1724342 (Refugee)

[2018] AATA 4963

1724342 (Refugee) [2018] AATA 4963 (21 September 2018)

DECISION RECORD

DIVISION:Migration & Refugee Division

CASE NUMBER:  1724342

COUNTRY OF REFERENCE:                  Ethiopia

MEMBER:Melissa McAdam

DATE:21 September 2018

PLACE OF DECISION:  Sydney

DECISION:The Tribunal remits the matter for reconsideration with the direction that the applicant satisfies s.36(2)(a) of the Migration Act.

Statement made on 21 September 2018 at 12:17pm

CATCHWORDS

REFUGEE – protection visa – Ethiopia – particular social group – people with mental illness – major depressive disorder – high level of stigma about mental illness – unable to receive adequate psychiatric treatment in Ethiopia – ability to adequately function in society – religion – Muslim convert – disapproval by relatives – imputed political opinion – supporter of opposition parties – Coalition for Unity and Democracy – applicant not of any political interest – ethnicity – Amhara – credibility – applicant uncooperative – behaviour consistent with diagnosis of treating specialists – decision under review remitted for reconsideration

PRACTICE AND PROCEDURE – applicant resistance to attending hearing – hearing postponements due to medical condition – decision made on review

LEGISLATION
Migration Act 1958 (Cth), ss 5H, 5J, 5K, 5L, 5LA, 36, 65, 499

Migration Regulations 1994 (Cth), Schedule 2

Any references appearing in square brackets indicate that information has been omitted from this decision pursuant to section 431 of the Migration Act 1958 and replaced with generic information which does not allow the identification of an applicant, or their relative or other dependant.

STATEMENT OF DECISION AND REASONS

APPLICATION FOR REVIEW

1. This is an application for review of a decision made by a delegate of the Minister for Immigration on 5 October 2017 to refuse to grant the applicant a protection visa under s.65 of the Migration Act 1958 (the Act).

2. The applicant who claims to be a citizen of Ethiopia, applied for the visa on 15 September 2017.

   CRITERIA FOR A PROTECTION VISA

3. The criteria for a protection visa are set out in s.36 of the Act and Schedule 2 to the Migration Regulations 1994 (the Regulations). An applicant for the visa must meet one of the alternative criteria in s.36(2)(a), (aa), (b), or (c). That is, he or she is either a person in respect of whom Australia has protection obligations under the ‘refugee’ criterion, or on other ‘complementary protection’ grounds, or is a member of the same family unit as such a person and that person holds a protection visa of the same class.

4. Section 36(2)(a) provides that a criterion for a protection visa is that the applicant for the visa is a non-citizen in Australia in respect of whom the Minister is satisfied Australia has protection obligations because the person is a refugee.

5. A person is a refugee if, in the case of a person who has a nationality, they are outside the country of their nationality and, owing to a well-founded fear of persecution, are unable or unwilling to avail themself of the protection of that country: s.5H(1)(a). In the case of a person without a nationality, they are a refugee if they are outside the country of their former habitual residence and, owing to a well-founded fear of persecution, are unable or unwilling to return to that country: s.5H(1)(b).

6. Under s.5J(1), a person has a well-founded fear of persecution if they fear being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, there is a real chance they would be persecuted for one or more of those reasons, and the real chance of persecution relates to all areas of the relevant country. Additional requirements relating to a ‘well-founded fear of persecution’ and circumstances in which a  person will be taken not to have such a fear are set out in ss.5J(2)-(6) and ss.5K-LA, which are extracted in the attachment to this decision.  

7. If a person is found not to meet the refugee criterion in s.36(2)(a), he or she may nevertheless meet the criteria for the grant of the visa if he or she is a non-citizen in Australia in respect of whom the Minister is satisfied Australia has protection obligations because the Minister has substantial grounds for believing that, as a necessary and foreseeable consequence of being removed from Australia to a receiving country, there is a real risk that he or she will suffer significant harm: s.36(2)(aa) (‘the complementary protection criterion’). The meaning of significant harm, and the circumstances in which a person will be taken not to face a real risk of significant harm, are set out in ss.36(2A) and (2B), which are extracted in the attachment to this decision.

   Mandatory considerations

8. In accordance with Ministerial Direction No.56, made under s.499 of the Act, the Tribunal has taken account of policy guidelines prepared by the Department of Immigration – PAM3 Refugee and humanitarian - Complementary Protection Guidelines and PAM3 Refugee and humanitarian - Refugee Law Guidelines – and relevant country information assessments prepared by the Department of Foreign Affairs and Trade expressly for protection status determination purposes, to the extent that they are relevant to the decision under consideration.

   SUMMARY OF CLAIMS AND EVIDENCE

   Protection visa application

9. The following is a summary of the claims and information provided by the applicant in his Protection visa application:

   a.The applicant was born on [date] in [Town 1], Region 2 of Ethiopia. 

   b.He is ethnic Amhara and Muslim. 

   c.He lived in Dessie, Ethiopia between September 1993 and November 2011.

   d.He departed Ethiopia on [date] November 2011 and arrived in Australia on [date] November 2011.

   e.Between November 2000 and September 2007 he was [employed by Agency 1], in [Town 2] in Wollo. He then studied and was supported by his father in Ethiopia and on a scholarship in Australia.

   f.He graduated from university in ‘[Academic discipline 1]’ at [University 1].

   g.He left Ethiopia because he could not continue to further his education there.

   h.He is studying for a research thesis at [an Australian university] on ‘[a particular research topic].

   Mental Health claim

   i.The applicant claims protection as a person who suffers severe mental illness or severe major depression.

   j.Mental health treatment is very poor in Ethiopia and insufficient for the needs of mental health patients. There is a bad attitude towards the mentally ill in Ethiopia.

   k.There is only one specialised hospital in Ethiopia, which is in the capital, Addis Ababa. It is the Amanuel Mental Health Hospital. It has only a few beds. The services in the hospital are inadequate. Nurses treat only minor cases. It is inundated with hundreds of sick people. There are very few psychiatrists in Ethiopia, only 63.  They all work in Addis Ababa or other large cities. There are insufficient resources to treat mentally ill people in Ethiopia.

   l.Doctors sometimes use physical restraints on patients because of the lack of available medication. There is no reliable supply of psycho-tropic medication.  Inappropriate drugs are sometimes used.

   m.Taking a mentally ill person to hospital is considered a last resort in Ethiopia, so doctors mostly treat chronically ill patients at hospitals. Not all patients get an opportunity to see a doctor. An estimated 90% of people with severe mental illness never receive evidence-based care in Ethiopia.  Less than 1% receive continued care.

   n.People who are mentally ill are insulted, frightened, abused and attacked in Ethiopia. There is no specific legislation to protect the rights of people with mental health conditions. There is no legislation concerning mental health in Ethiopia. There are no social support systems available to people with mental illness in Ethiopia. There is limited coverage for mental health care in the National Health Insurance Scheme.

   o.He will not be able to get medical treatment for his illness outside of Addis Ababa. The only available treatment and care is in the one hospital in Addis Ababa. Not everyone who requires treatment can be seen at the hospital because of the lack of resources.  There are insufficient beds for the number of people requiring treatment. He will not be able to get appropriate medication in Ethiopia.  Incorrect prescriptions are not simply because of scarcity but also because of the poor attitudes of responsibility to people with mental illness in Ethiopia. The government has opened many general hospitals throughout the country but none for mental health. The government trains general doctors but has made no effort to train doctors in psychiatry.

   p.The applicant fears discrimination in Ethiopia because of his mental health condition, in finding employment, during employment, and living in the community. He may be denied basic services in Ethiopia because of his mental health.  He may not be able to obtain employment in Ethiopia because of the discrimination against people who are mentally ill.

   q.The applicant provided a number of research articles and reports about the availability and standards of mental health care in Ethiopia.

   Political Claim

   r.The applicant claims to have been a member of the Coalition for Unity and Democracy (CUD) from around the beginning of 2005. He was previously a ‘hidden member’ of the CUD from around 2003.

   s.The Ethiopian government has mistreated, harassed, discriminated against, detained and punished CUD members and supporters.

   t.If he returns to Ethiopia the applicant fears his home will be unlawfully searched; he will experience intimidation; he will be arbitrarily arrested or detained; he will be pressured to become an informant against others; he will be dismissed from or denied  employment; he will be prohibited from promoting opposition party groups; and he will be arrested and tortured. He will be arrested for communicating with designated terrorist groups and monitored by the government.

   u.Because he has applied for protection in Australia he will be arrested in Ethiopia for criticising the government.

   v.The applicant submitted a number of reports about the CUD, and the political and general situation in Ethiopia.

   Religion

   w.The applicant claimed to fear harm in Ethiopia as a Muslim.

   x.He grew up in a Christian family.  His family  do not tolerate the applicant’s adoption of Islam and are denying the family relationship and threatening the applicant’s life through neglect.

