“We must construe ‘exceptional’ as an ordinary, familiar English adjective, and not as a term of art. It describes a circumstance which is such as to form an exception, which is out of the ordinary course, or unusual, or special, or uncommon. To be exceptional, a circumstance need not be unique, or unprecedented, or very rare; but it cannot be one that is regularly, or routinely, or normally encountered.”
“The Governor thought that compassionate grounds would only exist if there was serious or terminal illness or something of equal severity. I do not think that compassion arises only in cases of death or illness. There are compassionate grounds whenever there is pain or suffering or distress or misfortune. The narrow scope of the power under section 102(3) results more from the requirement of exceptional circumstances than the element of compassion. In the present case, the repeated indications of immediate release, or that it would be forthcoming if the judges so recommended, must have given rise to real feelings of upset and disappointment on the part of the Claimant, and indeed of his family. It would be an act of compassion to release him in such circumstances.”
“Since being imprisoned, Stefanos’ symptoms have returned significantly once again due to the experience of imprisonment and the high stress levels associated with his environment. Once again, he is suffering from traumatic reliving of the kidnap through flashbacks & nightmares, awakes during the night screaming & crying, often having urinated himself, claustrophobia and a general sense of panic and anxiety. The violent and high stress environment being a constant trigger of his symptoms, the prison cell & being locked up causing him to relive the traumatic event where he was locked in a room for many hours, without support to calm him when he suffers. When not suffering from the forced reliving of the event, Stefanos has a constant ‘fear of the unknown’. He has spent the last few years trying to put the kidnap & memories of the gang behind him, yet once again, he is within a system where a fear of retribution causes constant psychological suffering. The unnatural & violence atmosphere causes him to be constantly scared and paranoid which put all together is having an overall negative effect on his health. Stefanos symptoms are frequently & easily triggered. Often unexpectedly, during the night, checks by officers can cause a fright that develops into a panic attack. Confrontation between prisoners & acts of violence cause Stefanos to hyperventilate & tremble uncontrollably and graphic, disturbing intrusive thoughts plague him most days. He has been sharing a cell with other prisoners although as a result of the panic attacks (screaming, crying & general erratic behavior [sic]) the prison are helping to allocate him a single cell. Attempts to access mental health care have been either inadequate or inappropriate. Despite bringing his symptoms to the attention of mental health since being imprisoned in August, he has not seen a psychologist. … Stefanos general suffering as a result of his symptoms is intolerable. He is desperate to find a solution. He feels that he cannot take the pain anymore and does not have where to turn. Stefanos is scared of what this is doing to his long-term mental health, he does not want to be a victim but is noticing significant change in himself as a result of his suffering. Stefanos’ deterioration is having a negative impact not only on him, but his family also. He wants to be a good & strong father for his family like he once was, especially for his 4 years old daughter. He has a significant sense of loss and urgently wants to regain his livelihood. … It was evident [on30 December 2023 ] that having been exposed to such horrific trauma, that Stefanos case was complex. Furthermore, failure to address this trauma in previous years via therapy, has clearly had a significant impact of the severity of the PTSD Stefanos is suffering from. Often such avoidance to directly address disorders that follow from exposure to events of a traumatic/horrific nature, manifests into complex PTSD and are characterized by the very symptoms Stefanos is experiencing. … Since the appointment on the30th December 2022 , I have had sight of Stefanos’ medical records which details the history of his condition since the attack. It is evident that previous attempts of therapy were traumatic for Stefanos (as they generally are for events of this level). This resulted in an avoidance by Stefanos to continue which has allowed the unaddressed trauma to manifest into complex PTSD. … Due to the traumatic events that Stefanos was exposed to, I strongly advise against any form of therapy being undertaken in a prison environment. It is clear that despite previous years of ‘coping mechanisms’, that prison is having a severe negative impact on Stefanos’ condition. It is a