Psychiatric Injury CASES

In English law, psychiatric injury (nervous shock) refers to a medically recognised psychiatric condition caused by a defendant’s tort. Mere grief, distress, or anxiety is not enough without a recognised disorder (for example, PTSD, major depressive disorder, or an adjustment disorder).

Definition and principles

Claims divide into primary victims and secondary victims. Primary victims are directly involved in the incident or within the range of foreseeable physical injury; ordinary negligence principles apply. Secondary victims are witnesses to injury to others and must satisfy control mechanisms: (i) a close tie of love and affection; (ii) proximity in time and space to the accident or its immediate aftermath; (iii) direct perception by sight or hearing (not via third-hand reports). Modern authority also emphasises the need for an identifiable accident or external event rather than a gradual realisation.

Common examples

• Employee suffers PTSD after being involved in an explosion at work (primary victim).
• Parent witnesses a child’s serious injury in a road traffic accident and develops a recognised disorder (secondary victim).
• Rescuer directly exposed to danger at a disaster scene (often treated as primary depending on facts).
• Claims failing where distress stems from news of injury, negligent information, or a prolonged deterioration without a single event.

Legal implications

• Diagnosis must be a recognised psychiatric condition; expert medical evidence is standard.
• For secondary victims, all control mechanisms must be met; bystanders with no close tie usually fail.
• Causation and remoteness apply; the “egg-shell skull” rule means vulnerability does not defeat liability once duty and breach are established.
• Limitation is generally three years from injury or date of knowledge (with court discretion to extend).

Practical importance

Plead whether the claimant is primary or secondary, set out the accident/event, the control mechanisms (if secondary), and provide early psychiatric evidence to confirm diagnosis and causation.

See also: Negligence; Duty of care; Secondary victims; Proximity; Rescuers; Pure psychiatric harm; Personal injury; Limitation.