Psychiatric evidence in suicide and self-harm claims
Independent psychiatric review of the care given before a death by suicide or an act of serious self-harm, in claims by estates, families and people who survived, for claimant, defendant and single joint expert instructions. Free initial screening call and fixed fees with no hidden charges.
- Section 12(2) approved
- Claimant, defendant and SJE
- Judged without hindsight
Claims that follow a death or serious self-harm
In these claims a patient known to mental health services has died by suicide or seriously harmed themselves, and the question is whether the care before it fell below a reasonable standard and, if so, whether reasonable care would probably have prevented it. Dr Pradhan reviews the risk assessment, observation, leave, discharge and follow-up decisions against the information available at the time.
The claim may be brought by the estate and the dependants after a death, by a patient who survived, or under the Human Rights Act alongside negligence. Where the patient survived, the report can also address the psychiatric injury, treatment needs and prognosis.
Dr Pradhan is section 12(2) approved and is regularly appointed as a single joint expert.
The decisions a claim examines
The review identifies the points at which the care could have changed course, and asks three questions of each:
- What did the clinicians know, or ought they to have known, about the risk at that point?
- Was their response within the range of reasonable psychiatric practice at the time?
- Would a reasonable response probably have prevented the death or the self-harm?
A death by suicide does not of itself mean that the care was negligent. The report assesses the care without hindsight and says where reasonable psychiatrists could differ.
Submit an enquiryCare commonly reviewed
Claims after suicide or self-harm commonly involve:
- Assessment after self-harm in an emergency department
- The risk formulation, and the response to it
- Observation levels on a ward
- Leave from a ward, and absconding
- Discharge planning and follow-up
- Crisis team and home treatment decisions
- Decisions not to admit, or not to assess under mental health legislation
- Large supplies of medicines prescribed to a patient at risk
- Communication with the family and between services
- Mental health care in prison
- The psychiatric injury of a patient who survived
- Joint statements, supplementary questions and second opinions
Send a short chronology of the care, the allegations and any limitation date, and Dr Pradhan will say whether the issues fall within her expertise and, if they do, confirm a fixed fee.
Submit an enquiryWho brings the claim
The route affects what the psychiatric evidence has to show.
The estate
A claim on behalf of the person who died depends on breach of duty and causation, as in any negligence claim.
Dependants and family
Dependants can claim for their financial loss and, in some cases, an award for bereavement. The review addresses whether the death would probably have been avoided.
Human rights
Where a trust knew or ought to have known of a real and immediate risk of suicide, Article 2 can require it to take reasonable steps to prevent it. Claims have a one-year time limit, which the court can extend.
Survivors of self-harm
Where the patient survived, the claim also needs evidence of the injury: the diagnosis, how much of it the negligence caused, treatment and prognosis.
Negligence, Article 2 and the inquest
In negligence, the care is judged by the standard accepted as proper by a responsible body of psychiatrists at the time, and causation on the balance of probabilities. Under the Human Rights Act, the question is whether the authorities knew or ought to have known of a real and immediate risk of suicide and failed to take reasonable steps to avoid it. The operational duty applies to detained patients and, as Rabone showed, can apply to voluntary patients.
Where there has been an inquest (in Scotland, a fatal accident inquiry), the report takes account of the evidence given and the findings, alongside the records. For claims in England and Wales it is structured for CPR Part 35; reports for Scotland and Northern Ireland are prepared to the requirements of those courts.
The Supreme Court held that a trust owed an operational duty under Article 2 to a voluntary psychiatric patient at real and immediate risk of suicide, and that her parents were victims who could bring a claim.
Related pages
Suicide and self-harm claim questions
If your question is not answered here, call and Dr Pradhan will advise on scope and timescale.
Call 0121 752 6065Who can bring a claim after a death by suicide?
The estate and the dependants can bring a claim in negligence, and close family members may have a claim under the Human Rights Act. Which routes are open is a legal question; the psychiatric review addresses the questions each route raises.
The patient was not detained. Can Article 2 still apply?
It can. In Rabone the Supreme Court held that the operational duty was owed to a voluntary patient at real and immediate risk of suicide. Whether it applies is a legal question; the report addresses the risk known at the time.
The patient survived. Does Dr Pradhan assess them?
Yes. She can review the care and assess the claimant’s present condition, including the psychiatric injury, treatment needs and prognosis.
Does the report take account of the inquest?
Yes, alongside the records. If an inquest is still to come, mention it in the enquiry and Dr Pradhan will advise on the psychiatric questions it may raise.
How quickly can a review be delivered?
It depends on the volume of records. The timescale is confirmed at the outset, once the records and the allegations have been seen; mention any limitation date in the enquiry.
Instruct Dr Pradhan on a suicide or self-harm claim
Send a short chronology of the care, the allegations, the funding route and any limitation or hearing dates.
- Phone0121 752 6065
- Emailinfo@
doctorpradhan.co.uk - Consulting Rooms NationwideAbacus Court, Harborne, Birmingham B17 0HH
Please do not include medical records or a detailed personal history in this form. Dr Pradhan will confirm how to send the papers once the instruction is agreed.
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If the matter is urgent, call 0121 752 6065.