reoccurring reason for his condition being ‘triggered’ due to the relation of imprisonment and the events he was exposed to. … The significance of Stefanos’ trauma and how it relates to surroundings would make it much more traumatic for him to undergo therapy in a prison. Doing so would cause unnecessary pain and intolerable exposure to the event. This could manifest into long-term damage to his mental wellbeing and could leave him in an unstable condition. … Overview & Analysis I have concluded that Stefanos requires urgent treatment in order to stop the deterioration of his mental state as a result of the continued exposure to the symptoms of PTSD and to prevent the condition becoming chronic and difficult to treat. Stefanos needs therapy to address the trauma in a stress free, relaxing environment that would allow his condition to remit fully. Small doses of medication would be offered alongside to complete the treatment. I strongly emphasise my advice that urgent therapy to address the trauma, due to the complexity of his condition and level of trauma he was exposed to is not carried out in a high-stress unsupportive environment such as prison. Doing so could have devastating consequences for his mental stability. I suggest that the therapy is conducted in a supportive environment where Stefanos feels safe and secure and the surroundings would be suited to dealing with his condition and enabling his recovery. Post recovery, Stefanos would need to continue ongoing treatment in a comfortable environment to achieve full remission from the symptoms and ensure the recovery is long term, finally achieving full remission. I have referred Stefanos case to Dr Shoka for a detailed diagnosis and treatment/management plan.”
“Based on my assessments, I advise that EMDR therapy will be the most appropriate & effective method of therapy to improve Stefanos symptoms & remit them. … It is important to emphasise that EMDR therapy should be offered to Stefanos in an anxiety-free, supportive, relaxing & conductive environment. The reasoning for this is that, whilst EMDR therapy is generally recognised as a safe & effective approach to dealing with trauma, therapy for patients with a significantly horrific trauma like Stefanos, will be distressing & as a result may leave them with negative post-therapy side effects. An inadequate post – therapy environment could aggravate this & leave Stefanos in an unstable condition. … I would not advise that Stefanos undergo therapy in any form that requires recalling the trauma in a prison environment where: a) The sessions may be limited & aftercare inadequate, b) The significantly aggravating trigger in Stefanos condition is the experience of the prison environment & the locked cell. … Therapy within a prison environment for a patient with Stefanos circumstances, where he will be returned to a high stress & triggering environment would be irresponsible & could result in severely negative consequences such as a development of further mental health conditions, suicidal intentions, and general mental instability. Moreover, to allow Stefanos to recall the event & then confine him alone to a room would be inhumane, considering the circumstances of his trauma. … Lastly, I advise that the therapy is offered to Stefanos as a matter of urgency. Whereas in previous years, Stefanos has tended to be aware & avoid his triggers, this has not been possible in prison and realistically will not always be possible to apply. As a result, Stefanos is suffering intolerably from his symptoms.”
“During the call, Stefanos described the psychiatrist being very understanding of his issues. However, he continues to feel unable to address the traumatic memories through any form of direct trauma-based therapy and listed the physical reactions he experiences in response to any exposure to reminders, memories or recalling of the trauma and the distress this causes. Stefanos experiences overwhelmingly realistic sensations of being back at the scene of the trauma, a sense of panic and feeling unsafe as if something terrible is about to happen. This takes place even in the safety of the psychiatrist room and such reactions can arise during attempts to recall less distressing parts of the trauma or even at the very discussion of carrying out trauma-based therapy. … [H]is fear and mental reluctance to directly address the trauma is exacerbated by the high stress environment of the prison, which happens to be a daily reminder of his trauma and therefore a constant overstimulating trigger of his symptoms. Constant unsuccessful attempts of pushing distressful thoughts out of his mind will only cause further problems in the long term for Stefanos, as it already has, because doing so interferes with how he processes and makes sense of the trauma that took place. Stefanos has been continuing to experience the symptoms of his C-PTSD (anxiety, hyper