   Departmental Interview, 22 September 2017

10. The following is a summary of the information the applicant provided at his Departmental Interview:

    a.He prepared his Protection visa application himself.

    b.He was a member of the CUD in Ethiopia for one year, in around 2005. The CUD had a lot of popular support. The applicant was involved in advertising and promoting the party.  There were a lot of demonstrations about the election result at the time. The government aims were about one culture, one language and one Ethiopia. There are four different parties in the government, administered by one party, the EPRDF.  He does not support the current government because they aim to make a great nation of Tigray.

    c.The CUD organised demonstrations against the government. The CUD won seats in the election. The applicant was in Addis Ababa at the time, [studying].  He helped organise demonstrations. He did this secretly.

    d.The applicant now supports the Semayawi or Blue Party. They oppose the government but do not have any power. He supports the political opinion of the Blue Party. He communicates with some colleagues who have been caught in Addis. His colleagues tell him he should not communicate with them again. There is no freedom of speech in Ethiopia. The Blue Party did not stand in the 2015 election. It was the CUD running then. He has not communicated with anyone from the Blue Party. He last communicated with the CUD Party. The government hounds people who are with the CUD. The Delegate put to the applicant that the CUD no longer exists. The applicant responded on a different topic.

    e.The applicant worked for [Agency 1] in Addis Ababa between 2000 and 2005. He generally supported the government at the time.  He was a secret supporter and member of the CUD.  He recruited members to the CUD. The government has a list of CUD members.  He did not get rounded up in 2006 because he was in hiding. He remained in hiding in Ethiopia until 2011.  He got a scholarship to Australia before he was found.

    f.He was able to leave Ethiopia on his own passport by giving some people in the government some money.  He asked his colleagues about the situation. Through another person, [Mr A], the applicant found someone in the government to help them. [Mr A] had some affiliation with CUD but was not in the party.  He was a friend of the applicant. The applicant gave him around [number] birr to give the government person, about six months before he left Ethiopia. The money was to pay the person to hide the applicant’s information.

    g.The applicant fears the government in Ethiopia. Special Intelligence have infiltrated everywhere.  The applicant was involved in some fighting in a demonstration in 2005 in Addis. He and others in the demonstration were hit. The government officers went to the applicant’s house to interrogate him one evening. They threatened him to stop his activities. They came three times. He was threatened and beaten each time.

    h.There is a regional conflict between the Oromo and the Amhara in Ethiopia. This will affect him because he is Amhara. There are a lot of demonstrations in the Amhara region, against the government.

    i.His father is old and dying. He lives in Dessie. The applicant has no brothers and  sisters. His father adopted his deceased brother’s son.

    j.His mother died when he was young. She was Muslim. He only discovered his mother was Muslim in 2002. He changed his religion to Islam in around 2003. His father did not know at the time but discovered this in 2006 because someone saw the applicant in a mosque in Dessie.  He told the applicant to change his religion back but the applicant refused so there was a conflict between them.

    k.He has been warned to change his religion. He is considered apostate.  All the religious far away relatives will harm him.  He was slapped once by his uncle and cousin. He was not harmed again because he lived in Addis.

    l.The delegate put to the applicant that there are 25 million Muslims in Ethiopia and he could live in a Muslim community. The applicant responded he could not because his family is Christian and will try to harm him.

    m.His father worked in a government office in the past. His last job was in a hospital. He supported the applicant during the applicant’s study. The applicant and his father do not speak because the applicant changed his religion.  Ethiopia is considered a Christian country. There are problems for Muslims.

    n.The applicant is not married and has never been married.  He wrote in his Student visa application that he is married because he had a relationship with a woman at the time. She came to Australia with him but there were some difficulties. The relationship ceased in 2013.

    o.He lived in a mosque in [Australian City 1]. He also has Ethiopian friends in Australia who support him. He stays with them in [City 1].

    p.He stopped studying in Australia because of a medical issue. He will be harmed in Ethiopia because of a medical reason. He cannot get medical treatment in Ethiopia. He developed his condition in Australia in 2012.  He is on medication and getting mental health support in Australia. He will not receive this in Ethiopia. There is a shortage of psychiatrists in Ethiopia. They do not have the appropriate medicine to prescribe so they often prescribe the wrong medication.

    q.He sees a psychiatrist, [Dr B], in Australia.  [Dr B] has been treating the applicant since 2012.

    r.There is no legislation in Ethiopia to protect people with mental illness from discrimination. He knows people in Ethiopia, but he does not know anyone who would offer him work or accommodation.  Ethiopians believe mental illness comes from the evil eye or evil spirits. He witnessed people with mental illness being neglected in Ethiopia. People are afraid to touch or have anything to do with them. The applicant had a similar prejudice against people with mental illness when he lived in Ethiopia.

    Delegate’s Decision

11. The Delegate found the applicant credible regarding his mental illness. She accepted he is Amharic and Muslim, and that he was a past CUD member.  She did not accept that he was or will be politically active in Ethiopia. She did not accept he feared harm as a Muslim in Ethiopia. She found that there was no real chance of serious or significant harm to the applicant in Ethiopia. She considered that the State of Emergency in Ethiopia was a law of general application which did not give rise to a personal risk of significant harm to the applicant.

    Information to the Tribunal

12. The Tribunal invited the applicant to a hearing on 28 November 2017. 

13. On 24 November 2017 the applicant sent an email message to the Tribunal in which he wrote:

    Attached is a response to invitation of a hearing scheduled to be held on 28 November 2017. I am not in a position to attend the hearing due to my medical condition. I have attached a letter from a medical practitioner and a treating doctor in relation to adjourning my hearing and running the proceeding after six months.

14. The applicant submitted a more detailed postponement request in which he wrote the following:

    Currently I am not in a position to run this case and attend the hearing scheduled on 28 November 2017 dues to my health condition. I am currently under medical treatment with a psychologist and psychiatrist. I am currently under medical treatment and attention due to my poor (bad) medical condition. My medical condition is a mental illness. Due to this medical condition l am not competent to run this proceeding. My medical condition is also a disability. And my current permanent residency is in [City 1].

    The immigration detention I have been has worsened my mental health condition. Before detention I was also under the same medical treatment

    A medical report letter which is based on the assessment of my mental health condition states that l am not competent to attend the hearing scheduled on 28 November 2017 and to run this proceeding before six months. Annex-1 is a medical support letter stating I cannot attend the hearing scheduled to be held on 28 November 2017 and adjourn the proceeding process after six months.

    Further, I have a medical treatment scheduled to be held on 28 November 2017. This is the same day the tribunal hearing to be held. As a result I am not in a position to attend the hearing. Annex-2 states my scheduled appointment. Further, I have a medical treatment schedule with a psychiatrist to be held on 15 January 2018. Annex-3 states my schedule appointment with my psychiatrist. The effect of my depression is stated in medical report letter in Annex-4 from my psychiatrist.

15. The applicant also attached the following letters with his postponement request:

    a.From [Dr C], Psychologist, dated 23 November 2017, in which [Dr C] wrote:

    [The applicant] has requested a letter of support in his application to delay his hearing. I am happy to provide this support.  I commenced seeing [the applicant] in 2012 after he was referred by his GP. After a break in treatment, he consulted again Tuesday. He has expressed an inability to attend the hearing scheduled for the 28th of November 2017. Currently his mental health condition (Major Depressive Disorder) limits his capacity to attend and also be present and contribute to the proceedings in general. I would strongly recommend he is given leave for a period of six months so that he can concentrate on his treatment, liaise with his psychiatrist, whom I am in contact with, and be in a better position to represent himself to the best of his ability was [sic] his health has improved.

    b.From [Medical Centre 1], confirming his appointment on 28 November 2017.

    c.From [Dr B], Consultant Psychiatrist, dated 20 March 2017, in which Dr [B] wrote:

    [The applicant] has requested a support letter regarding his current Court matters. He wishes me to describe his depression, its treatment and the effects that this has had on his activities and function,

    I met [the applicant] following referral by his general practitioner. Our first meeting was on 13 September 2012. He has a Major Depressive Disorder and at times has had psychotic symptoms of paranoia. He required an admission to psychiatric hospital. He currently has ongoing depressive symptoms and Is taking medication for the treatment of that depression. He feels very tired, lacking in energy and motivation. His cognition is impaired with regard to his ability to organise his thoughts, concentrate and remember. He is socially withdrawn, anxious and has lost weight. He has a poor appetite and poor sleep.

    His depression and its symptoms cause impairment in his ability to function with regard to administrative and study tasks and will undoubtedly have impaired his capacity to manage the current legal proceedings.

    d.From the Practice Manager for [Dr B], confirming his appointment on 5 January 2018.

1. The Tribunal agreed to postpone the applicant’s Hearing and on 29 November 2017 invited the applicant to a hearing on 5 March 2018.

2. On 13 February 2018 the applicant sent an email message to the Tribunal in which he wrote:

   Attached is a response to the invitation of the hearing to be held on 5 March 2018. I am not in a position to attend this hearing schedule for 5 March 2018. Explanation for the reasons are available in the attached letter response with this email.

