#JulianAssange extradition hearings Part 2 - Day 12 (Thread)

Court is due to sit 10:00 am.

Medical testimony is expected to continue. Yesterday the court heard that Mr Assange is at "very high risk of suicide" should he be extradited

via @SputnikInt
Dr Quinton Deeley has been sworn in. He's a Consultant Psychiatrist specialising in autism, ADHD, learning disability, and acquired brain injury in adults, mental health conditions such as depression, anxiety, obsessive compulsive disorder, psychosis, bipolar affective disorder..
... he examined Mr Assange. An Autism Diagnostic Observation Schedule (Ados) test administered in his presence. Due to COVID there was a big gap between the test being administered and a phone call with Dr Deeley.
Observation alone of “no suicidal intent” within medical records or prison records, without any further information, doesn’t necessarily entail that a full assessment has occurred, Deeley says.
Based on the assessment a separate collateral interview with his mother in my view Mr Assange satisfies the diagnostic criteria of Asperger's syndrome.
“Characteristic traits are evident across the life course [of Mr Assange” Dr Deeley says. Adding that he found Mr Assange to be “An intelligence person characteristic of many high functioning people on the autism spectrum”.
To summarise it is true that many perhaps majority on the spectrum do not form relationships or at least successfully. There are a minority, often in practice struggling in understanding more nuanced aspects of relationships.
Dr Deeley gives his view that in his view Mr Assange's "risk of suicide" would be high should he be extradited.
Ability to tolerate stress in general is reduced in people on the autistic spectrum and the rates of suicide are higher among people in the autistic spectrum compared to members of the general public, Dr Deeley explains to the court.
Reality of the situation is that people determined to kill themselves do kill themselves both within the British prison state as well as within their American counterpart, Dr Deeley says.
James Lewis QC:
Why you were so qualified to opine on prison notes if you have only been to prison once in the last year?
Dr Deeley: I think that Mr Assange has identified that he is selective in who he engages with in terms of his disclosure of his thoughts and feelings of his mental state.
Documentation from the prison notes varies in terms of details.
James Lewis QC will challenge the idea that Mr Assange is on the autisim spectrum on the basis that other medical experts disagree with the diagnosis.
Lewis QC: You're either autistic or not you don't become autistic right?

Dr Deeley: "A person’s autistic traits may become evident as their circumstances change". The assumption is that the traits are always there even if they are not expressed.
Lewis QC: You can now make the diagnosis because it is a lifelong condition? You’re looking back?

Dr Deeley: Yes
USG is going to play some clips of Julian Assange speaking at the FrontLine club as an example of his ability to engage in "conversational interchange" which Dr Deeley says he hasn't seen.
Before the video is played (some tech issues) Lewis QC asks: Where you aware that Mr Assange hosted a television chat show in 2011 called the Julian Assange show for the TV programme RT?

Dr Deeley: No. Not necessarily. ... >
It’s remarked in the interview with Dr Dreyfuss, when Mr Assange is talking about subjects which he is knowledgeable and has an interest is able to do so at length. Not unusual for people who are on the highly intelligent on the autism spectrum.
What happens with intelligent people with autism very often it is outside those set pieces with which those people are interested in, and more spontaneous interactions, whih prove much more challenging, Dr Deeley says.
Lewis QC: Are you trying to give an objective opinion to this court?
Dr Deeley: I am.
Lewis QC: If we show material which shows opposite to the trait you should take this into account?
Dr Deeley: Yes
Lewis QC: So you’ve got to now take them into account rather than try to excuse them away without seeing what they are.
Dr Deeley: Yes. I was trying to offer some important context for the court.
Court is now playing a video of Julian Assange answering a question at the Front Line club regarding putting the lives of sources at risk. Mr Assange is giving a detailed answer as to the publication of materials.
Court is now playing an answer from Mr Assange to a second question at the FrontLine club.
Mr Assange says in the second clip that we are "not obligated to protect other people’s sources, military sources, spy organisations sources, except from unjust retribution, there are numerous cases where people sell information or frame others or engage in genuinely traitorous..
...behaviour. And actually that is something for the public to know about [..] to know about that behaviour"

