Click here to view the paper: https://miclu.org/assets/uploads/Analysis-of-the-Home-Office-CIN-on-Mental-Health-version-3.pdf 

This research paper by Dr Micah Anne Neale analyses the Home Office Country Information Note (CIN) on mental healthcare in Albania (version 3.0).

Dr Neale’s analysis is significant because the CIN is frequently relied upon by Home Office decision-makers and Tribunal judges to assess the availability of mental healthcare in Albania.

Assessment of the availability of mental healthcare in Albania may be important in different contexts:

Article 3 medical claims

For example, such assessment is critical where an individual raises an “Article 3 medical” claim based on their mental ill-health and risk of suicide on return.

In that context, decision-makers must assess whether the individual would face a real risk of a serious, rapid and irreversible decline in the state of their mental health resulting in intense suffering, or a significant, meaning substantial, reduction in their life expectancy resulting from a completed act of suicide (MY (Suicide risk after Paposhvili) [2021] UKUT 232 (IAC)).

The individual must “provide strong evidence of the seriousness of the illness including the treatment involved and the consequences of removal of treatment” and “provide sufficient evidence to cast doubt on the availability or accessibility of treatment in the receiving state,” after which the burden shifts to the Respondent to dispel any doubt (THTN v Secretary of State for the Home Department [2023] EWCA Civ 1222 at [43]-[51]).

In Albanian cases, the CIN frequently forms the centrepiece of the Home Office’s position as to the availability of sufficient treatment.

Asylum claims based on risk of trafficking/re-trafficking

Another context in which decision-makers may need to assess the availability of mental health provision is, for example, where an individual raises an asylum claim based on a risk of trafficking or re-trafficking on return. In that context, their state of health, particularly their mental health, is highly relevant to their risk of being re-trafficked. That was established in relation to trafficked women in TD and AD (Trafficked women) CG [2016] UKUT 92 (IAC) at headnote (h).

Country background evidence (from reports cited in current or previous Home Office CPINs) shows that mental health problems also represent a risk factor for trafficking or re-trafficking of men and boys.[1] In this regard, whether an individual can access timely and sufficient mental healthcare on return, such as to lessen their vulnerability to exploitation, is often a salient issue.

Reliance on a flawed CIN

It is not permissible for Tribunal judges simply to take Home Office CPINs/CINs at face value. Such documents “are not themselves evidence but identify the position adopted by a government department,” although they may be “secondary, or even tertiary, sources of information” to the extent that they set out evidence from other sources (Roba (OLF – MB confirmed) Ethiopia CG [2022] UKUT 1 (IAC) at [84]).

It is therefore incumbent both on appellant’s representatives, and on Tribunal judges, critically to examine the CIN and to consider whether it provides sufficient evidence to support the Home Office’s conclusions.

Dr Neale’s research paper reveals significant weaknesses in the CIN: it relies on a paper that appears to have been published in a counterfeit academic journal that isn’t properly peer-reviewed. It also relies on a thesis by a Master’s student, but omits many quotes from that thesis that undermine the Home Office’s case. It also quotes many other sources selectively, and ignores evidence that would have undermined the Home Office’s case.

Other key points identified, taken cumulatively suggest that many Albanians with mental health issues would face serious difficulties funding the mental healthcare they need on return – yet the CIN is typically relied on by the Home Office to dismiss such arguments.

These weaknesses are likely in many cases significantly to undermine the Home Office’s assertion that sufficient mental health treatment is available. This paper is therefore an important resource for lawyers representing vulnerable Albanian asylum-seekers.

 

[1] Asylos and Asylum Research Centre, “Albania: Trafficked boys and young men,” May 2019, pp 30-31 https://www.asylos.eu/Handlers/Download.ashx?IDMF=b49e66a6-a777-47da-90f7-b2fcc14946fa  See also Asylos, “Albania: Trafficking,” 2024, pp 33, 45-46, 149 https://www.asylos.eu/Handlers/Download.ashx?IDMF=7c677570-ca08-4b31-bc48-752e4526bb7b  in relation to mental health as a risk factor for trafficking or re-trafficking.