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Behavioral Health and Occupational Medicine: Concepts

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Handbook of Behavioral Health Disability Management

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Abstract

The extensive role and impact of behavioral health factors are still poorly recognized and accepted in occupational and environmental medicine. They strongly influence worker absenteeism and presenteeism and workplace function, generating very significant direct and indirect costs to enterprises and exacting a large societal toll in terms of productivity. They contribute to delayed and failed recovery from work-related conditions and unnecessary disability, exert profound iatrogenic effects, and are fundamental to medically unexplained physical symptoms. This chapter reviews these considerations in detail, discusses how they constitute a major management dilemma for all stakeholders, and explores some reasons for the widespread reluctance to address these issues.

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Notes

  1. 1.

    These spheres of influence include administrative and medical factors, BH elements, personal and sociocultural influences, and systemic and workplace factors (Caruso et al. 2011).

  2. 2.

    This includes disproportionate claim costs, with 7–8% of claims generating roughly 80–85% of costs (Kennedy 2016; Rosenblum 2016), and disparate cost generation by physicians, with 4–7% of physicians engendering 70–72% of costs (Bernacki, Tao, and Yuspeh, 2010; Wolfe 2013).

  3. 3.

    Many of these considerations, especially AABEs, apply to other stakeholders as well as the AW, including family members and significant others, clinicians, allied health personnel, insurers, employers, regulators, and both plaintiff and defense attorneys.

  4. 4.

    Christian (2017) added an economic dimension, which may become important in motivation and as a driver of behavior.

  5. 5.

    Psychological distress refers to negative affect and mood and consequent emotional suffering, which may adversely impact work and daily living function without necessarily meeting criteria for diagnosis as a psychiatric disorder (Drapeau et al., 2012).

  6. 6.

    Examples include fibromyalgia, irritable bowel, and chronic pelvic pain syndromes; multiple chemical sensitivity; and idiopathic environmental intolerance.

  7. 7.

    These terms often appear to be used euphemistically when the clinician has no better descriptor for pain or other symptoms of uncertain etiology.

  8. 8.

    See http://www.lni.wa.gov/ClaimsIns/Files/OMD/MedTreat/2016PDIRResourceFinal.pdf

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    Garson M. Caruso

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Caruso, G.M. (2018). Behavioral Health and Occupational Medicine: Concepts. In: Warren, P. (eds) Handbook of Behavioral Health Disability Management. Springer, Cham. https://doi.org/10.1007/978-3-319-89860-5_9

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