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Innovations in Prevention and Management
Behavioral Health Disability Innovations in Prevention and Management Pamela A. Warren It’s a frequent occurrence: a sick worker is treated for physical symptoms, but receives little care for the accompanying psychological problems. The employee is put on ineffective medication, is suspected of malingering, and never fully recovers. The authors of the Behavioral Health Disability attribute this no-win situation to systemic misunderstandings between medical and mental health providers, employers, and insurers—often despite earnest efforts toward integrative care. In its place, they set out a practical, evidence-based framework not only for more accurate evaluation and more effective treatment of conditions, but also better collaboration across specialties, with the legal and insurance systems, and with the workplace, resulting in fewer mental health disability claims, fewer “maintenance” prescriptions, lower costs, and ultimately better outcomes for clients. This book: • Represents the viewpoints of multiple treating professionals—primary care, occupational medicine, psychology, psychiatry, and rehabilitation medicine—as well as legal, employer, and insurer perspectives. • Identifies strengths and weaknesses in standard assessment, treatment, or policy for each specialty. • Examines referral, documentation, and compliance issues. • Describes the medicalization of psychosocial concerns, and how it can be avoided. • Includes strategies for addressing the individual’s return to work. • Offers recommendations for immediate and long-term improvements in disability case management. The Behavioral Health Disability provides groundbreaking guidance for the spectrum of professionals involved in psychiatric disability cases, among them health and clinical psychologists, psychiatrists, primary care physicians and rehabilitation specialists, clinical social workers, nurses, and insurance companies.
Overview of the scope of psychological and behavioral health disability -- Overview of the lack of coordination of treatment -- Overview of lack of coordination among all professionals involved in the psychological and behavioral health disability process -- True psychological concerns versus psycho-social concerns -- Comorbidity and psychological concerns -- present multiple perspectives from different types of professionals involved in the psychological and disability process. -Primary Care Medicine and Psychological and Behavioral Health Disability -- Epidemiological and prevalence of psychological and behavioral health concerns in primary care medicine -- Discussion of usual care treatment process: strengths and weaknesses -- Determining current psychological functioning: strengths and weaknesses -- Referral and coordination of treatment considerations: strengths and weakness in current process -- Medicalization: The process of taking everyday occurrences and identifying them as medical concerns -- Malingering and symptom exaggeration -- Patient compliance issues: limitations and strategies for improved management -- Appropriate documentation of limitations in functioning -- Treatment outcomes: Strategies for addressing individual’s return to work -- Occupational Medicine -- Epidemiological and prevalence of psychological and behavioral health concerns in Occupational Medicine -- Discussion of usual care treatment process: strengths and weaknesses -- Determining current psychological functioning: strengths and weaknesses -- Referral and coordination of treatment considerations: strengths and weakness in current process -- Medicalization: The process of taking everyday occurrences and identifying them as medical concerns -- Symptom exaggeration and malingering -- Patient compliance issues: limitations and strategies for improved management -- Appropriate documentation of limitations in functioning -- Treatment outcomes: Strategies for addressing individual’s return to work -- Psychology -- Epidemiological and prevalence of psychological and behavioral health concerns in Clinical Psychology -- Discussion of usual care treatment process: strengths and weaknesses -- Determining current psychological functioning: strengths and weaknesses -- Appropriate psychological testing -- Symptom exaggeration and Malingering -- Referral and coordination of treatment considerations: strengths and weakness in current process -- Medicalization: The process of taking everyday occurrences and identifying them as medical concerns -- Patient compliance issues: limitations and strategies for improved management -- Appropriate documentation of limitations in functioning -- Treatment outcomes: Strategies for addressing individual’s return to work -- Psychiatry -- Epidemiological and prevalence of psychological and behavioral health concerns in Psychiatry- Discussion of usual care treatment process: strengths and weaknesses -- Determining current psychiatric functioning: strengths and weaknesses -- Psychological testing -- Symptom exaggeration and Malingering -- Referral and coordination of treatment considerations: strengths and weakness in current process -- Medicalization: The process of taking everyday occurrences and identifying them as medical concerns -- Appropriate documentation of limitations in functioning -- Treatment outcomes: Strategies for addressing individual’s return to work -- Rehabilitation -- Epidemiological and prevalence of psychological and behavioral health concerns in Psychiatry -- Discussion of usual care treatment process: strengths and weaknesses -- Determining current psychiatric functioning: strengths and weaknesses -- Rehabilitation assessment and testing -- Symptom exaggeration and Malingering -- Referral and coordination of treatment considerations: strengths and weakness in current process -- Medicalization: The process of taking everyday occurrences and identifying them as medical concerns -- Patient compliance issues: limitations and strategies for improved management -- Appropriate documentation of limitations in functioning -- Treatment outcomes: Strategies for addressing individual’s return to work -- Legal Perspective -- Plaintiff versus defense perspective on psychological and behavioral health disability -- State legislative considerations -- Federal considerations: FMLA and ADA -- HIPAA limitations with disability -- Legal perspective in defining appropriate outcome -- Employer Perspective -- Maintaining a productive workplace -- Workplace absence policy: Strengths and weakness in current employer policies -- Problematic workplace behaviors that serve as catalysts for filing for a psychological disability claim -- Obtaining required documentation: strengths and weaknesses in current process -- Gaps in communication with treating professionals -- Appropriate workplace accommodations -- Helping the employee stay at work -- The insurer and psychological/behavioral health disability -- Insurer perspective -- Case management perspective -- Current issues in providing insurance coverage for psychological, behavioral health, and co-morbid claims -- Current identified drivers of psychological disability claims -- Strategies for effective management -- Future Directions -- Summarization/recap -- Recommendations for initiating immediate change in the process -- Implications for long-term change -- Implications for future research.