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One of the most frequent reasons we have to get back to solicitors is because we are uncertain if they truly understand the difference between psychiatric and psychological – psychiatrist and psychologist. We know there is uncertainty because we often see the words used interchangeably within a single letter of instruction.

This makes us nervous! And here is why. The term psychological covers both normal and abnormal reactions and, if you are looking for a report you can, realistically only be interested in the abnormal (or, at the very least, some delineation of where such a boundary lies in your client’s case). And the reason we get nervous is best illustrated by clinical negligence cases where it is the norm for a client to be very distressed by whatever has befallen them. Very often this is accompanied by righteous indignation and, not infrequently, this transmits itself to the client’s representative.

So here, in a nutshell, is the problem. If the client’s situation is such that it is all too easy to understand why they might be distressed, it is inherently likely that the distress they feel is a normal human reaction. It is a psychological reaction but is quite likely not to be, in any shape or form, a recognised psychiatric condition.

Taking this a stage further, feeling depressed or low in mood is almost always insufficient, of itself, to make a diagnosis of any sort of depressive disorder. Yet this can be quite counter-intuitive to a solicitor faced with a clearly upset and distressed client who tells them they are depressed. Unfortunately this can be further complicated because it is not uncommon for GPs to react in much the same way and prescribe antidepressants.

We understand that solicitors far prefer psychiatric reports in these cases because they know that courts take these more seriously than psychological reports. As we in Allen Associates produce both types we are sad that this is the reason but, as can be seen from my comments above, we would see the logic a little differently. We would say that the only purpose of a psych… report is to make a stand alone psychiatric diagnosis over and above any physical one caused by the alleged negligent act. From our point of view, it follows that we would recommend a psychiatrist to do this report, albeit for very different reasons.

So please consider language in your letter of instruction and generally try and substitute the word psychiatric for psychological and be understanding when sometimes we tell you there is no psychiatric disorder.

Danny Allen

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