The medical and legal trauma of disasters

Personal injury compensation: no claim without pain?

Aims and Method

To identify the experiences of patients pursuing a personal injury claim, we carried out a retrospective questionnaire survey.

Results

Sixty-one patients from a regional traumatic stress clinic took part. Most were satisfied with the conduct of legal, medical and psychiatric personnel. Thirty-two (53%) reported that the legal proceedings had had an adverse effect on their health/well-being, and about a third reported an adverse effect on domestic relationships. Twenty-four patients (40%) were dissatisfied with the provision of information. More information about the whole legal process would have been welcomed by means of an information leaflet (n=57, 93%), a helpline (n=48, 79%), or a videotape (n=42, 68%).

Clinical Implications

Although seeking redress may contribute to the patient's adjustment, this survey demonstrates that it is not a step to be taken without consideration. As part of their therapeutic management, mental health professionals should consider the implications of such a step with their patients.

[The influence of different accident types on the process of trauma adaption and psychosocial adjustment]

OBJECTIVES

Accidents often have a traumatic impact on the victims. The influence of individual trauma adjustment on psychosocial convalescence is examined according to the different types of accidental event.

METHODS

192 accident victims were consecutively examined over a period of 12 months. Subjective trauma evaluation and characteristics of trauma adjustment were assessed and differentiated according to the type of accidental event (motor-vehicle, work, and recreational activity accident).

RESULTS

The three groups varied in their demographics, in injury severity (ISS), in subjective evaluation, in symptoms of mental and posttraumatic stress, and in the predicting variables. The lowest level of stress after 12 months was found after accidents that had occurred during recreational activities. The prevalence of posttraumatic stress symptoms was similar among motor-vehicle and work-accident victims, whereas victims of recreational activity accidents primarily showed symptoms of other Axis I disorders.

CONCLUSIONS

Individual adjustment to trauma and the type of accident influence mental health. The role of other variables (work re-entry, claims, financial compensation) also has to be considered. We accentuate the need for immediate psychiatric evaluation and intervention when necessary.

Workplace trauma and the law

The law places increasing responsibilities on organizations to protect its workforce from psychological injury. This paper looks at the development of British law relating to traumatic stress and explores a growing concern of clinicians that the law and the legal processes themselves may increase the psychological injury of victims of traumatic stress. The statutory requirement for organizations to provide effective support for employees following a traumatic incident is enshrined in law. However organizations are confused by the conflicting statements on the effectiveness of debriefing and trauma counselling.

Effects of litigation settlements on posttraumatic stress symptoms in motor vehicle accident victims

In order to investigate the effects of the initiation of litigation and its settlement on victims of motor vehicle accidents (MVAs), we followed up 132 MVA victims from an initial assessment 1 to 4 months post-MVA for 1 year. Of the 67 who had initiated litigation, 18 (27%) settled within the 12 months, while 49 still had litigation pending; 65 never initiated litigation. Those who initiated litigation had more severe injuries and higher initial levels of posttraumatic stress (PTS) symptoms. All three groups improved in major role function and had reduced PTS symptoms over the 1 year follow-up. Those whose suits were still pending, as well as those whose suits had been settled, showed no reduction in measures of anxiety or depression, whereas the nonlitigants did show improvement on these measures.