Behavioral Healthcare

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Behavioral Healthcare

Key Takeaways

  • According to a report by the International Risk Management Institute (IRMI), one out of every five American adult suffers from at least one mental health condition that affects their daily lives. Injured workers receiving workers' compensation tend to develop psychological problems like anxiety, stress, and depression while undergoing physical treatment due to reasons that include financial worry from loss of work, absence of the daily routine, or worry about their physical health due to pain from their injuries.
  • Workers who become severely injured at the workplace and receive workers' compensation are often prescribed opioid drugs like OxyContin to treat their painful conditions. Opioids are highly effective for pain management because "opioids attach to proteins called opioid receptors on nerve cells in the brain, spinal cord, gut, and other parts of the body. When this happens, the opioids block pain messages sent from the body through the spinal cord to the brain."
  • Since a primary symptom of PTSD is the deliberate avoidance of the accident site or the place where the worker became injured, injured employees receiving workers' compensation "can have an extremely difficult time returning to work."

Introduction

Injured workers going out of work temporarily on workers' compensation suffer from several psychological issues that include anxiety, stress, depression, drug and alcohol abuse, and post-traumatic stress disorder (PTSD). These psychological problems and their impact on both the employees and their employers/companies have been discussed below.

Anxiety, Stress, and Depression

  • According to a report by the International Risk Management Institute (IRMI), one out of every five American adult suffers from at least one mental health condition that affects their daily lives. Injured workers receiving workers' compensation tend to develop psychological problems like anxiety, stress, and depression while undergoing physical treatment due to reasons that include financial worry from loss of work, absence of the daily routine, or worry about their physical health due to pain from their injuries.
  • Marty Brooks, Absentia Solutions' account manager, captures the mental state of these workers perfectly when he says, "They’re worried about where their next check is going to come from. They’re worried about if they’re going to keep their job. They’re worried about their health in general … Some of that I do think can lead to depression."
  • IRMI also mentions that over 50% of "injured workers experience clinically-related depressive symptoms at some point, especially during the first month after the injury. In addition to the injured worker himself, family members are 3 times more likely to be hospitalized 3 months after the person's injury."
  • In a study conducted by the Institute for Work & Health, a Toronto-based non-profit research organization, 332 workers who were suffering from work-related musculoskeletal injuries and had filed workers’ compensation claims were interviewed over a period of 12 months. The study revealed that half of the workers had "experienced symptoms of depression at some point in the 12 months following the injury." These symptoms included sadness, loss of appetite, restless sleep, difficulty concentrating, and crying spells. 1 in 10 workers were diagnosed with depression by a physician during this period.
  • The same study also revealed the impact of the issue on their employers. Only 10% of the workers that had experienced depression during their recovery phase post injury "were able to return to work and stay at work. The remaining 90% either had never made a return-to-work attempt or had tried to return to work but had at least one recurrence of work absence."
  • According to a study conducted by BMC Public Health, employees receiving workers’ compensation "are 33% more likely to develop depression than people without occupational injuries." Also, depressed employees tend to be absent for 6-25 more workdays annually compared to their colleagues that are not depressed.
  • On the flip side, employees that "feel emotionally under-prepared to return to work" and incorrectly consider their anxiety and depression as symptoms of physical pain run the risk of re-injury upon return to work resulting in loss of productivity for the company. According to Paradigm Catastrophic Care Management's CEO Kevin Turner, "You don’t want to send somebody back to work who is not mentally ready to go back to work. They may have met the physical requirements to go back to work but if you put someone back in the work environment that still is suffering from depression or has family issues, it’s going to impact not only the injured worker and the family, but the employer as well."

