Pure Psychiatric Harm

Introduction

Following on from **pure economic loss**, this chapter examines the second major category of loss for which the tort of negligence imposes **restricted rules of recovery**: **pure psychiatric harm**. As a general rule a defendant owes no duty to a claimant not to inflict pure psychiatric harm, because such a claimant typically lacks a **sufficiently proximate link** with the defendant. Damages are recoverable only in a few defined circumstances. This chapter sets out the **limiting factors** for a duty of care, the critical distinction between **primary victims** (**Page v Smith [1995]**) and **secondary victims** (the **Alcock** control mechanisms), the treatment of **rescuers** (**White v Chief Constable of South Yorkshire Police [1999]**), and the operation of the **'egg-shell skull' rule** in relation to remoteness of damage.

Assessment focus

For the SQE1 FLK1 assessment you must be able to **apply** the rules on pure psychiatric harm to a realistic client scenario, not merely recall them. You should be able to **classify** a claimant as a **primary victim** or a **secondary victim**, apply the **Page v Smith** test to primary victims (foreseeability of **physical** injury), and apply each limb of the **Alcock control mechanisms** to secondary victims (**foreseeability of psychiatric harm**, **proximity of relationship**, **proximity in time and space**, **proximity of perception**, and a **medically recognised** illness). You should also be able to deal with **rescuers**, who are treated as primary victims only if exposed to a foreseeable risk of physical injury. Questions are single best answer questions (SBAQs) set in client-based scenarios; this is a **closed-book** assessment, so commit the tests and leading cases to memory.

Study tips

1) Memorise the **three threshold requirements** common to all claimants: pure psychiatric harm = harm with **no physical impact**, caused by a **sudden shock**, and amounting to a **medically recognised psychiatric illness** (or a shock-induced physical condition). 2) Master the **primary v secondary** divide: a primary victim was in (or reasonably believed himself to be in) the **actual area of danger**; for primary victims only the risk of **physical** injury need be foreseeable (**Page v Smith**). 3) Memorise the **five Alcock control mechanisms** for secondary victims and remember they are designed to **reduce** the number of claimants. 4) Treat **rescuers** like any other victim (**White**): primary only if in the area of danger; otherwise secondary, and the **close tie of love and affection** limb will usually defeat a professional rescuer. 5) Note that the **'egg-shell skull' rule** applies once a duty is established: the defendant must take his victim as he finds him and is liable for the **full extent** of the psychiatric harm, even if greater than foreseeable.