3. The applicant attached a more detailed request for postponement in which he wrote:

   Currently, I am not in a position to attend the court proceeding for my hearing scheduled for 5 March 2018 and not in a position to run the case in general. This is because of my chronic and severe mental health condition. My chronic and severe mental health condition coupled with the high dose of medication and the side effects of medication does not allow me to represent, run and attend the court proceeding at the moment. Moreover, I am self-represented.

   On 24 November 2017 I made an application to adjourn the hearing for six months supported by a medical letter evidence. However, the tribunal scheduled the hearing for 5 March 2018 on the basis of may be I will be available. However, this hearing date will not be achievable at the moment and is not compatible to the medical letter evidence and testimony provided at the time and the schedule was based on an assumption which was wrong. …

   A revised medical evidence dated 25 January 2018 by a psychologist attached with this letter stated that my mental illness is a debilitating chronic illness. It is at the chronic stage. Refer Annex-2 for the revised medical letter.

   Further, the same medical letter dated 25 January 2018 stated that my mental illness limits my capacity to attend and also be present and contribute to the proceeding. Refer the medical letter in Annex-2.

   The medical letter dated 25 January 2018 stated that I have symptoms of impaired cognition, sleep and energy difficulty, difficulty in sense of connection, pronounced low mood, no motivation. Please refer the medical certificate in Annex-2.

   The medical letter evidence dated 25 January 2018 stated that this doctor agreed with the other doctor, i.e. a psychiatrist, explanation in the medical letter dated 20 March 2017 for the symptoms of my mental illness and its effect on the proceeding present at the moment . Refer Annex-3 for the medical letter dated 20 March 2017 which states its effect on the legal proceeding.

   The medical letter by a psychiatrist dated 15 January 2018 stated that my illness is a severe depressive illness and I am receiving pharmacological and psychological treatment at the moment. Refer the medical letter in Annex-4.

   The psychiatrist medical letter dated 15 January 2017 stated that I am unwell to attend the court and my illness is a case for at least the next six months to be adjourned Refer the Medical letter in Annex-4.

   The psychiatrist starts to see me on 15 January 2018. Refer Annex-5. My next treatment is on 26 February 2018. Refer Annex-6.

   Currently I am under three different types of medication by a psychiatrist with a high dose. Please refer Annex-7. The medication is not still working.

   Both the doctors in their letter stated that my illness is a severe and chronic mental illness which does not allow me to be heard and represent in the court. Refer the attached medical letter dated 15 January 2018 and 25 January 2018 in Annex-2 and Annex-4.

   Further, please also refer the medical letter dated 20 March 2017 in Annex-3 for the effect of my mental illness on the court proceeding which has been agreed by the psychologist at the moment.

   Because of these facts and circumstances I am currently at a disadvantage and unable to run the proceeding and appear in the hearing scheduled 5 March 2018. In this circumstance it would be injustice and denying an opportunity to be heard.

   As a result, I would like to ask the tribunal (the court) to adjourn the hearing to be held after August 2018, i.e. at least six months as mentioned in the medical letter dated 15 and 25 January 2018.

4. The applicant attached the following documents with his further postponement request:

   a.A copy of the same letter, referred to above, from [Dr C], Psychologist, dated 23 November 2017.

   b.A further letter from [Dr C], Psychologist, dated 25 January 2018, in which he writes:

   [The applicant] has requested a letter of support in regard to his current court matters. I am happy to provide this support. I have read and agree with the letter from [Dr B]  dated 20th March 2017.

   I commenced seeing [the applicant] in 2012 after he was referred by his GP. After a break in treatment, he consulted again recently on four occasions and I plan to see him fortnightly for the foreseeable future. Currently his mental health condition (Major Depressive Disorder) limits his capacity to attend and also be present and contribute to the court proceedings. Major Depressive Disorder can be a debilitating chronic illness and [the applicant] reports symptoms impacting his motivation, cognition, sleep and energy, sense of connection, and mood generally. He is however participating in treatment, attends all appointments and reports being compliant with his medication.

   I would strongly recommend he is given leave from court attendance for a period of six months so that he can concentrate on his treatment, liaise with his psychiatrist and GP and be in a better position to represent himself to the best of his ability once his health has improved.

   c.A copy of the same letter, referred to above, from [Dr B], Consultant Psychiatrist, dated 20 March 2017.

   d.A further letter from [Dr B], Consultant Psychiatrist, dated 15 January 2018, in which he writes:

   [The applicant] has a severe depressive illness and is receiving pharmacological and psychological treatment for that. He is too unwell to attend Court, and I anticipate this will be the case for at least the next six months.

   e.A medical prescription dated 15 January 2018, in the applicant’s name for [a range of medications].

5. The Tribunal wrote to the applicant on 19 February 2018 to inform him that the scheduled hearing would not be postponed.

6. On 28 February 2018 the applicant sent a further email message to the Tribunal requesting a hearing postponement.  He attached a more detailed request for postponement in which he wrote:

   Due to medical condition I am currently unable to attend the court hearing on 5 March 2017. Currently I am in a serious and severe mental health condition.

   I have a treatment on 5 March 2018 with a GP and 6 March 2018 with a Psychologist. I would not be competent to respond and attend the hearing. In general, at the moment I am not competent.

   Annex-1 shows I have a treatment with a psychologist on 6 March 2018. The [Refugee Centre 1] letter in Annex-2 shows that I am not competent for the hearing due to my severe mental health condition. Refer Annex-2. Further psychiatrist report letter would be ready for Friday 2 March 2018 or Monday. 5 March 2018. A GP (General Practitioner) treatment confirmation for 5 March 2018 would be available on Friday 2 March 2018. Both the psychologist and psychiatrist recommended the hearing to be postponed at least six months. Refer Annex-3. In Annex-3 both the psychiatrist and psychologist letter also states I am not competent at or for the hearing.

   As a result, I would like to ask kindly the tribunal to adjourn the hearing at least six months. I would not be in a position to represent myself and respond at the hearing to be held on 5 March 2018.

   My health condition results an opportunity to be heard and injustice. I would like to ask an accommodation according to the medical report presented to the tribunal in Annex-3 and Annex-2.

   Further, I am in a medication. Refer Annex-4. The medication is new and there is a change every time and the medication is prescribed on 27 February 2018. I will see the psychiatrist on 26 March 2018.

7. The applicant attached the following documents with his further postponement request:

   a.An email from ‘[Medical Centre 1]’ dated 28 February 2018, confirming his appointment with [Dr C] on 6 March 2018.

   b.A letter from  [Refugee Centre 1] Counsellor, [Ms D], dated 21 February 2018, in which she writes:

   [The applicant] has been attending regular counselling sessions with myself at [Refugee Centre 1] since January 2018. He presents with high levels of depression, anxiety and PTSD. He completed the Hopkins Anxiety Questionnaire which scores at 2.9 where scores greater than 1.75 are considered symptomatic for anxiety and on the Hopkins Depression scale he scores at 3.06 where scores greater than 1.75 are symptomatic for depression.

   From his presentation at counselling sessions I am aware his functioning is severely impacted by these health conditions. He makes an effort to come to counselling sessions although he initially did not manage to attend due to his depression and anxiety. It appears he is unable to participate in any activities or social interactions due to his debilitating symptoms. I understand due to these circumstances he missed attending a court session. He is also attending a psychiatrist for treatment.

   Please excuse him from the requirement to attend court in person due to the serious health condition he is experiencing.

   c.A copy of the same letter, referred to above, from [Dr C], Psychologist, dated 25 January 2018.

   d.A copy of the same letter, referred to above, from [Dr B], Consultant Psychiatrist, dated 15 January 2018.

   e.A medical prescription for the applicant, dated 27 February 2018, for [a range of medications].

   f.A letter from the Practice Manager for [Dr B], dated 28 February 2018 confirming that the applicant attended an appointment with [Dr B]  on 27 February and that he has another appointment on 26 March 2018.

8. The Tribunal wrote to the applicant again on 1 March  2018 to inform him that the scheduled hearing would not be postponed. At 4:58 pm on 2 March 2018 (a Friday) the applicant sent a further email message to the Tribunal requesting a hearing postponement.  He attached a more detailed request for postponement in which he wrote:

   A medical evidence is attached with this letter from GP (General Practitioner) and psychiatrist. The medical evidence are labelled as Annex-6 for GP and Annex-7 for psychiatrist. I am not competent and in a position to represent myself.

   As a result, I can not attend the court hearing on 5 March 2018. I would like to ask the court to adjourn the hearing as stated in the medical evidence provided in my adjournment enquiry letter dated 26 February 2018.

9. The applicant attached the following documents with his further postponement request:

   a.   A letter, dated 2 March 2018 from [Dr E], in which he writes that the applicant has an appointment at his practice on Monday 5th of March .

   b.   A further letter from [Dr B], Consultant Psychiatrist, dated 27 February 2018, in which he writes:

   As written in my previous letter (15 January 2018), [the applicant] has a severe depressive illness and is too unwell to attend Court.

   His symptoms are - sleep difficulty, pronounced low mood, lack of concentration, headache, lack of motivation, anxiety, drowsiness from medication, lack of energy, withdrawal, irritability, negative thinking, reduced appetite, loss of weight and difficulty attending. These symptoms will affect his functioning in the legal proceedings. He is receiving medication and psychological help to treat his illness.

