Psychiatric Harm

Tort Law > Psychiatric Harm

You encounter a claimant who claims psychological injury after witnessing a traumatic event, and you must immediately classify them as either a primary or secondary victim - this distinction determines the entire test and whether the claim will succeed. Psychiatric harm questions are heavily examined on SQE1.

What Is Psychiatric Harm in SQE1?

Candidates often lose marks on SQE1 by failing to classify the claimant as a primary or secondary victim before applying the relevant test — the distinction determines which criteria apply, and examiners test it repeatedly. Psychiatric harm refers to a medically recognised psychiatric illness caused by the defendant's negligence. Mere grief, distress, or emotional upset - however severe - is not sufficient. The law restricts recovery for psychiatric harm more tightly than for physical injury, largely to prevent indeterminate liability.

The key distinction is between primary victims (those directly involved in the incident or in the zone of physical danger) and secondary victims (those who witness the incident or its immediate aftermath). This classification drives the analysis and determines which test applies. Understanding negligence duty breach causation and remoteness will help you see how psychiatric harm fits within the broader negligence framework, and examining occupiers' liability will show how these principles apply in specific premises contexts.

Key Principles for SQE1

Recognised psychiatric illness: The claimant must suffer a medically recognised condition - such as PTSD, clinical depression, or pathological grief. Ordinary grief, distress, or anxiety is not enough (Hinz v Berry [1970]).
Primary victims: Persons who were directly involved in the incident or reasonably believed they were in physical danger. A primary victim need only show that personal injury of some kind was foreseeable - they do not need to show that psychiatric harm specifically was foreseeable (Page v Smith [1996]).
Secondary victims - the Alcock control mechanisms: A secondary victim must satisfy all of the following (Alcock v Chief Constable of South Yorkshire [1992]): (1) a close tie of love and affection with the primary victim (presumed for spouses, parents, and children; must be proved for others); (2) proximity in time and space to the incident or its immediate aftermath; (3) perception through their own unaided senses (seeing or hearing the event, not being told about it later).
Immediate aftermath: The courts have extended proximity to cover the 'immediate aftermath' of the incident (McLoughlin v O'Brian [1983] - seeing injured family members in hospital shortly after the accident), but this is narrowly applied.
Rescuers: A professional rescuer may recover as a primary victim if they were in physical danger, but not simply because they witnessed horrific scenes (White v Chief Constable of South Yorkshire [1999]).
Bystanders: Ordinary bystanders cannot generally recover for psychiatric harm as secondary victims unless they meet the Alcock criteria.

Exam tip

Always identify whether the claimant is a primary or secondary victim—this determines everything. Primary victims only need to show personal injury was foreseeable; secondary victims must satisfy all three Alcock criteria without exception. Watch closely for the perception requirement: learning about the incident by telephone fails this test, even if the claimant later attends the hospital. The immediate aftermath doctrine is narrowly applied.

How This Appears in SQE1 Questions

SQE1 questions present a scenario and ask whether a particular individual can recover for psychiatric harm. The trap is applying primary victim rules to a secondary victim, or vice versa. For secondary victims, work through each Alcock criterion methodically - if any one is missing, the claim fails. Watch for scenarios where someone is told about the event by telephone (perception requirement fails) or where the relationship is not one of close love and affection. This is a classic SQE1 trap.

Quick Example Scenario: Maria's husband is seriously injured in a workplace explosion. Maria is at home when she receives a phone call telling her about the accident. She rushes to the hospital and sees her husband in intensive care three hours later. Maria develops PTSD.

Maria is a secondary victim. She has a close tie of love and affection (spouse - presumed). However, she learned about the incident by telephone (perception through own senses - not satisfied at the time of the event). Seeing her husband three hours later may or may not fall within the 'immediate aftermath' - courts apply this narrowly. Maria's claim is uncertain and may fail on the Alcock criteria.

Common Mistakes Students Make

Confusing primary and secondary victims - primary victims are in the zone of danger; secondary victims witness from outside it.
Forgetting that the claimant must have a medically recognised psychiatric illness - distress alone is not enough.
Failing to work through all three Alcock criteria for secondary victims - missing one is enough to defeat the claim.
Assuming rescuers automatically qualify - after White, professional rescuers are not treated as primary victims unless they were personally in physical danger.

Quick Summary

Psychiatric harm must be a recognised psychiatric illness, not mere grief or distress
Primary victims are in the zone of physical danger — no proximity requirements (Page v Smith)
Secondary victims must satisfy the Alcock criteria: close tie, proximity in time and space, direct perception
The Alcock criteria are strictly applied — TV broadcasts do not count
Rescuers may qualify as primary victims if in physical danger themselves

Want to test this now? Try a few SQE1-style questions below before moving on.

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Practise Psychiatric Harm Questions for SQE1

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Psychiatric Harm for SQE1