Addressing Mental Health in the Workplace Using the Case Manager Approach

Mental health has traditionally been considered a pariah in workers’ compensation claims management. The old way of thinking is that when psychological issues enter the picture, claim costs spin out of control and return-to-work delays soar.

That perception has gradually diminished over the past decade as professionals are realizing that addressing these factors early can help reduce delays later. Though psychosocial factors such as isolation, post-traumatic stress and depression can incur following an injury and during recovery, the fact is, a good number of injured employees come into the workers’ comp system with mental health conditions, whether diagnosed or not. 

It may be surprising to learn that mental illness is one of leading causes of worker disability in the U.S. A recent study published by disability insurer Unum shows the true extent of the problem. Researchers surveyed 1,800 workers and reported 42 percent were aware of a colleague with a mental health issue. More than half — 62 percent — said they had experienced a period where they have felt mentally unwell. Of 500 workers who had been diagnosed with a mental health issue, many said they had come to work while they had suicidal feelings.

Those are some hard numbers to swallow considering that work and purposeful activity have the greatest impact on moderating depression, building self-esteem and negating idleness. As those in our industry know, workplace injuries can have a significant effect on mental health, which increases as an injured worker is out of the office.

Lessons from case managers

That’s why the case manager’s role is so important in workers' comp, they often play the role of detective in discovering underlying problems that may delay a case. The injured worker often needs an advocate to help him or her get back to a normal routine. Take for instance, the breadwinner who sustained a significant shoulder crush injury that kept him from doing purposeful activity until 8 months later, when he was assigned to case manager Julie Wilcox. The employee told Wilcox, he was suicidal with feelings that “the world gave up on him.” Wilcox immediately put a plan into action that addressed these psychosocial factors and allowed the injured worker to receive the extensive shoulder surgery he needed to regain full function and return to work.

But how can managers and even co-workers help address mental health issues in the workplace? The stigma associated with mental health lingers and addressing the issue or even recognizing the symptoms related to mental health can be a challenge, but may not be as difficult as they seem. For instance, people with anxiety disorder may seem disorganized or scattered. They may show signs of stress, avoid social interactions, are irritable, avoid eye contact, and have nervous habits. Depressed workers may also seem scattered or absentminded. They may show indifference or have inappropriate reactions to coworkers. Often, they are isolated from team members, and lack confidence in their abilities.

There’s a lot we can learn from case managers like Wilcox when it comes to addressing mental health in the workplace. One of the most important ones is simply through engagement. Nurses are trained to listen to what injured employees say, why they’re saying it, and if they represent issues hindering their recovery. Normalizing the conversation about mental health and “checking in” on co-workers can go a long way in creating a healthier environment. In fact, some companies have established “mental health champions,” employees who receive special training and encourage dialogue about mental health issues.

Another is to realize there is no one-size-fits all approach to managing depression and anxiety. Each individual has his or her own problems. A person’s background, culture and education level also play a role in how they’re feeling. Workers should feel comfortable seeking help as soon as possible. Policies that protect against discrimination and those that provide adequate accommodations can go a long way.

And, while most of us aren’t equipped to handle mental health issues in the workplace, we can offer resources to help. Many companies offer resources that are readily available to help, like employee assistance programs that help individual with emotional and substance use issues, interpersonal relationships and other problems that may be affecting their productivity.

In the end, a company’s success is built on the employees who work there. Incorporating compassion, communication and comprehension strategies shouldn’t be considered a nice thing to try but an important goal to meet in developing a successful corporate culture.