2538695 (Refugee)
[2025] ARTA 2222
•24 September 2025
2538695 (Refugee) [2025] ARTA 2222 (24 September 2025)
Decision and
Reasons for Decision
Respondent:
Minister for Immigration and Citizenship
Tribunal Number:
2538695
Tribunal:
General Member F Robertson
Date:
24 September 2025
Place:
Perth
Decision:
The Tribunal sets aside the decision under review and remits the application for reconsideration with an order that the applicant must be taken to have satisfied s 36(2)(a) of the Migration Act 1958 (Cth)
Statement made on 24 September 2025 at 7:56am
CATCHWORDS
REFUGEE – protection visa – Pakistan – particular social group – men in Pakistan who suffer from a serious mental illness – previously an Australian citizen – immigration detention – criminal history – school bullying – abuse from family – mental health concerns – ongoing psychological distress – self-harm and suicidal ideation – drugs and alcohol to cope – period of homelessness – severe social stigma and discrimination attached to mental illness in Pakistan – fears denial of access to essential medical care, significant economic hardship and ill-treatment – inability to function safely when his mental health is not properly managed – lack of psychiatric services – decision under review remitted
LEGISLATION
Migration Act 1958 (Cth), ss 5, 5AAA, 5H, 5J–5LA, 36, 65, 369, 499
Migration Regulations 1994 (Cth), Schedule 2
CASES
ASB17 v Minister for Home Affairs [2019] FCAFC 38; (2019) 268 FCR 271
AVQ15 v Minister for Immigration and Border Protection [2018] FCAFC 133; 266 FCR 83; 361 ALR 227
Chan v Minister for Immigration and Ethnic Affairs (1989) 169 CLR 379
CQG15 v Minister for Immigration and Border Protection [2016] FCAFC 146; 253 FCR 496
DQU16 v Minister for Home Affairs [2021] HCA 10; 273 CLR 1
EIG17 v Minister for Immigration, Citizenship and Multicultural Affairs [2023] FedCFamC2G 804
EZC18 v Minister for Home Affairs (2019) 168 ALD 441; [2019] FCA 2143
Fox v Percy [2003] HCA 22; 214 CLR 118
Minister for Immigration and Citizenship v SZQRB [2013] FCAFC 33; 210 FCR 505
Minister for Immigration and Ethnic Affairs v Guo [1997] HCA 22; 1997 CLR 559
Minister for Immigration and Multicultural and Indigenous Affairs v SCAR (2003) 128 FCR 553; [2003] FCAFC 126
Randhawa v Minister for Immigration, Local Government and Ethnic Affairs (1994) 52 FCR 437
Selvadurai v Minister of Immigration and Ethnic Affairs and J Good (Member of the Refugee Review Tribunal) [1994] FCA 301; 34 ALR 347
Sundararaj v Minister for Immigration and Multicultural Affairs [1999] FCA 76
SZLVZ v Minister for Immigration and Citizenship [2008] FCA 1816
Trawl Industries v Effem Foods Pty Ltd (1992) 27 NSWLR 326, 348
W375/01A v Minister for Immigration and Multicultural Affairs [2002] FCAFC 89; 67 ALD 757
Any references appearing in square brackets indicate that information has been omitted from this decision pursuant to section 369 of the Migration Act 1958 and replaced with generic information.
Statement of reasons
INTRODUCTION
This is an application for review of a decision to refuse to grant the applicant a Subclass 866 Protection (Class XA) visa under s 65 of the Migration Act 1958 (Cth) (Act).
The applicant is [an age]-year-old male who was born in Pakistan and was previously an Australian citizen. That citizenship was subsequently invalidated. The applicant thereafter applied for a protection visa in June 2025. That application was refused by a delegate of the Minister for Home Affairs on 22 July 2025.
The applicant has applied for review of that decision. The application was heard on 22 September 2025. Following that hearing, I have determined that the decision under review should be set aside, and the application remitted for reconsideration in accordance with an order that the applicant satisfies s 36(2)(a) of the Act. These are my reasons.
CRITERIA FOR THE GRANT OF A PROTECTION VISA
The criteria for a protection visa are set out in s 36 of the Act and Schedule 2 to the Migration Regulations 1994 (Cth). An applicant for the visa must meet one of the alternative criteria in s 36(2)(a), (aa), (b), or (c). That is either, they are a person in respect of whom Australia has protection obligations under the ‘refugee’ criterion or on other ‘complementary protection’ grounds or are a member of the same family unit as a person who satisfies either s 36(2)(a) or (aa).