James Lewis QC: Asks whether Dr Deeley sees these two clips as contradicting the diagnosis of Mr Assange as being on the autism spectrum?
Dr Deeley responds: No, I wouldn’t agree actually. I think that is a very important example of what I was talking about. A highly rehearsed role talking about a question in which he has expertise in a highly structured context within an impressive monologue....
... There isn’t a quality to having to respond to an informal social interaction in which he is required to notice and respond to the emotional cues of his interlocutor. He is in his comfort zone… but quite distinct of those provided by Dr Dreyfus in some detail...
James Lewis QC: Are you trying to help this court?
Ed Fitzgerald QC: Objection
Judge: Overruled.
Dr Deeley: Well, I am trying to help this court. I understand my duty is to the court.
James Lewis QC: Is now reading through prison medical notes (possibly from when Mr Assange was in the medical wing) to Dr Deeley of cases of Mr Assange as having "good eye contact" at times "smiling inappropriately", "interacted well with patients and staff" on different dates.
Dr Deeley answers that these notes of "good eye contact" "must be placed within the context of the totality in the context of the case".
... Eye contact must be in context of all non-verbal communication (body, posture, etc). Assessed in more formal settings like when people are being interviewed as well as more spontaneous items. Its not concluded that Mr Assange has a complete absence of non-verbal communication
It’s a judgement about the amount and quality of non-verbal communication that he exhibits. I do accept that he was depressed in time and that is an explanation for the reduction in communication. Dr Deeley explains.
James Lewis QC: Is now asking Dr Deeley why he omitted certain comments from the medical notes & ADOS test from his final report for the court. Dr Deeley says he was engaged in a "careful process" of weighing available lines of evidence before coming to his ultimate conclusion.
Q. Did you know he was given sole custody of his son after a custody battle?
A. Yes.

Q. Would it not occur to you that no court is going to give sole custody of a child to someone who exhibits these symptoms?
Q. No. Im not familiar with the detailed reasoning & assessment made by the court at the time. 2 some people on autistic spectrum can function as parents & manage some of the demands of every day life and so does not preclude...
Q. Doesn’t preclude & so is not consistent with..?
... A. I don’t accept that …. So the observations offered by Mr Assange's mother for that is that he had a preference for solitary play but he did develop in his teens in particular a small friendship with boys who shared his intense interest in computers &...
... again I would say that is not inconsistent with a diagnosis in autism spectrum disorder.
**There are further questions from James Lewis QC for the US, with examples of Mr Assange being self-less and kind towards animals, to Dr Deeley who keeps saying that they are not in and of themselves inconsenstient with a diagnosis of autistic spectrum disorder.
James Lewis QC: He has written books, published articles, given speeches. Why have you excluded that information and only given the information which supports your conclusion Dr?

A. "The evidence that you are citing does not contradict the observations"
Q. But we all have these traits Dr. I mean you are looking up at the ceiling when answering my questions.

A. I don’t think I would score very high on the ADOS test. “The question has not been raised hitherto” [laughter in court]
There is a continous back and forth regarding various aspects of the test. Dr Deeley is standing firm that the "evidence is there" to substantiate his opinion. Cross-examination is almost over and has shifted to "suicide risk".
Any responsible clinician carrying for Mr Assange under present circumstances would ensure that risk of suicide was actively managed should a determination be made to extradite him, Dr Deeley says.

