Psychological distress amongst injured workers – a national view

It is relatively rare that injury schemes research spans the entire country, but Professor Alex Collie presented some of his recent research on this at IDSS 2019, with a focus on psychological distress among injured workers with either musculoskeletal disorder or mental health condition.

Prof. Alex Collie is the Director of the Insurance Work and Health Research Group in the School of Public Health and Preventive Medicine at Monash University. He leads a variety of research work, with a specific focus on injury and illness compensation systems and their impact on the work, social and health outcomes of injured and ill people.

Prof. Collie presented a paper (recently published in the Journal of Occupational Rehabilitation) at IDSS 2019 on Psychological Distress in Workers’ Compensation Claimants. The research summarises a survey that was done on injured workers across all of Australia, drawing from the national database of injured works from SafeWork Australia. While the work has some limitations (based on a snapshot rather than longitudinal results, and is primarily observational), it provides an important view into how injured workers are faring psychologically, in a way not visible to injury schemes directly.

Survey respondents were gauged for psychological distress using the Kessler-6 scale. The survey found that 38% of the cohort with accepted musculoskeletal disorders were experiencing moderate or severe psychological distress, which was higher again for those not working.

While almost all (94%) people with a psychological injury who were suffering psychological distress had received specialist psychological treatment, the same was not true of those with a physical injury.

Of those who hadn’t returned to work after a year with a musculoskeletal main injury who also had severe psychological distress, only 42% of them had accessed specialist psychological services.

The main findings were thus:

  • Rates of psychological distress among those with musculoskeletal disorders were high.
  • Most injured workers with musculoskeletal disorders and psychological distress do not access mental health services.

It also suggests that there is a significant underservicing of people with a secondary psychological need. Better screening or information to injured workers are potential remedies for this.

Regression analysis revealed strong associations between psychological distress and other factors including being off work, poor general health, low work ability, financial stress, stressful interactions with healthcare providers and having diagnosed mental health conditions.

The Q&A session that followed the presentation was relatively wide-ranging. Three important follow-up points that Prof. Collie made were:

  • There is a need for schemes to be clear about their language and terminology in the area of mental health related claims – there is considerable variety despite the extensive amount of time and effort spent on the subject.
  • It is important to view this research along with other work going on that delves further into the causes of psychological distress.
  • There were not statistically significant differences between different jurisdictions (states’ schemes) in the regression modelling. While this does not prove there are no differences, it does suggest that many issues related to psychological distress may be common to many schemes.

The research complements a lot of ongoing work from actuaries and schemes into understanding the extent of mental health issues in injury and disability schemes.

See the session presentation here.

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