Mansaray v. Secretary of State for the Home Department

Haja Mansaray, a Sierra Leone national, appealed a decision to refuse her asylum. She alleged that her removal would be contrary to the Refugee Convention and in violation of article 3 (inhuman or degrading treatment) of the European Convention on Human Rights (ECHR), because she would be unable to access the mental health care she needed if she were returned to Sierra Leone.

Mansaray claimed that she was raped and her husband and father were killed during an attack in Sierra Leone. She had lost her house and did not have any contact with her daughter. She also felt that she had little chance of remarriage. These events had caused her to suffer from depression and post-traumatic stress disorder.

The Adjudicator did not accept Mansaray’s evidence that she was raped or that her family had been killed, but accepted the medical evidence in relation to her mental state and her subjective belief. However, the Adjudicator rejected her appeal. Mansaray appealed to the Immigration Appeal Tribunal (IAT).

The IAT held that Mansaray’s removal did not breach her human rights under article 3 of the ECHR. It considered that even if they accepted that the Adjudicator’s findings were flawed, Mansaray could not show that returning her to Freetown would put her at risk of a violation of article 3 of the ECHR.

The IAT found that mental health care was available in Freetown, although it was limited to one psychiatrist who was able to prescribe anti-depressants and provide counselling. The IAT also referred to reports that NGOs were now providing psychosocial services and the WHO had begun to assist with post-crisis mental health responses in Sierra Leone. Further, the UNHCR had not assessed Sierra Leone as a country that it would be unsafe to return to, and Mansaray was relatively well off and had a house in Freetown to which she could return.

As such, while the level of mental health care provided in Sierra Leone may still have been limited, the Applicant could not show the level of severity required to prove a violation of article 3 of the ECHR.

“If we accept that the Adjudicator’s credibility findings were flawed, and for the sake of argument we are prepared to do so, then it remains the case, nevertheless, that in our view the appellant has not shown a real risk of a breach of her human rights under Article 3 on return to Sierra Leone. We should say that we do not agree with Mr Yeo’s argument that the Adjudicator made a finding of fact in this regard having determined the appeal as regards the Refugee Convention question and the issue of Article 3, in so far as it was founded on a risk of physical harm. He made the point at paragraph 13 that: 'It seems to me that, arguably, it would be degrading to return the appellant to Sierra Leone without knowing that she would be able to receive some kind of help for her severe depression'. He went on to recommend the grant of one years exceptional leave to remain in order for her to obtain the twelve months counselling and the anti-depressants recommended by Dr Shehadeh. We do not see how this can properly be regarded as a finding of fact. It is in our view, no more than a comment by the Adjudicator in the light of the evidence as he saw it from the doctor and on the objective evidence which we have described above.” Para. 11

“We note that there is some mental healthcare in Freetown, albeit of a limited amount only. There is a psychiatrist there and there is no indication that he or she is not able to prescribe anti-depressants, nor unable to provide counselling. We note that the World Health Organisation has begun to assist the government of Sierra Leone in coordinating their mental health response to the crisis. Even if one accepts the appellant’s history as she claims it to be, and as a consequence of which the doctor made his recommendations, we do not consider that the high threshold of Article 3 has been reached in this case. We do not consider that it would be inhuman and/or degrading to return the appellant to Sierra Leone in the light of the diagnosis of the doctor and the recommended treatment. We bear in mind the recommendations of the UNHCR, but we agree with Mr Sheik that what is being suggested is essentially a counsel of prudence and caution, rather than an indication of a genuine risk on return of persecution and/or breach of Article 3.” Para. 13.