Why Courts Still Need the Anchor of 'Recognizable Psychiatric Injury'

When the Supreme Court of Canada decided Saadati v. Moorhead (2017), it loosened the threshold for proving psychological injury in negligence cases. The Court held that damages could be awarded even without a psychiatric diagnosis, based on lay testimony about changes in behavior and functioning.

From a mental health perspective, that decision is both understandable and risky. While it acknowledges that psychological harm is as real as physical harm, removing the anchor of recognizable psychiatric injury or illness introduces its own problems.

Diagnosis is a Safeguard

Psychiatric and psychological diagnoses are imperfect, but they are the best system we have for distinguishing ordinary human distress from clinical-level impairment. Tools like the DSM-5 and ICD are often criticized for shifting categories over time, but that evolution reflects advances in evidence and consensus– not arbitrariness.

For conditions like PTSD, structured interviews allow examiners to assess symptoms in a consistent, reproducible way. Validity tests like the MMPI-2-RF or SIRS-2 help detect exaggeration or feigning. These instruments are not about pathologizing normal upset, they are about ensuring that when we say “injury,” we mean something measurable and clinically significant.

Limits of Lay Testimony

Family and friends often notice changes first. Their testimony about personality shifts, mood changes, or cognitive decline can be compelling. But memory is selective, and interpretation is subjective. Loved ones may unintentionally overstate or misattribute changes, especially in the emotionally charged aftermath of an accident.

Without the structure of clinical evaluation, there is no reliable way to distinguish between temporary distress or grief, and a psychiatric injury that meets established medical criteria. That distinction matters, not because lived experience is invalid, but because compensation systems rely on verifiable and reproducible standards.

Protecting Credibility

The irony is that relaxing diagnostic thresholds may actually weaken the credibility of mental injury cases overall. If courts rely solely on lay accounts, psychological harm risks being dismissed as vague or exaggerated.

Recognizable psychiatric illness is not a barrier. It is a shield. This standard reassures courts, insurers, and opposing counsel that claims rest on more than perception. It protects plaintiffs by separating their injuries from ordinary upset and gives mental health professionals the opportunity to use validated methods to anchor testimony in data.

A Clinical Perspective for 'Recognizable Psychiatric Injury'

As clinicians, we know psychiatric diagnostics are imperfect, but the alternative (deciding legal liability entirely on lay testimony) creates even greater uncertainty. Diagnosis, supported by standardized tools and clinical practice guidelines, provides a principled middle ground. Mental injury deserves equal respect to physical injury. That respect is best preserved when courts continue to look for evidence that is recognizable, reliable, and rooted in clinical science.