This week is Queensland’s Mental Health Week (7-15 October) and falls in National #SafeWorkMonth where the focus is working together to ensure a safe and healthy workplace.
The climax of these key moments in October have put a spotlight on the latest research findings from WorkCover Queensland and MAIC that show an increase in both primary and secondary mental health injury claims arising from workplace incidents and car accidents.
Since 2017, WorkCover Queensland has seen an increase in psychological injury claims lodgements by 27%.1 In 2022, of the 92,424 workers’ compensation statutory claims lodged, approximately 6% relate to psychological injuries.2
Tracking the exact numbers relating to compulsory third party (CTP) claims is more difficult due to how data is kept and reported. However, of finalised claims for accidents occurring in 2021 approximately 22% had a psychological injury component, compared to 15% for accidents occurring in 2017.3
The final report into the 2023 Review of the Queensland Workers’ Compensation Scheme on the 4th of October, dedicated an entire chapter and nine recommendations related to mental health injuries.
Mental health injury is expected to be a significant focus for some time to come. And while there has been solid progress in response to the rising statistics, the most critical issue is improvement in the return-to-work processes, especially in the workers’ compensation context.
What is a primary and secondary psychological injury?
A primary psychological injury is where that is the primary injury. For example, a major depressive condition arising from workplace bullying or Post-Traumatic Stress Disorder (PTSD) from a car accident. It is possible in such cases that any physical injury is secondary or minor in comparison to the dominant psychological condition.
Whilst a secondary psychological injury is where there is a physical injury followed by a diagnosed psychological injury or reaction. Think an adjustment disorder following a lumbar disc protrusion.
The progress over the years
Over the years, especially since Covid-19, the rise in the number of psychological injuries has been met with progress in various areas in response.
The medical and allied health profession is spearheading the recognition, diagnosis, and management of psychological injuries. Conversations with providers have been focused on the extent of training they are undergoing to identify and manage such injuries. Client’s and their family are now speaking more openly about their mental health following an accident.
In the CTP space, the greater recognition of psychological injuries is not leading to claims costs increasing. This would suggest that perhaps with quick treatment funded by the insurer, the impact of a psychological injury (and likely mostly secondary psychological injury) can be minimised – which translates to no discernible increase in claim sizes.
In the workers’ compensation space, statutory scheme durations and costs are higher and return to work outcomes lower. Statutory claims with a secondary mental health component are also more likely to lead to a common law claim and increased claim costs.
- Scepticism – awareness and open discussion has also come with some scepticism. Suggestions are that injured people are “egging it on”, increasing their claims, or lack resilience. I see clients who are at their most vulnerable, but have the desire to beat it for themselves and their families. Making a claim is necessary to assist in recovery after injury.
- Meaningful return-to-work – many can begin exhibiting mental health symptoms when a return-to-work program is being developed or is commenced. Having a person with multiple trade qualifications and expertise counting nuts and bolts whilst sitting on a crate alone in the corner of a warehouse, is not meaningful. Efforts need to be made to engage injured workers in meaningful work.
- Genuine employer engagement with return-to-work – this is at risk when an employer breaches the suitable duties program, directs the worker to do something different to the agreed program, turns a blind eye to co-workers who fail to assist in the process, or isolates the worker for making a claim and refusing to offer alternative duties.
- Communication with an injured person – an overwhelming majority of clients say the employer did not check in with them after they were injured. There’s no magic to such conversation, but it goes a long way to offer a “how’s it going, I hope your recovery goes well and we see you back soon. Do you want us to keep you updated if there are any changes at work?”
- Early intervention – initially funding of psychological counselling is generally done well by insurers, but it is when the need is more entrenched (and costs more) that insurers are less willing or seeking medico-legal reports (interestingly costing more than the funding request). And, when our healthcare system takes months to get a booking with a psychologist or psychiatrist (and weeks with a GP), we have a real systemic community-wide issue.
So, it seems while there’s been progress, we still have some improvements to make. My hope is that the policy response to mental health injury claims is based on accurate data, is measured, and addresses the fundamental underlying drivers and challenges.
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