Consideration
15 At the heart of the Appellant's first ground of appeal is an assertion that the Authority did not adequately consider the Appellant's PTSD and the exacerbation of his condition if he were to be returned to Sri Lanka. More specifically, criticism was directed at paragraphs [38]-[40] of the Authority's reasons, extracted in full below.
Post-Traumatic Stress Disorder
38. The applicant claims to suffer PTSD and has provided a report from a consultant psychiatrist, dated 29 September 2016, in support of this claim. The report diagnoses chronic PTSD that has been 'recently amplified' by the applicant's protection visa process. The applicant has also provided a report from Companion House, an organisation that works towards assisting survivors of torture and trauma. From these reports I note that the applicant has undergone counselling and has attended a Tamil Men's Group in Australia since 2013. His counselling was initially done weekly but by September 2016, it was being undertaken on an "as needs" basis. There is nothing in either report to indicate that he has asked for or been assessed for any residential-based programs. Both reports note that the applicant is anxious about returning to Sri Lanka and that a return may exacerbate his PTSD. I accept the evidence in these reports and I find that the applicant is suffering from PTSD and that this may be exacerbated by a return to Sri Lanka.
39. I have considered whether the applicant will be able to access appropriate care if he was to return to Sri Lanka. Information in the referred materials indicates that the main public mental health facility in Sri Lanka is the National Institute of Mental Health (NIMH), which operates two residential facilities in Colombo. In addition, every district in Sri Lanka apart from Monaragala (in the south-east) has a hospital offering treatment for mental health. The World Health Organisation (WHO) has commented that Sri Lanka's progress in the mental health sector is commendable and it has achieved a significant improvement in human resources development and the expansion of resources and facilities. The WHO said that Sri Lanka "is doing much better in the field of mental health when comparing with the world's status". On the other hand, the UN has expressed a concern that mental health services remain insufficient to cope with widespread post-conflict mental disorders. Other information indicates that the government provides free healthcare for the public at all state hospitals, which are located in almost every city as well as in major towns. These are equipped with modern equipment and provide a range of medical services, although it is noted that these hospitals can be congested. There is also a private health system but this is expensive and the cost would be borne almost entirely by the user.
40. I take into account that the health care system in Sri Lanka may face some difficulties, although the information above is now some five years old. I also take into account that the applicant has not previously been hospitalised and is undertaking as-needs counselling. There is no evidence before me that indicates that the applicant would require hospitalisation in Sri Lanka, although I accept this could be needed if his condition deteriorates. However, I am satisfied that if he did require more intensive treatment including hospitalisation, this could be obtained in his district or in Colombo. I am therefore satisfied that the applicant would be able to seek mental health care in Sri Lanka if he was to require it. I find that the applicant does not face a real chance of serious harm arising from his diagnosed PTSD. [footnotes omitted]
16 The Appellant's submission is that the Authority's reasoning process was flawed because it did not involve a 'proper, genuine and realistic consideration' of the Appellant's circumstances. I do accept that proposition.
17 At [38], the Authority considered the contents of the reports specifically prepared in relation to the Appellant's chronic PTSD. Those reports indicated, and the Authority accepted, that the Appellant was suffering from PTSD and that returning to Sri Lanka might exacerbate his condition. The Authority also noted that while the Appellant initially received weekly counselling, he was now only undertaking counselling on an ad hoc basis.
18 At [39], the Authority then considered the availability of mental health services in both Colombo and, crucially, other districts in Sri Lanka. This included an assessment of the 'significant improvement' in the mental health sector identified by the World Health Organisation (WHO), as well as recognition of the ongoing limitations associated with the delivery of mental health services in Sri Lanka, such as congestion (in public hospitals) and prohibitive cost (in the private health system).
