Uncovering Mental Health Profiles of Workers with a Physically Disabling Injury or Illness Using the Complete State Mental Health Framework.

Abstract

Background: Complete mental health encompasses both mental illness (MI) symptoms and positive mental health (PMH). Distinct profiles of MI and PMH have not been explored among injured workers. This study describes latent mental health profiles among workers with a disabling physical work injury/illness and identifies differences in sociodemographic and return-to-work factors, health correlates, and disability claim duration and cost between profiles.

Methods: 1132 Ontario workers with a physical work-related injury/illness who received lost-time claim benefits were surveyed 18 months post-injury. MI was defined by the self-reported presence of a mood and/or anxiety disorder diagnosed by a healthcare professional pre- or post-injury. The Mental Health Continuum Short Form measured aspects of PMH. Claim information was obtained via administrative records. Latent profile analysis identified the unique number of MI and PMH profiles. Chi-Square and ANOVA tests compared sociodemographic, return-to-work, health, and claim outcomes between classes.

Results: Four latent MI and three latent PMH classes were uncovered. Eighteen percent of participants exhibited high MI symptoms diagnosed pre- and post-injury and 14% exhibited languishing PMH. Classes with higher MI burden and languishing PMH were more likely to report financial concerns during their claim, pain interference, other health conditions, and opioid use. Claim duration and wage-replacement benefits were ~ 20 days longer and ~ $2000 greater, respectively, among the highest MI and lowest PMH classes.

Conclusions: Workers' compensation claimants exhibit both flourishing and languishing mental health profiles. The demographic, health, and return-to-work characteristics of latent classes may help identify claimants who may benefit from additional psychological support when returning to work.