mental health disability management
Post on 22-Jul-2015
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ACHIEVING ABILITYProven Strategies to Help Employers
Effectively Manage Mental Health Claims
and Return to Work
Liz R. Scott, PhD
Principal / CEO
Organizational Solutions Inc.
www.orgsoln.com
info@orgsoln.com
• Over 130 employees
• Services provided in both official languages
• Over 1,000 corporate clients across Canada
• Regulated healthcare professionals & Paralegals
• High level of experience in the Disability Management and Workers’ Compensation field
• Invited Speakers & Authors of publications in the field
• Committed to the Power of DM to reduce human and financial cost through the provision of “the RIGHT care, at the RIGHT time, for the RIGHToutcome©”
Organizational Solutions Inc. offices
Organizational Solutions Inc.
• Organizational Solutions Inc – Nationwide Workers’ Compensation & Disability Management (DM) firm –with over 130 highly qualified staff
• Significant and positive experience in all sectors
• Over 25 years of experience in the field, education includes PhD, MEng, MBA, MSc, RN, teach University of Guelph, Ryerson and McGill, vibrantly lead OSI’s matrix
• Significant and positive experience in all sectors
• Committed to the Power of DM to reduce human and financial cost through the provision of “the Right care, at the Right time, for the Right outcome© OSI”
Agenda
• Complexity of Mental Health Claims
• Recognizing an Employee whose Mental Health impacts their work
• Importance of objective medical, the right diagnosis and the right treatment
• Effective return to work planning
• Duty to Accommodate
Business Challenges Concerning Disability / Absence Management
Current Disability / Absence Management Context in Canada
Rising Costs of Disability and Benefits
Current State of Health Care in Canada
The Duty to Accommodate
Current Context in Canada
• Time lost for disability and person absences increased by 60% from 1997 to 2007(1)
• Aging population
• Increasing incidence of mental health
• Escalating work-life conflict
• CSA Standard - Psychological Health and Safety in the Workplace
• More generous sick and family leave benefits
• Many organizations are still not aware of the cost drivers and reasons for absences
• Lack of policies, processes, roles and responsibilities
(1) Statistics Canada
Changing Legislative Environment
• Quebec allows “mental disorders”
• BC now allowing “mental disorders”
• Human Rights Commission Paper
• CSA standard
Drivers of Disability
Source: Human Resources Leadership Survey: Workplace Health Strategies in Canadian Organizations (2011).
Almost half of all respondents indicated Mental Health as their number one driver of STD
Current State of Health Care in Canada
• Shortage of family physicians;
• Limited patient time with physicians;
• Long referral waiting times (for specialists);
• Increased reliance on drugs
Median Wait for an Orthopaedic Surgeon in 2012 increased by 147% compared to 1993.
Health Care in Canada - Trends
Complexity of Mental Health
• No lab, no physical, few objective tests
• Collection of symptoms equate to a diagnosis
• Takes 1.7 times longer
• Not a fatal condition - don’t die soon
• Massive reserves - $250,000
• Media promotes “self diagnosing”
• Psychological diagnosis often gets interpreted as disability – perceived disabled once labeled
Trends in Mental Health
It is estimated that between compensation and lost productivity, mental health issues cost the Canadian economy $51 billion a year, of which $20 billion alone would be lost productivity.
The total loss represents 4% of GDP
(Towers Watson, 2012)
Factors that InfluenceMental Wellbeing
Social Factors;Previous learningCultural factorsPatient role – what’s Expected of us / asked of usModeling
Genetic Factors;Predisposed to waysof responding to / copingwith stress
Psychological Factors;Anxiety, stress, fear, tension
Family Factors;Observed experience ofillness as child; waysParental models soughthelp when ill
Health Beliefs;Extent of internal locus of controlPersonal coping styleBeliefs, expectations communicatedby professionalsHarrison & Hart, 2006
Most Frequent Mental Health Conditions
50%
19%
19%
5%
3% 2%1%1%
Depression
Adjustment Disorder
Anxiety
Alcoholism
Acute Stress Disorder
Bipolar Disorder
PTSD
Withdrawal
An integrated systematic process of
returning people to functioning lifestyles following an event
of disability by ensuring that they are in active treatment
and return to work as soon as possible…
Injury/Illness TreatmentReturn to
Work
DISABILITY MANAGEMENT IS:
Evidence Says…
• Recognize signs and symptoms early
• Workplace awareness
• Separate mental illness from life events / workplace issues
• Objective medical – the right diagnosis
• Appropriate treatment promptly
• Return to work!
