Mental health issues and medication use in injured workers

For some injured workers, their experiences dealing with a lost-time claim have led to mental health problems or issues with medication use.

As part of their study into long- term and prolonged claims, Scientist Dr. Ellen MacEachen and Research Assistant Lori Chambers looked more closely at these two areas. In addition to conducting a focused “mental health” analysis of interviews with 69 injured workers, peer helpers and service providers, the research team reviewed the studies on mental health problems such as anxiety or depression.

MacEachen noted that most mental health research takes a psychological approach – which means it focuses on diagnosing and treating an individual.

However, she notes, “There is very little understanding of systematic pathways to mental health problems in the context of work injury.” There may be a number of external stresses or situations that can be identified. Reducing these stresses may minimize the emotional strain in some workers as they proceed through the return-to-work process.

“Mental health issues are associated with denied and delayed claims,” says MacEachen. “And when a worker fails in return to work or in retraining, you can begin to see mental health problems.”

She also says that the experience of dealing with the bureaucracy involved in a compensation claim can create stress and a sense of loss of control in a worker. In their interviews, all of the workers said they had taken medication following their work injury. Twenty had used morphine-like drugs, opioids, to manage pain, and eight had used anti-depressants.

The effects of the medication can also make a return to work more difficult by impairing their communication and ability to focus, says MacEachen. With opioids, workers should not be driving, operating heavy machinery, or engaged in intense learning programs, but these limitations are sometimes not recognized.

What can help? MacEachen suggests that having someone “on their side,” with face- to-face contact, could help workers cope.

There also needs to be a shift away from the thinking that mental health issues should be recognized and treated after they develop, says MacEachen. Instead, there needs to be a way to flag potential problems before they fully emerge. If not, a worker’s situation can turn from one health problem, a physical one, to mental health problems that can last a long time.

Source: At Work, Issue 52, Spring 2008: Institute for Work & Health, Toronto