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Psychiatric injury, supporting claimants and vicarious trauma

As a serious injury lawyer, I act on behalf of claimants who have, almost always, been through some sort of traumatic life event, resulting in a personal injury claim.

What is trauma?

Trauma is a word that we're probably all very familiar with.  It's used frequently in everyday conversation and language, but what do we actually mean by trauma? Clinically, trauma is often described as an emotional response to a terrible or jarring event, like an accident, whether it is life threatening or harmful physically or emotionally, and that has a lasting effect and impact on wellbeing. One key element of the definition is often noted to be the lasting and / or enduring nature of the emotional response. 

Although the figures vary, one estimate suggests that 50 to 70% of people will experience a trauma at some point in their lives, and around 20% of people who experience a trauma may go on to develop Post Traumatic Stress Disorder (PTSD) in response, equating to around 10% of the population, which is arguably quite a shocking statistic. 

The sources of trauma themselves can be wide ranging. The estimated risk for developing PTSD in those that have experienced a 'serious accident'' is around 17% and 'witness to death or serious injury' is around 7%. 

More optimistically, evidence suggests that trauma is, mostly, treatable, nevertheless to be differentiated from curable. This brings into stark focus the importance of ensuring that claimants are supported with specialist, bespoke care and treatment which may include talking therapies, eye movement desensitisation and reprocessing (EMDR), cognitive behavioural therapy (CBT), arts and creative therapies, medication, or a combination of several, in order to ensure that they achieve the best outcome possible.

It's to be noted that not everyone who is traumatised or who experiences a trauma suffers with PTSD, although they may experience some of the symptoms and some will be diagnosed with the disorder and/or additional conditions such as anxiety or depression. For example, a trauma response may include anxiety, difficulties regulating mood, feeling withdrawn, sleep issues and shock. PTSD has a very specific diagnostic criteria and includes flashbacks, nightmares, avoidance behaviours and hypervigilance. It's obviously essential that all diagnoses are explored by the appropriate experts.

Supporting claimants

The starting point in terms of supporting claimants who have suffered trauma must first be to ensure that, as a serious injury specialist, I understand what trauma is, what it looks like and what the signs of trauma are.

Next, I must understand how trauma impacts my client individually, including how it effects their engaging with me as their legal advisor and the litigation process as a whole. They may find talking about particular parts of the circumstances of their claim particularly re-traumatising. Equally they may wish to avoid having to look at or view particular pieces of evidence. It's important to be flexible and responsive to how they need the process to feel to them, whilst also being patient and compassionate.

Importantly, it also must be appreciated that no claimant’s experience of trauma is the same. To do this, I adapt my style to individual clients and understand that their needs will differ depending on their own circumstances and a web of complex and overlapping bio-psychosocial factors such as their physical health, lifestyle, peer group, professional background, socio-economic status, culture and family circumstances.

Equally as important in supporting claimants who have or are experiencing trauma is managing their expectations of the litigation process, both in terms of what the process involves and requires from them, and also what its ultimate outcome will be. Financial compensation can often feel anticlimactic to those claimants who might feel that the ending of the litigation will bring them a sense of 'justice' or 'closure' which, in reality, may not come, or at least not in the way they had anticipated or hoped for.

Linked to that is the importance of claimants being properly supported to understand the ultimate purpose of litigation, to put them back in the position, or as close to as possible, that they would have been absent the accident. 

Hopefully, clients will reach the end of their claim and feel confident that they have been provided with the means and tools to ensure that they are supported to achieve their best possible long-term outcome. 

At the same time, claimants must be supported to come to terms with the fact that their best possible outcome now is probably a very different 'new normal.'

Vicarious trauma and making sure you look after yourself

With these issues in mind, it's important to reflect on the importance of looking after myself as a serious injury professional. 

By the very nature of the job, I deal with inherently traumatising material, whether that be in terms of expert reports, witness statements, CCTV or dashcam footage, reviewing police disclosure, photographs, medical records or case management reports. I do this job because I genuinely care about my clients and want to ensure that they receive a fair and just outcome that protects their future, but that can come with its own challenges.

As such, legal professionals can be at risk of 'vicarious trauma' and must be mindful of that. A key to this is having access to good supervision and support and a working environment that permits and empowers professionals to have open and honest conversations. Good quality training on the issue is, of course, essential too; we must know how to spot the signs in ourselves and know where and how to seek support.

Find out more about Irwin Mitchell's expertise in supporting people and families affected by serious injuries at our dedicated section on our website.