For most people the accident or the assault is months behind them by the time anyone mentions a psychiatric report. The physical injuries have been examined and written up. What has not been written down anywhere is the part that has not healed: the road still avoided, the sleep that breaks at the same hour, the jolt at a sound nobody else in the room noticed. When a solicitor suggests a report on that side too, the first reaction is often reluctance to tell the story again.
Behind that reluctance sit two plain questions. What does a PTSD assessment report involve, and who should write it? And is this PTSD at all, another reaction to trauma, or something that will settle with time?
If you are at immediate risk of harming yourself or someone else, call 999 or go to A&E. For urgent mental health help, call NHS 111 and choose the mental health option, or call Samaritans free on 116 123, any hour.
Who carries out the assessment?
At Clinique Alpa, PTSD and psychiatric injury reports are consultant psychiatrist led, and our psychiatry services page sets out the wider range. My own part is usually earlier. As a GP whose special interest is psychological medicine, with a parallel medico legal practice, I am often the first conversation: whether a specialist assessment is the right next step, and whether the person needs evidence, treatment, or both.
What should a PTSD assessment report cover?
Medico legal evidence is part of my working week, and when a psychiatric injury report lands on my desk, these are the things I look for. They are also the reason a proper assessment takes time.
The event, in your words
The account starts with what happened, then what happened in the hours and days afterwards. It does not have to be told in one go or in perfect order. A good assessment lets you set the pace and records what you say in your own words, not tidied into clinical language before it reaches the page.
The symptoms, sorted carefully
PTSD has a recognisable shape. Reliving the event through intrusive memories, flashbacks or nightmares. Avoiding places, people or conversations that bring it back. Feeling constantly on guard, startling easily, sleeping badly, losing your temper more quickly. Changes in how you see yourself and others, often guilt, shame or a sense of detachment. Timing matters: symptoms that persist beyond the first month, or that appear later, carry different weight from the distress of the first few weeks. So does how often they happen and how much they intrude.
Life before the event
A report has to deal openly with what came before: earlier mental health difficulties, earlier trauma, bereavement, alcohol. This is not a trap. A report that ignores your history is weak evidence, and an honest account of where you were before is what allows an opinion on what the event changed.
The records
GP records, hospital and A&E notes, occupational health files and any counselling or therapy notes are read alongside your account. Where they agree, that is recorded. Where they differ, that is recorded too, with any explanation. This is why reports wait for records rather than racing ahead without them.
What else it might be
Not every reaction to trauma is PTSD. Depression, generalised anxiety, a specific fear of travel after a road accident, an adjustment reaction that is settling, alcohol used to manage sleep, or symptoms after a head injury can all sit alongside PTSD or instead of it. Several may be present at once. A report that names only PTSD, without having considered the others, invites challenge.
Effect on life, prognosis and treatment
The report sets out how the symptoms affect work, driving, relationships and daily life, and what is likely to happen with and without treatment. Where treatment would help, it says what kind, such as trauma focused talking therapy, and roughly how many sessions. Throughout, opinion is kept separate from fact, and the opinion stays independent of whoever instructs or pays for the report.
Is a psychiatric report always the right next step?
No, and it is worth saying plainly. In the first weeks after a frightening event, distress, poor sleep and vivid memories are common and often ease. At that stage the usual approach is support and a review, not a formal report. Where the main need is treatment rather than evidence, the priority is getting treatment started, through your NHS GP or privately; a report can follow later if a claim needs one. If you are not in a claim and want to understand what is happening, a GP appointment is usually the place to begin. We tell you which route fits before anything is booked.
When should you get help sooner?
- Thoughts of suicide or self harm, or a feeling that others would be better off without you. If the risk is immediate, use the crisis routes above.
- Drinking more, or using anything else, to get to sleep or blank out memories.
- Flashbacks, or spells of feeling detached from your surroundings, that make driving or work unsafe.
- Barely eating or sleeping for more than a week or two.
- Symptoms getting worse rather than better as the months pass.
What do you need to send or bring?
In a personal injury claim, the solicitor's letter of instruction sets the questions, and the records do much of the work: GP records, hospital notes, any occupational health or counselling records and earlier reports. If you are coming yourself, bring a short written timeline: the date of the event, when the symptoms started and what help you have had. Writing it down beforehand means you do not have to retell everything from memory in the room.
How do we arrange PTSD reports at Clinique Alpa?
Solicitors can instruct directly by email or phone, and individuals can contact us too. Psychiatric report fees are arranged individually and confirmed before anything is booked, and the timescale is stated when we quote. Assessments take place in person at 466 Green Lanes, Palmers Green. For how I approach medico legal evidence more generally, see medico legal reports from a GP in London.
If you want a clinical view rather than a report, start with a 30 minute appointment with me in clinic. The fee is £100. I take the history, check sleep, mood and the physical side, and give you an honest opinion on whether a consultant psychiatrist assessment would help. If a referral is right, the referral letter is included in the consultation fee, written where clinically appropriate after assessment. With your consent, a summary goes to your NHS GP. Book a GP appointment if that is the route you want.
This is an independent clinical opinion. It cannot be written to a required conclusion and does not guarantee the outcome of any claim, application, exemption or hearing.
All medico-legal assessments and expert reports are independent professional opinions. No particular diagnosis, conclusion, causation opinion, prognosis, consistency assessment, recommendation or outcome can be promised or guaranteed.
Written by Dr Mitesh Parmar, MBBS MRCGP, Principal GP and Clinical Director at Clinique Alpa, 466 Green Lanes, Palmers Green, London N13 5PA. This article is general information, not personal medical advice. In an emergency call 999. For NHS advice call 111 or visit nhs.uk.