High Court dismisses SCCRC appeal reference, rejecting claims of psychiatric misdiagnosis

About this case:

• Citation:
  [2026] HCJAC 34
• Judgment:
  External link
• Court:
  Appeal Court of the High Court of Justiciary
• Judge:
  Lady Carmichael

The appellant was sentenced to a hospital order with a restriction on discharge after pleading guilty to assaulting his former solicitor. Following a reference by the Scottish Criminal Cases Review Commission, an appeal against sentence came before the Appeal Court of the High Court of Justiciary.

The appeal was heard by Lord Matthews, Lady Carmichael and the Lord Justice Clerk, Lord Beckett, with Wendy Culross and Gareth Reid appearing for the appellant and Alex Prentice KC, advocate depute, for the Crown.

Possible miscarriage of justice

Between 1994 and 1998, the appellant was convicted of various offences committed against his former solicitors. Aggrieved at the decision of one solicitor, Ms Elspeth Black, to withdraw from acting for him, the appellant made frequent visits to her office and, on one occasion, her home. In September 1997, he approached Ms Black’s car and caused her and her child alarm by consequence of his aggressive behaviour.

Immediately after pleading not guilty to the resulting charge of breach of the peace, he found Ms Black in the court’s car park and proceeded to assault her to her severe injury. After subsequently pleading guilty to the earlier charge alongside a new assault charge, the appellant was sentenced to a hospital order with a restriction on discharge.

At sentencing, the judge had various pieces of psychiatric evidence before him. While Drs Lindsay Thomson and Colin Gray both diagnosed the appellant with a paranoid delusional disorder, other psychiatrists acting for the defence regarded the appellant as having paranoid schizophrenia or borderline personality disorder.

The appellant has thereafter remained detained in a medical unit. In 2025, however, the Scottish Criminal Cases Review Commission referred the appellant’s case to the Appeal Court of the High Court Justiciary, considering it in the interests of justice to do so, in light of the possibility of a miscarriage of justice.

The appellant argued that evidence regarding his psychiatric presentation since his conviction demonstrated that, although he suffered from a personality disorder, he did not display the unwavering belief in falsehoods characteristic of a delusional disorder. Had his condition been monitored over a longer period, he submitted, the court would have come to a “more in-depth consideration” of his personality disorder when imposing a sentence.

Appellant pursued false beliefs to extremes

Lady Carmichael began her decision by framing the issue at hand: “There is no suggestion in this case that the diagnosis made by Professor Thomson and Dr Gray in 1998 was one that was not reasonable for them to make on the information available at the time. The appellant contends that this case is one … in which fresh evidence is available which supports the argument that a miscarriage of justice occurred by virtue of the disposal in 1998. Developments after conviction can be important in allowing psychiatrists and the court to reach a sound conclusion on a person’s earlier mental state; Mackison v Bernard (2025) … We are satisfied that we need to evaluate that new evidence, along with that of Professor Thomson, with a view to determining whether a miscarriage of justice has occurred.”

She continued: “Dr Walsh disputed to some extent that delusions might have an understandable foothold in reality. He suggested that it was wrong to characterise as delusional the appellant’s (false) beliefs that various persons in responsible positions or positions of authority had acted maliciously towards him. That was because it was understandable, in the context of his life history, that he might have formed such a view … We do not accept Dr Walsh’s evidence that the appellant’s beliefs were or are rational simply because they may seem subjectively rational to the appellant in the light of (genuine) adverse life experiences.”

Lady Carmichael added: “The appellant at the time held, with fixity and conviction, false beliefs about a complex conspiracy involving more than one solicitor and other people associated with them. He pursued those beliefs to extremes in 1997 by assaulting Ms Black. Professor Thomson noted that the appellant had not, since 1998, used violence towards persons or property. We accept that more extreme behaviour of itself does not necessarily indicate that an individual has a delusional disorder rather than a personality disorder. It may, however, be legitimate to infer that behaviour of that more extreme nature at or close to the time of diagnosis, against a background of still troubling, but less extreme behaviour over a longer period, is consistent with the presence of a delusional disorder in an individual who also has a personality disorder.”

Rejecting the appellant’s arguments regarding the possibility of a longer assessment period, she reasoned: “The fact that a longer period of interim detention would be available now than in 1998 is irrelevant. It would have made no difference to the sentencing of the appellant. It was only in 2005 that his primary diagnosis became one of personality disorder. There is no real prospect that, had interim detention lasted a year rather than 6 months, the appellant would have been diagnosed as having a personality disorder.”

She concluded: “The appellant has not demonstrated, on the evidence, that the diagnosis of a mental illness, namely paranoid personality disorder, on the basis of which the sentencing judge imposed a hospital order with a restriction on discharge, was incorrect. On the contrary, we accept Professor Thomson’s evidence that the diagnosis she made in 1998 was correct, and the appellant’s delusional personality disorder remitted so that the disorder which has remained is a personality disorder.”

The appeal was accordingly refused.