Ali

Ali was born in Syria and came to the UK via a small boat crossing the Channel, aged 22. Prior to leaving Syria he had experienced a number of traumatic situations involving violence against his family and being held in prison where he was subject to physical abuse.

Ali did not anticipate that he could be placed in detention in the UK but was taken immediately into an IRC. At the detention centre he met a nurse, with an interpreter, within two hours, but was disorientated both by the surprise of detention and also the stress of the Channel crossing. He found it difficult to understand the questions. Ali did attend a Rule 34 appointment with a GP within 24 hours and was able to disclose some of his experience of ill-treatment in Syria but was not asked about his mental health. A Rule 35(3) report was completed but not a Rule 35(1) report, so he was assessed as a level 2 adult at risk under the AAR policy and was not released.

Ali did not use the offer of a 30-minute meeting with a legal representative. He then remained in detention and had some contact with healthcare staff, making appointments for headaches and insomnia. There were no more checks of his mental health and no further reports to the Home Office about his risk level. At this time Ali was also experiencing flashbacks and periods of disassociation as the IRC environment regularly triggered reminders of his previous ill-treatment in prison in Syria. He did not feel able to discuss this with anyone as he feared that he was becoming mentally unwell and felt ashamed of this.

Ali started being visited by Paul. After several meetings he was able to explain that he was struggling with being in detention, finding it hard to sleep, was feeling worried all the time and was unable to eat. He also showed him a copy of his Rule 35(3) report. Paul did not discuss the time in Syria as Ali did not volunteer this information but the summary in the Rule 35(3) report gave him some understanding of Ali’s experiences. Paul talked to Ali about whether he would feel comfortable with him helping him to access copies of his medical records and Ali agreed. Paul could then see medical appointments showing the discussion of insomnia and lack of mental health assessment. He was worried that there had been no assessment of Ali’s response to detention which seemed surprising as he had discussed some highly traumatic experiences with the GP and Paul could also see that he was finding it very hard to be in detention.

The combination of the Rule 35(3) report and medical records made Paul think that a Medical Justice referral would be appropriate. He discussed this possibility with Ali who agreed to him contacting the charity and sharing his paperwork. In the meantime, Paul suggested that Ali should ask to see a doctor for a ‘Rule 35’ assessment and wrote down a short note to help Ali explain the type of appointment for when he went to the healthcare department. However, when Ali tried this he was told that there were no slots for an appointment for some weeks.

After the referral to Medical Justice, Medical Justice’s casework team contacted Ali and arranged for an assessment by a doctor. This led to a diagnosis that he was suffering from post-traumatic stress disorder and clinical depression and gave a clear summary of the risks of continued detention. After this Ali continued to have contact with both Medical Justice’s caseworker and Paul which led to a referral to a legal representative, who was then able to secure his release.