Refugee criterion
Section 36(2)(a) of the Act 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 decision‑maker is satisfied Australia has protection obligations because the person is a refugee. 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 themselves of the protection of that country.[1]
[1] Migration Act 1958 (Cth), s 5H(1)(a).
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.[2] Among other things, persecution must involve serious harm[3] and systematic and discriminatory conduct.[4]
[2] Migration Act 1958 (Cth), s 5J(1); DQU16 v Minister for Home Affairs [2021] HCA 10; 273 CLR 1 [10] (Kiefel CJ, Keane, Gordon, Edelman and Steward JJ).
[3] Migration Act 1958 (Cth), s 5J(4)(b). Section 5J(5) of the Act contains a non-exhaustive list of examples of harm that involve serious harm, without otherwise limiting the nature or type of harm that might come within s 5J(4)(b).
[4] Migration Act 1958 (Cth), s 5J(4)(c).
A fear of persecution will be 'well‑founded' if there is a 'real chance' that the person will suffer the feared persecution if returned to the receiving country and the real chance relates to all areas of that country.[5] A 'real chance' is a prospect that is not 'remote' or 'far‑fetched', it does not require a likelihood of persecution on the balance of probabilities.[6]
[5] Migration Act 1958 (Cth), ss 5J(1)(b)-(c); DQU16 v Minister for Home Affairs [2021] HCA 10; 273 CLR 1 [10] (Kiefel CJ, Keane, Gordon, Edelman and Steward JJ).
[6] DQU16 v Minister for Home Affairs [2021] HCA 10; 273 CLR 1 [10] (Kiefel CJ, Keane, Gordon, Edelman and Steward JJ) citing Chan v Minister for Immigration and Ethnic Affairs (1989) 169 CLR 379 at 389, 398, 407, 429.
Complementary protection criterion
A person who does not satisfy the ‘refugee criterion’ in s 36(2)(a) of the Act, may satisfy the 'complementary protection criterion' under s 36(2)(aa). That criterion is prospective and asks whether there are substantial grounds for believing that there is a real risk that the applicant will suffer significant harm as a 'necessary and foreseeable consequence' of return to the receiving country.[7]
[7] DQU16 v Minister for Home Affairs [2021] HCA 10; 273 CLR 1 [13] (Kiefel CJ, Keane, Gordon, Edelman and Steward JJ).
The ‘real risk’ test imposes the same standard as the ‘real chance’ test applicable to the assessment of ‘well-founded fear’.[8] As to what amounts to 'significant harm’, that term is exhaustively defined in s 36(2A) of the Act.[9]
CLAIMS AND EVIDENCE
[8] Minister for Immigration and Citizenship v SZQRB [2013] FCAFC 33; 210 FCR 505 [246] (Lander and Gordon JJ), [296] (Besanko and Jagot JJ), [342] (Flick J).
[9] DQU16 v Minister for Home Affairs [2021] HCA 10; 273 CLR 1 [14] (Kiefel CJ, Keane, Gordon, Edelman and Steward JJ); see also Migration Act 1958 (Cth), s 5 in respect of the definitions of 'torture', 'cruel or inhuman treatment or punishment' and 'degrading treatment or punishment'.
Delegate's decision
The delegate made a number of findings of fact in relation to the applicant's identity and the substance of his claims. The delegate accepted that the applicant is a Sunni Muslim from Lahore, Pakistan. This finding was based on the applicant’s statements and was supported by documents he provided, including his Pakistani birth certificate and an Islamic marriage certificate.
The delegate accepted that the applicant likely experienced some low-level harassment and bullying at school, and low-level ill-treatment from his family. However, the delegate was not satisfied that the applicant was actually harmed by his parents. The delegate found the applicant's account of abuse from his parents to be vague, unconvincing, and lacking in specific detail. It was noted that the applicant did not report any physical injuries or seek medical help for the alleged abuse. Similarly, the delegate found the applicant's claims of school bullying lacked detail and were undermined by a contradiction between his statement and his visa application form regarding his schooling history. The delegate also noted that the applicant has had no contact with the alleged bullies for over twenty years and did not express an ongoing fear of them.
