Filling the dark spot: fifteen injured workers shine a light on the workers compensation system to improve it for others

Executive summary   The Creative Ministries Network (CMN) provides support to people affected by workplace injury and work-related death. Over the last fifteen years CMN has undertaken a number of projects examining the relationship between work and suicide. These earlier studies highlighted a gap in the research into work injury and compensation in relation to workers’ mental health.[1]   Existing research has concentrated on examining the health and/or return-to-work outcomes of compensation processes rather than considering the impact of the process itself on workers’ health and recovery. The research has also largely been epidemiological and/or focused on particular industry settings, injury types or points in the process from injury through compensation, rehabilitation and return to work. Very little work has been undertaken on compensation systems[2] from the perspectives of injured workers.   This study is intended to continue CMN’s commitment to develop a better understanding of the role played by work injury in mental health and suicidality by understanding the ways in which the Victorian WorkCover system impacts on the mental health of workers with long-term injuries. The purpose was to identify how workers might be better supported after an injury, and identify changes that compensation authorities, employers and unions can make to reduce mental distress amongst injured workers who are clients of the WorkCover system.   Workers who took part in the study noted a number of positives in the current WorkCover system:   The existence of a system that had provided workers with income and financial assistance with medical and other expenses related to their injury.   The focus on return to work and the support provided to retrain and re-enter the workplace was seen as helpful.   The capabilities of insurers’ case managers and the return-to-work co-ordinators made a difference. Where these individuals were skilled both technically and interpersonally, able to show empathy and humanity, the injured workers reported a better experience and one that enhanced their mental health and recovery.   Largely positive interactions with healthcare providers.   From the perspective of the workers interviewed, the study also revealed a number of problems associated with Victoria’s WorkCover system:   Overall, workers experienced the system as unfair and unjust, believed it prioritised the interests of employers and failed to remedy the situation that had caused them injury in the first place.   The majority of workers reported being treated disrespectfully, dismissively or without humanity by the system.   Workers reported inefficiencies, errors and the complex requirements of the system combined to create a sense of being trapped in a game, where winning and disproving the worker’s version of events was the main aim.   Workers were not prepared for the evidentiary and adversarial nature of the process. This took a toll on their sense of trust, as did the poor interpersonal treatment they received from WorkCover personnel and, for some, their own employers.   Overall, workers struggled with the requirements of the process, especially at a time when the experience of being injured in the workplace affected their ability to function. The accumulation of these impacts left workers feeling devalued and dehumanised.   Specific points in the process that appeared to have the potential for particular impact on workers’ mental health were:   At the beginning, when workers were at their most anxious about whether their claim would be accepted.   Attending insurers’ doctors for medical assessment and medical panels.   Returning to work.   Workers identified several elements of their experience as helpful in terms of managing the process and contributing to better mental health and recovery. The most valued was support they had received to engage with the process. One aspect of this is technical support, independent advice to assist them to navigate the system. But workers also stressed the importance of emotional support, someone who believed their version of events without question, someone who could see the workers’ desire to return to work and could hold onto the good worker identity of the individual.   It was less important where this came from (union, family, friends, GP and psychologist were all mentioned). What was seen as vital was the person who provided the support understood what the WorkCover experience was like and could assist the worker to navigate it.   This finding highlights the important issue of how the system might better utilise trained peer support workers to assist injured workers, a topic CMN is particularly keen to engage with WorkCover on.   The project makes the following recommendations:   Recommendation 1 Funding is sought for a pilot project to develop, trial and evaluate an intervention that utilises trained peer support workers in assisting injured workers’ recovery for life and work.   Recommendation 2 A course outline be developed, drawing on workers’ lived experience knowledge, for the professional development of WorkCover insurance case managers aimed at improving their ability to deal with traumatised and ill clients.   Recommendation 3 That injured workers and/or their representatives are included in future relevant research reference groups and policy development processes.   Recommendation 4 Further research is undertaken in relation to workers’ lived experience and what supports their recovery, including interactions with the WorkCover system. This research would deliberately target workers with serious physical and psychosocial injuries but who have recovered. This research could identify what was different in the workers’ experience and how they understand their experience.     [1] Mental health’ in this report refers to the workers’ self-described experience of their own mental, emotional and psychological well-being. This definition of ‘mental health’ draws on the notion of a ‘lived experience’ knowledge base and is consistent with the conceptualisation of mental health, ill-health, distress found in the literature on mental health recovery.   [2] The ‘system’ referred to throughout this report is that of Victorian WorkCover, constituted by legislation and administered by the Victorian WorkCover Authority. The system has defined roles for private insurers, employers, trade unions, health providers, workers and injured workers. &nbsp

