Return-to-Work outcomes following mental health treatment among public safety personnel disabled by post-traumatic stress disorder

Objective: To evaluate the influence of a mental health treatment program for public safety personnel (PSP) disabled by post-traumatic stress disorder (PTSD) on return-to-work outcomes. Methods: A mental health treatment program established exclusively for PSPs disabled by work-related PTSD received 582 referrals over the period November 2021 to June 2023. Return-to-work outcomes were defined as the cessation of workers' compensation wage replacement benefits over an 18-36 month period following referral. Outcomes among the referral cohort were compared to PSPs not referred to treatment who also had an accepted workers' compensation claim for PTSD. Referrals were matched to non-referrals on age, sex, occupation and date of injury. Results: Among the 472 referrals to the treatment program eligible for inclusion in the study, 54.4% initiated treatment. There was no difference in return-to-work outcomes over the follow-up period between the referrals who initiated treatment (29.9%) and the 215 referrals not initiating treatment (32.5%, p = 0.612). In contrast, return-to-work outcomes were more positive among the matched non-referral comparison group (41.9%, p < 0.001, all referrals vs the matched non-referral comparison group). Conclusion: In this large cohort of PSPs disabled by PTSD, there was no evidence of a positive treatment effect on return-to-work outcomes. The prognosis for return-to-work among public safety personnel with long durations of recovery from PTSD is poor. The implications of this study point to the importance of the development and testing of novel evidence-based treatments and opportunities to support employers' commitment and capacity to provide suitable accommodation as strategies to improve return-to-work outcomes among public safety personnel disabled by PTSD