Psychological injury claims - including post-traumatic stress disorder (PTSD), depression, anxiety, adjustment disorder and other psychiatric conditions - are a distinct area of personal injury law. They are proved differently from physical injury: diagnosis by a consultant psychiatrist or clinical psychologist (using DSM-5 or ICD-11 criteria, validated scales, and the claimant's history) carries the valuation, not GP records or self-report alone. They are valued separately: the Judicial College Guidelines 17th edition (April 2024) runs two parallel brackets - 'psychiatric damage generally' and 'post-traumatic stress disorder' - each with severe, moderately severe, moderate and less severe tiers.
And they are subject to a distinctive legal framework - the 'recognisable psychiatric condition' requirement, and the primary / secondary victim distinction first laid out in Alcock v Chief Constable of South Yorkshire Police. Ordinary grief, upset or anxiety without a diagnosis does not found a claim; a diagnosed psychiatric condition does.
Casibus works with SRA-regulated personal injury specialists on a no win, no fee basis. Every case depends on its evidence.
JCG 17th edition psychiatric damage brackets
Psychiatric damage generally - severe
Marked problems with the injured person's ability to cope with life, education / work, relationships, the future, vulnerability and prognosis. Very poor prognosis. Treatment likely long-term. Top of the severe bracket sits in the upper-five to low-six figures.
Psychiatric damage generally - moderately severe
Significant problems but with a more optimistic prognosis than the severe bracket. Good response to treatment expected over time. Generally mid-five figures.
Psychiatric damage generally - moderate
Marked improvement by trial and a good prognosis, but with similar problems to the moderately severe bracket in the early stages. Typically low to mid five figures.
Psychiatric damage generally - less severe
Consideration given to duration and the extent to which daily activities and sleep were affected. The least severe bracket starts in the high hundreds and rises to the low five figures.
Post-traumatic stress disorder (PTSD) - parallel four-tier structure
JCG maintains a separate PTSD bracket because PTSD is a diagnostically-specific condition (re-experiencing, avoidance, hyperarousal, negative mood changes, for at least one month after a traumatic stressor). Severe PTSD involves permanent effects that prevent the claimant from working at all or functioning at pre-trauma level; moderately severe PTSD has substantial symptoms but with a better prognosis; moderate PTSD involves a largely recovered claimant; less severe PTSD involves largely complete recovery within 1-2 years with only minor symptoms persisting.
The 'recognisable psychiatric condition' threshold
English law does not compensate for ordinary distress, grief, upset or anxiety. The injury has to amount to a recognisable psychiatric condition - i.e. a condition capable of being diagnosed by a consultant psychiatrist using DSM-5 or ICD-11 criteria. That means: PTSD, major depressive disorder, generalised anxiety disorder, adjustment disorder, specific phobia, agoraphobia, dissociative disorders, acute stress disorder, and so on - yes. 'Feeling shaken', 'anxious about driving', 'sleeping poorly' - not without a diagnosis. Your solicitor will typically instruct a consultant psychiatrist to examine you early in the claim.
Primary vs secondary victim - the Alcock framework
The legal distinction between primary and secondary victims is central to psychiatric-injury claims arising from witnessing shock-inducing events.
Primary victim
Someone directly involved in the incident, in the 'zone of physical danger' - e.g. the driver in a car crash, a worker in a workplace accident, a patient in a negligent clinical event. Page v Smith [1996] AC 155 established that a primary victim can recover for psychiatric injury alone, provided physical injury to them was foreseeable. No need to foresee the specific psychiatric injury.
Secondary victim
Someone who witnesses or comes on the immediate aftermath of an accident involving a loved one. Alcock v Chief Constable of South Yorkshire Police [1992] 1 AC 310 (the Hillsborough case) imposes tight 'Alcock control mechanisms': close tie of love and affection with the primary victim; proximity to the accident or its immediate aftermath in time and space; perception by the claimant's own unaided senses (not via TV or report); and a sudden shocking event producing a recognisable psychiatric condition. Secondary-victim claims remain difficult, and the boundaries have been revisited repeatedly by the Court of Appeal and Supreme Court in recent years (Paul v Royal Wolverhampton NHS Trust [2024] UKSC 1 narrowed the scope of secondary-victim clinical negligence claims significantly).
Common routes to a psychological injury claim
- RTA - the crash itself, or the sequelae of physical injury, produces a PTSD / depression / anxiety pattern in a proportion of claimants. See road traffic accidents.
Evidence in psychological injury claims
You need: (i) a diagnosis from a consultant psychiatrist or clinical psychologist, using DSM-5 / ICD-11; (ii) a prognosis (whether the condition is likely to resolve, remit, or persist); (iii) a treatment plan (CBT, trauma-focused CBT, EMDR, medication); (iv) a statement from you about the functional impact on work, relationships, activities; (v) GP records, which should document symptoms and treatment; (vi) witness evidence from family members about observable changes. Validated assessment tools - the Impact of Event Scale-Revised (IES-R), CAPS-5, PCL-5 for PTSD; BDI-II for depression; GAD-7 for anxiety - routinely feature in expert reports.
Special damages in psychological injury claims
- Treatment costs - private CBT, trauma-focused CBT, EMDR, cognitive processing therapy.