Overview
Psychiatric injury (historically called "nervous shock") refers to a recognised psychiatric illness caused by the defendant's negligence. Mere grief, distress, or emotional upset is not sufficient — the claimant must establish a medically recognised psychiatric condition such as post-traumatic stress disorder, clinical depression, or pathological grief.
The law distinguishes between primary victims (those directly involved in the incident) and secondary victims (those who witness the incident or its aftermath). Different rules apply to each category.
Primary Victims
A primary victim is someone who was directly involved in the incident as a participant and was within the range of foreseeable physical injury. The leading case is Page v Smith [1996] AC 155, where the House of Lords held that if physical injury to the claimant was foreseeable, the defendant is liable for psychiatric injury even if psychiatric injury itself was not foreseeable.
Primary victims include those who were physically endangered by the defendant's negligence, even if they escaped physical harm. In Dulieu v White [1901] 2 KB 669, a pregnant woman behind a bar was a primary victim when a horse-drawn van crashed into the pub.
Rescuers may qualify as primary victims if they were exposed to physical danger during the rescue (Chadwick v British Railways Board [1967] 1 WLR 912). However, professional rescuers (e.g., police officers) who are not in physical danger are not primary victims (White v Chief Constable of South Yorkshire [1999] 2 AC 455).
Secondary Victims: The Alcock Criteria
A secondary victim must satisfy the control mechanisms established in Alcock v Chief Constable of South Yorkshire [1992] 1 AC 310 (arising from the Hillsborough disaster):
(1) Close tie of love and affection with the primary victim. This is presumed for spouses, parents, and children. For other relationships, it must be proved on the evidence.
(2) Proximity in time and space to the accident or its immediate aftermath. The claimant must have been present at the scene or its immediate aftermath (McLoughlin v O'Brian [1983] 1 AC 410 — a mother arriving at the hospital within two hours was sufficiently proximate).
(3) Perception through own unaided senses. Watching events on live television was held insufficient in Alcock because the broadcasting guidelines prevented the showing of identifiable individuals. However, hearing distressing events by telephone may suffice in some circumstances.
The "immediate aftermath" doctrine was narrowly applied in Taylor v A Novo [2013] EWCA Civ 194, where the Court of Appeal held that witnessing a death three weeks after the initial negligent act was too remote to qualify as immediate aftermath.
Key Cases
| Case | Key Principle |
|---|---|
| Page v Smith(1996) | Primary victims: if physical injury foreseeable, psychiatric injury recoverable |
| Alcock v Chief Constable(1992) | Established the three control mechanisms for secondary victims |
| White v Chief Constable(1999) | Professional rescuers not in physical danger are not primary victims |
| McLoughlin v O'Brian(1983) | Immediate aftermath includes arriving at hospital shortly after accident |
Exam Tips
Exam Tip
Always classify the claimant as primary or secondary victim first. For primary victims, you only need to show foreseeability of physical injury. For secondary victims, methodically work through all three Alcock criteria — miss one and the claim fails.
Common Mistake
Students often assume that all rescuers are automatically primary victims. After White v Chief Constable (1999), only rescuers who are themselves in physical danger qualify as primary victims. Professional rescuers who are not in danger must satisfy the Alcock criteria as secondary victims.