“28. [The appellant] stated that he fears for his life in Romania. He claimed that he was abused and tortured when arrested and in detention in Romania. He has provided no evidence of such matters. … 34. [The appellant] has suffered from panic attacks when he was in immigration detention. He has been taking some medication in that regard. He also suffers from bleeding from his bottom when passing stools. Other than that, he states that his health is okay.”
“…In my judgment there is no realistic prospect that this Article 8 appeal could succeed. The seriousness of the offending of driving without a licence is reflected in a two-year custodial sentence which it is appropriate for the extradition court to respect. The circumstances involved the Appellant crashing a car and being discovered by the police to have driven without a licence. That offence, moreover, had – as the Judge put it – been “committed during the currency of another sentence”
“(1) This section applies if at any time in the extradition hearing it appears to the judge that the condition in subsection (2) is satisfied. (2) The condition is that the physical or mental condition of the person is such that it would be unjust or oppressive to extradite him. (3) The judge must— (a) order the person’s discharge, or (b) adjourn the extradition hearing until it appears to him that the condition in subsection (2) is no longer satisfied.”
“In our view, the words in section 91 and section 25 set out the relevant test and little help is gained by reference to the facts of other cases. We would add it is not likely to be helpful to refer a court to observations that the threshold is high or that the graver the charge the higher the bar, as this inevitably risks taking the eye of the parties and the court off the statutory test by drawing the court into the consideration of the facts of the other cases. The term ‘unjust or oppressive’ requires regard to be had to all the relevant circumstances, including the fact that extradition is ordinarily likely to cause stress and hardship; neither of those is sufficient. It is not necessary to enumerate these circumstances, as they will inevitably vary from case to case as the decisions listed at para 72 demonstrate. We would observe that the citation of decisions which do no more than restate the test under section 91 or apply the test to facts is strongly to be discouraged. There is a real danger that the courts are falling into a similar error as courts fell into in relation tosection 23 of the Criminal Appeal Act 1968 and as described by Lord Judge CJ in R v Erskine[2010] 1 WLR 183 .”
“50. I consider that on these unique facts, the interference with the appellant’s Art. 8 rights would be exceptionally severe. This is an exceptional case in which it would be disproportionate to extradite the appellant, having regard to those aspects of this private life which would be interfered with by extradition; specifically, as emerges from the medical evidence, his chances of receiving appropriate therapy for his PTSD as against the chances of it becoming untreatable; the very high risk of suicide; and the recent deterioration in his mental health. I am conscious of the great importance of honouring extradition arrangements, but take into account that the appellant was free to leave the Netherlands when he was released, and had no obligation to cooperate with serving the longer sentence after he was released. One cannot under-estimate, with his history, which the DJ accepted, the anguish he must feel at the prospect of return to a Dutch prison and the fact that he may have, in effect, to serve part of the 4-year sentence he thought he had already served as well as the additional sentence. 51. In my judgment, the DJ's decision on s.25 was also wrong in the very unusual circumstances of this case. Two factors lead me to that view. The appellant's PTSD, depression, and very high risk of suicide were, in large measure, caused by the failure of the Dutch authorities to protect him when he was in prison in Holland. Second, if extradited, his PTSD could not be treated effectively, because he would be in the very environment which had caused his trauma. The appellant’s surrender to return to that environment in which the Dutch authorities had failed to protect him could lead to complex PTSD which does not respond to treatment. 52. For what it is worth, I consider that the DJ erred in equating the presumption about suicide with the considerations that arise under s. 25... I consider that s. 25 requires a wider focus and, on the unique facts of this case, that extradition would be oppressive because of the appellant's condition. 53. I consider that the appellant has shown that his precarious mental health is such that it would be unjust and oppressive to extradite him. This does not depend on the risk of suicide alone, and in that sense the presumption that the Dutch authorities will adequately guard against the risk of suicide is of limited relevance. It is not an answer to the appellant's argument, contrary to the reasoning of the DJ. Dr Dreyer's evidence, which the DJ accepted, shows that the appellant cannot receive effective treatment in a Dutch prison, not because the Dutch authorities cannot, in theory, provide treatment, but because such therapy would not be effective because it would be provided in the very place that had triggered the symptoms.”
