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Mental Health and Social Determinants of Health


The pandemic has led to a rise in mental health-related workers’ comp claims for first responders, according to Safety National’s Chairman and CEO Mark Wilhelm. There is also an uptick in mental health issues for injured workers, he said.

“Almost all states cover mental health as it relates to a physical injury,” he said. “Many states have passed the PTSD presumption, post-traumatic stress syndrome presumptions for first responders, and in those states, we’re seeing mental health claims.”

In addition to the pandemic causing stress on first responders, civil unrest has been a driver, as well. “So yes, we’re seeing stress claims from those first responders.” Even outside of the first responders, Wilhelm says there’s been an uptick in mental health issues as a result of physical injuries.

Jennifer Cogbill, senior vice president, GBCARE Client Services, at Gallagher Bassett, says mental health issues compromise the injured worker’s recovery.

“Most people have been under an extreme level of stress and uncertainty, which has negatively impacted overall mental health on a large scale,” she said. “Unfortunately, lack of awareness and effective treatment of mental health issues also play a part in compromising recovery for individuals.” It is important to understand the risk factors that could compromise the successful recovery of an injured worker, she said.

“Multiple studies have shown the socioeconomic impact on an injured worker’s ability to recover. Some of the contributing factors for high-risk individuals include higher incidence of comorbid conditions, lack of stable employment or good employer relationships, lack of access to quality healthcare providers, as well as fear and mistrust of healthcare providers.”

“There’s no question that social determinants of health can have a significant impact on a worker’s compensation,” Wilhelm said. Where they live, access to healthcare, transportation support systems, matter in the recovery of an injured worker, he said. “Work is a big part of people’s lives, so being away from work can lead to feelings of isolation and depression,” he said.

One of the most effective tools to combat health inequity of injured workers is targeted clinical advocacy, Cogbill said.

“Clinical advocates will build a relationship with the injured worker, identify their care needs, communicate the best provider options, and partner with them to develop a plan for recovery,” she said. “It is vital for employers to leverage the best data to identify candidates, as opposed to assigning a nurse across all claims. This strategy targets people at risk while lowering wasteful clinical spend.”

“We believe that adopting a biopsychosocial approach that looks at the whole person is the best way to understand the impact of a work-related injury on an individual and support them in their recovery,” said Dr. Marcos Iglesias, vice president, chief medical director, Travelers.

“Oftentimes, the gap between a prompt recovery from a work-related injury and a delayed one is a psychosocial barrier, such as fear of losing one’s job, perceived injustice or catastrophic thinking,” he said. Listening, identifying barriers and helping to find solutions to these barriers not only helps the injured employee and their employer, but could also lead to lower claim costs, according to Iglesias.