Drammeh, R (on the application of) v Secretary of State for the Home Department

The policy governing detainees with serious mental illness requires a purposive, pragmatic and fact-sensitive assessment. Diagnosis alone is insufficient. The decision-maker must consider the individual’s condition, the effect of detention, available facilities and the expected period of detention.

A detainee with capacity may refuse food, fluids or medical treatment, even irrationally, and those decisions ordinarily require respect. Such refusal may place the case outside the policy where the policy does not contemplate a capacitous refusal of treatment. The Hardial Singh principles remain independently applicable, with particular care required where mental illness is known.

The claimant was an overstayer and later became liable to deportation following criminal convictions. He claimed asylum and was detained under immigration powers. He had a diagnosed schizo-affective disorder and, from June 2013, refused food, fluids, medication and aspects of medical assessment.

The Secretary of State maintained detention, relying on the risk of absconding, the public risk, the claimant’s capacity and uncertainty about the extent of his fasting. The claimant challenged detention under the published policy, the Detention Centre Rules 2001, the Equality Act 2010, the Hardial Singh principles and the ECHR. The central issues were whether the mental-health policy applied, whether detention remained lawful and whether the food and fluid refusal was materially linked to serious mental illness.

1. Claim dismissed. The claimant did not establish that his serious mental illness could not be satisfactorily managed in detention, or that his food and fluid refusal was caused or materially influenced by that illness.
2. Chapter 55.10 of the Enforcement Instructions and Guidance was to be construed purposively and pragmatically. Its application depended on the whole factual situation, not diagnosis alone. Relevant matters included the effects of the illness on the individual, the effect of detention, available facilities, treatment and the expected period before removal.
3. The relationship between risk of deterioration and satisfactory management was fact-specific. A risk of deterioration did not automatically establish that detention was incompatible with the policy. The Secretary of State was required to make adequate inquiries and reach an independent decision, while giving particular care to the welfare of a detainee known to have mental illness.
4. The Court of Appeal’s reasoning in IM v Secretary of State for the Home Department [2013] EWCA Civ 1561, as applied in R (W) v Secretary of State for the Home Department [2014] EWHC 3485 (Admin), was applicable. A capacitous detainee who refused medical treatment unless released was outside the particular policy statements relied upon. The refusal did not itself require release, although the Secretary of State still had to act reasonably and lawfully.
5. Respect for personal autonomy meant that a capacitous decision did not lose its significance merely because it was irrational or self-defeating. The position would be materially different if the claimant lacked capacity. On the evidence, however, he remained capable of understanding the consequences of his decisions, and the wider clinical and behavioural evidence supported the Secretary of State’s assessment.
6. The Hardial Singh principles required a genuine intention to deport, detention only for that purpose, detention for no longer than a reasonable period and reasonable diligence and expedition. The court acted as de facto decision-maker on reasonableness rather than applying a Wednesbury test. Those principles, including the relevance of mental-health effects, did not render this detention unlawful.

First-instance judicial review proceedings. The judgment records earlier refusals of interim relief by Burnett J, Lang J and Jeremy Baker J, including release on bail by Jeremy Baker J on 19 July 2013 under [2013] EWHC 2980 (Admin). Those interim decisions were not the decision under review on the merits.