The great trauma gold rush: How 'post-traumatic stress disorder' has become the compensation culture's new money-spinner

The great trauma gold rush: How 'post-traumatic stress disorder' has
become the compensation culture's new money-spinner

By Kevin Toolis
Last updated at 2:06 AM on 27th July 2009

The trauma industry is rarely spoken about openly - but you hear about
it every day. The female prison worker, Sandra Hickinbotham, awarded
£100,000 after being 'traumatised' by watching a mock hostage training
exercise.

The police mechanic, Alexander Darg, awarded £400,000 for 'Complex
Regional Pain Syndrome' after cutting two fingers while working on a
police vehicle.

The train driver awarded £35,000 after hitting a goat that strayed
onto the line.
Money for nothing: Post-traumatic stress disorder is being exploited
by those looking to make quick money

Money for nothing: Post-traumatic stress disorder is being exploited
by those looking to make quick money

The ambulanceman who claimed £5,000 because the sight of injured or
dying people made him 'stressed'. The university administrator who
wanted £800,000 for what she claimed was fibromyalgia - searing pain
in the muscles - after a rear-end shunt that caused £250 of damage to
the car bumper.

The list goes on and on. Behind all these cases is a medical condition
called Post Traumatic Stress Disorder (PTSD) - and the bill for all
the compensation payments made to those suffering from it now runs
into hundreds of millions of pounds every year.

Incredibly, the National Health Service is now treating an estimated
220,000 people a year for PTSD - double the number of soldiers in the
British Army.

One London clinic, The Centre For Cognitive Behavioural Therapy, even
claims on its website that you can develop PTSD from the death of your
pet.

For the past six months, as part of a BBC Panorama programme, I, along
with veteran BBC war reporter Allan Little, have been investigating
the rise of the British Trauma Industry. And what we found was
extraordinary.

As a nation, we have never been safer, richer, and healthier - for one
thing, the Luftwaffe is no longer overhead - so where has all this
'trauma' come from? There's
doubt that some of it is genuine. Soldiers and civilians <cite>do </
cite>experience terrible events - and are left emotionally scarred by
them. These victims deserve proper, dignified care.

But many experts argue that a whole industry has grown up around PTSD
- and it is not just about making damaged people better.

'It's a money spinner. Let's be blunt about it. If you've got the
prospect of £100,000 by continuing to have headaches, flashbacks,
insomnia - you can see why people may not find it easy to relinquish
those symptoms.

'I hope that does not sound cynical but its part of clinical reality,'
says Prof David Alexander, a top PTSD expert at Aberdeen's Robert
Gordon University.

The condition - and the compensation industry that has grown up around
it - has its origins in war.

Soldiers from conflicts as far back as the siege of Troy have been
afflicted by terrifying and debilitating psychological symptoms long
after the battles ended.

While some doctors did treat 'battle fatigue' during World War I, it
wasn't formally recognised by offical psychiatric bodies until 1980,
when, lobbied by supporters of Vietnam War veterans, American
psychiatrists included a new formulation of this 'war syndrome' in
their medical Bible, the Diagnostic Statistical Manual III.

So what are the symptoms? In many cases - and this is part of the
problem - they are relatively vague. But there are some constant
features. 'I would expect the traumatised person to be showing three
core symptoms,' says Prof Alexander. 'First of all, recurrent,
repetitive and deeply disturbing recollections of the incident.

'And then flashbacks, as if the event is being constantly replayed. In
addition, the traumatised person will be for ever scanning their
environment for the next source of threat.'

These symptoms are not exclusive to PTSD, but the thing that did make
PTSD novel was that your trauma could be linked to a specific 'index
event' - an ambush in Vietnam, an explosion or a helicopter crash. And
because something or somebody caused your mental illness, you could
sue them for it.

PTSD soon became a recognised military disability, akin to losing half
your leg in a landmine explosion, and U.S. military lawyers were soon
arguing over how much compensation their soldier clients should
receive.

PTSD reached British shores in 1987, in the aftermath of the King's
Cross Tube fire.

Again, there is no doubt that many of the victims of that appalling
tragedy suffered genuine trauma. But even psychologists, such as Dr
James Thompson, who treated the King's Cross survivors wouldn't deny
that the industry surrounding the disorder has now become a
psychological monster.

'PTSD has become a fashionable diagnosis because it is about what the
world did to you. It's not about you having to put your hand up and
say I drank too much or I really am a nervous character,' says Dr
Thompson.

'It has aspects of an alibi because it can allow you to say it's not
my fault. It is the world's fault - and that's attractive to all of
us.'

A chain of national disasters - Clapham Junction in 1988; Piper Alpha
in 1988; Hillsborough in 1989; the Paddington train crash in 1999 -
swiftly followed and we soon became accustomed to the army of PTSD
trauma counsellors, and lawyers, who followed in their wake.

