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1. The plaintiff is 34 years of age. She comes from Bangor Erris, but she has been living with her partner in Castlebar for the past several years. On 27th June, 1997 she was a back-seat passenger in her sister’s car which was involved in a head-on collision with the defendant’s vehicle. Liability is not in issue.

2. In consequence of a head injury the plaintiff was rendered unconscious for a minute or two. Her only memory of the accident is of a loud bang when the vehicles collided. She was detained in hospital for seven days suffering from shock; facial cuts in which glass was embedded; a laceration of the left leg which required sutures; severe pain running down from the top of the head to the side of her nose; pain in the right shoulder, right ear and left leg. After some time she developed pain in the neck. She was sent to Dublin for a brain scan but nothing was found. Though there are some minor sequelae, the plaintiff has made a good recovery from her physical injuries. The headaches cleared up eventually and she no longer requires medication in that regard, thought she stated that she still gets the odd headache now and then. The neck injury has cleared up and the shoulder injury is much improved - the only residue being some difficulty with heavy lifting and certain housework such as bed making. There are scars in the region of the forehead. Those within the hairline are not visible, but two others, though faded, are apparent at close range.

3. The plaintiffs’ main problem is substantial post traumatic stress disorder relating to the gravity of the accident. While in hospital she suffered shock and nightmares with flash-backs to the accident. These symptoms became more acute when she returned home. She consulted her GP, Dr. Anne Long, in that regard. In July, 1997 her orthopaedic surgeon referred her to Dr. John Connolly, Chief Psychiatrist at St. Mary’s Hospital, Castlebar. She has remained under his care ever since. From mid 1997 until October, 2000 the plaintiff has had numerous admissions to Dr. Connolly’s hospital as an in-patient amounting in all to 137 days which included a period of about 2 months in the late Summer and early Autumn of 2000.

4. The plaintiff has always suffered from mild mental disorder in consequence of which she has never had gainful employment. However, it appears that prior to the accident she did not seek or receive any psychiatric treatment or medication.

5. Dr. Connolly diagnosed the plaintiff as suffering from severe post traumatic stress disorder. She had bouts of depression which included suicidal tendencies. On one occasion she attempted to kill herself by slitting her wrists. She is susceptible to mood swings ranging from euphoria to suicidal depression. Another consequence of the plaintiff’s psychiatric disorder is substantial weight gain. She was a large young woman at the time of the accident whose weight was 14 stone. Her weight is now 20 stone. This is the product of “comfort eating” arising out of her depression. A further contributory factor is that her psychotropic medication which she will require permenantly is by nature appetite promoting.

6. Since coming under the care of Dr. Connolly the plaintiff, when not an in-patient, attends a rehabilitation centre daily which is associated with the hospital. She receives her medication there and also has the benefit of a sheltered workshop where she is engaged in horticultural activities potting plants and the like. She enjoys the work and

7. October, 2000. The plaintiff’s medication had been changed some weeks before then and that had brought about a significant improvement in her situation. Surprisingly she was not distressed by her court appearance and in evidence she expressed enthusiasm about her future prospects in life, including her intention to marry her boyfriend and to rear a family. Dr. Connolly’s evidence, however, was much less sanguine. He expressed the opinion that the plaintiff would require on-going daily medication for the rest of her life; that she would never be fit for ordinary gainful employment and it would be necessary for her to continue attending the rehabilitation centre permanently (a factor which, he said, probably would have been advantageous in any event bearing in mind her mild mental disablement). In his opinion it was also probable that she would require in-patient treatment for an average period of 6 weeks per annum which would continue indefinitely and he recommended that her condition should be monitored on a monthly basis.

8. Dr. Raymond O’Toole, a consultant psychiatrist gave evidence at the October hearing on behalf of the defendant. He had interviewed the plaintiff twice i.e., in January and September, 2000. He stated that originally his prognosis was guarded and he did not consider that the plaintiff was likely to reach her pre-morbid state. He found that when he saw her in September, 2000 she was much improved. She was not depressed and her energy appeared to be good. In consequence of this he was a lot more optimistic about her future than he had been at the earlier interview. In his opinion the long term prognosis is much improved and at that time he was more hopeful that she might return to her pre-morbid level. He stated that he could not predict the extent of future hospitalisation which the plaintiff might require. He conceded that she might need such treatment but not for as long as six weeks a year on average into the future.