The delegate did not accept that the sexual abuse occurred as claimed. This conclusion was reached because the information provided by the applicant was found to be extremely limited. The applicant was unable to provide identifying details for the alleged perpetrators beyond nicknames and gave only general descriptions of the alleged incidents. The delegate found there was no independent or corroborating evidence to support the claim. It was also noted that the applicant has had no contact with the individuals concerned since approximately 2010.
The delegate accepted that the applicant has a history of mental health concerns and continues to experience ongoing psychological distress. This finding was based on documentary evidence provided by the applicant, including a 2017 mental health discharge summary, a 2024 referral form relating to self-harm and suicidal ideation, and 2025 clinical notes showing ongoing engagement with mental health services. The delegate acknowledged limitations in the evidence, such as a six-year gap in medical records and the absence of a current formal diagnosis but was nevertheless willing to accept the applicant suffers from ongoing mental health issues.
Review application
The applicant applied for review of the delegate's decision in July 2025.
The applicant provided a written statement in support of the review application. The content of that statement can be summarised as follows. The applicant was born in Pakistan in [year] and grew up in a large, chaotic, and tense joint family household. He describes his childhood as one of neglect, fear, and violence, where he was beaten for minor mistakes. He alleges he was physically abused by his uncles, who hit him with a steel ruler or belt and constantly told him he was not normal. He also states he suffered sexual abuse by two cousins. This environment of abuse and neglect left him with deep emotional scars and a belief that he was a failure and unworthy of life.
The applicant came to Australia at [age], but his struggles continued. He faced unstable family relationships, bullying, and turned to drugs and alcohol to cope with his trauma. This led to a period of homelessness where he felt disconnected from his family and society.
The applicant states that the trauma from his childhood has caused long-standing mental health issues. He has been diagnosed with [Mental health condition 1], [Mental health condition 2], severe and recurring [Mental health condition 3], and [Mental health condition 4], which includes experiencing [Symptom 1] and [Symptom 2]. He is prescribed [Medication 1] and was also prescribed [Medication 2] to manage his symptoms, which he states he needs to avoid a rapid decline in his health.
The applicant claims his mental health has severely deteriorated during his four years in immigration detention, which he describes as making him feel trapped and hopeless. He states he has attempted suicide more than 10 times, with at least five of these attempts occurring in detention. He asserts that he requires ongoing psychiatric assistance and specifically needs access to Dialectical Behaviour Therapy (DBT), a treatment he found beneficial in the past.
The applicant believes that being forced to return to Pakistan would be a ‘death sentence’. He fears he would have no access to the medication and therapy he relies on, stating that proper mental health services are unavailable or unaffordable. He also highlights the severe social stigma attached to mental illness in Pakistan, where he fears being labelled as cursed or insane and being denied treatment.
Furthermore, the applicant notes that suicide is treated as a crime in Pakistan, and he fears being arrested or institutionalised if he were to harm himself. He also states that he cannot speak or read Urdu and has not lived in the country for 17 years, which would leave him with no support and no ability to survive. The applicant further claims that he fears harm because he will not sufficiently conform to the strict religious expectations of Pakistani society.
The applicant appeared before the Tribunal on 22 September 2025 to give evidence and present arguments. That said, prior to the applicant appearing before the Tribunal he initially refused to be escorted to the hearing room and demanded to be returned to the detention centre. It was only with the patient and empathetic approach of Ms Soueid that the applicant eventually agreed to participate in the hearing.
However, having had the opportunity to hear submissions from Ms Soueid prior to the applicant agreeing to attend the hearing, I formed the view that in circumstances where the applicant’s claims (as confirmed by Ms Soueid) were limited to those arising out of and in relation to his mental health, there was limited utility in me questioning the applicant at length about his past experiences and that the question of whether I accept that the applicant’s mental health is as claimed is ultimately one to be determined having regard to the overall evidence before me. I remained conscious that questioning an applicant with serious mental health difficulties, even in good faith, can amount to a constructive failure to exercise jurisdiction.[10]
[10] See Minister for Immigration and Multicultural and Indigenous Affairs v SCAR (2003) 128 FCR 553; [2003] FCAFC 126.
In this regard, I note the applicant also relies on a report from consultant psychologist [Mr A]. A copy of that report was provided shortly after the conclusion of the hearing. The applicant’s representative had intended to provide it in advance of the hearing but it has been overlooked. In any event, the report was referred to in the written submissions filed which I deal with below.
Mr [A’s] report provides a narrative of the applicant's life, explaining his current psychological state as a direct consequence of his past experiences.
