Psychiatric injuries sustained as a result of an injury or medical negligence are often overlooked or downplayed when the claim is of a modest nature. It is very much accepted that life changing injuries such as amputations or brain damage go hand in hand with psychiatric conditions such as depression and anxiety. However, pain in its many forms and varying degrees of intensity and length can and often does lead to the development of psychiatric injury which should not be ignored or dismissed.
Take for example a person who goes into hospital for a knee replacement only for something to go wrong due to negligence. Further surgery is needed, the length of stay in hospital is increased, the outcome is not as good as hoped for and the person may be in either the same or worse position than before the operation. The usual first reaction is that of anger and this feeling sometimes never goes away. Even the most positive of people find being the victim of medical negligence difficult to deal with. Take for example the most inspiring and exceptional teenager, Stephen Sutton, who despite coming to terms with his terminal cancer at such a young age and coping with it in the most selfless of ways possible, admitted to ‘there always being anger’.
Then comes the pain. Pain affects people in different ways. Some people use it as a spur to recovery, others can’t see beyond the next couple of hours between medication. Dealing with pain on a day in day out basis is draining and puts a great strain on loved ones around the sufferer. Even if there is an anticipated end point to such pain either through natural recovery or planned further surgery, pain can change people’s lives. Some people go on to develop adverse behaviour in the form of chronic regional pain syndrome and even lose the use of an affected limb even though physically there should be no reason why recovery should not be made. Other people go through periods of depression of varying degrees of severity. The lucky ones respond well to treatment or make a natural recovery once their physical condition has improved. Others are not so lucky and continue to suffer with depression and clients of mine in this situation often admit to thoughts of suicide in their darkest moments.
Therefore the psychiatric injury, whatever its form, does not necessarily end when there has been a recovery from the physical injury. Going back to our example of a knee replacement, very often a person will need both knees replacing. However, that person may still be angry at the hospital for messing up their operation in the first place which prevents them even contemplating allowing that hospital to operate on them again. Even if they switch hospitals, they may have lost all faith in the medical profession and will choose to live in pain rather than take the risk of going through that experience again. They may require counselling to help them make that decision and therapy to help them overcome their anxiety with varying degrees of success. If relatively young, a person may need two or three replacements in the future and just that thought can cause great ongoing anxiety.
Of course, I only meet such people if their psychiatric condition is as a result of negligence and they wish to bring a claim. Bringing a claim can be stressful and it can be lengthy. If a client’s expectations are not carefully managed this can lead to an increase in psychiatric symptoms. It needs to be carefully explained to a client that bringing a claim should not be used as the focal point for their recovery. The most important thing is for a client to make as good a recovery as possible and a good solicitor will do everything they can to help them achieve this throughout the life of a claim.
However modest a client’s claim, their psychiatric injury should be fully explored and dealt with sympathetically. The right expert should be instructed who will identify the appropriate treatment. Where possible, such as when liability has been admitted, an interim payment should be requested to obtain treatment as soon as possible rather than waiting for the case to conclude. A non-life changing physical injury can lead to a life changing psychiatric condition and, as already said, this possibility should not be ignored or dismissed.