9. In the light of the substantial conflict between the prognosis of Dr. Connolly and Dr. O’Toole and also bearing in mind that the plaintiff had required prolonged hospitalisation up to a time shortly before the trial, it seemed to me that in the interest of justice to both parties it was premature to arrive at any firm conclusion as to her probable future and that some further time should be allowed to elapse before final assessment of damages. For that reason I took the unusual step of adjourning the trial for three months with a view to hearing further medical evidence at that time on the plaintiff’s continuing progress. The trial was resumed on 15th January, 2001 and I had the benefit of hearing further evidence from Dr. Connolly and Dr. O’Toole. In the intervening period the plaintiff has had three short periods in hospital of a few days on each occasion - two before Christmas and one afterwards. Otherwise she has continued to attend the rehabilitation centre on a daily basis. It is now not in dispute that the plaintiff continues to suffer periodic severe mood swings which have necessitated three short periods of in-patient treatment in hospital. Insofar as experience over the last three months can be relied upon as the basis for a positive prognosis, it seems that there had been some modest improvement in the plaintiff’s situation but the overall picture is not greatly different from what it was at the earlier hearing. Dr. Connolly continues to be of opinion that the plaintiff probably will require in-patient treatment on average of six weeks per year indefinitely. Both doctors agree that she should continue attending the rehabilitation centre on a daily basis. It seems probable that it is the source of much of her improvement. Dr. O’Toole now accepts that the plaintiff is likely to require hospitalisation each year, but he does not accept a probable average of six weeks per annum. He anticipates that there will be some further improvement in the plaintiff’s general condition but he does not expect her to return to her pre-accident state of mental health. The real difference between Dr. Connolly’s opinion and that of Dr. O’Toole is that the latter attaches substantial significance to the effect of the litigation on the plaintiff’s condition up to the present. He stated in evidence “I think the whole process of the court appearance creates a considerable increase in anxiety, and she gets distraught. When that happens her mood goes down and her anxiety goes up. I think those are the days when she begins to feel suicidal as she put it herself” . Dr. O’Toole was asked what the prognosis would be for the plaintiff once the court case is out of the way. His answer was “I have little doubt that when the court case is out of the way that is one hurdle we have mounted and things will be easier for her...... I would anticipate if this court case is settled that’s a further reduction in stressors for her....”. Dr. Connolly attaches less significance to the aggravating effect of the litigation on the plaintiff’s situation.

10. Having assessed all of the medical evidence in this difficult case, it seems to me that the following factors are of particular significance:-

11. I am satisfied that on the balance of probabilities the end result for the plaintiff is that her psychiatric profile has suffered significant permanent damage. Her enjoyment of life has been curtailed and to a lesser extent will continue to be affected in the future. However, the accident has led to an unexpected advantage for the plaintiff which might never have arisen otherwise. There is no doubt that the rehabilitation centre which she now attends has brought some order and satisfaction into her life which she did not previously enjoy.

12. It has also emerged in evidence that as the plaintiff’s earnings from the investment of damages will exceed £77.50 per week, she will loose her weekly disability benefit of £47.00 plus £5.00 fuel allowance. Her damages will also result in the loss of her medical card up to age 70. In consequence she will be liable for the first 10 days of in-patient hospital treatment per annum. The extent of her annual liability in that regard is £260.00. She will not be charged for attendance at the day centre/rehabilitation unit. In short, the future estimated annual cost of hospitalisation and medical treatment for the plaintiff is £1,260.00 i.e., £26.00 per week. When added to the weekly loss of disability benefit and fuel allowance the total is £78.00 per week. I have not taken into account possible loss of rent allowance as it is unlikely to arise because that particular benefit is in the name of the plaintiff’s partner. I calculate the capital value of the foregoing weekly loss which the plaintiff will sustain, taking into account Reddy -v- Bates , at £60,000.00. Special damages to date have been agreed at £21,375.00 (which includes a Kinlen order for 137 days in hospital at £125.00 per day).

13. I assess damages for suffering and loss of enjoyment of life by the plaintiff up to date at £60,000.00 and in the future at £80,000.00. Accordingly, the grand total of damages amounts to £221,375.00.

14. One other aspect of this case causes me some concern. Having regard to the plaintiff’s pre-accident mental condition which has been significantly aggravated by the post traumatic stress disorder from which she now suffers and will continue to suffer into the future, it is evident that she would have difficulty in managing the amount of damages which I have assessed. It seems to me that she should be brought into wardship so that damages d may be managed on her behalf. The registrar of this court should refer my judgment to the registrar of Wards of Court with a request that the President of the High Court consider taking the plaintiff into wardship. The amount of damages should be paid to the solicitor for the plaintiff out of which he should pay £1,000.00 to her. The balance should be retained by him on deposit pending the President’s decision in the matter.