Mr [A] portrays the applicant as a man whose life has been shaped by profound and unresolved trauma, dating back to a turbulent and unloving childhood in Pakistan. The report explains that the applicant's core feelings of being an unloved failure stem from this early environment of neglect and abuse. These deep-seated psychological wounds were compounded by his later use of illicit drugs and alcohol, which the psychologist views as a form of self-medication for his untreated symptoms.
Mr [A] concludes that the applicant's criminal history and poor impulse control were not inherent traits, but rather the unfortunate consequences of his untreated mental health conditions. The depth of the applicant's despair is most evident in his history of self-harm. The report notes that he has attempted to end his life on more than ten occasions, with at least five of these attempts occurring during his time in immigration detention. His suicidal thoughts are described as a daily struggle.
Despite this history, Mr [A] found the applicant to be cooperative and respectful during their assessment. Nevertheless, Mr [A] observed that the applicant suffers from a complex set of conditions, including:
(a)[Mental health condition 3];
(b)[Mental health condition 1];
(c)[Mental health condition 2]; and
(d)a history of a substance use disorder.
Applicant’s submissions
The applicant’s solicitor, Ms Soueid, provided detailed written submissions dated 17 September 2025 comprising 43 pages and 196 separate paragraphs. Those submissions emphasise that the applicant seeks a protection visa on two alternative grounds. The primary submission is that he meets the refugee criterion under section 36(2)(a) of the Act. The submissions argue that he has a well-founded fear of persecution because he is a member of a particular social group, and he cannot access state protection or safely relocate within Pakistan.
Alternatively, it is submitted that the applicant meets the complementary protection criteria under section 36(2)(aa) of the Act. This argument is based on a real risk that he will suffer significant harm if returned to Pakistan.
The submission directly addresses the delegate's reasons for refusing the visa. In this regard, it is argued:
(a)the delegate’s adverse credibility finding is rebutted by the forensic psychologist’s report;
(b)the delegate's finding that adequate mental health services are available in Pakistan is factually incorrect. It relies on country information which it is submitted demonstrates Pakistan’s mental health system is systemically neglected, under-resourced, and inaccessible for a person without financial means or family support;
(c)the delegate erred in finding that the applicant did not face no real chance of persecution or significant harm, pointing to the report of Mr [A] (which I note was not before the delegate), which suggests the applicant is at ongoing risk of self-harm and that removal to a stressful and unsupported environment will foreseeably trigger a relapse, exposing him to serious harm.
In terms of the particular social group that the applicant is said to be a member of, the particular social group is defined as ‘men in Pakistan suffering from mental health issues’. It is argued that this group is identifiable by innate and immutable characteristics (gender and mental health status) and is socially distinct within Pakistan, where men with mental illness face marginalisation and discrimination.
The submission argues that there is a 'real chance' the applicant would be persecuted. This argument is based on the combined effect of several factors.
The forensic psychologist’s report is used to establish the severity of the applicant's mental illness and his high risk of further deterioration if returned to Pakistan. This is linked to extensive country information which, it is submitted, shows that individuals with mental illness in Pakistan face serious harm arising from the cumulative effect of:
(a)pervasive social stigma, including within the healthcare system, leads to discrimination, mistreatment, and the denial of access to care. Cultural beliefs often result in people being subjected to unregulated ‘spiritual healers’ instead of evidence-based treatment;
(b)a healthcare system which is described as critically under-resourced, with a severe shortage of psychiatrists and facilities, leaving the vast majority of people with mental health conditions untreated;
(c)a strained job market and high unemployment, combined with discrimination against people with disabilities, would deny the applicant the capacity to earn a livelihood; and
(d)a worsening political environment, resurgent militant violence, and a high rate of violent street crime create a dangerous environment to which the applicant would be exposed.
It is also submitted that the applicant's non-practice of Islam places him at risk of serious harm under Pakistan’s harsh blasphemy laws.
The submission argues that state protection is not available. It contends that Pakistani authorities are unable or unwilling to protect him, pointing to information on the security situation, ineffective police and judicial systems, and pervasive corruption that requires bribes for access to basic services.
It is further submitted that internal relocation is not a reasonable option. The risks the applicant faces, namely stigma, lack of services, and discrimination, are described as systemic, pervasive, and applicable across the entirety of Pakistan, meaning no area of the country would be safe for him.
