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Case Study: When altering your reactions can affect RTW outcomes

At Work Options we see many situations where a worker submits a claim for an injury at work, and doesn’t always have the experience they expect. In this case study, we look at a landscape labourer who was suffering from unknown mental health issues, and an employer who could have acted differently to avoid a negative and costly experience for both the employer and worker.

Case Study:

Ron* was a 38 year old labourer working for a landscaping business in New South Wales when he tripped on-site and fractured his right elbow, resulting in a worker’s compensation claim. Due to the nature of his work and the injury sustained, Ron was deemed ‘unfit’ for work and took temporary leave whilst he recovered. Whilst on leave, the employer made no attempts to communicate with Ron, until 6 weeks post-injury and post-surgery, when Ron was given the capacity to return to work in alternate duties. At that time the employer did not engage in discussion with Ron, but rather sent him a pre-drafted return to work plan outlining office-based duties.

Ron became frustrated with the lack of communication and spoke aggressively to colleagues who were contacting him via phone, the insurance agency and the Workplace Rehabilitation Consultant. The employer responded to Ron’s frustration by telling him to ‘pull himself together and understand that they were trying to support him’.

After a number of weeks of non-communication between Ron and the employer, Ron made a suicide attempt. Following this, Ron spent extended periods of time at home, not engaging in normal self-care or hygiene practices, which further isolated him from any support outside of his family. It was then discovered through Ron’s wife that there was an extensive history of mental health in his family.

Over the next several months, Ron rejected any communication attempts from the employer and insurance company, made three additional suicide attempts and was admitted to two impatient units for a combined total of 15 weeks. The employer became frustrated with Ron’s aggressive behaviour, considering it inappropriate, and elected to no longer attempt to engage with him.

After two years Ron had still not returned to work and his mental health did not improve during this time.

Recommendations:

  1. Communication is key! As soon as an employee is injured at work, it is important that the employer or a colleague checks on them regularly to ensure that they feel supported and are open to the recovery process. In this case, if communication lines were open, it would have been easier for the employer to determine that Ron was suffering from a mental health condition, which could have been managed and potentially prevented from escalating to suicide attempts.

Open communication may seem like a simple step however is often not done, particularly when mental health is concerned, for fear of making it worse for the individual.

 

  1. It is important to understand that, even when introducing positive changes, people experiencing low mental health will often react emotionally and can feel increased stress with change. This is likely how Ron felt when he received a return to work plan outlining alternate duties, without first being notified. By consulting Ron initially, he would have felt as though he had some input on the plan itself, and felt compassion from his employer.

This logic also applied when a person is still working within the workplace – businesses have a legal obligation to make reasonable adjustments to the workplace environment when a worker has disclosed low mental health, and that person needs to be a part of that discussion.

 

  1. Using language such as “we will work through it together” or “we are here to support you” shows empathy for the injured workers situation and allows them to feel valued. In this case, using language like “pull yourself together”, gave the opposite effect and caused Ron to stop communication altogether. This behaviour known as ‘avolition’ or ‘demotivation’ is typical for people experiencing low mental health, and is a sign that they often need more support to help them during these periods. It is important that if things have escalated to this point, professional advice should be sought. Suicide is fundamentally a coping strategy, a sign that a person doesn’t have a better way of coping or needs more communication around their mental health experience, and should be done professionally.

 

  1. Often people with low mental health such as Ron don’t understand why things happen unless it is explained to them; again, communication is key. Despite non-communication from Ron over the next several months as well as additional suicide attempts, although his aggressive behaviour was in fact unacceptable, reasonable attempts need to be made to explain why the employer’s communication will cease.

Although Ron’s reactions to his alternate duties were considered aggressive and unreasonable, his actions are realistic for someone suffering with a mental health condition. If your seeing signs similar to this case in your workplace, ensure that you initiate engagement, provide communication and support, and show compassion. Follow these steps, suggest and seek professional support if required, and preserve employee performance at work.

 

 

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