15 minute break for counsel to consult with client.
Following re-examination there is discussion with the judge & counsel about the fact that a witness due to speak later this afternoon isn't available. Judge very reluctant to "lose" the afternoon and is emphasising that she wants an alternative witness to speak today if possible.
Fitzgerald QC earlier told the judge that even if we finished all the witnesses, and that is a tall answer, we couldn’t have closing submissions and wouldn’t be fair and appropriate to try to do that next week.
Court has risen for lunch.
Court has recommenced. Professor Faisal has been sworn in.
He has qualifications in forensic psychiatry. That means he has specialist training in the assessment and management of mental disorders in prisoners… and some expertise in dealing with people who go before the court including their diversion in [secure hospitals].
Professor Faisal says he visits prisons once a fortnight… weekly for about 10 years before that.
"As a consultant I was visiting prisons more often than that as well"
Professor Faisal "has given expert evidence by the government legal department, UN tribunal, LIBERTY, defence solicitors, and Prisoners Ombudsman in 6 occasions, coroners, and a specialisation in prison suicide."
He has published extensively on this topic and done a number of empirical studies and recognised as one of the world’s experts on prison suicides.
"I didn’t think his depression would be called severe depression with psychotic features at the time of my assessments in March and June", Professor Seena Fazel says.
** note the correct spelling of the name is Seena Fazel not Faisal as I mistyped earlier **
Mr Assange's condition " is not sufficiently severe for him to resist committing suicide" is Mr Fazal's assessment.
Important to state is that suicide risk is something that changes. It is “dynamic” and changes in relation to circumstances. "Very, very difficult to anticipate" with any certainty what one’s suicide risk would be within a month or two months, particularly if circumstances change
Suicide rates in prisons in England and Wales are substantially higher 4 -5 times higher than in the US

What I’ve read is that [the US] do offer standard assessment and treatment in US prisons and medications. Professor Fazal says at the end of his examination by James Lewis QC
[Not verbatim] Q. You’re not saying the others got it wrong in December when they diagnosed him severe depression "psychotic symptoms"

A. No, I am not.
Professor Fazal notes that Mr Assange's suicide risk was high in June at the time he assessed him. He also conceedes that as he said previously it was a fluctuating his assessments of Mr Assange don't contradict the other sentences.
There are many risk factors Professor Fazal says. "life in prison" or a "very long sentence" would be a risk factor he agrees.
Q. "Solitary confinement seems to exacerbate symptoms of mental illness and recommendations have been made to avoid its use in those with pre-existing psychiatric disorders", Ed Fitzgerald quotes from 2011 article written by Professor Fazal.
Q. Someone in their cell with 22 hours a day and is deprived with association with other prisoners [the Mandela Rules definition] would you accept that that condition would exacerbate the underlying disorder?
A. ProfFazal: One of the ways it is treated and managed is being active. That’s why people are encouraged to exercise and associate with other prisoners. There’s less opportunities to treat the depression. That’s how I would understand the exacerbation in that it removes the..
... opportunities to treat parts of the depressive illness.
Q. And increase a sense of hopelessness and sense of loneliness?
A. It might do, yes
Q. Someone with a pre-existing condition exposed to solitary confinement runs a serios risk that it leads to a deteriorate?
A. It does increase the risk. I don’t add serious because it depends on the individual person.
Q. Knowing what we know about Mr Assange.. for him to be in isolation would exacerbate the condition?
A. I would want to know what the conditions are...
... access to family other systems of support. So if all of that is removed, then I would accept that.
Discussing SAMs:
Mr Assange would not be able to associate with other prisoners. Wouldn’t be able to have contact with the outside world
Judge: To be fair that is one interpretation of SAMs..
Ed Fitzgerald: On the basis that is correct. Would you accept that under those...
... conditions … would exacerbate his condition?
A. Yes

Q. Might lead to him going back to the severe state of depression when seen in November 2019?
A. Probably going a little bit too far forward.

