4
Psychiatric and
Psychological Damage
This chapter covers those cases where there is a recognisable psychiatric injury.
In part (A) of this chapter some of the brackets contain an element of compensation
for post-traumatic stress disorder. This is of course not a universal feature of cases
of psychiatric injury and hence a number of the awards upon which the brackets
are based did not reflect it. Where it does figure any award will tend towards the
upper end of the bracket. Cases where post-traumatic stress disorder is the sole
psychiatric condition are dealt with in part (B) of this chapter. Part (C) deals with
cases of sexual and/or physical abuse. In those cases, in addition to psychological
injury and the physical injuries inflicted, awards often include an element for injury
to feelings caused by the abuse itself and by any denial of the offences and the
need for the injured person to relive the abuse in court or other proceedings.
(A) Psychiatric Damage Generally
The factors to be taken into account in valuing claims of
this nature are as follows:
(i) the injured person’s ability to cope with life, education,
and work;
(ii) the effect on the injured person’s relationships with family,
friends, and those with whom he or she comes into contact;
(iii) the extent to which treatment would be successful;
(iv) future vulnerability;
(v) prognosis;
(vi) whether medical help has been sought.
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(a) Severe £66,920
to £141,240
In these cases the injured person will have marked
problems with respect to factors (i) to (iv) above and the
prognosis will be very poor.
(b) Moderately Severe £23,270
to £66,920
In these cases there will be significant problems associated
with factors (i) to (iv) above, but the prognosis will be
much more optimistic than in (a) above. While there are
awards which support both extremes of this bracket, the
majority are somewhere near the middle of the bracket.
Cases involving psychiatric injury following a negligent
stillbirth or the traumatic birth of a child will often fall
within this bracket. Cases of work-related stress resulting
in a permanent or long-standing disability preventing a
return to comparable employment would appear to come
within this category.
(c) Moderate £7,150
to £23,270
While there may have been the sort of problems associated
with factors (i) to (iv) above there will have been marked
improvement by trial and the prognosis will be good.
Cases of work-related stress may fall within this category if
symptoms are not prolonged.
(d) Less Severe £1,880
to £7,150
The level of the award will take into consideration the
length of the period of disability and the extent to which
daily activities and sleep were affected. Cases falling short
of a specific phobia or disorder such as travel anxiety when
associated with minor physical symptoms may be found in
Chapter 14: Minor Injuries.
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(B) Post-Traumatic Stress Disorder
Cases within this category are exclusively those where there is
a specific diagnosis of a reactive psychiatric disorder following
an event which creates psychological trauma in response to
actual or threatened death, serious injury, or sexual violation.
The guidelines below have been compiled by reference
to cases which variously reflect the criteria established in
the 4th and then 5th editions of ‘Diagnostic and Statistical
Manual of Mental Disorders’ (DSM-IV-TR and DSM-5).
The symptoms may include nightmares, flashbacks, sleep
disturbance, avoidance, mood disorders, suicidal ideation,
and hyper-arousal. Symptoms of hyper-arousal can affect
basic functions such as breathing, pulse rate, and bowel
and/or bladder control.
(a) Severe £73,050
to £122,850
Such cases will involve permanent effects which prevent
the injured person from working at all or at least from
functioning at anything approaching the pre-trauma level.
All aspects of the life of the injured person will be badly
affected.
(b) Moderately Severe £28,250
to £73,050
This category is distinct from (a) above because of the
better prognosis which will be for some recovery with
professional help. However, the effects are still likely to
cause significant disability for the foreseeable future. While
there are awards which support both extremes of this
bracket, the majority are between £35,100 and £45,300.
(c) Moderate £9,980
to £28,250
In these cases the injured person will have largely recovered,
and any continuing effects will not be grossly disabling.
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(d) Less Severe £4,820
to £9,980
In these cases a virtually full recovery will have been made
within one to two years and only minor symptoms will
persist over any longer period.
(C) Sexual and/or Physical Abuse
The cases in this section include damages for the sexual
and/or physical abuse itself as well as any psychiatric injury
caused to the injured person. This section will also be relevant
in injury following image-based abuse. In many cases there
is also an element in the award of general damages for the
indignity, mental suffering, humiliation, distress, or anger
caused by such an attack. This is sometimes characterised as
aggravated damages, but more properly is injury to feelings
and is included in the brackets below. Where the element for
injury to feelings has been broken down in reported cases,
which is usually where there is significant injury, the range is
usually in the region of £18,310 to £30,510.
The factors to be taken into account in valuing general
damages for the abuse and the psychiatric injury in claims
of this nature are as follows:
(i) the nature, severity, and duration of the abuse and
any physical injuries caused;
(ii) the nature and duration of the psychological injury
and its effect on the injured person’s ability to cope
with life, education, and work;
(iii) the effect on the injured person’s ability to sustain
personal and sexual relationships;
(iv) abuse of trust;
(v) the extent to which treatment would be successful;
(vi) future vulnerability;
(vii) prognosis for psychological injury.
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Aggravating features which would lead to an additional
sum for injury to feelings include:
(i) the nature of the abuse;
(ii) the level of abuse of trust;
(iii) any manipulation following the abuse to stop
reporting of the abuse, or to seek to put blame on the
injured party;
(iv) the need for the injured party to give accounts and
evidence of the abuse in criminal or civil proceedings,
or in any other relevant investigation.
(a) Severe £109,830
to £183,050
In these cases the injured person will have suffered both
serious abuse over a prolonged period and severe or
moderately severe and prolonged psychiatric injury. At
the upper end the abuse will have had serious effects on
their ability to cope with education, work, and to sustain
personal and sexual relations. There may be elements of
false imprisonment.
(b) Moderately Severe £54,920
to £109,830
In these cases the injured person will have suffered serious
abuse and/or severe or moderately severe and prolonged
psychiatric injury. Cases in this category will not have both
serious and prolonged abuse and severe or moderately
severe and prolonged psychiatric injury but may have one
of those features. At the upper end the abuse will have
had serious effects on their ability to cope with education,
work, and to sustain personal and sexual relations. There
may be elements of false imprisonment. Where, despite
the seriousness of the abuse and problems caused, the
prognosis is good, the lower end of the bracket is appropriate.
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(c) Moderate £25,100
to £54,920
Cases where the abuse is less serious and prolonged
and there is a less severe psychological reaction with
fewer effects on education, work, or relationships. This
bracket also includes cases where there has been a more
serious level of abuse, but the psychological reaction is
limited and is either resolved or the prognosis is good.
There may be some aggravating features.
(d) Less Severe £11,870
to £25,100
Where the abuse is a lower level of seriousness and short-lived
and the psychological effects are mild or resolved quickly, or
the prognosis for resolution with treatment is very good. There
will be few if any aggravating features.
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