alertness, vivid flashbacks of the event, night time claustrophobia, panic attacks, nightmares, intrusive thoughts). However, he also stated how some of his symptoms have negatively developed over recent months. Nightmares have increased in intensity and Stefanos often feels ‘out of body’ experiences and even feelings of physical pain on his body specifically relating to acts that took place during his trauma. This understandably being very distressing for Stefanos, especially when awaking frantically during the night, alone and confined to his cell. Furthermore, his nightmares are often spilling out into his waking life and he sees danger everywhere, causing him to panic. Panic attacks have also increased in frequency and now take place outside of his cell more often than before, in environment where Stefanos is unable to find escape due to the restricted movements within the prison. As a result, Stefanos now feels he is living in a cycle of being ‘in fear of fear’ – developing a behavioural avoidance by way of being increasingly reluctant to leave his cell. Stefanos is being fearful of being in a situation (such as work or exercise time) where the intense and unexpected onset of physical sensations from an attack can overwhelm him and he is unable to escape from the trigger/location or find a safe place in order to calm down. Overwhelming physical sensations include feeling very hot or very cold, trembling, increased heart rate, becoming dizzy and nauseous and a heightened arousal of fight or flight that causes extreme panic. Also infrequently, Stefanos has lost a conscious awareness of his surrounding for a few moments (although not fainted). These reactions understandably being distressing for him in a prison environment, in front of other inmates, where he feels isolated from support or protection. … Stefanos’ family have noted significant change in his physical, mental, and behavioural state. During nights of high and tense emotions over the phone, or a lack of contact from Stefanos, they have felt it necessary to call and ask the prison to carry out welfare checks on him. The family describe days where Stefanos can be detached or unresponsive, along with infrequent but worrying bouts of confused or disoriented states. This has certainly caused significant anguish for them and concerns for his general wellbeing. Such display of erratic behaviour is likely to be due continued endurance of his symptoms and the extreme stress this causes Stefanos – possibly causing mental instability. Stefanos himself described infrequent, yet erratic behaviour when in his cell, such as laughing hysterically and then simultaneously beginning to cry his eyes out, which he said confuses him. … I understand from Stefanos that the prison psychiatrist has shown him deep understanding of his mental inability to engage in trauma-based therapy and has nevertheless continued to help him apply alternative methods to help challenge his symptoms. Stefanos actively applies grounding techniques during attacks/flashbacks (using sight, sound, touch in order to find a safe place) and exercises such as nightmare image reverse where attempts are made to change ending of negative, traumatic nightmares into positive ones while awake. He has also tried to understand the sources of his triggers in order to understand and address them. However, evidently these less directive measures are not being successful in decreasing his symptoms and Stefanos’ C-PTSD ultimately does require a form of trauma-based therapy that undeniably will be distressing for Stefanos. Despite the demoralising and unnatural environment of his imprisonment, Stefanos continues to show motivation to collaborate with forms of treatment and has shown resilience even under extreme stress – I commend him for this and explained the importance of him being less self-critical in regards to how he is dealing with his symptoms. Nonetheless, his mental resistance to consider trauma-based therapy in prison is understandably immense and as previously stated in the medical report, there are grave concerns about the consequences for his mental stability should he attempts any distressing evoking of traumatic memories in prison. Moreover, less directive methods of therapy may be counter-productive in the long term, as consistent evoking of Stefanos anxiety by application of exercises that ultimately will not succeed in reducing his symptoms, could make matters worse rather than help. As is such, the treatment plan advised in April continues to be the appropriate route for Stefanos. In fact, the advice is further supported due to how his symptoms have since developed.”
“3. The Secretary of State is asked to exercise his power to release Mr Neophytou (‘the Applicant’) on compassionate grounds. These grounds concern his medical condition and needs. An expert medical report accompanies this application.”
