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Mental Health Claims Management and Return to Work: Qualitative Insights from Melbourne, Australia

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Abstract

Purpose Mental health conditions (MHC) are an increasing reason for claiming injury compensation in Australia; however little is known about how these claims are managed by different gatekeepers to injury entitlements. This study, drawing on the views of four stakeholders—general practitioners (GPs), injured persons, employers and compensation agents, aims to describe current management of MHC claims and to identify the current barriers to return to work (RTW) for injured persons with a MHC claim and/or mental illness. Methods Ninety-three in-depth interviews were undertaken with GPs, compensation agents, employers and injured persons. Data were collected in Melbourne, Australia. Thematic techniques were used to analyse data. Results MHC claims were complex to manage because of initial assessment and diagnostic difficulties related to the invisibility of the injury, conflicting medical opinions and the stigma associated with making a MHC claim. Mental illness also developed as a secondary issue in the recovery process. These factors made MHC difficult to manage and impeded timely RTW. Conclusions It is necessary to undertake further research (e.g. guideline development) to improve current practice in order to enable those with MHC claims to make a timely RTW. Further education and training interventions (e.g. on diagnosis and management of MHC) are also needed to enable GPs, employers and compensation agents to better assess and manage MHC claims.

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Acknowledgments

We gratefully acknowledge the technical advice and support of Ms Natalie Bekis, Ms Louise Goldman, Ms Tamara Fitzgerald and Mr Jamie Swann, from WorkSafe Victoria and the TAC, for their assistance with recruitment. We also thank Ms Amy Allen for assistance with data collection and analysis. Finally, we express our gratitude to the individuals who participated in the study. This project was funded by the Institute for Safety, Compensation and Recovery Research (ISCRR). ISCRR is a joint initiative of WorkSafe Victoria, the Transport Accident Commission and Monash University.

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Authors and Affiliations

  1. Department of General Practice, Faculty of Medicine Nursing and Health Sciences, School of Primary Care, Monash University, Building 1, 270 Ferntree Gully Rd., Notting Hill, Melbourne, VIC, 3168, Australia

    Bianca Brijnath, Danielle Mazza & Nabita Singh

  2. Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia

    Agnieszka Kosny & Alex Collie

  3. Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, Australia

    Rasa Ruseckaite & Alex Collie

Authors
  1. Bianca Brijnath
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  2. Danielle Mazza
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  3. Nabita Singh
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  4. Agnieszka Kosny
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  5. Rasa Ruseckaite
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  6. Alex Collie
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Correspondence to Bianca Brijnath.

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Brijnath, B., Mazza, D., Singh, N. et al. Mental Health Claims Management and Return to Work: Qualitative Insights from Melbourne, Australia. J Occup Rehabil 24, 766–776 (2014). https://doi.org/10.1007/s10926-014-9506-9

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  • DOI: https://doi.org/10.1007/s10926-014-9506-9

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