Mental health suffers among workers permanently impaired by job injury

Depression and related symptoms are more common among workers with permanent impairments following a work-related injury than in the general population, according to a new study from Trent University and the Research Action Alliance on the Consequences of Work Injury.

Published: April 23, 2013

Workers who suffer a permanent impairment following a work injury are at greater risk of depression, sleep problems and medication abuse than the general population, according to new research from Trent University and the Research Action Alliance on the Consequences of Work Injury (RAACWI).

Our study paints a troubling picture of the mental health of injured workers with permanent impairments, who are struggling both physically and psychologically, says Dr. Fergal O’Hagan, assistant professor in Trent’s Psychology Department and lead author of the study. These workers may require mental health services and supports outside of the scope usually provided by the workers’ compensation system. The study was published in the July/August 2012 issue of the Canadian Journal of Public Health (vol. 103, no. 4, pp. 303-308).

The consequences of work injury are a major public health issue. Each year in Ontario, about 15,000 workers sustain a permanent physical impairment as the result of a workplace injury, according to the Workplace Safety and Insurance Board (WSIB). These impairments are characterized by ongoing pain, physical limitations and the inability to participate in some activities—all factors that make people susceptible to mental health problems.

Survey determines onset of problems

O’Hagan and his team used survey data collected by RAACWI to conduct the study. RAACWI was a six-year community/academic alliance, and Institute for Work & Health Scientist Dr. Emile Tompa was its academic lead.

The RAACWI survey included information from 494 injured workers in Ontario. These workers were English-speaking people aged 25 to 55 who filed first-time claims with the WSIB between 2002 and 2007, and then went on to be certified as permanently impaired between 2005 and 2007. O’Hagan sought to understand how many of these injured workers with permanent impairments were experiencing mental health problems, and when these problems first appeared—before or after the injury.

Depression elevated in injured workers

The key findings connected the dots between permanent work injuries and mental health problems:

  • Mental health problems were elevated in the injured workers compared to the general population. For example, the study found greater rates of diagnosed depression (38 versus 12 per cent), sleep problems (75 versus 48 per cent), medication abuse (12 versus two per cent), and problems concentrating (42 versus 10 per cent).
  • Among those reporting mental health problems, most arose after the injury. Post-injury onset was reported by 81 per cent of those diagnosed with depression, 92 per cent of those with sleep problems, 96 per cent of those abusing medications and 88 per cent of those having problems concentrating.

O’Hagan was surprised by the findings. What got me the most were the extent and range of problems, he says. Injured workers’ depressive symptoms were high years after the injury, in men and women, in those in high and low income brackets, with high and not-so-high levels of education. It was across the board. He also saw an unsettling number of people who described their use of prescription or over-the-counter medications as “abusive.”

O’Hagan hopes that workers’ compensation boards will pay more attention to the mental health of workers with permanent injuries. He suggests that services need to better integrate psychological care with physical rehabilitation. He also proposes a long-term tracking system of injured workers to check physical and psychological recovery.

This study is available online at