“25. At the time of the decision to activate the sentence term the severity of the PTSD symptoms of the Applicant could not have been and was not known. There is now clear and compelling evidence available that details the matters set out below that show the exceptional circumstances that justify and require an ERCG to be applied in this case. 26. The impact of the Applicant’s imprisonment has been to worsen and trigger his PTSD symptoms. The prison environment provides direct reminders of his trauma, which is causing the Applicant intense mental suffering, fear and anguish; and it precludes effective treatment. The application is supported by the evidence of a joint medical expert report of Professor Sam Lingam, consultant paediatric neurologist with considerable experience of medico-legal reports for victims of torture, and previous medical assessor member of the Tribunals Service, and Dr Ahmed Shoka, consultant psychiatrist.” (Subsequent paragraphs elaborated on the matter by reference to the medical evidence.) The representations also raised matters concerning the claimant’s family circumstances. The first concerned his daughter: “22. In 2018 the Applicant’s daughter [name For this and similar references within square brackets within this paragraph 23, see paragraph 53 of this judgment. ] was born. This was a life changing event for him. He is close to her and a caring father. The impact on his daughter of his imprisonment is noted by the Meadows Nursery in a letter dated25 October 2022 .” “43. The Applicant has a positive and supportive loving relationship with his partner [name] of 12 years. His daughter [name] is now 4 years-old. He loves being a father and is a devoted parent. [His partner] juggles work and being in effect a single mother under the present circumstances. The Applicant expresses significant concern about not being able to be a father whilst imprisoned and with what kind of person he will be when released if this was to be only after suffering as he is for a number of years during which time his mental health will continue to deteriorate and compound as the experts have identified.”
“24. On Friday13 October 2023 , the Applicant’s mother suffered a stroke and was admitted to hospital. This has considerably impacted the Applicant whose own mental wellbeing is further worsened as a result. The Applicant is deeply anxious to be with his mother to assist in her recovery, particularly as he is her only son and main form of support. Medical evidence from her doctor Dr Tahir confirmed in August 2023 that she was suffering even then from paranoia, anxiety and chronic depression (for which she took medication) and ‘is feeling very isolated after her son was imprisoned’.” “42. In addition to his own health the Applicant is now extremely worried for his mother (who is very close to him as her only child). On13 October 2023 , as mentioned above, the Applicant’s mother suffered a stroke and was admitted to the Queen Elizabeth’s Hospital in Birmingham. The Applicant believes his mother’s stroke may have been exacerbated by her alcohol dependence, which she suffered in relapse after the Applicant’s kidnap as well as associated depression. The Applicant’s own mental health has deteriorated on hearing the news about his mother who is said to be confused and delirious. As his mother’s main form of support, the Applicant is anxious to be able to assist her in her recovery and to help her to take steps to keep her away from alcohol. Her stroke is devastating for the family. It is now even more important the Applicant can be effectively treated and recover so that he can be strong for his mother and his partner [name], so he can provide his care and support. Her incapacitation means that [name] is alone.”
“45. In light of the above facts, it would be consistent with the obligations upon the Secretary of State under theHuman Rights Act 1998 to release the Applicant on compassionate grounds. Not doing so would conversely not be compatible with the psychological well-being of the Applicant, and indeed the balance of interests of family members also, in light in particular of an absence of risk posed to the public by such proportionate compassionate release.”
“If you submit any information that will assist a decision including contact details of parties that can contribute to a decision being made such as Consultants, a point of contact from the family to liaise with and any other agency involved in ongoing care that will be given going forwards. A copy of the Judge’s sentencing remarks, along with a rationale why Mr Neophytou’s release would be justified in exceptional circumstances I will then make a decision if the Prison supports this application or not.”
“The rationale for why release is justified is set out in the representation documents and supported by the various appendices. As explained in paragraph 10 (c) of the representations document there were no sentencing remarks by a Judge as there was no sentencing exercise. Our client had a default sentence activated in default of payment and his release is unconditional.”
“I have escalated this to the Deputy Governor, Rachel James to review my decision not to process the request for ERCG on the grounds outlined in my initial response to you. She will provide a response including her view on my decision and the response to your pre-action letter.”