   I'd be grateful if [the applicant]'s legal proceedings could be delayed until he is medically well enough.

10. On the morning of 5 March 2018 the applicant again wrote to the Tribunal stating:

    Description on the adjournment enquiry issues

    I am not in a position to represent myself at the hearing. I will allow the tribunal to make a telephone call at the time of the hearing if needed, i.e. to describe my circumstance or to know about my situation. I am under treatment today with a GP and [Refugee Centre 1]).(

    My treating psychologist mentioned that he tried to contact [a named person], the registrar, about my circumstance and I am not meaningful at the moment. I am at the bed currently and am not in a position to carry myself. I am under supported by others for my day today activity. As a result, I will not be available at the hearing for a hearing 5 March 2018. However, you may call on my phone and have some understanding about my situation. The councillor also seeing me today 5 March 2018. In addition to the counsellor letter sent in my last email enquiry, you may speak to the counsellor at the time of the hearing as I will be under treatment at the time of the hearing.

    Therefore, I would like to ask kindly the tribunal to understand me and consider my request. My situation is not appropriate for communication. My medical condition Is described in the medical report provided before.

11. The applicant did not attend the hearing on 5 March 2018 and did not respond to a telephone call from the Tribunal at the hearing time.

12. On 11 April 2018 the Tribunal wrote to the applicant again, inviting him to a hearing scheduled for 20 June 2018. In the hearing invitation the Tribunal highlighted to the applicant the following information:

    The Tribunal notes you are applying for protection, primarily claiming you will face harm in Ethiopia because of your mental illness. Given the nature of your claims it is important for the Tribunal to see you in person at a Hearing, to assist it to assess the impact of your mental health issues upon you.

    The Tribunal will take into consideration the nature of your mental health issues in the conduct of the Hearing.  The Tribunal is open to offering to conduct the hearing by video in the [City 1] area if you wish to request this. You are also able to request to have a support person or persons present with you during the hearing.

    The Tribunal notes that you have not attended the two hearings previously scheduled for you and that you asked for postponements of the hearings on the basis of your mental health. Please note that the Tribunal will not postpone the hearing again on this basis.

    If you are not able to attend the hearing you should advise us as soon as possible. Please note that we will only change this date if satisfied that you have a very good reason for being granted an adjournment. If we do not advise you that an adjournment has been granted, you must assume that the hearing will go ahead.

13. On 19 June 2018 the applicant telephoned the Tribunal to advise that he was unable to attend the next day’s hearing because he was not feeling he was able to, and that he needed six months before he would be able to attend the hearing. 

14. Later on 19 June 2018 a Tribunal officer contacted the applicant by telephone to inform him the Tribunal had not agreed to postpone the scheduled hearing.  The applicant responded that he understood.

    Tribunal Hearing, 20 June 2018

15. The applicant attended the scheduled hearing on 20 June 2018 but stated he was unable to speak with the Tribunal and that he would not answer any questions.  The following is a summary of the information the applicant provided at the hearing:

    a.He came to the hearing by himself.  He just came to explain personally about his situation. It was very hard for him to come but he thought it would be a good idea for the Tribunal member to see him personally.  He was all day in bed as he was on medication. The medication causes [certain side effects]. He started with a particular dosage, it went higher but on 4 June the dosage was reduced. It goes up and down all the time.  He has particular problems. He has a patience issue, the doctor mentioned he has antitonia – he cannot sit for a long time. It is not fair for him to be at the hearing, he is not ready. He cannot explain things properly.  He lives in [City 1]. He came to [City 2] for the hearing by train. He had difficulty on the train because it is very hard to get to the train station and to travel the distance. It was difficult because of his condition, because he is ill.

    b.The Tribunal explained it had offered to conduct the hearing by video in [City 1]. He responded he came because he needed the Tribunal to see him personally. Otherwise he would not havecome to the hearing.

    c.He is returning to [City 1] after the hearing by train.

    d.He knows he is applying for a Protection visa. but he has a problem because he cannot recall some of the evidence.  The medication has an extra impact on his memory.  He is no situation to explain why he cannot return to Ethiopia.  He has three claims, which include his racial and political claim as well as his mental health.  He is not in a position to speak about them. Because of his mental issue he is not in a condition to explain why he cannot return to Ethiopia.  How can he answer, he is not in a good condition currently and he is not prepared to answer the Tribunal’s questions.

    e.The Tribunal asked him to explain his circumstances in Ethiopia the way he is explaining his circumstances in Australia.  He responded that he has forgotten some of the events that occurred.  How could he know how it would be in Ethiopia.  He is not prepared and he is under medical care.

    f.Other people tried to assist him to write his claims.  Other people who know him in [City 1] wrote the letters.  One person is [a named person].  He is a person who knows the applicant and tries to assist him.

    g.The applicant wrote the claim papers when he was in detention.

    h.He has a headache. He wants to stand up and go.  He feels very drowsy.  He currently doesn’t know what is happening in Ethiopia.

    i.He believes he can speak at a hearing within three months as the medication should be working by  then. The medication was working for a while. The doctor says it will take some time to help him.  He has major depressive illness with cognitive disability. He can’t sit in one place for a long time. and has headaches and anger issues. He cannot communicate properly with people and gets angry others don’t understand his circumstances. He mostly stays in bed and cannot get up and work. He has anxiety. He feels if he tries to do something he will fail and someone will do something to him. He thinks negatively about everything. He has cognition problems. He was well for a time but he is suffering again.

    j.He was not unwell in Ethiopia. He became unwell in Australia. If he becomes normal again he will be able to work he thinks. The doctors don’t know what caused his illness in Australia.

    k.He does not have any family anymore.  

    l.The Tribunal suggested to the applicant that it ring [Dr C] during the hearing to take further evidence from him. The applicant agreed to this. The Tribunal therefore telephoned the doctor’s clinic but [Dr C] was with a patient and unavailable to speak.  His receptionist informed the Tribunal [Dr C] would return the call.

    m.The Tribunal suggested to the applicant that it write to him and give him a further opportunity to respond in writing regarding his protection claims. The applicant agreed to this.

16. Following the hearing on 20 June 2018 the Tribunal received a telephone call from [Dr C].  During the call the Tribunal discussed with [Dr C] his professional opinion about the applicant.  It largely reflected the reports he had written with some additional detail about examples of manifestations of the applicant’s symptoms.  [Dr C] also expressed concern about the applicant’s current lack of responsiveness to the medication prescribed to him.

17. The Tribunal wrote to the applicant on 3 July 2018 inviting him to provide further information in relation to his application regarding specific aspects of his claims for  protection.

18. At about 5pm on 31 July 2018 the applicant sent an email message to the Tribunal in which he wrote:

    On 26 July 2018 I had been given a medical treatment. On this date the doctor had taken all the information to write the medical report and information and mentioned that the report will be available on 2 or 3 August 2018. As a result, I would be able to submit my response by 3 August 2018. Currently I am under changed medication dose which is not still functioning. I would like to ask kindly the tribunal understanding.

1. On 24 August 2018 the applicant submitted a letter from his treating psychologist [Dr C], dated 9 August 2018. In the letter [Dr C] writes:

   I commenced seeing [the applicant] in 2012 after he was referred by his GP for symptoms consistent with a Major Depressive Disorder. In terms of his condition and functioning of [the applicant] as per the last session, July 27, 2018 my notes read "mood was stable [depressed] and affect withdrawn. He had reduced his medication however still noted side-effects such as dry mouth and headaches (8/10). He is sleeping at night and challenging his desire to sleep with physical activity however he sleeps during the day, every day. He notes poor energy. His appetite has improved and there is good structure to his nutrition. He attends [Mental Health Support Service 1] some two days per week He is being social [limited] . Memory is problematic.

   [The applicant] describes his daily functioning as impacted in terms of socialization, memory, concentration, energy, sleep, appetite, mood and motivation. His thinking is described as overwhelmingly negative. He presents in session consistent with these descriptions.

   [The applicant] reports his behaviour, personality and social interactions are all impacted by the Major Depressive Disorder. Behaviourally he reports instances which can be classified as avoidant and reports he is more likely to withdraw. In terms of personality, there is increased anxiety, disagreeableness and a propensity for him to be easily frustrated and irritated. Socially he perceives himself and others negatively, predicting negative outcomes which feeds into a more passive and avoidant coping style.

   Others would be aware of [the applicant] experiencing a Major Depressive Disorder by his behaviour (as mentioned above), lack of completion of activities of daily living (for example participation in study/completion of activities around the home) and through observation of his affect and through his tone of voice.

   The prognosis for his mental health is good given he is receiving treatment from a Psychiatrist and Psychologist using evidence based treatment, with regular review. Moderating this good prognosis is his current uncertain immigration status, delays with the recommencement of study and limited social support.

