Adelaide Psychological Services supports the initiatives by the SA Government to improve psychological rehabilitation services for workers with a mental health injury by amending the WorkCover Act and by re-organising the responsible agency to form ReturnToWorkSA. The public was informed that the old WorkCover Corporation had faced financial troubles because of both the increasing number of claims for mental health injuries and the long periods workers remained on income support. This is clearly an area where skilled rehabilitation psychologists can make a contribution to the community.
After a year of planning and 6 months of implementation, it is timely to review how well the new system is operating.
Adelaide Psychological Services is disappointed by the limited leadership shown by senior staff of the new ReturnToWorkSA. As many psychologists have moved into private practice following the introduction of Medicare funding for psychological therapy in 2007, it is possible to widen the group of skilled therapists who assist workers with a mental health injury, and to move away from reliance solely on a small group of therapists who operated with WorkCover while the troubles were developing. It is appropriate for ReturnToWorkSA to introduce new practice guidelines to coordinate the efforts of multi-disciplinary professionals who operate within the Workers system, and to move away from the old system that did not work.
New practice guidelines could recognise not all workers have the same issues or the same level of difficulty, to introduce a system that provides a sequence of services that are delivered in phases for workers at each phase of recovery. It is not sensible to continue with a system that dichotomises workers into those whose problems are simple and can be resolved within a few weeks, and those who are permanently impaired. Many workers have serious injuries and require carefully coordinate inter-disciplinary support for a period of many months before they return to work, and these are the workers who should benefit from a revised system.
One senior staff of the old WorkCover informed the writer that WorkCover did not plan to introduce guidelines for dealing with complex cases, saying complex issues could wait until the Workers Rehabilitation and Compensation Tribunal made rulings. This approach leads to litigation that is unnecessary and that increases psychological trauma for workers who are already injured.
Many cases have predictable complexities that would benefit from administrative guidelines provided in advance. Workers who do not quickly return to work due to a mental health injury commonly have a medical treatment team (including a GP, physiotherapist, surgeon and psychologist), a return to work or rehabilitation coordinator, and a case manager. But there are no guidelines about how these three sets of professionals will communicate or coordinate their efforts.
The powers of case managers have been increased, but the public has no precise information about how case managers use their new powers. The new system continues the considerable confusion that bedevilled the old system, leaving workers still exposed to frustrations arising from dysfunctional communication within the rehabilitation system. The new system appears to be diverting workers with a mental health injury away from effective therapy that is provided promptly. The current system continues to exacerbate mental health distress for workers who begin with a mild and treatable case of anxiety or depression.
Adelaide Psychological Services also has concerns about the limited role being played by the national association presenting psychologists, the Australian Psychological Society. These concerns were accentuated during the recent AGM of the state branch in December 2015. Representatives of the national society meet regularly with ReturnToWorkSA. But questions are being asked about whether the current committee is supporting the interests of the few psychologists who have always liaised with the WorkCover Corporation and who contributed to the troubles emerging, or whether the committee represents the interests of its wider membership.
The involvement of the state government in changing legislation reflects the high level of public interest in this important topic of how best to provide rehabilitation for workers with a psychological or mental health injury they incurred in their workplace. There is a need for ongoing open discussion until the public is confident that changes have been made and a new system is functioning well.