Image: iStock. By Bianca Brijnath, Monash University and Danielle Mazza, Monash University.
Doctors face many challenges when managing work-related mental health problems, leading some to counsel patients against pursuing basic labour rights because it may prove detrimental to their mental health, the General Practitioner (GP) Return to Work study has found.
The study examined the GP’s role in facilitating return to work after injury, arguing that some GPs find dealing with the worker’s compensation system so onerous and difficult that they are reluctant to follow through with some claims.
The study results are based on interviews with 93 GPs, injured patients, compensation scheme personnel and employers as well as an analysis of 125,000 compensation claims issued by around 10,000 GPs.
One doctor in the study said his instinctive response to the many patients who wanted to pursue worker’s compensation for stress, anxiety, depression and other work-related sickness was to dissuade them.
“When people come and ask me, that they perceive they’re being bullied at work and say, ‘I’m going to put in a Workcover claim,’ I say, ‘Well just be careful because you have every right to, if you feel that you’ve been hard done by, but it’s going to be a dog fight.'”
This response was typical of the GPs interviewed.
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GPs reported difficulties with the initial assessment and diagnosis of mental health injuries (as opposed to some easily diagnosable physical injuries such as fractures and lacerations). In 96% of initial sickness certificates issued for work-related mental health problems, GPs classified patients as “unfit for work”.
GPs also reported conflicting medical opinions among clinicians about the difference between mental illnesses developed as a result of work-related stress and pre-existing mental illness secondary to work. This has a flow-on effect to workers compensation claims, as many schemes will only cover mental illness that arises as a consequence of work.
The strong stigma associated with making a work-related mental health claim also makes patients reluctant to seek help from psychiatrists and psychologists. They fear this health record will limit future employment prospects. GPs often have to juggle protecting their patients’ private health information alongside employers’ and insurance agents’ requests for further details.