   The treatment required includes Psycho-Education and Cognitive-behavioural Therapy (Behavioural interventions, Behaviour modification, Exposure techniques, Activity scheduling, and Cognitive therapy). Relaxation strategies (progressive muscle relaxation and controlled breathing) will also be used. Medication management will be provided by his Psychiatrist and social supports by [Mental Health Support Service 1]. More stable accommodation, assistance with academic studies and returning to paid employment may also be important into the future.

   It is my opinion that [the applicant] will likely suffer significant harm if he returns to Ethiopia given he will not receive adequate treatment for his Major Depressive Disorder and this disorder would progress if left untreated. He describes an inability to access support in Ethiopia given healthcare system issues. Although recent progress has been made e.g.   [the applicant] will not receive the same level of evidence based care were he to return to Ethiopia. Socially and economically he will also be disadvantaged which will impact on his mental health. [The applicant] reports he has had no contact with his stepmother for some 15 years. His mother is deceased and his father deceased also. He has not had contact with anyone from Ethiopia for some time and notes friends who lived in the country have now left. He has an adopted brother and sister however no other support.

   Continuing mental health issues would produce significant barriers to cultural re-integration, employment and socialization should he return to Ethiopia. Having a mental health problem in Ethiopia significantly impacts the ability of a person to obtain and maintain employment . His ability to establish and maintain his accommodation and housing would also be seriously impacted. 

   I continue to provide ongoing treatment with his Psychiatrist [Dr B].

   Country Information

2. DFAT’s County Information Report, published on 28 September 2017, contains the following:

   The UN estimates Ethiopia’s population to be around 104 million people…. There are more than 80 different ethnic groups in Ethiopia, although Oromos, Amharas, Somalis and Tigrayans make up around 75 per cent of the population. Geographically, the population is broadly divided into Christian groups in the highlands, Muslim groups in the lowlands, followers of animist religions in the south, and a mixture of these three groups in the south-west of the country. The official national language is Amharic, although there are different official working languages in regions such as Oromia, the Somali region, Tigray and Afar. English is the most widely-spoken foreign language, and is taught in all secondary schools.

   Around 80 per cent of the population of Ethiopia lives in rural areas. Oromia is the largest region by population, with around 37 per cent of the total population, followed by Amhara (23 per cent), Southern Nations, Nationalities and People’s Region (SNNP – 20 per cent), the Somali region (six per cent) and Tigray (six per cent). …

   …

   Ethiopia’s health system has undergone a significant transformation over the last two decades, including an expansion of health facilities and an increase in the number of health professionals working across the country. There have been strong improvements in some health outcomes; however, these improvements have come from a very low base…. Despite these significant improvements, Ethiopia still lags on a number of important health indicators….

   …

   Most Ethiopians live in rural areas, and approximately 85 per cent of the population is engaged in the agricultural sector, primarily subsistence agriculture. The continuing drought has had a significant impact on the wellbeing and livelihoods of the rural population and on Ethiopian food security …

   Increasing urbanisation is also placing pressure on urban infrastructure, housing and service provision. …  A key challenge for Ethiopia is to improve opportunities for formal paid employment, particularly in urban areas and particularly for women.

   …

   The Ethiopian People’s Revolutionary Democratic Front (EPRDF) controls Ethiopian politics. After winning around 83 per cent of the vote and winning 473 of the 547 seats in the HoPR in Ethiopia’s first democratic elections in 1995, the EPRDF and its affiliated parties subsequently won elections in 2000, 2005, 2010 and 2015. The only meaningful challenge to the EPRDF came in 2005, when opposition parties made significant gains, particularly in urban areas, winning 174 seats. Opposition parties disputed the results of the 2005 elections. Subsequent protests resulted in violence between protesters and government security forces, during which nearly 200 protesters died. A crackdown on opposition parties, independent organisations and media freedoms followed. In 2009, the government introduced the Anti-Terrorism Proclamation (the ATP), under which it has arrested large numbers of opposition figures and journalists. The EPRDF and its affiliated parties won all but two seats in the 2010 general election, and all 547 seats in the 2015 general election, as well as winning 1,966 of the 1,987 seats in the 2015 regional council elections, thus retaining control of all regions of the country. Opposition groups raised concerns about access to polling stations, harassment of voters and restrictions on campaign activities

   Ethnicity is an important factor influencing politics in Ethiopia. The EPRDF is a coalition of predominantly ethnically based political parties, dominated by the Tigrayan People’s Liberation Front (TPLF). In addition to the parties aligned with the EPRDF, there are a number of ethnically based opposition political groups. The Tigray People’s Democratic Movement (based predominantly in Eritrea near the Ethiopian border), the Ogaden National Liberation Front (ONLF, based in the Somali region) and the Oromo Liberation Front (OLF, with leadership based in Eritrea and a presence in the US and Europe) have armed militant wings that occasionally launch attacks against government facilities and personnel. The Ethiopian government has declared these groups to be terrorist organisations and has outlawed them. Of the main legal political opposition groups, Medrek (also known as the Forum for Democratic Dialogue in Ethiopia) is a coalition of political parties, some of which are ethnically-based, while the Semayawi Party (widely known as the Blue Party) is a nationwide, non-ethnically-aligned party made up of (predominantly young) people opposed to the ruling EPRDF.

   …

   DFAT is aware of some concerns that ethnic Tigrayans dominate positions of power in the, intelligence services, the military and business, despite Tigrayans making up only around 6 per cent of the Ethiopian population. Around 90 per cent of the military leadership is reportedly Tigrayan. Long-term EPRDF leader Meles Zanawi was Tigrayan, but his successor, Hailemariam Desalegn, is from the Wolayta ethnic group in the Southern Nations, Nationalities and Peoples’ (SNNP) region. Tigrayans, Amhara and Oromo share senior public service positions, and Tigrayans have complained that Amhara and Oromo dominate the public service (although these groups comprise a much larger proportion of the Ethiopian population).

   DFAT assesses that, in most cases, official discrimination (such as systematic state-sanctioned discrimination, denial of public services, or higher detention rates) based on race and/or ethnicity is rare in Ethiopia. This assessment is in line with the constitutional prohibitions on discrimination, and in part reflects the need for the government to maintain its legitimacy through inclusiveness, given the large number of diverse ethnic groups within the country.

   Societal discrimination based on ethnicity can occur, but is predominantly in the form of positive discrimination in favour of a particular ethnic group (especially Tigrayans in the government/public service sector and the military and intelligence services) rather than active discrimination against people of a different race or ethnicity. However, there are some exceptions to this general tendency

   …

   Ethiopian society is deeply religious, and religion plays a strong part in daily life. According to the US State Department’s 2015 International Religious Freedom Report (the latest available), around 44 per cent of the population belongs to the Ethiopian Orthodox Church, 34 per cent are Sunni Muslim and 19 per cent belong to Christian evangelical and Pentecostal groups.

   …

   Low-level informal and societal discrimination does occur on the basis of religion. A religious group that forms a minority in a particular area or region may face some discrimination. For example, according to the US State Department, Protestant Christians have claimed that they face unequal treatment by local government officials on matters such as religious registration and obtaining land for churches and cemeteries. Muslims have also complained of difficulties obtaining permission to build mosques from local authorities in Axum, an area that contains many of the oldest Orthodox churches in the country. The Ministry of Federal and Pastoral Development Affairs has reportedly claimed that these perceived inequalities are the result of poor local administration. DFAT assesses that such examples of perceived discrimination represent acts of societal discrimination by individuals within local administrative centres rather than a systematic policy of discrimination by the government.

   While there are some tensions between religious groups across Ethiopia, these tensions rarely result in serious, systematic discrimination or violence between different groups. The two largest religious groups, Orthodox Christians and Muslims, generally respect each other’s right to practise their religion, despite some low-level mutual mistrust between the groups. While intermarriage and religious conversions are rare, the broader Ethiopian community generally tolerates both, although there may be issues at a household level around familial acceptance of inter-religious marriage. DFAT has observed people of different faiths openly attending their respective religious services without facing discrimination or harassment. In many parts of the country, particularly Oromia region and major cities such as Addis Ababa where there are large numbers of Orthodox Christians and Muslims, mosques and Orthodox churches are located within close proximity of each other, with no evidence of hostility or tension. DFAT assesses that the risk of serious, systematic societal discrimination or violence on the basis of religion in Ethiopia is low.

   …

   Muslims

   There have been numerous protests, particularly between 2011 and 2013, by members of the Muslim community regarding perceived interference in Islamic affairs. In particular, there were complaints that a training program run jointly by the government and the Ethiopian Islamic Affairs Supreme Council (EIASC) was aimed at introducing a ‘foreign religious philosophy’ known as ‘al-Ahbash’. Protesters alleged that the government, concerned about religious-based violence and a rise of Salafism and Wahhabism in Ethiopia, brought in al-Ahbash clerics from Lebanon to train all Ethiopian clerics. Al-Ahbash is an Islamic group that is based in Lebanon but its founder was an Ethiopian (the Arabic name ‘Al Ahbash’ refers to Habesha a name use by Ethiopians for Ethiopia’s highland region). The government’s decision in 2011 to close the Awolia College, the only Islamic College in the country, also attracted protests.