As an alternative, it is submitted that there is a real risk that the applicant will suffer significant harm if returned. The harm identified includes being arbitrarily deprived of his life (due to a foreseeable suicide or deterioration of his health without treatment), and being subjected to cruel, inhuman, or degrading treatment (through institutionalisation in unsafe facilities, neglect, or abuse by traditional healers). It is argued that this risk is personal to the applicant due to his specific vulnerabilities and is not a risk faced by the general population.
ANALYSIS, FINDINGS AND REASONS
An applicant is responsible for providing sufficient evidence to establish their claim to be a person in respect of whom Australia has protection obligations.[11] When assessing the claims made, I am not required to uncritically accept any or all the allegations made.[12] I do not need rebutting evidence before finding a particular factual assertion is not made out.[13]
[11] Migration Act 1958 (Cth), s 5AAA; AVQ15 v Minister for Immigration and Border Protection [2018] FCAFC 133; 361 ALR 227 [43] (Kenny, Griffiths and Mortimer JJ); EIG17 v Minister for Immigration, Citizenship and Multicultural Affairs [2023] FedCFamC2G 804 [148] (Ladhams J).
[12] SZLVZ v Minister for Immigration and Citizenship [2008] FCA 1816 (Middleton J).
[13] CQG15 v Minister for Immigration and Border Protection [2016] FCAFC 146; 253 FCR 496 [65] (McKerracher, Griffiths and Rangiah JJ); Selvadurai v Minister of Immigration and Ethnic Affairs and J Good (Member of the Refugee Review Tribunal) [1994] FCA 301; 34 ALR 347 [7] (Heerey J).
I have considered the 'Refugee Law Guidelines' and 'Complementary Protection Guidelines' prepared by the Department of Home Affairs and the Department of Foreign Affairs and Trade (DFAT) Country Information Report[14] to the extent relevant and material to the disposition of this review application.
[14] 'DFAT Country Information Report Pakistan', Department of Foreign Affairs and Trade, 30 April 2025, 20250430093349 (2025 DFAT Report).
Credibility
The assessment of credibility is a difficult task,[15] which should be careful, thoughtful, and conducted fairly and reasonably.[16] Inconsistencies in an account may or may not be significant[17] and allowances may be required where an account is given through an interpreter.[18] I should usually give the benefit of the doubt to those who are generally credible but are unable to substantiate their claims.[19]
[15] See Fox v Percy [2003] HCA 22; 214 CLR 118 [31] citing Samuels JA in Trawl Industries v Effem Foods Pty Ltd (1992) 27 NSWLR 326, 348.
[16] See AVQ15 v Minister for Immigration and Border Protection [2018] FCAFC 133; 361 ALR 227 [22]–[28] (Kenny, Griffiths and Mortimer JJ).
[17] ASB17 v Minister for Home Affairs [2019] FCAFC 38; (2019) 268 FCR 271 [39]–[45] (Griffiths, Mortimer and Steward JJ).
[18] See, for example, Sundararaj v Minister for Immigration and Multicultural Affairs [1999] FCA 76 [5] (Burchett J), W375/01A v Minister for Immigration and Multicultural Affairs [2002] FCAFC 89; 67 ALD 757 [15]–[19] (Lee, Carr and Finkelstein JJ); AVQ15 v Minister for Immigration and Border Protection [2018] FCAFC 133; 266 FCR 83 [22]–[28] (Kenny, Griffiths and Mortimer JJ) and ASB17 v Minister for Home Affairs [2019] FCAFC 38; 268 FCR 271 [39]–[45] (Griffiths, Mortimer and Steward JJ).
[19] Randhawa v Minister for Immigration, Local Government and Ethnic Affairs (1994) 52 FCR 437; see also Department of Home Affairs, ‘Policy – Refugee and Humanitarian – The Protection Visa Processing Guidelines’, section 15.6, as re-issued 1 January 2023 (Protection Visa Processing Guidelines); UN High Commissioner for Refugees (UNHCR), Handbook on Procedures and Criteria for Determining Refugee Status and Guidelines on International Protection Under the 1951 Convention and the 1967 Protocol Relating to the Status of Refugees, April 2019, HCR/1P/4/ENG/REV 4 [203]-[204].
As foreshadowed above, I have also approached the resolution of this review application with the principles referred to by the Full Court in Minister for Immigration and Multicultural and Indigenous Affairs v SCAR (2003) 128 FCR 553; [2003] FCAFC 126 in mind.
