REPORT EXAMINES PATHWAYS TO SECONDARY PSYCHOLOGICAL INJURY

A Monash University report commissioned by Safe Work Australia (SWA) has identified key factors contributing to the secondary psychological injuries that can increase physical injury claim costs and delay recovery and return to work. The research team conducted a targeted literature review, interviews with industry stakeholders, a survey of injured workers, and quantitative analysis of workers’ compensation claims and payments data to comprehensively understand and define secondary psychological injury.

The term “secondary psychological injury” has a specific meaning in workers’ compensation legislation in some Australian jurisdictions. Such legislative definitions typically indicate a diagnosed psychological condition with onset after a primary physical injury, reflecting a ‘narrower’ interpretation than that developed in the Monash-SWA project. Reflecting on the findings of the project researchers propose the adoption of a consistent working definition of secondary psychological injury that ensures clarity, provides a reference point, and facilitates progress toward minimising its occurrence and impact, in a way that is consistent, relevant and transferable between jurisdictions.

The multiple compensation system, personal and workplace factors (such as manager actions and attitudes) were identified as key drivers of secondary psychological injuries, with stakeholders and injured workers repeatedly highlighting that uncertainty regarding compensation claim processes was a key contributor. Pre-injury mental health concerns and a loss of control over their financial and healthcare decisions when engaged in compensation processes where decision making is undertaken by others (e.g., insurers), also elevates the risk of injured workers experiencing secondary psychological harm.

Researchers examined the identity of key stakeholders when considering secondary psychological injuries, when the injuries occur and what screening tools or monitoring methods are used to detect them.

Perhaps the most pressing question addressed in the report is “What are the modifiable aspects of the workers’ compensation process that may mitigate secondary psychological injury?” The report goes on to identify several modifiable aspects:

• Reducing worker uncertainty by providing information about worker entitlements, obligations and the overall function of the workers’ compensation system was proposed as beneficial by several stakeholders.
• Upskilling claims managers and providing resources and training around communication, the workers’ compensation process, and being able to offer clear explanations of processes may improve the claims experience of workers. Specialist claims manager roles, with expertise in handling more complex claims (e.g., challenging pre-injury socioeconomic circumstances) may be useful. High levels of turnover in claims managers often means that workers have to deal with multiple claims managers – an experience many find stressful. Increasing claims management capacity may reduce this phenomenon.
• The actions and attitudes of managers at every stage of the claim, from immediately after injury through the return-to-work process, were found to be an important risk factor to secondary psychological injury. Assisting employers to better understand their role in return to work may also improve recovery and reduce the risk of secondary psychological injury. Employers have particularly important roles in the prevention, identification and management of secondary psychological injury. These roles extend beyond rehabilitation and return to work to include prevention via the identification and reduction of workplace psychosocial risks.

The project has generated eight recommendations for actions that can be taken at a regulator and scheme level to modify, remove or introduce relevant policies and practices without needing legislative reform:

1. Adopt a national working definition of secondary psychological injury.
2. Develop more consistent approaches for risk screening (at an individual level) and monitoring (at a portfolio level).
3. Reduce uncertainty for workers.
4. Minimise repetitive or unnecessary information gathering exercises or assessments.
5. Consider offering additional support throughout the claims process to assist workers with pre-injury mental health conditions and those with long-duration claims.
6. Explore the financial and economic impacts of secondary psychological injury and the impact this has on return to work.
7. Develop a better understanding of the mental health symptoms experienced by workers with secondary psychological injury.
8. Conduct a detailed investigation of current interventions being offered in the sector and the evidence for their effectiveness.

Returning to work after a work-related injury or illness can be challenging. HSRs can play a key role in the process of creating a well-planned transition can make a positive difference.

While not directly responsible for return-to-work programs, HSRs may exercise their rights and powers under the Occupational Health and Safety Act 20094 (OHS Act) to assist injured workers in negotiating a safe and sustainable return to work. HSRs can download OHS Reps Return To Work Guide For HSRs - OHS Reps to be better equipped to ensure return-to-work arrangements for DWG members are fair, sustainable, and set up for success.

Read more: Monash Uni research - Examining pathways to secondary psychological injury: final report