   As is the case with other forms of anti-government protests, a number of participants in these protests were arrested and detained. For example, in August 2015 a court sentenced 18 Muslims, including clerics and journalists, to between seven and 22 years imprisonment under the ATP for their role in a protest in July 2012. Five of the 18 people arrested—who are known as the Arbitration Committee Members—were pardoned and released in September 2015, and a further nine members were pardoned in September 2016. However, supporters of the Arbitration Committee Members have continued to be detained and sentenced. For example, on 21 December 2016 the High Court found 20 Muslims, including two journalists, guilty of terrorism-related offences for protesting the detention of the Arbitration Committee Members, including through columns in Islamic newspapers and on social media.

   Physical protests against perceived government interference in Islamic affairs have been less prevalent in the years since 2013, but criticism of the government online and in news publications continues. DFAT assesses that people who openly oppose or criticise the government, including through these forums, face a risk of harassment, arrest and detention. This is true of all people who criticise the government, including those critical of perceived government interference in religious matters. In this context, DFAT assesses that the arrest and detention of Muslim protesters is a result of a complex interaction of religious, security and political factors.

   …

   In practice, political freedoms in Ethiopia are very restricted, and became more restricted following the introduction of a State of Emergency in October 2016. Opposition groups and independent commentators such as journalists and bloggers who oppose the government’s policies are regularly harassed and detained. While the wording of the ATP is similar to legislation in some western countries such as the UK and Australia, its implementation is significantly more restrictive of political freedoms, and the government has been criticised for perceived breaches of human rights. These alleged breaches include restrictions on the freedom of expression, freedom of association and the activities of civil society organisations and journalists, as well as more serious allegations of extrajudicial killings, torture, arbitrary detention, harassment and abuse, particularly against political opponents and independent journalists and bloggers. There are reports of public servants who are not EPRDF members having their career progression curtailed. Government security forces reportedly regularly detain and torture—and sometimes commit extrajudicial killings of—vocal opponents of government policies. Armed opposition groups, including the ONLF and the OLF, have also been accused of carrying out abuses and violent attacks on government forces and civilians.

   Prominent members of all opposition groups—including legal opposition groups not classified as terrorist organisations—are regularly monitored, harassed, arrested and either charged under the ATP or detained without charge. Periods of detention can vary from a few days to several years. There were reports of a crackdown in the lead-up to the 2015 elections. For example, on 8 July 2014 four prominent members of three opposition parties, the Unity for Democracy and Justice, the Arena Tigray Party and the Blue Party were arrested and held in the Maekelawi detention facility. At least one of those arrested claimed to have been tortured in detention, and all were reported to have been denied access to lawyers and family members. The four were charged in October 2014 under the ATP. In August 2015, more than 12 months after their arrest (and several months after the 2015 elections) the Federal Court found no evidence that these individuals had links to terrorist acts or organisations.

   Arrests of protesters and opponents of the government have continued since the 2015 elections, particularly in the context of large-scale protests and the imposition of a State of Emergency in October 2016. This includes, but is not limited to, high profile opposition leaders. For example, the leader of the opposition party the Oromo Federalist Congress (OFC) and the MEDREK opposition coalition, Merera Gudina, was arrested in December 2016 shortly after returning from a trip to Europe. While in Europe, Mr Gudina had made a speech to the European Parliament about large-scale arrests in Ethiopia under the State of Emergency, and appeared publicly with Berhanu Nega, the leader of the banned opposition group known as Ginbot 7. Mr Gudina had reportedly been warned by his supporters not to return to Ethiopia, but had not heeded these warnings. Mr Gudina was charged under the ATP in February 2017, and at the time of publication he remains in custody and is standing trial on terrorism charges.

   DFAT assesses people who openly oppose the government face a high risk of being monitored, harassed, arrested and detained as a result of their political opinion. All vocal opponents of the government face this risk, including high-profile opposition leaders but also otherwise low-profile people who attend anti-government protests. There are also reports that family members and neighbours of members and supporters (or perceived supporters) of opposition groups may be monitored, harassed, arrested and detained by authorities.

3. A 2016 Ethiopian research article published in a psychiatry journal[1], focussing upon residents in the Ethiopian town of Gimbi, reported that 35% of its 816  research participants agreed that mental illness was punishment by God and 49% were ‘unsure’ about this.  64% agreed that an evil sprite could be the cause of mental illness and 27% were ‘unsure’ about this. 65.7% of participants believed evil sprites cause ‘major depressive disorder’ while 13% believed it was caused by God’s punishment and 18.1% believed it to be by ‘witchcraft’.  53.4% percent believed that ‘major depressive disorder’ should be treated by prayer and 19.4% by ‘holy water’.

   [1] Benti M, Ebrahim J, Awoke T, Yohannis Z, and Bedaso A, ( 2016), ‘Community Perception towards Mental Illness among Residents of Gimbi Town, Western Ethiopia’, Hindawi Publishing Corporation , Psychiatry Journal, Volume 2016.

1. Another 2016 research article[2], which surveyed the Ethiopian town of Jimma[3]  stated that its respondents “had high scores for a stigmatizing attitude towards” people living with mental illness (‘PWMI’)  in Ethiopia, and that its “study revealed that a negative attitude towards PWMI is widespread”.  The report contained the following further information:

   One-third of the respondents … reported that they had been threatened or attacked by PWMI, and 61% had witnessed others being threatened or attacked.

   The majority of the respondents (74.9%) believed that keeping PWMI behind locked doors is the best way of handling PWMI. More than three-fourths of the participants (86.3%) stated that adults with mental illness needed the same kind of control and discipline as young children (A5), and more than half (56.3%) rejected … the view that virtually anyone can become mentally ill. …

   The majority of respondents (68.4%) rejected the statement that describes the mentally ill as having been the subject of ridicule for too long. Although a large portion of the respondents (96%) agreed that they have a responsibility to provide the best possible care for PWMI, 84.0% believed that increased spending on mental health services is a waste of tax money. A total of 85.1% of respondents rejected the statement “We need to adopt a far more tolerant attitude toward the mentally ill in our society”, and more than three-fourths agreed with the statement “It is best to avoid anyone who has mental problems”. …

   The statement “The mentally ill should be isolated from the rest of the community” was found acceptable by majority of the respondents (84.8%), and 93.0% of them did not want to live next door to someone who has been mentally ill. A total of 82.7% of the respondents believed that a woman would be foolish to marry a man who had suffered from mental illness, even though he seemed to be fully recovered. The majority of respondents (73.7%) believed that anyone with a history of mental problems should be excluded from taking public office. Only 7.3% of respondents believed that PWMI should not be denied their individual rights, and 78.3% of the respondents did not agree that PWMI should be encouraged to assume the responsibilities of normal life.  A total of 89.6% of respondents rejected the statement “No one has the right to exclude the mentally ill from their neighbourhood”. In general, most of the residents believed that PWMI are a threat to society and should be avoided, indicating that most of them had socially restrictive view towards the PWMI. …

   The statement “Residents should accept the location of mental health facilities in their neighborhood to serve the needs of the local community” was rejected by 90.9% of residents. Many respondents (85.0%) also did not agree with the statement “The therapy for many mental patients is to be part of a normal community”.  A total of 74.5% of respondents had a negative view about providing mental health services through community-based facilities, and a large number (91.5%) rather believed that locating mental health facilities in a residential area downgrades the neighborhood. …

   Overall, the residents are likely to deny PWMI their individual rights, prevent them from taking on various responsibilities and forbid people from marrying and living together with PWMI. In general, few respondents have information on mental health. In situations like this, mental health facilities are expected to play a great role in enhancing mental health awareness, but in contrast our findings show that health service institutions contribute less to delivering mental health information than other sources.

   [2] Reta Y, Tesfaye M, Girma E, Dehning S, Adorjan K (2016) ‘Public Stigma against People with Mental Illness in Jimma Town, Southwest Ethiopia’. PLoS ONE 11(11): e0163103. doi:10.1371/journal.pone.0163103

   [3] Reportedly the “largest city in south-western Ethiopia”.

2. A 2016 article in the Journal of Neuropsychopharmacology & Mental Health,[4] states:

   It is estimated that about 25 million Ethiopians suffer some form of mental disorder, while less than 10 per cent receive any form of treatment, and less than 1 per cent receive specialist care.
   

   [4] Ayano G (2016) ‘Primary Mental Health Care Services in Ethiopia: Experiences, Opportunities and Challenges from East African Country’. Journal of Neuropsychopharmacological Mental Health 1: 113.

   Psychiatrists are an extremely scarce resource in Ethiopia; in population of over 101 million, there are only 63 psychiatrists, yielding a ratio of 0.65 psychiatrists to 1 million people. Most of the psychiatrists are concentrated in the large cities and consequently treatment gap exists as a high proportion of Ethiopians live in rural areas (more than 80 percent of the populations of the country live in rural areas) and therefore have no access to mental health services. … The resultant effect of all these impediments is the rising number of people with mental health disorders living on the streets, a major social problem requiring urgent attention.