“16. … Governor Keller confirmed to me that, in making his original decision, he had had before him the bundle of documents provided by the Claimant’s solicitor and the ERCG policy. He also met with the Claimant on several occasions to discuss the application and spoke with Dr Abbie Willis, the prison psychologist who is working with the Claimant. The content of these discussions surrounded the nature of the Claimant’s condition and his current treatment needs. They also confirmed that other treatment could be obtained in the custodial environment that could support the Claimant. Governor Keller duly sent on to me the information he held on the Claimant to support my review. … 20. In the course of starting the review of Governor Keller’s decision and then in the course of providing this witness statement I have had the chance to consider the documents and other information which was before Governor Keller at the time of his decision. Having done so, I entirely agree with Governor Keller’s decision not to refer the Claimant’s ERCG application to the PPCS. To me it is absolutely clear that the facts of the Claimant’s case do not meet the threshold set out in the relevant policy. Indeed they do not come close to meeting that threshold. Based on my experience as a Governor, I do not think that the circumstances of this Claimant are exceptional at all. If I had been asked to make this decision, I would have made the same decision as Governor Keller. … 24. The threshold for progressing applications for ERCG under the Policy is necessarily high and will not be applied to frequently arising levels of need as this would effectively create an inordinate volume of applications for ERCG from many prisoners who could argue that the prison environment is detrimental to their mental health, is causing suffering or does not provide as therapeutic an environment as that that could be provided in the community. While the Claimant has presented as being down and anxious at times during his sentence, this cannot be seen as something that could be considered to meet the high bar of presenting need in the case of ERCG considerations as this would introduce far more conjecture into any potential case the Policy ever intended. The Claimant is not currently under consultant care through our approved provider, and it is not possible, especially given the substantial time elapse since assessment and the absence of any legitimate authority, to utilise the views of the professionals within the bundle. 25. In summary, the First Defendant took the decision not to refer the Claimant application for ERCG to PPCS for consideration as it was considered that the application did not meet the necessary levels of severity and exception. While the prison accepts the Claimant’s diagnosis of PTSD and the potential need for treatment and the difficulties caused by his mother ill-health, this is not something that would get him to the threshold of ERCG as the precedence that would be set by a case of this nature would be impossible to manage and would constitute a fundamental abuse of process if there were to be consideration given around preferential treatment settings and possible outcomes where treatment is not received as desired.”
“I have considered your request for the Prison to apply for early release on compassionate grounds, (ERCG), I am afraid that I do not agree that this meets the threshold for the Prison to support this application. I will set out my rationale for this decision below. … I fully accept that Stefanos is suffering from PTSD caused by the historic kidnap incident and subsequent trial and conviction of those responsible. I also accept that treatment is required to help Stefanos with this through either CBT or EMDR and that either of these treatments are emotionally difficult and that Prison may not be the best environment to undergo this. I also accept the difficulty caused by the recent deterioration Stefanos’ Mum’s health and her recent hospitalization. … [The fundamental principles in paragraph 1.4 of the Policy] need to be met before Prison can support and apply for ERCG.”
“Moving on to the impact of PTSD this is a condition that has been diagnosed ahead of his imprisonment, including an earlier sentence that has already been served. This means that the facts existed at the time of sentencing so does not satisfy 1.4c). Whilst there is some merit in leaving the treatment of PTSD through EMDR or CBT they are both treatments that are available in Prison and have not been tried. This decision has been made by Stefanos who is more motivated by the option of release ahead of trying the treatment that is available. Again, from an exceptional point of view the existence of serious mental health problems that escalate the risk of suicide and self-harm are fare to common [sic] with a number of people assessed as needing hospitalisation to manage their mental health. The prison system has safe systems of work to support prisoners through heightened risks of this nature. Which in my view means that Stefanos case does not meet the threshold required to meet paragraph 4.17 …”
“1. Mr Stefanos Neophytou is presently detained under a default term activated as he was unable to pay a sum due under a confiscation order. He is not detained under any criminal punitive sentence or on account of any assessed risk to the public.”
“27. … The Claimant has been unable to pay the confiscation order sum, which sum was arrived at as the result of assumptions about lifestyle offence income and depended upon the assumed existence of undisclosed assets therefrom. He had been unable to rebut the legislative assumptions. …”