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Post-Traumatic Stress Disorder and Ambulance Workers

In April 2003, findings published in the British Medical Journal showed that emergency service workers are at high risk of developing post-traumatic stress disorder (PTSD).  The study questioned 617 personnel who worked for ambulance service, and it found that 22% suffered from some form of PTSD.

This is a troubling figure.  Ambulance personnel are required to attend situations that most of us could not begin to comprehend such as suicides, sudden infant death, and events such as the 7th July 2005 London bombings, which resulted in gruesome and distressing scenes, too graphic to be shown in the media, but sights these brave individuals had to face head on.  It is vitally important that ambulance staff are supported fully in their workplace, to ensure they stay psychologically safe, not only for themselves, but for the wider community who rely on them in times of desperate need.

What is PTSD?

PTSD can be caused by a single one-off event or after being exposed to a series of traumatic circumstances.  In the First World War the condition was named Shell Shock. It was later to become known as PTSD in 1980s.  Its symptoms include:

  • Hyper-arousal (always feeling on edge)
  • Irritability
  • Sleep disturbances
  • Experiencing flashbacks
  • Anxiety and depression

When left untreated, and in extreme cases, PTSD has led to the suicide of first response workers. After a series of suicides, the governments of British Columbia and Alberta in Canada introduced legislation which applies a presumption that any emergency worker suffering from PTSD is presumed to have acquired the condition as a direct result of their work.  This has made claiming for compensation and support easier.

Compensation for Ambulance Staff Suffering from PTDS in Britain

Historically, the British courts have been reluctant to award compensation to emergency workers who have suffered from PTSD due to having to attend a horrific event caused by a third party’s negligence.  This, coupled with claimants no longer having access to legal aid to fund personal injury claims, has meant successful cases remained few and far between until recently.

However, with the growing acceptance that PTSD is a serious, life-affecting illness, and the advent of no win no fee arrangements to fund claims, things are starting to change and emergency workers are beginning to achieve the compensation they deserve.

A tragic incident that has led to many developments in this area of law was the Hillsborough Football Stadium disaster in 1989.  Although these particular claims involved police officers present at the scene, the principles of the cases could be applied equally to ambulance workers.

Traditionally, the courts have divided people who claim for psychiatric injury after a traumatic event into three categories:

  1. Those who are personally involved in the event who receive both physical and psychological injuries.  These victims are automatically entitled to claim for both mental and physical damage.
  2. People are put at risk of physical injury and escape it, however, go on to suffer from physiological damage.  They are known as primary victims.
  3. Individuals who are not in any physical danger, however, suffer from physiological injury, such as PTSD, because of the event they have directly witnessed.  These people are referred to as secondary victims.

One category of secondary victims is emergency service workers, who suffer from PTSD due to witnessing traumatic events whilst doing their job.  In the case of Alcock v Chief Constable of South Yorkshire which stemmed from the Hillsborough disaster, the House of Lords outlined ‘control mechanisms’ designed to limit the number of secondary claims which could be brought before the courts.  In order to qualify for compensation, it was held a secondary victim must prove the following:

“1. There must be a close tie of love and affection between the plaintiff and the victim.  2. The plaintiff must have been present at the accident or its immediate aftermath.  3. The psychiatric injury must have been caused by direct perception of the accident or its immediate aftermath and not by hearing about it from somebody else.”

The courts have not always been consistent when deciding on compensation claims for secondary victims.  For example, in the case of Chadwick v British Railways Board, decided prior to Alcock, the court did allow a secondary victim who assisted in rescuing people from a train crash to claim compensation.  In reaching his decision that the defendant did owe the claimant a duty of care, Waller J quoted Cardozo J in Wagner v  International  Railway Company 232 NY Rep 176, 180 (1921):

“Danger invites rescue. The cry of distress is the summons to relief. The law does not ignore these reactions of the mind in tracing conduct to its consequences. It recognises them as normal. It places their effect within the range of the natural and probable. The wrong that imperils life is a wrong to the imperilled victim; it is a wrong also to his rescuer.”

However, a majority of the House of Lords declined to follow Chadwick in the case of White v Chief Constable of South Yorkshire. The claimants were police officers involved in the rescue at Hillsborough.  The officers claimed that their employers, the South Yorkshire Police, where negligent, and as a consequence they had developed psychiatric injuries after participating in the rescue of the victims of that tragic event.  Their Lordships held that the claim could not succeed because they were not in any physical danger, therefore they could not be seen as primary victims, and they did not satisfy any of the criteria which would have put them in the category of secondary victims. The Law Lords felt it was unfair to award compensation to rescue personnel, when many of the victim’s families were denied any form of compensation.

The tables were turned again in 2001 when a court awarded a police officer suffering from PTSD after Hillsborough £330,000 in compensation.

Unclear Precedents

In recent years, there have been a few successful claims by ambulance officers against their employers for not providing appropriate support for PTSD.  Although the law remains a little unclear, the respect and recognition that PTSD now receives will undoubtedly increase the likelihood of claimants being successful in gaining compensation to allow them to move on with their lives.

If you are an emergency worker and suffer from PTSD, which you believe was caused as a direct result of the trauma you experienced through your employment, then please contact us today.  We offer a no win no fee arrangement and have the necessary experience and expertise to bring forward your case and fight for your compensation.