3. According to an Ethiopian Online Psychology website:

   In a country where people are already struggling for survival, the impact of  mental illness on the person and their family is immense. Stigma, discrimination and human rights abuses are part of the everyday life of the mentally ill and their families in Ethiopia. Mentally ill persons with no kind of family structure are even worse hit and end up on the street and ultimately a burden on society.[5]

   [5] Zepsychologist, 2015, “Culture and Mental Health in Ethiopia”, 7 October,

4. The World Health Organisation has also reported from Ethiopia that people with mental illness are “affected by stigma and discrimination” and are often the “most marginalized”.[6]

   [6] WHO, 2016, “Mainstreaming mental health in Ethiopia”, April,

5. A  2017 article in the journal BMC Psychiatry, states:

   … . The aim of this study was to explore barriers to, and facilitators of, service user/caregiver involvement in rural Ethiopia to inform the development of a scalable approach.

   …  Stigma and exclusion were noted to operate within the health system, in the community and even to affect the self-identity of the person with mental illness and their family. Half of policy/planning level participants perceived that service providers, policy makers and health system managers at all levels had negative attitudes towards mental health and people with mental health problems. Examples presented by some interviewees to support this perspective included (i) the lack of prioritization of mental health in the policy agenda compared to other public health concerns, and (ii) the widespread assumption that service users would be unable to contribute anything of value to the mental health system because of the effects of mental illness. Some policy/planning level participants  articulated that system-level stigma would be an insurmountable barrier to service user involvement. …

   The low status of people with mental illness in society was considered to be an important barrier to involvement. The service user and caregiver participants described repeated experiences of unsupportive, discriminatory behavior from the local community and a lack of acceptance of their right to take on social roles. As a consequence some interviewees spoke of experiencing diminished opportunities for productive lives and exclusion from their civic rights (employment, participation in meetings, and voicing their say). Exclusion resulting from stigma was also reported to affect their access to treatment and thereby to impede recovery and limit their capacity to be involved in system strengthening.

   CONSIDERATION OF CLAIMS AND EVIDENCE

6. The applicant submitted his Ethiopian passport. On the basis of this document and the applicant’s oral evidence the Tribunal is satisfied the applicant is a citizen of Ethiopia. The Tribunal assesses the applicant’s claims against Ethiopia as his country of nationality and receiving country.

   Credibility

7. It has been a difficult and drawn out process to attempt to obtain detailed information from the applicant.  He was extremely resistant to attending a hearing for the opportunity to present more detail about his claims for protection. The Tribunal notes he was similarly resistant to attending a Departmental interview at the primary stage of his application process.

8. The Tribunal has tried several ways to facilitate the applicant’s hearing attendance and re-scheduled his hearing, without being able to progress the applicant’s matter satisfactorily. When the applicant did briefly attend a Tribunal hearing he was uncooperative and would not respond to many of the Tribunal’s questions in a meaningful way. His manner was argumentative, irritable, and withdrawn.  He was on medication and also complained of a severe headache which further reduced his willingness to engage in the hearing.

9. With little apparent prospect of being able to conduct a detailed hearing with the applicant in the near future, the Tribunal has decided to determine the application on the information available to it. This includes a great deal of written information which is largely credible, reliable and detailed.

10. Regarding the applicant’s mental health, there are several reports and letters from accredited specialists who have been treating the applicant over the past few years, that the applicant has suffered from Major Depressive Disorder since developing the disorder in 2012.

11. The applicant’s behaviour at his hearing and during the application process also appears to be consistent with the symptoms of his disorder, as outlined by his treating specialists.  On one view it could be perceived that the applicant has been calculatingly obstructive in the review application process, to avoid a potentially negative decision. The Tribunal considers this assumption unlikely as it could not reasonably be contemplated by the applicant that such an approach would indefinitely and ultimately succeed.  Further, at his brief presentation at a hearing he displayed emotional fragility and difficulties as well as the volatility referred to by his treating specialists as symptomatic of his mental illness. The Tribunal therefore considers the applicant’s behaviour in resisting the Tribunal’s invitations to a hearing, and his lack of cooperation, as further evidence the applicant suffers from a mental illness.

12. On the basis of all the information before it the Tribunal accepts the applicant has developed a serious mental illness in Australia, namely Major Depressive Disorder.

13. On the basis of the applicant’s written and oral information and the lack of any evidence to controvert  this particular claim, the Tribunal accepts the applicant is of Amhara ethnicity.  The Tribunal also accepts the applicant was born Christian but now identifies as Muslim and associates with Muslims.

14. Regarding the applicant’s political claim, the Tribunal notes that the country information indicates most Ethiopians supported the CUD at the time of the 2005 election, with the CUD reportedly receiving the popular vote in the election. On the basis of the applicant’s written information and the country information the Tribunal accepts the applicant supported the CUD in 2005. 

    Fear of Harm in Ethiopia

    Political Opposition

15. The evidence submitted by the applicant does not show he would be of any political interest to the authorities now on return to Ethiopia.  For the years he remained there after the 2005 election troubles he did not experience any direct threat or harm from the authorities. He continued to work and study in Ethiopia without interference from the authorities. There is no evidence that the applicant has had any political involvement while in Australia, or that he intends to be politically active on return to Ethiopia.  On the information before it the Tribunal is not satisfied there is a real chance of harm to the applicant in Ethiopia because of his political opinion.

    Muslim

16. The Tribunal also notes that the applicant was able to live in Ethiopia as a person who identifies as Muslim, without experiencing any real harm apart from being slapped in about 2004 by his uncle and nephew.  For his next seven or so years in Ethiopia the applicant did not experience any real problems caused by his identification as Muslim. Given there are millions of Muslims in Ethiopia the Tribunal considers he will be able to return there and live as a Muslim without experiencing serious harm. While his remaining relatives may disapprove of him, there is no evidence to suggest they would cause him any serious or significant harm.  On the information and evidence before it the Tribunal is not satisfied there is a real chance the applicant will face serious or significant harm in Ethiopia as a person who has left Christianity and identifies as Muslim.

    Amhara

17. The applicant has not presented any evidence he has been personally subjected to any harm or threats of harm as an Amhara in Ethiopia. Nor has he provided any specific  information about any actual threat to him as an Amhara, on return to Ethiopia. The available country information does not indicate that Amharas in Ethiopia face serious or significant harm just because they are Amhara. On the information and evidence before it the Tribunal is not satisfied there is a real chance the applicant will face serious or significant harm in Ethiopia because he is Amhara.

    Mental Health

18. The Tribunal accepts that the applicant will face a difficult situation if he returns to Ethiopia. He is suffering from a serious mental health issue, Major Depressive Disorder, which adversely affects his ability to function in society and to interact with society.

19. He does not have a current home in Ethiopia and is now without close family there. He has no current employment in Ethiopia. He is estranged from his relatives because he has left the Christian religion and identifies as Muslim.

20. The Tribunal notes the available country information referred to above, that there is a high level of stigma about mental illness in Ethiopia and that people with mental health problems can face discrimination from the community and even from medical practitioners and care workers. The information highlights that there is a prevalent belief in Ethiopia that mental illness is caused by evil spirits or God as a punishment for the sufferer’s wrongdoing.  Instead of being recognised as a medical ailment treatable with medication and appropriate support and counselling, preferred treatments can be based upon superstitious remedies.

21. The Tribunal considers that the applicant, as someone without ready access to a support network in Ethiopia, will likely face significant difficulties in his attempts to find housing and employment, and in accessing basic services and treatment in Ethiopia, because of the discrimination and stigma against people with mental illness.

22. The applicant has no secure source of income in Australia and is relying upon charity to survive. If he returns to Ethiopia it will as a person without funds, support, a job, and a home there.

23. The Tribunal considers that the applicant’s prospects of finding housing and employment, and access to suitable mental health services, are very low.  In view of the lack of available government welfare the Tribunal considers he will be without income and without accommodation for an indeterminate period of time.

24. As someone with serious mental health issues, who is not supported by his relatives, and who would be homeless and jobless, the Tribunal is satisfied there is a real chance the applicant’s capacity to subsist in Ethiopia will be threatened. The Tribunal considers that this amounts to serious harm within the Act.

25. The Tribunal considers that the applicant’s diminished prospects for obtaining employment, housing and appropriate care in Ethiopia is attributable to the stigma surrounding mental illness that he is likely to encounter. The Tribunal also notes the information that addressing mental health needs in Ethiopia is considered a low health priority, which goes beyond a mere lack of resources generally available. The Tribunal therefore finds that the threat to the applicant’s capacity to subsist in Ethiopia is due to his mental illness.

26. The Tribunal considers that people with mental illness share a particular characteristic which sets them apart in Ethiopian society.  The Tribunal therefore finds that people with mental illness are a particular social group in Ethiopia.

27. The Tribunal considers that the essential and significant reason for the serious harm the applicant faces in Ethiopia is his membership of a particular social group, namely people with mental illness or mental health disorders.