Many of the survivors of those disasters suffered genuinely disabling
traumatic reactions. But despite its textbook origins, an exact
clinical definition of PTSD remains elusive, allowing some 'victims'
and lawyers to argue for compensation when none is deserved.

More important, the British legal system, and the personal accident
injury business in particular, began to change in 2000 with the
widespread adoption of the No Win, No Fee method of funding claims.
This meant that potential 'victims' had nothing to lose from launching
a claim in the courts - as even if they failed, they wouldn't have to
pay the costs.

Now, the process of making a compensation claim often begins with a
'claim farmer'. It is their job to encourage people who have had an
accident - and may now be suffering from trauma - to come forward.
Indeed, if you see an advert urging you to make a claim, there is
probably a claim farmer behind it.

Dial their number and your call will more than likely be answered in a
drab call centre, where a host of workers sift through hundreds of
thousands of claims, trying to find those with the best chance of
success.

There is, after all, an awful lot of money to be made from claim
farming. Last year, there were more than 800,000 personal accident
claims in the UK alone, fuelling an industry worth £7billion a year.

If a case is deemed 'viable', the farmer will then sell it on to a
network of solicitors for around £500. Some trade unions even gain
referral fees from passing on the details of work accidents involving
their members.

But PTSD isn't as clear-cut as a broken leg after falling off a faulty
ladder. It's all in the mind. And almost impossible to disprove.

'You can teach yourself PTSD on the internet in five minutes,' says Dr
Thompson.

Conveniently, many of the claim management companies, such as Claims
Direct, will actually list the symptoms of PTSD on their websites and
allow you to launch your claim with a click of the mouse at the bottom
of the same web page.

Jo Pizzala - a leading defence solicitor whose firm, Cogent, acts on
behalf of many of the UK's top insurance firms - is all too familiar
with the kind of cases that can result.

'I had a gentleman who was a professional driver - his bus was hit in
a low-speed impact. He claimed he had PTSD from the car hitting him
and that he would never work as a driver again. Nor, he claimed, would
he be able to drive his own car.'

'But within four months of him issuing proceedings, we had video
surveillance footage of him driving a car with his own personal number
plate on it.'

The other pillar of the British Trauma Industry is the nationwide
network of therapists, psychologists and psychiatrists - some of whom
are all too willing to supply an official diagnosis of PTSD, usually
for a standard hourly consultation fee of between £400 and £500.

I spoke to one psychologist who said he had personally diagnosed more
than 40,000 cases of PTSD - and who flitted between lucrative one-hour
consultations at a network of clinics across South-East England.

PTSD might have its origins on the battlefields of the Vietnam War,
but it is now most commonly diagnosed in those who have suffered minor
road accidents and bullying in the workplace.

Indeed, over the years, the type of events allegedly behind cases of
PTSD have become less and less severe. Initially, when dealing with
Vietnam veterans, the patient would have had to have personally
suffered an event so terrifying that it would cause distress to anyone
who witnessed it. Now, it seems someone else's nasty experience on the
way to work could become my lifelong, disabling trauma.

Professor Simon Wessely is deeply critical of this ever-widening
definition of PTSD within his profession, and of his colleagues who
summarily hand out PTSD diagnoses for legal claims.

'Professionals are human like anyone else and where money is involved,
it alters behaviour. To say that my colleagues are completely immune
to this would be flying in the face of reason.

'I think we have moved away from the original concept of PTSD and I
believe the concept is now open to abuse.'

There's another problem, too. Is all this talk of trauma, PTSD and
psychological injury actually making us sicker as a society?

Professor Chris Brewin of University College London says not. 'I think
we are more aware now that there is a minority of people who don't
cope and that if you leave them on their own, their physical health
suffers and it ends up costing a great deal not only to them, but to
society, too.'

But other sociologists certainly believe that PTSD is what they call a
'negative cultural script'.

'You're an ambulance driver and your union sends you a leaflet saying
you're in great danger of suffering from PTSD. And then the next time
you encounter something horrific, you think: "Am I suffering from
PTSD?"' says Dr David Wainwright, a health sociologist at the
University of Bath, who studies the connections between illness and
society.

'You start to see the problems of everyday life as some sort form of
mental illness. And there's very little evidence to suggest that is a
helpful way of dealing with things.'

Bad things happen to human beings. And some people will be emotionally
scarred and traumatised by those events. As a civilised society, we
have to find a way to help them.

But the British Trauma Industry is not solely driven by what's in the
best medical interest of the patient. It is also driven by cash. Lots
of it. And it's high time we did something about it.

* Kevin Toolis is director of Panorama: The Trauma Industry, BBC
1, tonight at 8.30pm.

http://www.dailymail.co.uk/news/article-1202347/The-great-trauma-gold-rush-How-post-traumatic-stress-disorder-compensation-cultures-new-money-spinner.html;jsessionid=DBFE76507871C896360D339F82A07F23#ixzz0MSyoPpVd

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