Mental Health Claims Management and Return to Work: Qualitative Insights from Melbourne, Australia Bianca Brijnath • Danielle Mazza • Nabita Singh • Agnieszka Kosny • Rasa Ruseckaite • Alex Collie Ó Springer Science+Business Media New York 2014 Abstract Purpose Mental health conditions (MHC) are an increasing reason for claiming injury compensation in Australia; however little is known about how these claims are managed by different gatekeepers to injury entitle- ments. This study, drawing on the views of four stake- holders—general practitioners (GPs), injured persons, employers and compensation agents, aims to describe current management of MHC claims and to identify the current barriers to return to work (RTW) for injured per- sons with a MHC claim and/or mental illness. Methods Ninety-three in-depth interviews were undertaken with GPs, compensation agents, employers and injured persons. Data were collected in Melbourne, Australia. Thematic techniques were used to analyse data. Results MHC claims were complex to manage because of initial assessment and diagnostic difficulties related to the invisibility of the injury, conflicting medical opinions and the stigma asso- ciated with making a MHC claim. Mental illness also developed as a secondary issue in the recovery process. These factors made MHC difficult to manage and impeded timely RTW. Conclusions It is necessary to undertake further research (e.g. guideline development) to improve current practice in order to enable those with MHC claims to make a timely RTW. Further education and training interventions (e.g. on diagnosis and management of MHC) are also needed to enable GPs, employers and compensa- tion agents to better assess and manage MHC claims. Keywords Australia Á Insurance claims review Á Mental health Á Return to work Introduction In Australia work-related mental stress is the second most common cause of workplace compensation claims after manual handling [1]. Mental stress can have a deleterious effect on an individual person’s physical and psychological health, work productivity and wider social relationships [2, 3]. Prolonged exposure to mental stress in the workplace— whether as a result of high work load, exposure to violence, bullying and/or harassment, trauma and other factors—can lead to mental illnesses, such as depression, post-traumatic stress disorder (PTSD) and anxiety, as well as physical conditions, such as increased blood pressure, migraines, and sleep disorders [4, 5]. In 2007 work-related mental health conditions (MHCs) were estimated to cost the Australian economy $14.1 bil- lion with direct costs to employers in the vicinity of $10 billion [6]. Albeit high, these costs do not capture the full extent of the problem as a number of people (as many as 70 %) either do not apply for mental stress claims or have their claims rejected [7, 8]. Though the reasons for underreporting of MHC claims in Australia are not entirely clear, a Canadian study suggests that the fears of being B. Brijnath (&) Á D. Mazza Á N. Singh Department of General Practice, Faculty of Medicine Nursing and Health Sciences, School of Primary Care, Monash University, Building 1, 270 Ferntree Gully Rd., Notting Hill, Melbourne, VIC 3168, Australia e-mail: bianca.brijnath@monash.edu A. Kosny Á A. Collie Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Sciences, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia R. Ruseckaite Á A. Collie Institute for Safety Compensation and Recovery Research, Monash University, Melbourne, Australia 123 J Occup Rehabil DOI 10.1007/s10926-014-9506-9