Diagnosing and managing work‐related mental health conditions in general practice: new Australian clinical practice guidelines

Mazza, Danielle; Chakraborty, Samantha P; Brijnath, Bianca; Nowak, Heather; Howell, Cate; Brott, Trevor; Atchison, Michelle; Gras, David; Kenardy, Justin; Buchanan, Richard; Tawia, Seyram

doi:10.5694/mja2.50240

Topics

General medicine

Mental disorders

Occupational diseases

Abstract

Introduction: In Australia, mental health conditions (MHCs) arising from workplace factors are a leading cause of long term work incapacity and absenteeism. While most patients are treated in general practice, general practitioners report several challenges associated with diagnosing and managing workplace MHCs.

This guideline, approved by the National Health and Medical Research Council and endorsed by the Royal Australian College of General Practitioners and the Australian College of Rural and Remote Medicine, is the first internationally to address the clinical complexities associated with diagnosing and managing work‐related MHCs in general practice.

Main recommendations: Our 11 evidence‐based recommendations and 19 consensus‐based statements aim to assist GPs with:

the assessment of symptoms and diagnosis of a work‐related MHC;
the early identification of an MHC that develops as a comorbid or secondary condition after an initial workplace injury;
determining if an MHC has arisen as a result of work factors;
managing a work‐related MHC to improve personal recovery or return to work;
determining if a patient can work in some capacity;
communicating with the patient's workplace; and
managing a work‐related MHC that is not improving as anticipated.

Changes in management as result of the guideline: This guideline will enhance care and improve health outcomes by encouraging:

the use of appropriate tools to assist the diagnosis and determine the severity of MHCs;
consideration of factors that can lead to the development of an MHC after a workplace injury;
more comprehensive clinical assessments;
the use of existing high quality guidelines to inform the clinical management of MHCs;
consideration of a patient's capacity to work;
appropriate communication with the workplace; and
collaboration with other health professionals.

1 Monash University, Melbourne, VIC
2 National Ageing Research Institute, Melbourne, VIC
3 Mental Health Australia, Canberra, ACT
4 Royal Australian College of General Practitioners, Melbourne, VIC
5 Western Industrial Screening and Accident Clinic, Melbourne, VIC
6 Royal Australian and New Zealand College of Psychiatrists, Melbourne, VIC
7 Royal Australasian College of Physicians, Melbourne, VIC
8 University of Queensland, Brisbane, QLD
9 Australian Psychological Society, Melbourne, VIC
10 Office of Industrial Relations, Queensland Government, Brisbane, QLD
11 Comcare, Melbourne, VIC

Correspondence: Danielle.Mazza@monash.edu

This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

Acknowledgements:

The development of this guideline was supported by the Australian Government Department of Jobs and Small Business and Comcare, the Office of Industrial Relations — Queensland Government, the State Insurance Regulatory Authority (NSW), ReturntoWorkSA, WorkCover WA and the Institute of Safety, Compensation and Recovery Research. The development of the final recommendations has not been influenced by the views or interests of the funding bodies.

Competing interests:

The online Supporting Information includes the declaration of competing interests.

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