Drug and Alcohol Abuse

  • Workers who become severely injured at the workplace and receive workers' compensation are often prescribed opioid drugs like OxyContin to treat their painful conditions. Opioids are highly effective for pain management because "opioids attach to proteins called opioid receptors on nerve cells in the brain, spinal cord, gut, and other parts of the body. When this happens, the opioids block pain messages sent from the body through the spinal cord to the brain."
  • However, research has shown that long-term usage of opioids can result in addiction and even overdose. Opioids can trick the brain and body into believing that the drug is necessary for survival. Data revealed by the National Institute on Drug Abuse has shown that over 2 million Americans suffer from opioid misuse and over 90 Americans die of opioid overdose every day.
  • The opioid addiction is more pronounced among workers in the construction and mining industries compared to employees of any other sector. According to an article by CBS News, since construction and mining workers are subjected to intense physical labor that often results in pain and injury, they are prescribed opioids "to alleviate pain from on-the-job accidents" that later turns to addiction.
  • Research has also revealed the link between depression and alcohol abuse. Almost one-third of people suffering from depression have an alcohol-related problem. As mentioned above, injured workers receiving workers' compensation tend to suffer from depression. This leads to several of them becoming addicted to alcohol.
  • Drug and alcohol abuse by employees result in companies facing several expensive problems like injuries, lost productivity, and increased health insurance claims. According to data released by the National Clearinghouse for Alcohol and Drug Information (NCADI), drug and alcohol abuse by employees result in companies in the US suffering a loss totaling $100 billion every year.
  • The CBS News article also stated that construction and mining workers "missing three or four days of work per month because of illness or injury was associated with a significantly higher incidence of non-prescription opioid use."

Post-traumatic Stress Disorder (PTSD)

  • Post-traumatic stress disorder (PTSD) is defined as "a mental health condition that is triggered by a terrifying event such as experiencing or witnessing a traumatic event involving actual or threatened death or serious injury." Research has established that workplace PTSD is common among employees that have been injured in the workplace.
  • According to the American Psychiatric Association (APA), "approximately 3.5% of American adults are affected by PTSD every year," and one in 11 Americans are diagnosed with PTSD during their lifetime. The National Center for PTSD has revealed that women are twice as susceptible to PTSD than men.
  • Often, individuals with PTSD suffer from other psychological conditions like depression. The Center for Workplace Health states that workers suffering from PTSD tend to be more absent from work, have higher frequency of medical visits, generally lower hourly pay, a higher likelihood of underemployment or unemployment, and higher difficulty in meeting the demands of work resulting in lower productivity.
  • Since a primary symptom of PTSD is the deliberate avoidance of the accident site or the place where the worker became injured, injured employees receiving workers' compensation "can have an extremely difficult time returning to work."
  • In addition to workers suffering from PTSD delaying their return to work, PTSD symptoms can also impair the employee's memory, ability to focus, and ability to stay awake during work. This results in anxiety, fear, panic attacks, flashbacks, emotional outbursts, poor relationships with colleagues, lower productivity, and absenteeism.
  • According to Mariellen Blue, national director of case management services at Genex Services, "For them, doing normal, ordinary tasks can become quite overwhelming, and the ability to develop and maintain relationships is often negatively impacted and there’s also an increased risk of self‑injury behaviors, again, such as substance abuse, self‑mutilation, and even a high risk of suicide."
  • However, Mariellen Blue also suggests that it is imperative that employees suffering from PTSD and on workers' compensation focus on returning to work to continue their healing process. She says, "Research has shown that employees who are unable to return to work also experience more persistent PTSD symptoms."

Research Strategy

For providing an overview of the behavioral and psychological issues that workers going out of work temporarily on workers' compensation have to face and how these issues affect both the employees and their employers/companies, we have leveraged the most reputable sources of information in the public domain, such as reports and data released by reputed organizations like the International Risk Management Institute (IRMI), the Institute for Work & Health, BMC Public Health, the National Institute on Drug Abuse, the American Psychiatric Association (APA), the National Center for PTSD, the Center for Workplace Health, and the National Clearinghouse for Alcohol and Drug Information (NCADI), third-party media publications like CBS News, and journals and blogs like WebMD and Risk & Insurance. A few older study reports and quotations from industry experts have also been used to make the research brief more comprehensive.

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