28. The Tribunal is satisfied that the harm is discriminatory and systematic in that it will be done intentionally and selectively to the applicant. The Tribunal is also satisfied that it will be the situation for the applicant throughout Ethiopia so that the real chance of serious harm to the applicant relates to all areas of  Ethiopia.

29. The available information shows that while the Ethiopian government is trying to address discrimination and improve access to basic services within the country it has not yet achieved more than limited success. The Tribunal is not satisfied that, as circumstances are currently and for the reasonably foreseeable future, the Ethiopian state will be able to provide effective protection to the applicant against the harm he faces in Ethiopia.

30. For these reasons the Tribunal is satisfied that the applicant has a well-founded fear of persecution in Ethiopia, for reasons of his membership of a particular social group, as defined in the Act.

31. There is no evidence or indication that the applicant has a right to enter and reside in another country and the Tribunal accordingly finds he has no such right.

32. For the reasons given above, the Tribunal is satisfied that the applicant is a person in respect of whom Australia has protection obligations under s.36(2)(a).

    DECISION

33. The Tribunal remits the matter for reconsideration with the direction that the applicant satisfies s.36(2)(a) of the Migration Act.

    Melissa McAdam
    Member

    
    

    ATTACHMENT  -  Extract from Migration Act 1958

    5 (1) Interpretation
    …
    cruel or inhuman treatment or punishment means an act or omission by which:

    (a)severe pain or suffering, whether physical or mental, is intentionally inflicted on a person; or

    (b)pain or suffering, whether physical or mental, is intentionally inflicted on a person so long as, in all the circumstances, the act or omission could reasonably be regarded as cruel or inhuman in nature;

    but does not include an act or omission:

    (c)that is not inconsistent with Article 7 of the Covenant; or

    (d)arising only from, inherent in or incidental to, lawful sanctions that are not inconsistent with the Articles of the Covenant.

    …
    degrading treatment or punishment means an act or omission that causes, and is intended to cause, extreme humiliation which is unreasonable, but does not include an act or omission:

    (a)that is not inconsistent with Article 7 of the Covenant; or

    (b)that causes, and is intended to cause, extreme humiliation arising only from, inherent in or incidental to, lawful sanctions that are not inconsistent with the Articles of the Covenant.

    …
    torture means an act or omission by which severe pain or suffering, whether physical or mental, is intentionally inflicted on a person:

    (a)for the purpose of obtaining from the person or from a third person information or a confession; or

    (b)for the purpose of punishing the person for an act which that person or a third person has committed or is suspected of having committed; or

    (c)for the purpose of intimidating or coercing the person or a third person; or

    (d)for a purpose related to a purpose mentioned in paragraph (a), (b) or (c); or

    (e)for any reason based on discrimination that is inconsistent with the Articles of the Covenant;

    but does not include an act or omission arising only from, inherent in or incidental to, lawful sanctions that are not inconsistent with the Articles of the Covenant.

    …
    receiving country,  in relation to a non-citizen, means:

    (a)a country of which the non-citizen is a national, to be determined solely by reference to the law of the relevant country; or

    (b)if the non-citizen has no country of nationality—a country of his or her former habitual residence, regardless of whether it would be possible to return the non-citizen to the country.

    …

    5J Meaning of well-founded fear of persecution

    (1)For the purposes of the application of this Act and the regulations to a particular person, the person has a well-founded fear of persecution if:

    (a)     the person fears being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion; and

    (b)     there is a real chance that, if the person returned to the receiving country, the person would be persecuted for one or more of the reasons mentioned in paragraph (a); and

    (c)     the real chance of persecution relates to all areas of a receiving country.

    Note:    For membership of a particular social group, see sections 5K and 5L.

    (2)A person does not have a well-founded fear of persecution if effective protection measures are available to the person in a receiving country.

    Note:    For effective protection measures, see section 5LA.

    (3)A person does not have a well-founded fear of persecution if the person could take reasonable steps to modify his or her behaviour so as to avoid a real chance of persecution in a receiving country, other than a modification that would:

    (a)     conflict with a characteristic that is fundamental to the person’s identity or conscience; or

    (b)     conceal an innate or immutable characteristic of the person; or

    (c)     without limiting paragraph (a) or (b), require the person to do any of the following:

    (i)alter his or her religious beliefs, including by renouncing a religious conversion, or conceal his or her true religious beliefs, or cease to be involved in them practice of his or her faith;

    (ii)conceal his or her true race, ethnicity, nationality or country of origin;

    (iii)alter his or her political beliefs or conceal his or her true political beliefs;

    (iv)conceal a physical, psychological or intellectual disability;

    (v)enter into or remain in a marriage to which that person is opposed, or accept the forced marriage of a child;

    (vi)alter his or her sexual orientation or gender identity or conceal his or her true sexual orientation, gender identity or intersex status.

    (4)If a person fears persecution for one or more of the reasons mentioned in paragraph (1)(a):

    (a)     that reason must be the essential and significant reason, or those reasons must be the essential and significant reasons, for the persecution; and

    (b)     the persecution must involve serious harm to the person; and

    (c)     the persecution must involve systematic and discriminatory conduct.

    (5)Without limiting what is serious harm for the purposes of paragraph (4)(b), the following are instances of serious harm for the purposes of that paragraph:

    (a)     a threat to the person’s life or liberty;

    (b)     significant physical harassment of the person;

    (c)     significant physical ill‑treatment of the person;

    (d)     significant economic hardship that threatens the person’s capacity to subsist;

    (e)     denial of access to basic services, where the denial threatens the person’s capacity to subsist;

    (f)    denial of capacity to earn a livelihood of any kind, where the denial threatens the person’s capacity to subsist.

    (6)In determining whether the person has a well‑founded fear of persecution for one or more of the reasons mentioned in paragraph (1)(a), any conduct engaged in by the person in Australia is to be disregarded unless the person satisfies the Minister that the person engaged in the conduct otherwise than for the purpose of strengthening the person’s claim to be a refugee.

    5K  Membership of a particular social group consisting of family

    For the purposes of the application of this Act and the regulations to a particular person (the first person), in determining whether the first person has a well‑founded fear of persecution for the reason of membership of a particular social group that consists of the first person’s family:

    (a)     disregard any fear of persecution, or any persecution, that any other member or former member (whether alive or dead) of the family has ever experienced, where the reason for the fear or persecution is not a reason mentioned in paragraph 5J(1)(a); and

    (b)     disregard any fear of persecution, or any persecution, that:

    (i)the first person has ever experienced; or

    (ii)any other member or former member (whether alive or dead) of the family has ever experienced;

    where it is reasonable to conclude that the fear or persecution would not exist if it were assumed that the fear or persecution mentioned in paragraph (a) had never existed.

    Note: Section 5G may be relevant for determining family relationships for the purposes of this section.

    5L  Membership of a particular social group other than family

    For the purposes of the application of this Act and the regulations to a particular person, the person is to be treated as a member of a particular social group (other than the person’s family) if:

    (a)     a characteristic is shared by each member of the group; and

    (b)     the person shares, or is perceived as sharing, the characteristic; and

    (c)     any of the following apply:

    (i)the characteristic is an innate or immutable characteristic;

    (ii)the characteristic is so fundamental to a member’s identity or conscience, the member should not be forced to renounce it;

    (iii)the characteristic distinguishes the group from society; and

    (d)     the characteristic is not a fear of persecution.

    5LA  Effective protection measures

    (1)For the purposes of the application of this Act and the regulations to a particular person, effective protection measures are available to the person in a receiving country if:

    (a)     protection against persecution could be provided to the person by:

    (i)the relevant State; or

    (ii)a party or organisation, including an international organisation, that controls the relevant State or a substantial part of the territory of the relevant State; and

    (b)     the relevant State, party or organisation mentioned in paragraph (a) is willing and able to offer such protection.

    (2)A relevant State, party or organisation mentioned in paragraph (1)(a) is taken to be able to offer protection against persecution to a person if:

    (a)     the person can access the protection; and

    (b)     the protection is durable; and

    (c)     in the case of protection provided by the relevant State—the protection consists of an appropriate criminal law, a reasonably effective police force and an impartial judicial system.

    ..

    36Protection visas – criteria provided for by this Act

    …

    (2A)A non‑citizen will suffer significant harm if:

    (a)     the non‑citizen will be arbitrarily deprived of his or her life; or

    (b)    the death penalty will be carried out on the non‑citizen; or

    (c)     the non‑citizen will be subjected to torture; or

    (d)    the non‑citizen will be subjected to cruel or inhuman treatment or punishment; or

    (e)     the non‑citizen will be subjected to degrading treatment or punishment.

    (2B)However, there is taken not to be a real risk that a non‑citizen will suffer significant harm in a country if the Minister is satisfied that:

    (a)     it would be reasonable for the non‑citizen to relocate to an area of the country where there would not be a real risk that the non‑citizen will suffer significant harm; or

    (b)    the non‑citizen could obtain, from an authority of the country, protection such that there would not be a real risk that the non‑citizen will suffer significant harm; or

    (c)     the real risk is one faced by the population of the country generally and is not faced by the non‑citizen personally.

    …