Q. Would you accept that there is that risk there?

A. There is but I can’t put a direct causal link. Because there are so many other factors that must be considered. For example, his understanding of the prospects of going forward is key....
... So, it is quite difficult to be certain about whether that regime would mean he would become severely depressed. I agree to general principle it would lead to worsening of symptoms… not how severe it would be.
I can say there is a risk to worsening symptoms.
Thank you. Now second point…

Solitary confinement seems to exacerbate symptoms of mental illness and recommendations have been made to avoid its use in those with pre-existing psychiatric disorders.
Approximately 50% of suicides are the 3 – 8% of prisoners of all the prison population who are in isolation.

A. These stats come from states with large prison populations but only two out for the whole country and needs to be seen in light of absolute numbers of suicides.
Prof Fazal continious to say "even if large portion of suicide deaths are based in segregation still need to be seen in the rate of suicide number of thousand prisoners".
“Hopelessness is an important risk factor", professor Fazal says. He says that a single risk factor isn't enough, even if it is "isolation". Different people will react differently to different risk factors.
Prof Fazal accepts he’s not an expert on SAMs and that other experts will “definitely” need to be asked. He has also never been to ADX in Colorado. He’s superficially familiar with the place. Not aware of it being described as a “clean version of hell” by the prison warden...
... who also called it who called it “unfit for human habitation”.
Q. Would you accept that your own literature and world literature is inappropriate to detain those with mental health conditions in isolation?

A. In some individual cases there may well be good reasons to use special measures. But it is “not recommended” generally.
Q. Mr Assange’s mental condition might well reduce his capacity to resist mental prompting from his mind?
A. If severely depressed & in isolation... yes, I think I would agree with that. I wouldn’t say substantially reduce I would say reduce because I think there are other factors that have to be considered. But they are 2 important factors. Also notes "capacity" isnt a medical term
Q. We can talk about a human society to reduce the pressures and reduce risks that lead to suicide?

A. Exactly, yes.
Professor Fazal is now going over some of the traits which are autistic like that he identified in Mr Assange and noted that he is not an expert though Dr Deeley (who testified this AM) is an expert in the field.
#JulianAssange is on the 'High Functioning' End of the Autism Spectrum, Expert Tells Old Bailey

My review of this morning's testimony

Professor Seena Fazel says he's not familiar with the ADX Colorado, or the Federal prison system so can't comment.

Re-examination by government. [not verbatim]

Q. Would your assessment of risk change if Mr Assange was sent to a lower sentence?

A. Yes. Studies have found that there is a lower risk for those who had shorter sentences compared to those with longer sentences.
Mr Lewis is now asking the witness whether max 22 hours a day with breaks for phone calls and excercise would change his position on isolation and risk factors. He is saying that he factors include ability to excercise, receive counseling and meet and speak to others.
Mr Lewis is now reading from a statement which describes what inmates can expect including rest, relaxation and access to fresh air for short periods.
On the face of it it looks like there is a range of activities and treatment that would reduce the risk but I would want to know more about whether they are implemented in practice and the quality of them, so its difficult for me to say a lot, says Prof Fazal
Suicidal ideation does correlate to suicide but it is not straightforward because it is estimated that many million people per year have suicidal ideation but a minority act on those and even less die from suicide, says Prof Fazal.
Q. Finally, you were asked about autism and taken to autistic traits. But in your opinion and your examination do you think the traits reach the autistic spectrum?
A. Well, I wasn’t, I didn’t, I didn’t come to that view but with the caveat that I would only have come to that view that it was clear cut… because it is not clear cut. And as clinicians we all have training in diagnosis including people with autism spectrum disorder…
...I think we would agree there are traits that are evident from the history and also from the interview and that is as far as I would go.

"on the basis of my assessment and with the caveats I said before it would be on the mild end", Prof Fazal says.

*re-examination is over*
Fidel Narvaez, ex-counsel for the Ecuadorian Embassy, says that at the end of today Judge Vanessa Baraitser denied a request by the defence for a one-month adjournment to prepare closing arguments, after all the witness evidence has finished next week.

via @SputnikInt

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