Recognizing Early Warning Signs
• lateness or frequent breaks away
from office
• excessive sick leave &
‘presenteeism’ (on the job
absenteeism)
• reduced quality of work
• high rate of accidents
• Withdrawal / avoidance
• employee errors
• missed deadlines
• changes in physical appearance
• confusion or forgetfulness
• employee conflict
• inappropriate behaviour, mood
swings, negative attitude
Psychological Health in the Workplace• Prevention
• Understand your organizational needs & identify potential and existing issues
• Develop prevention and management strategies for psychological health
• Educate staff on mental illness and coping skills• Remove stigma by education on the realities of mental illness
• Learn mental health coping strategies are strained by stress, burnout, conflict or life events
• Awareness of mental health resources
• On line tools, Peer support, posters, articles, newsletters, lunch & learns, etc.
• Manager training to identify and address workplace mental health issues• Effectively recognize and manage mental health related issues in the workplace
• Principles and practicalities to manage issues related to employee mental health in the workplace including communication
• Managing conflict, performance management, return to work etc.
• Early intervention and employee support• Prevention & crisis response
• Temporary accommodation
• Modified work and accommodation• Return to work process
• Accommodation ideas for mental health related situations
Workplace Solutions
• Establish programs that support positive mental health and focus on coping strategies
• Ensure workplace addresses and recognizes the key areas of positive mental health
• Differentiate between workplace / personal issues and disability
Organizational Support
Sometimes there is a Problem
• Work with the team through individual & group sessions on respectful communication and workplace behaviours
• Provide coaching to the manager
• Facilitate work team and manager training on wide range of topics
The Solutions….
APPROPRIATE CLAIM INITIATION
ELIMINATE THE CONFUSION BETWEEN ILLNESS AND CHOICE ISSUES!
• Appropriate paperwork
• Solid adjudication / determination of disability
• Appropriate treatment / intervention
• Focus on RTW / capability
Event
Appropriate Assessment
Treatment & Stay at Work
Coping Mechanisms
Recovery & Return to
Work
The SolutionAction Driven Case Management
The absolute weight doesn't matter.
It depends on how long I hold it.If I hold it for a minute, it's not a problem.
If I hold it for an hour, I'll have an ache in my arm.If I hold it for a day, my arm will feel numb and paralyzed.
In each case, the weight of the glass doesn't change, but the longer I hold it, the heavier it becomes.“
"The stresses and worries in life are like that glass of water.Think about them for a while and nothing happens.
Think about them a bit longer and they begin to hurt. And if you think about them all day long, you will feel paralyzed –
incapable of doing anything.
Remember to put the glass down!
Stay At Work / Return to Work Is Healthy
Diagnosing Mental Illness
• Subjective symptoms that strung together create a diagnosis
• A disturbance in thoughts, feelings and perceptions that has a direct
affect in day to day function
• May affect thinking, mood and behaviour; This is associated with
distress and or functional impairment with symptoms varying from
mild to severe
• Affects people of all ages, from all walks of life
• Impacts on a personal, social and financial level
• This is goal focused treatment that will resolve the condition and enable a return to work
• Psychological disability management is essential to resolve the increased number of psychological claims
Access to Appropriate Care
Treatment Plan
• Addresses specific mental health issues as it pertains to work
o Prepares employee to return to work
o Helps employee find new ways of thinking and behaving in the workplace
o OSI liaises with family doctor, mental health services
o Attendance & compliance
• Number of treatment sessions can vary
Effective Return to Work Plan
• Focus on abilities NOT disability
• Develop a clear plan
• Document
• Set Goals
• Timelines
• Progressive (Max 6-8 wks)
• Communicate with Stakeholders
• Manage resistance and relationship
Duty to Accommodate
• Obligation to accommodate up to undue hardship
• Mental illness is recognized under the Human Rights Code
• Return to work strategies
6 Months761
Claims
Average durations reduced from 35 days to 19
That’s 16 days saved per claim
Savings of 12,176 days (761 claims x 16 days)
Average Salary 40k ÷ 250 days = $160 cost / dayat 70% payout =$112
Daily cost $112 x 12,176 total days saved
WE SAVED OUR CLIENT $1.364 MILLION DOLLARS IN 6 MONTHS
Case StudyTHE ROI EQUATION
AnalysisPeriod
Claim Volume
Impact on Duration(Days Saved)
Impact on Payout
Potential Savings
A 4 to 1 Return on Investment
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