Monday, September 8, 2014

Mental Health and Success

Yesterday's Los Angeles Times article on the revelation of California Secretary of State, Debra Bowen's, life long struggle with depression got me thinking about how significant mental health is to overall health, and how it can impact the ability of employees to deal with a work injury (or even a perceived work injury), let alone just plain working even if the body is healthy.

Workers' compensation is not well adjusted for mental health issues. Mental "injuries" are the bane of workers' compensation.

Look at the various state laws in the current, "modern" workers' compensation state - generally there now has to be some significant "physical" event or issue to trigger benefits for a mental injury.

I put "modern" as an adjective in the above sentence because, for all of the sophistication, education and knowledge we as humans have accumulated in the past 100 years or so since workers' compensation first came around our "medicine" is decidedly in the 19th Century when it comes to psychology and psychiatry in managing and paying for mental health in industrial settings.
CA Sec of State, Debra Bowen
Even California, once the most liberal of states when it came to psychological or psychiatric injury, has put into place limitations requiring (unless a sudden and traumatic injury) that at least 50% of a person's mental health issue be from work before it is "compensable."

Granted, most of the laws on the books now constricting the availability of mental health treatment or recognition of mental health issues as possibly having some industrial causation is rooted in abuses of those laws, principally by professionals that sought to exploit the inherent amorphous nature of mental health and the liberal extensions of the law that metamorphosed over the years.

The problem with the laws that artificially limit the availability of "compensation" for mental "injuries" is that there they inhibit the ability of injured workers to get the treatment needed for a successful return to work.

When we look at the marvelous abilities of people with substantial physical limitations from birth, and their abilities to overcome the difficulties associated with these limitations, we derive hope and optimism for anyone faced with a disability - and we also as a consequence understand how powerfully important mental health is in dealing with physical limitations.

The story of Jennifer Bricker, the little girl abandoned at birth because she was born with no legs, whose adoptive parents never let her use the word "can't", and who ended up becoming a champion acrobat (and as it ends up the natural birth sister of Olympian Dominique Moceanu), inspires the optimist in me.

Other stories of similar import abound: last year at the California Workers' Compensation and Risk Conference in Dana Point keynote speaker was Bethany Hamilton, who lost an arm to a shark attack in Hawaii while surfing at age 13, and who went on to become an internationally ranked, professional surf champion.

Or Jessica Cox, born with no arms, who went on to becoming a private pilot, among many of her accomplishments.

If someone with such a huge impediment (at least to us born with normal function) can overcome all of the obstacles and hurdles in life to become what she wants to be and do incredible things, why are some unable to persevere and get over their work injury?

Why do some become slaves to their workers' compensation claim?

How is it that a top political figure, such as Debra Bowen, is able to manage her depression for so long and contribute to society, do her job, carry on as though she were perfectly healthy physically and mentally?

The difference, I suspect, is that workers' compensation systems don't want to deal with mental health.

Workers' compensation came out of a period of time when there was little to no understanding of mental health. An injury was a traumatic affair - cut off hand, fall from a roof, broken bone. Affected body part was treated with no concern or understanding of the psychological impact of the injury, or the psychology or psychiatry of the patient in any manner whatsoever.

The "Great Generation" knew very little about mental health, and just toughed it out. Mental health wasn't recognized except in pejorative terms; it was shameful to see a psychologist or therapist, family psychological history was kept "in the closet" and if you were depressed you just kept that to yourself...

Nothing in the origin of workers' compensation had anything to do with mental health.

Yet mental health has everything to do with whether or not someone can successfully deal with trauma - any kind of trauma: physical or mental.

I am reminded of mental health issues every time I visit my mother, a resident at a memory care facility. There are many different mental health issues at that facility and every day I see the same faces of deteriorated mental capacity, from advanced stage dementia and Alzheimer's Disease, to neurological impairments that prevent a well functioning brain to deliver the right messages to body parts or speech.

These folks look vapid and lost - but they aren't! Tell them jokes and they find humor and laugh; say "hello Tommy" to them and they smile; hold their hands and they look at you with gratefulness and warmth. They would tell you their amazing life's stories ... if they could remember.

The federal government used to be responsible for taking care of that small segment of the population that had severe mental health problems and subsidized psychiatric hospitals across the nation. That ended in the Ronald Reagan era when he eliminated federal spending on mental health from the budget.

I find it ironic that the President who stopped paying for mental health services himself became the victim of Alzheimer's Disease...

We all have different abilities to deal with life and the various twists and turns that come along. Some, like Bricker, Hamilton and Cox don't know the word, "can't."

Others didn't have that imbedded into their psyche. Recognizing and treating mental health as an overall part of successfully rehabilitating injured workers is important. How that is accomplished of course is subject to vast volumes of debate.

Billionaire John Paul DeJoria, the man behind brands such as Paul Mitchell, PatrĂ³n, and Rok Mobile (and who was once homeless and destitute), said in a video interview at Business Insider, "successful people do the things unsuccessful people don't want to do."

I think that DeJoria's quote can be extended to systems as well.

[Do you know of someone that was injured at work and overcame incredible obstacles to get back to work and become successful? If so, nominate them for a Comp Laude Award.]

1 comment:

  1. Wow Right on the mark, again sir. I know a rant a lot about the WA WC system. But I will say one thing about them though. They do agree and cover my mental health issues at this time. The only problem we have is with which providers they will pay for me to see, and which ones perscription or advice they will respect. And in our mental health care today their seems to be two different schools of thought on how to go about treating folks fighting against this sometimes broken comp systems. Some say to follow the truth in your heart and fight back against the abuse being imposed upon you. Civilly of course. While the others say find the right designer drug to help you cope and endure and learn to accept your abuse. Try and find out what you need to change...ect.... When what some of us injured workers needed to start with, is for our Grand Bargain to have been honored to start with. Honest injured folks fighting for their honor for decades, in a system they can not sue for harm done for the most part in. Doing this to folks would drive any one mad over time. And that is what makes this whole thing so much more abusive. The powers and elected folks that be, all ignore this abuse is going on, and some even condone it. Knowingly dragging folks throw a long legal system that only 1 in 50 will ever see the fight all the way through to the bitter end. For it destroys the lives of those laborers and injured workers who do try and stand up for their Grand Bargain many of whom, them and their employers have been paying premiums into. Only to be betrayed and drug through the legal mud, once injured are harmed on or by our jobs. WE ARE PATIENTS first and foremost. And any system that strives to deprive, one of their rights and justice and seek to destroy their mental health, then that same system profits off the misery in our MH systems? I don't know? but how can this even be a safe public safety policy to have in place. A system that is in some cases intently driving folks insane by intently hindering their roads to justice, so as folks will give up or go mad.... Not sound public policy, if you ask me. But of course im just an injured worker, who has been driven insane by the pure injustice and indignity of it all as an employee and a HUMAN, it degust me to the core. For it reeks of class ware fare, doled out willy nilly. All based in the most part these days on some ill educated Dr.s or MA's guts instincts. Which are proving to be wrong when we look at the objective medical evidence that in many cases is just being tossed to the side. and folks left the the whim of a bias one sided moral agenda pushing co. Dr.s flip of a coin. Peace as always. to all at the table in our world one day. Even the laborers and the "PATIENTS" being abused in this manor. Great Report though. I love it. That perks up my depression a bit lately, just to see that the TRUTH about workers comp is really getting out in to the open now days. Thanks for all you do folks. Your the best, and you do tell both sides. The sad part, is that one side is truly fleecing the American Labor force out of it's grand bargain, and patients out of their civil rights.