Mental Health and Workers' Comp: A Crisis Employers Can't Ignore

The World Health Organization defines mental health as “a state of mental well-being that enables people to cope with the stresses of life, realize their abilities, learn and work well, and contribute to the community.” [1] Several factors—individual, family, and professional—significantly influence a person’s mental health. In today’s workforce, many employees struggle with workplace stress, lack of motivation, and loneliness, leading to burnout. [2] Recent years have shown that mental health issues account for a substantial number of workers' compensation claims. This can significantly impact a worker’s recovery time, return to work, and job performance, driving up costs for payers. However, early detection of mental health concerns, preventative efforts in the workplace, and diverse treatment options can help mitigate some of these costs.

Mental health issues in workers' comp claims can arise in multiple ways. For some individuals, mental health conditions existed before experiencing a physical injury. For others, these conditions developed secondary to a physical injury. Lastly, some workers have filed for workers' comp purely citing severe mental health concerns that impact their ability to work. While each circumstance is unique, employers can take similar actions to decrease overall costs.

Common mental health concerns observed in workers' compensation claims include depression, anxiety, stress, and post-traumatic stress disorder (PTSD). These conditions can complicate the recovery process following a physical injury and delay the return to work [3], resulting in increased time off, which can be quite costly for payers. In addition to delayed recovery, mental health conditions increase the likelihood of developing chronic or severe health conditions such as diabetes mellitus, heart disease, and stroke. [4] The risk of workers' comp claims being diagnosed with a mental health disorder increases with the claim size. A study by the National Council on Compensation Insurance found that 48% of all claims with costs incurred over $500,000 are diagnosed with a mental disorder. [5] This illustrates the gravity of mental health conditions on claims costs and overall physical health.

Employers can reduce mental health costs in the workplace by implementing strategies for early detection, creating a supportive environment, and offering a variety of treatment options. Integrating mental health screenings into workers' comp assessments will improve early diagnoses of mental health conditions. [3] Earlier diagnoses lead to earlier treatment and a quicker return to work, reducing the duration of disability and being more cost-effective for payers.

Implementing Employee Assistance Programs can create a supportive environment by offering mental health resources to facilitate faster recoveries. Providing access to both pharmacological and non-pharmacological treatments has shown better efficacy in managing mental health conditions. While pharmacological therapy for mental health disorders may be covered by workers' compensation programs, this does not always extend to non-pharmacological therapies. However, evidence shows that Cognitive Behavioral Therapy (CBT) may be as effective in treating Major Depressive Disorder (MDD) as second-generation antidepressants. [6] The American College of Physicians recommends initiating therapy for MDD with either CBT monotherapy or second-generation antidepressants. [7] Including coverage for non-pharmacological therapies can improve patient outcomes and reduce lengthy recovery costs.


By Saloni Desai

PharmD Candidate (P4)

LinkedIn

For questions, e-mail pharmd@prodigyrx.com

Citations

  1. https://www.who.int/health-topics/mental-health#tab=tab_1

  2. https://www.apa.org/pubs/reports/work-in-america/2024

  3. https://www.claimsjournal.com/news/national/2024/04/18/322964.htm

  4. https://www.cdc.gov/mentalhealth/learn/index.htm  

  5. https://www.ncci.com/Articles/Documents/AIS2024-BIG3.pdf  

  6. https://www.acpjournals.org/doi/full/10.7326/M15-2570  

  7. https://www.acpjournals.org/doi/full/10.7326/M15-2570  

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