this matter was reported to the police. 6.3 AS has various historic risk factors for future violence towards others, including history of previous violence, presents with personality disorder, previous substance misuse, employment problems, lack of stable relationship, and early maladjustment. Clinically he presents as impulsive and lacks insight into his behaviour. If released into the community risk factors would include lack of support and exposure to drugs and alcohol. I note that AS has not been violent towards others in prison (albeit threatened this), however overall his risk of engaging in future violence, particularly further assaults remains significant.”
“I am the resident consultant forensic psychiatrist at HMP Wandsworth and have provided psychiatric assessment and treatment for AS for the past 9 months. In this context I advise that I am not able to give an independent view in relation to the questions asked of me by the Court. In addition, in January this year AS made threats to harm me. I therefore do not see him myself for psychiatric review: this is provided to him by other psychiatrists from the in reach team. Both issues as outlined could be considered a conflict of interest in respect of my duty to provide an independent opinion to the Court. For this reason I have provided the Court with a short report to give information about AS’s previous and current presentation and treatment. …I have refrained from giving my expert opinion in relation to his suitability for detention owing to the conflict as outlined above. I understand that the Court will be furnished with two independent reports to address the issue of fitness for detention. I do however consider that it is appropriate to comment on risk, hence the amendments to my original report.”