May 2022 – The Rising Tide of Mental Health Advocacy
“We need more effective methods of identifying mental health issues…”
Wherever we look there seems to be more knock-on effects from the pandemic.
Increased levels of anxiety.
Individuals reassessing their priorities.
Claims operation staff ‘churn’.
Resistance to return to the office.
However, maybe one beneficial side-effect of the pandemic is that we are witnessing an increased acceptance of mental health as a treatable condition, rather than a sign of weakness.
Historically we have seen, in our data, a large proportion of MH issues going unreported and therefore untreated.
People don’t want to admit to depression!
And people don’t want to admit to feeling anxious!
This is particularly true in the workplace environment.
One of the issues with employment-based benefits particularly in the US is that most individuals’ health and wellness services are provided through their employer.
Furthermore, for any physical condition, we know that return to work is complicated by MH issues.
A rotator cuff injury has a published medical guideline for recovery, depending on the level of physical activity required by the job.
Yet there is no guideline for the complication of a MH condition for that same individual!
We see clearly that when our employee has complicating MH factors, recovery will take longer.
If our claimant is also depressed about their job, hate their boss, has family stresses, financial worries, and the very thought of returning to work, makes their shoulder pain even worse.
Is this classifiable as major depression?
No probably not, but it will be enough to disrupt a normal RTW. Such an unreported MH condition will make the RTW more complex.
In The Claim Lab’s work with other clients, we see that it’s the minor levels of depression and anxiety that are likely to go untreated. This diagnosis is not likely to be on the claim form, and employees are very reticent to talk about such feelings in anything related to a workplace situation.
At the moment, in the US, there is much discussion about the 24-month limitation on Mental Health claims.
In this new world, post pandemic, is policy restriction sustainable?
A number of States are already passing legislation to prevent insurance carriers from using this policy clause.
In Canada and Australia, no such limitation exists.
In the US many carriers do not actively manage claims with a MH primary DX because the policy terms prevent the claim from lasting more than 24 months?
We see much evidence to suggest, in US data, that post 24 month “MH” claims morph into something else… maybe an MSK pain claim at some point.
Interestingly, in the US we see proportionately many more MSK claims than we do in Canada. In fact, if you combine MSK and MH together the Canadian and US data shows a similar level of incidence!
So, the fear in the US of “OMG, how do we price for this?” well … maybe you are already!
Also, if the US was to invest proactively in MH interventions in the same way the Canadian claims operations do, then results could improve further.
However, this is a diversion, as the real issue is not the severe MH claims, as they are relatively easy to identify and there are interventions that work. Canadian claims operations have proved this.
The more complex issue is the volume of claims where there is an unreported, co-morbid MH issue, that will make RTW far more complex.
We can now identify these issues within claims data, the challenge now is to build a more effective claim process to provide a support environment to intervene early in the process to help individuals with an underlying mental health issue get them back to work sooner…
This month is Mental Health Awareness Month and will help to bring such issues into sharp focus.
To learn about the identification of mental health issues, email us at info@claimlab.org
Thank you!
Ian Bridgman
Executive Director