In this regard, I recognise that particular care is required when dealing with the evidence, and even the question of whether to take evidence, from psychologically vulnerable applicants. There are many reasons for that, including that inconsistencies in an applicant’s testimony can often form the basis of an adverse credibility assessment. It is also well recognised that some kinds of inconsistency are less reliable as a basis for an adverse credibility finding when assessing a psychologically vulnerable applicant.
Country of nationality
The applicant claims to be a citizen of Pakistan. The applicant travelled to Australia on a passport which appears to have been regularly issued by that country. I find that Pakistan is the applicant’s country of nationality and the receiving country.
Does the applicant satisfy the refugee criterion?
The mere fact that a person claims fear of persecution for a particular reason does not establish either the genuineness of the asserted fear or that it is ‘well-founded’ or is for the reason claimed.[20]
[20] Minister for Immigration and Ethnic Affairs v Guo [1997] HCA 22; 1997 CLR 559 [124] (Brennan CJ; Dawson, Toohey, Gaudron, McHugh, Gummow JJ).
Does the applicant have a well-founded fear of persecution?
As I will explain, I have reached a different conclusion to that of the delegate who refused the applicant’s visa application. Unlike the delegate, I do not consider it necessary to explore the applicant’s claims of past childhood sexual abuse in Pakistan. That is because of the views that I have reached about his mental health and I consider it is not necessary to consider whether the antecedent history recounted by the applicant is correct in order to accept the veracity of the applicant’s mental health history that has been recorded in contemporaneous materials over the last decade.
Otherwise, I note that I have had the benefit of significant new evidence that was not before the delegate and the assistance of comprehensive submissions in relation to the country information. The information that I have the benefit of but which was not available to the delegate includes the detailed expert report from Mr [A], and a detailed statement from the applicant himself. This new information, when considered alongside the relevant country information, provides a context for the findings I now make.
As I will explain below, I accept the applicant has a well-founded fear of persecution for reasons of his membership of a particular social group. This particular social group consists of men in Pakistan who suffer from a serious mental illness. The persecution he fears is a combination of harms, including the denial of access to essential medical care that threatens his capacity to subsist, significant economic hardship, and the real prospect of significant ill-treatment, compounded by an endemic failure of state resources and a society where his condition is met with severe stigma and discrimination.
It is the combination of the severity of his particular conditions, the acute and life-threatening ways in which those conditions manifest, and the demonstrably inadequate and often harmful environment for persons with such illnesses in Pakistan that compels this result. In these specific and particular circumstances, I cannot find that the chance of the applicant being seriously harmed is remote. As the chance of harm is not remote, I must assess it as a real chance of serious harm.
I accept the evidence of Mr [A], whose report provides a clear but concerning clinical picture. I found his report to be thorough, well-reasoned, and persuasive. The applicant’s condition is not a minor or moderate psychiatric issue; it is a complex, chronic, and severe illness with a history of acute, often life-threatening, outward manifestations. I further note and find on the material available to me that the applicant’s clinical history pre-dates the cancellation of his citizenship and his current application for a protection visa so it cannot be said that his presentation is a construct designed towards achieving a particular migration outcome.
The applicant has been diagnosed with several serious conditions, including [Mental health condition 1], [Mental health condition 2], and Severe and Recurring [Mental health condition 3]. However, it is important to recognise that these diagnoses are not merely labels, but manifest in tangible, dangerous, and debilitating ways. The evidence before me paints a portrait of a man whose daily existence is a struggle against profound psychological pain.
The most alarming outward manifestation of his illness is his acute and persistent suicidality. The applicant has attempted suicide on more than ten occasions. Critically, at least five of these attempts have occurred while in the structured environment of immigration detention, with the most recent being an attempted hanging. This demonstrates that his risk of self-harm is not abstract or historical; it is current, immediate, and high. The psychologist confirms that the applicant experiences suicidal thoughts on a daily basis. This is not simply a symptom of depression; it is an active and observable behavioural characteristic of his illness that poses a direct threat to his life. Whilst it is well established that suicide does not come within the definition of an arbitrary deprivation of life for the purposes of a definition of significant harm,[21] the prospect of an attempted suicide and what might follow that event are matters which are necessary to take into account.
[21] As to which see generally EZC18 v Minister for Home Affairs (2019) 168 ALD 441; [2019] FCA 2143.
