One of the Biggest Reasons Workers Don't Return from Injury

Did you know that many workers who sustain both minor and major injuries, including compensable injuries, within weeks or months suffer from episodes of depression? Some bouts of depression clear up with time, but others linger on and on. Workers who witness a workplace fatality or gruesome injury, such as an amputation, can suffer from post-traumatic stress disorder (PTSD).

According to many medical studies, the mental health (emotional, psychological) consequences of sustaining an injury on the job, or witnessing a life-impacting injury to a co-worker, often go undiagnosed and untreated. That can impact businesses in various ways.  Employees may miss time from work, have decreased productivity, experience social withdrawal, and disrupt collaborative projects. Depressed employees may experience “presenteeism”, in which they conceal their symptoms, show up for work, but are unfocused and unproductive. Even worse, these employees are high-risk candidates for another work-related injury.

In a study, “The Effect of Post-Injury Depression on Return to Pre-Injury Function: A Prospective Cohort Study,” 18.1% of 275 adults treated in hospital emergency departments for minor injuries were diagnosed with depression during the post-injury year. The depressed group was less likely to return to pre-injury levels of activities of daily living, and they were also less likely to return to pre-injury work status. The researchers concluded that the impact of post-injury depression is not limited to patients with serious injuries.

A study, “Incidence of Depression After Occupational Injury,” conducted by the U.S. Centers for Disease Control and Prevention (CDC) and drawing on nearly 367,900 injured and non-injured workers from a 2005 database, found that the odds of injured workers being treated for depression were 45% higher than those of non-injured workers.

Early intervention goes a long way toward successfully treating depression and PTSD, however, this is not often happening. Researchers in one study concluded that “injured workers with ongoing depressive symptoms do not seem to be getting the diagnosis and treatment that may be needed.” Among those at the six-month post-injury mark who still reported high levels of depressive symptoms, relatively few (about one in eight) had been diagnosed with depression. “The mental health of injured workers has been neglected for too long,” said researchers.

One barrier to treatment can be that injured workers are unaware of the symptoms of depression. Medical experts say that injury victims must pay attention to their own symptoms. Managers should be alert to changes in the mood of injured workers as they return to their jobs, and how they reintegrate themselves into regular workplace communication and collaboration. Be aware of signs of disengagement, isolation and withdrawal. As a manager, it’s not your job to make clinical diagnoses, but if you have reasons to suspect that a recently injured employee may be suffering related mental health issues, seek the counsel of occupational medical specialists. Act sooner rather than later, and do not put it off. Early recognition of a problem can go a long way in preventing the negative effects that come with a worker’s depression as the result of injury. As the research shows, depressed workers stay out of work longer or fall subject to presenteeism and their performance on the job is severely hindered.

To support your employee and your organization you might find treatment resources for recently injured and possibly depressed employees through a worker’s compensation claims representative, a nurse case manager, or an employee assistance program (EAP). The best response to trauma-related depression often involves medical intervention, therapeutic assistance, and peer support. Don’t expect employees who have been injured on the job, and who return to work with lingering mental health effects to “tough it out” and to “snap out of it.” According to the evidence, that’s not usually going to happen.

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