To get people back to work after being off with a mental illness, the whole system — including physicians, psychiatrists, psychologists and insurers — need to engage in a collaborative effort to ensure individuals get the correct diagnosis and treatment with a focus on returning to the workplace.
That’s the message Carmen Bellows, a psychologist and western region mental-health consultant for group disability at Sun Life Financial, relayed to the audience at the recent Mental Health Summit in Vancouver. “It is important to break down silos and forge better relationships with everyone involved in providing care to someone going off on disability because of mental illness,” she said, adding that a lack of integration can be confusing and stall progress, making it difficult to get someone back to work.
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To help bridge the gap in understanding between providers and insurers, Bellows and her team consulted with members of the Canadian Psychology Association and the Canadian Psychiatry Association at their annual conferences to discuss ways to improve collaboration and communication.
“As insurers, our role is to provide income replacement, to minimize the impact of the disability and to increase function,” said Bellows. “So when we get information from the physician that is just the diagnosis, we don’t understand what’s going on with the individual or what the hurdles are for re-engaging with employment. It’s really important to specify symptom severity to determine the level of functional impairment.”
One issue identified by the mental-health community was filling out the required forms. “They told us the forms are tedious and they didn’t understand why they had to fill all this out,” said Bellows. “The second part is in regard to diagnosis. There was a real feeling of disrespect when we didn’t accept their diagnosis or asked for an independent medical exam.”
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More universal forms in the insurance industry could make the paperwork easier and provide clarity and collaboration to help specialists and physicians feel more respected. “They need to recognize that for a claim to be accepted, the individual needs to be actively engaged in appropriate treatment that mitigates the loss of function,” said Bellows. “And they should know that the condition identified needs to prevent the individual from doing the duties of their specific job.”
After reviewing the literature, Sun Life psychologists adopted three specific terms from the American Medical Association — risk, capacity and tolerance — to create an ongoing language to help psychiatrists and psychologists think about work ability and restrictions. “It’s important to include ongoing objective measures of response to treatment and treatment outcome,” said Bellows. “We continue to reach out to providers to ensure that information can be shared and effectively communicated to each other to get people back to work in a timely fashion.”
She concluded by stressing that the individual involved needs to feel supported and not policed. “That’s really paramount,” said Bellows.
Read more stories from the Mental Health Summit