Another critical manifestation of his untreated trauma has been his past reliance on illicit substances as a form of self-medication. The evidence shows that his use of drugs and alcohol was a desperate attempt to cope with the psychological symptoms he was experiencing. This self-medication has led, in the applicant’s case, to further destructive outcomes, including psychotic episodes and offending behaviour that brought him into contact with the criminal justice system. The psychologist directly links his forensic history to his past lack of treatment and the impact of substance use on his judgment and impulse control. This history provides objective evidence of his inability to function safely when his mental health is not properly managed.
The severity of his condition has also manifested in a chronic inability to maintain stability in his life. His statement describes periods of homelessness and an erratic employment history, which the psychologist connects to the deterioration of his mental health. His illness has plainly had a debilitating effect on his capacity to engage in the ordinary activities of life, such as working and securing housing.
I accept that the applicant suffers from a severe and complex mental illness. This illness is not a largely or predominantly passive or hidden condition. I find that it is, and would be in the reasonably foreseeable future, characterised by observable outward manifestations, including acute suicidal ideation, a history of substance abuse as a maladaptive coping mechanism, and a demonstrated inability to function when left without structured psychiatric support. It is this specific, manifested severity that distinguishes his case and grounds the foundation of my assessment of the risk he faces in Pakistan.
The 2025 DFAT Report indicates that Pakistan’s public health sector did not fully recognise psychology as a separate profession resulting in inadequate resources being available in that sector.[22] Whilst mental health care is available, it is significant underfunded and leaves more than 90 per cent of people untreated.[23] Treatment is even harder to obtain in rural areas and for people who are poor and the most vulnerable.[24]
[22] 2025 DFAT Report, [2.35]-[2.39].
[23] 2025 DFAT Report, [2.35]-[2.39].
[24] 2025 DFAT Report, [2.39].
First, I am satisfied that the formal healthcare system is fundamentally inadequate to meet the needs of the population, let alone the needs of an individual with a condition as severe as the applicant’s. The statistics are stark. The country has fewer than 500 psychologists for a population of over 240 million people.[25] The ratio of psychiatrists to the population is one of the lowest in the world. The system is so underfunded and poorly resourced that, as I have noted, it leaves more than 90 per cent of people with common mental health conditions untreated.[26] There are only 2.1 mental health beds per 100,000 people. For the applicant, who requires consistent, specialised psychiatric care and medication to manage his life-threatening symptoms, this systemic breakdown amounts to a practical denial of essential healthcare.
[25] 2025 DFAT Report, [2.37]
[26] 2025 DFAT Report, [2.37].
Second, beyond the structural failings of the health system, the applicant would face pervasive and harmful social stigma. The 2025 DFAT report confirms that mental illness is heavily stigmatised and widely misunderstood in Pakistan, particularly where the mental illness is, properly understood, debilitating.[27] It is otherwise reported that stigma is ‘a major obstacle to the effective management of mental illnesses,’ characterised by ‘detriment, incomprehension, and discrimination’.[28]
[27] 2025 DFAT Report, [3.223]-[2.230].
[28] Madeeha Malik, Hamza Saeed, Azhar Hussain & Ayisha Hashmi, ‘Burnout and Mental Illness Related Stigma among Healthcare Professionals in Pakistan’ (2023) 14(3) Archives of Pharmacy Practice <>
This stigma can have dire consequences. It often prevents individuals from seeking or receiving evidence-based medical care. Instead, they are directed toward traditional or faith-based healers.[29] As detailed in the country information, the practices of these healers can be actively harmful, involving physical punishment, exorcisms, and other dangerous rituals. The applicant, presenting with acute and observable symptoms, would be at a very high risk of being subjected to such ill-treatment. Furthermore, the stigma extends to discrimination in essential areas of life. [30] DFAT assesses that people with mental impairments face a high risk of official and societal discrimination, including the denial of employment and exclusion from community life.[31] They are often viewed as people ‘in need of medical help or charity, instead of worthy of jobs’.[32] The stigma is present even in more urban environments and even among more highly educated sectors of the population.[33]
[29] Shah I, Khalily MT, Ahmad I, Hallahan B. Impact of Conventional Beliefs and Social Stigma on Attitude Towards Access to Mental Health Services in Pakistan. Community Ment Health J. 2019 Apr;55(3):527-533. doi: 10.1007/s10597-018-0310-4. Epub 2018 Aug 4. PMID: 30078064.
[30] 2025 DFAT Report, [3.223]-[2.230].