19 At [40], the Authority evaluated the information in the preceding paragraphs. On that basis, the Authority was satisfied that the Appellant would be able to access mental health care in Sri Lanka if he required it. The Authority also noted that the Appellant had not been previously hospitalised due to his PTSD. The Authority explained that there was no evidence to suggest the Appellant would require hospitalisation if returned to Sri Lanka but, if his condition deteriorated, appropriate care would be available in both Colombo and other districts in Sri Lanka. Weighing up these various considerations, the Authority concluded that the Appellant did not face a real chance of serious harm arising from his diagnosed PTSD.
20 This reasoning process was considered, thorough and balanced. The Authority critically engaged with both the general country information and the Appellant's personal circumstances. This demonstrated an active intellectual engagement with the materials, in which the Authority accepted that the Appellant suffered from chronic PTSD, which would likely be exacerbated on his return to Sri Lanka, but that appropriate mental health services would be available to the Appellant, irrespective of where he lived in Sri Lanka. Bearing in mind that a determination that the Authority failed to engage in active intellectual process will not lightly be made and must be supported by clear evidence, I am not persuaded by the Appellant's submissions.
21 The Appellant was unable to point to any particular issue, of significance, that the Authority did not address. I do not accept that the Authority's findings were at too high a level of generality or merely repetitive of general country information. I am also not satisfied that the Authority failed to properly consider the Appellant's claim merely because it did not reach a view about issues such as where the Appellant would live, how far he would have to travel or how he would conduct himself in Sri Lanka. To the extent such issues are not expressly discussed in the reasons, I infer it is because they did not assume sufficient importance or prominence, in the context of all the information before the Authority and the findings made by the Authority, to warrant detailed consideration.
22 The First Respondent submitted that even if an error occurred, such an error was not 'material' in the sense contemplated by the High Court in Hossain v Minister for Immigration and Border Protection (2018) 264 CLR 123; [2018] HCA 34 at [30] (Kiefel CJ, Gageler and Keane JJ). The relevant paragraph in that decision is extracted below:
Whilst a statute on its proper construction might set a higher or lower threshold of materiality, the threshold of materiality would not ordinarily be met in the event of a failure to comply with a condition if complying with the condition could have made no difference to the decision that was made in the circumstances in which that decision was made. The threshold would not ordinarily be met, for example, where a failure to afford procedural fairness did not deprive the person who was denied an opportunity to be heard of "the possibility of a successful outcome", or where a decision-maker failed to take into account a mandatory consideration which in all the circumstances was "so insignificant that the failure to take it into account could not have materially affected" the decision that was made. [footnotes omitted]
23 During the course of the hearing, this issue was the subject of detailed submissions from counsel for the Appellant and First Respondent. Although I am not required to determine the question of materiality in light of my conclusion above, I note that I am not satisfied that any error by the Authority would be material in the sense contemplated by the High Court in Hossain.
24 In relation to the Appellant's claim for protection as a refugee, the Appellant submitted that the requisite convention nexus was established because the Appellant's PTSD was associated with his past experiences at the hands of the Sri Lankan Army (SLA), which were related to his ethnicity, and that his mental health condition would be exacerbated by his return to Sri Lanka. I consider that such a nexus is peripheral to the grounds under the Refugee Convention. The position might have been different if, for example, there was evidence that the Appellant was denied access to mental health services on the basis of his ethnicity or as a returned asylum seeker. However, no such information was before the Authority to demonstrate the requisite convention nexus.
25 In relation to the Appellant's claim for complementary protection, the Appellant submitted that there was a real risk that the Appellant would suffer significant harm to his mental health as a necessary and foreseeable consequence of being returned to Sri Lanka. The Appellant submitted that if the Authority had given proper, genuine and realistic consideration to the Appellant's chronic PSTD, there were a range of possibilities open to the Authority on remittal. I have concluded above that the Authority did in fact undertake an 'active intellectual process', which itself disposes of the first ground of appeal. I also consider that the Authority's conclusion would not have been any different even if it had considered the matters identified by the Appellant to constitute an error. Accordingly, I do not accept that any alleged error would have been material.