“1. Does [the appellant] qualify for a diagnosis of PTSD? [The appellant] has given a consistent account of experiencing physical and sexual abuse when detained in prison in Romania between 2013 and 2017. This account has been consistent across the course of a number of different interviews conducted with different interviewers and across time: [the appellant] has given the same account to his local mental health team in Portsmouth, to his GP, to the primary care psychology service in Portsmouth, to Dr Gregory and to myself. His account is consistent with him experiencing symptoms of PTSD as described by Dr Gregory. To make a diagnosis of PTSD the person needs to be exposed to death, threatened death, actual or threatened serious injury or actual or threatened sexual violence: [the appellant] has been exposed to actual serious injury, and actual and threatened sexual violence. He persistently re-experiences the trauma in the form of unwanted upsetting memories by way of nightmares and flashbacks. He shows avoidance of trauma related thoughts and physical reminders of the abuse he suffered. He manifests negative thoughts and feelings that began or worsened after the trauma he experienced, showing a negative affect and a difficulty experiencing a positive affect. He manifests trauma related arousal and reactivity that began or worsened after the trauma, being hypervigilant, showing a heightened startle response and having difficulty sleeping. [The appellant]’s symptoms had lasted more than a month, and have caused him distress and functional impairment and are not due to medication or substance misuse or other illnesses – hence, he meets diagnostic criteria for PTSD. 2. If so, why and what effect does his PTSD have on him? Please [sic] answer to question 1. Symptoms of PTSD appear preoccupying for [the appellant] and cause him high levels of anxiety and distress. 3. What treatment options are open to him? The NICE Guidelines for the treatment of PTSD suggest interventions including Cognitive Processing Therapy, Cognitive Therapy for PTSD, Narrative Exposure Therapy and Prolonged Exposure Therapy. The NICE Guidelines suggest that EMDR should be offered to adults with a diagnosis of PTSD who present with non-combat related trauma. It is noted by NICE that EMDR for adults should typically be provided for eight to 12 sessions but more if clinically indicated, for example if the patient (as in the case of [the appellant]) has experienced multiple traumas. [The appellant] appears partway through a treatment course of EMDR. The effect of this will need to be assessed in due course. 4. What would be the likely effect of returning him to a Romanian prison? This is likely to significantly aggravate symptoms of PTSD given that it would mean [the appellant] returning to an environment where he experienced the trauma that caused symptoms of PTSD to develop. He is likely to experience a significant increase in his level of anxiety. I think there is a possibility that he will become overwhelmed with distress and thoughts of suicide, leading to a significant risk that [the appellant] will attempt to end his life. His GP records note relatively recent attempts at suicide which have occurred at least partly in the context of [the appellant] experiencing symptoms of PTSD and one attempt seemingly related to the prospect of him returning to Romania. 5. Is it likely that treatment in a Romanian prison could alleviate any such effect? I think it will be very difficult, likely impossible, to offer treatment in a Romanian prison that could alleviate [the appellant]’s distress and anxiety. I would respectfully suggest that what is needed is for [the appellant]’s symptoms of PTSD to be effectively treated, and even if this were possible in a Romanian prison, I think such treatment is highly unlikely to be effective given that it would be being offered in an environment which is very likely to be highly triggering to [the appellant]’s symptoms of PTSD. 6. What would be the suicide risk if [the appellant] is returned to prison in Romania? Ie how does he assess [the appellant]’s suicide risk if returned, how strong would be the urge, and would he be able to resist the urge to attempt suicide? It is not possible to assess the risk of suicide entirely accurately. However, clinically, I think [the appellant] would be at significant risk of suicide if he were returned to prison in Romania: his symptoms of PTSD stem from his experiences in prison in Romania and the content of the symptoms directly relate to these earlier experiences; symptoms of PTSD cause him profound distress and anxiety; the prospect of returning to Romania has played a significant part in the suicidality that he has demonstrated in recent years; returning to Romania is likely to further aggravate symptoms of PTSD and hence exacerbate his distress and anxiety.”