[31] 2025 DFAT Report, [3.230].
[32] 2025 DFAT Report, [3.226].
[33] Salman Shafiq, ‘Perceptions of Pakistani Community Towards Their Mental Health Problems: A Systematic Review’ (2020) 3(1) Global Psychiatry 29-52, <
I am satisfied based on the country information before me that the environment in Pakistan for a person with a severe mental illness is one of systemic neglect and societal hostility. There is a near-total absence of an adequate public health safety net. This is replaced by a social framework of stigma, misunderstanding, and discrimination that exposes vulnerable individuals to a high risk of mistreatment and a denial of their basic needs. I accept that the outward characteristics he displays would result in his being unable to obtain, or remain, employed.[34] The situation is starker for men in particular, who are expected to not show weakness or emotion.[35]
[34] Shah I, Khalily MT, Ahmad I, Hallahan B. Impact of Conventional Beliefs and Social Stigma on Attitude Towards Access to Mental Health Services in Pakistan. Community Ment Health J. 2019 Apr;55(3):527-533. doi: 10.1007/s10597-018-0310-4. Epub 2018 Aug 4. PMID: 30078064.
[35] See Men and Mental Health: A Stigma, Savaira, 8 June 2024, <>
I accept the applicant faces the denial of access to basic services, and that the denial would threaten his capacity to subsist. I accept that when attempting to access government services or even employment in Pakistan, a person experiencing, among other things, [Mental health condition 4] and [Symptom 2] would be treated not with empathy, respect and understanding but with antipathy. For the applicant, this is not a mere inconvenience, but would, over time, involve a real and credible threat to his ability to subsist. Without the medication and psychiatric support he receives in Australia, his ability to function and to manage his life-threatening impulses would be compromised.
I am prepared to accept in the circumstances that the applicant faces significant economic hardship that threatens the person’s capacity to subsist, arising from the denial of his capacity to earn a livelihood. The country information makes it clear that he would face profound discrimination in a job market that is already strained. With no family support, no financial resources, and a debilitating illness, he would have no realistic prospect of supporting himself.
I now turn to the critical question of whether the applicant faces a ‘real chance’ of serious harm occurring. A protection finding does not follow from every diagnosis of a mental health condition. Many individuals may be able to access some level of care, draw on family support, or manage their conditions without facing a risk that rises to the level of being a real chance of persecution. However, I am satisfied the applicant’s case is different. The chance of serious harm in his particular circumstances cannot be described as remote or fanciful. Because the chance of serious harm is not remote, I must find the applicant faces a real chance of serious harm.
I am satisfied that the applicant is a member of a ‘particular social group’ for the purposes of the Act. This group is properly defined as men in Pakistan with a serious mental illness. The characteristic of having a serious mental illness is an immutable one that the applicant cannot be expected to change. The group is also socially distinct within Pakistan, as evidenced by the pervasive societal stigma and discriminatory attitudes that set them apart from the general population.
The essential and significant reason for the persecution the applicant fears is his membership of this group. The harms he faces, the denial of healthcare, the risk of ill-treatment by traditional healers, social ostracism, and discrimination in employment, are not random. They flow directly and foreseeably from how Pakistani society and its institutions perceive and treat men with serious psychiatric conditions.
I am not satisfied that there is any permissible way that the applicant could modify his behaviour to avoid the real chance of harm that he faces. His mental health condition is not a voluntary choice, but an innate aspect of his personal psychology.
Finally, I am satisfied that this real chance of persecution exists in all parts of Pakistan. The evidence shows that the lack of psychiatric services and the social stigma are national, systemic problems. Relocating to a rural area would, according to DFAT, likely sever his access to treatment altogether. I am also satisfied that effective protection measures are not available from the state, whose healthcare and social support systems are the source of the neglect he fears.
There is no suggestion that the applicant can access a third country such that s 36(3) would be engaged.
For these reasons, I am satisfied the applicant has a well-founded fear of persecution within the meaning of s 5J(1) of the Act and is a refugee within the meaning of the Act. The applicant satisfies the refugee criterion in s 36(2)(a) of the Act.
DECISION
The Tribunal sets aside the decision under review and remits the application for reconsideration with an order that the applicant must be taken to have satisfied s 36(2)(a) of the Migration Act 1958 (Cth).
Date of hearing:
22 September 2025
Representative for the Applicant:
70. Ms Salma Soueid
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