Negligently inflicted psychiatric injury

The law adopts a restrictive approach in awarding damages for negligently inflicted psychiatric injury. In addition to the Caparo test for imposing a duty of care, the courts have laid down several obstacles which must be satisfied by claimants in order to establish liability for negligently inflicted psychiatric injury. Firstly there must be an actual psychiatric injury:

Behrens & ors v Bertram Mills Circus Ltd. [1957] 2 QB 1 Case summary

Emotions of grief or sorrow are not sufficient to amount to psychiatric injury:

Hinz v Berry [1970] 2 QB 40 Case summary

Nor are feelings of fear, panic or terror:

Hicks v Chief Constable of South Yorkshire [1992] All ER 65 Case summary

Reilly & Anor v Merseyside Regional Health Authority [1994] EWCA Civ 30 Case summary
Initially psychiatric injury claims were limited to those who feared for their own safety:
Dulieu v White [1901] 2 KB 669 Case summary

The law has since developed to allow more wide ranging circumstances but is still quite restricted. A distinction is drawn between primary and secondary victims see:

Alcock v Chief Constable of South Yorkshire [1992] 1 AC 310 Case summary

Primary victims

Primary victims are those who are involved 'mediately or immediately as a participant' Per Lord Oliver in Alcock v Chief Constable of South Yorkshire.

This was later restricted to those in the zone of physical danger. See:

Page v Smith [1996] 1 AC 155     Case summary

White & Ors v Chief Constable of South Yorkshire [1998] 3 WLR 1509    Case summary

An objective approach is taken as to whether the claimant is in the zone of physical danger:

McFarlane v E. E. Caledonia [1994] 1 Lloyd's Rep 16 Case summary

Primary victims only need to establish that physical harm was foreseeable. There is no requirement that psychiatric injury was foreseeable provided personal injury was foreseeable:

Page v Smith [1996] 1 AC 155 Case summary

A primary victim does not owe a duty of care to a secondary victim in relation to self-inflicted harm:

Greatorex v Greatorex [2001] 1 WLR 1970 Case summary

Secondary victims are those not within the physical zone of danger but witnesses of horrific events. Secondary victims must demonstrate the four Alcock criteria are present in order to establish liability:

1. A close tie of love and affection
2. Witness the event with their own unaided senses
3.Proximity to the event itself or its immediate aftermath
4. Psychiatric injury must be a result of a shocking event.

1. Close tie of love and affection

This will be presumed in parent and child and between spouses but must be proved in other relationships. In particular siblings are not normally considered to have a close tie of love and affection.

Alcock v Chief Constable of South Yorkshire [1992] 1 AC 310 Case summary

2. Witness the event with own unaided senses

Seeing the events on television is not sufficient.

3. Proximity to the event itself or its immediate aftermath

In Alcock, the relatives that had visited the make shift mortuary to identify loved ones, were held not to come within the immediate aftermath of the event. See also:

Taylorson & Anor v Shieldness Produce Ltd [1994] PIQR 329 Case summary

McLoughlin v O'Brian [1982] 2 WLR 982 Case summary

What constitutes immediate aftermath is decided on the particular facts of the case:

W v Essex County Council [2000] 2 WLR 601 Case summary

4. Psychiatric injury must be caused by a shocking event.

Lord Ackner in Alcock v Chief Constable of South Yorkshire stated:

"'Shock", in the context of this cause of action, involves the sudden appreciation by sight or sound of a horrifying event, which violently agitates the mind. It has yet to include psychiatric illness caused by the accumulation over a period of time of more gradual assaults on the nervous system."

This excludes those who suffer psychiatric injury as a result of the long term process of providing care for a loved one who has suffered severe injuries due to the defendant's negligence:

Sion v Hampstead Health Authority [1994] EWCA Civ 26 - Case summary