Food banks, austerity and critical social work

The Routledge Handbook of Critical Social Work brings together the world's leading scholars in the field to provide a cutting-edge overview of classic and current research and future trends in the subject

Workers’ compensation and mental health : examining the mental health impacts of involvement in the Victorian Work Cover system from the perspective of long-­term injured workers

The project aimed to explore long--term injured workers&rsquo; experiences and perceptions of their mental health as they progressed through the Victorian WorkCover process. The purpose of the project was to assist in understanding these factors in order to identify how workers might be better supported, and to identify changes that compensation authorities, employers and unions can make to reduce mental distress amongst injured workers. As a project based on workers&rsquo; accounts of their experiences, it aimed to provide a narrative basis for the development of supportive policy and practice to reduce mental distress amongst people who are clients of the WorkCover system. The project was a qualitative study based on fifteen in--depth interviews with people who had been injured at work and who had been off work for at least six months. The workers who took part in the study were recruited with the assistance of their trade unions, using an advertisement that was distributed via the unions&rsquo; regular communication channels. Workers were asked to tell their story of injury and recovery with a particular focus on how they felt and the factors that affected them, both positively and negatively. They were also asked what could or should be changed to support workers&rsquo; recovery and improve their experience of the WorkCover system. The workers who took part in the study came from a variety of industry sectors (education, textile and clothing manufacturing and meat industries) and different occupational categories (professional, trade/technical and manual). They included people whose primary injury was physical and those whose primary injury was psychosocial. <br /

Talking it up! Project report : Aboriginal voices in the formulation of health policy that works : full report

Initially, there were three separate strands to the work of the project: a series of forums involving group interviews/discussions with community members; a policy analysis that reviewed policies relating to Aboriginal health at federal and state level; and a literature review. The results of these three separate strands of analysis were then brought together in a fourth strand to the work, a process involving community members to discuss and agree the overall recommendations contained in this report.Through this structure, the project employed a participatory methodology as the basis for individual and collective empowerment in relation to health outcomes. As mentioned above, the need for the project was identified by Aboriginal people, through their own processes of healing. The need was presented by appropriate figures within their communities, namely community elders. They invited other Aboriginal people to take part through their own communication channels, thus ensuring that responsibility for engagement in the project, and in formulating action for improvement, remained with Aboriginal people and their families. However, the project design also recognised that Aboriginal people exist within broader structural and policy constraints which impact on their ability to manage their own lives successfully or otherwise. Thus the project sought to combine indigenous and non-indigenous knowledge through bringing together the three strands of work in the way described.A Community Reference Group guided the work of the project at all stages, endorsed the findings and drafted the recommendations. The two elders who had identified the need for the project formed the core of the group, and worked on the project from start to finish. At different times during the project, other community members joined the group to assist in its work, including training Aboriginal researchers, letting others know about the forums, discussing findings and drafting recommendations.Initially, there were three separate strands to the work of the project: a series of forums involving group interviews/discussions with community members; a policy analysis that reviewed policies relating to Aboriginal health at federal and state level; and a literature review. The results of these three separate strands of analysis were then brought together in a fourth strand to the work, a process involving community members to discuss and agree the overall recommendations contained in this report.Through this structure, the project employed a participatory methodology as the basis for individual and collective empowerment in relation to health outcomes. As mentioned above, the need for the project was identified by Aboriginal people, through their own processes of healing. The need was presented by appropriate figures within their communities, namely community elders. They invited other Aboriginal people to take part through their own communication channels, thus ensuring that responsibility for engagement in the project, and in formulating action for improvement, remained with Aboriginal people and their families. However, the project design also recognised that Aboriginal people exist within broader structural and policy constraints which impact on their ability to manage their own lives successfully or otherwise. Thus the project sought to combine indigenous and non-indigenous knowledge through bringing together the three strands of work in the way described.<br /

Talking it up! Project report : Aboriginal voices in the formulation of health policy that works : short report

Initially, there were three separate strands to the work of the project: a series of forums involving group interviews/discussions with community members; a policy analysis that reviewed policies relating to Aboriginal health at federal and state level; and a literature review. The results of these three separate strands of analysis were then brought together in a fourth strand to the work, a process involving community members to discuss and agree the overall recommendations contained in this report.Through this structure, the project employed a participatory methodology as the basis for individual and collective empowerment in relation to health outcomes. As mentioned above, the need for the project was identified by Aboriginal people, through their own processes of healing. The need was presented by appropriate figures within their communities, namely community elders. They invited other Aboriginal people to take part through their own communication channels, thus ensuring that responsibility for engagement in the project, and in formulating action for improvement, remained with Aboriginal people and their families. However, the project design also recognised that Aboriginal people exist within broader structural and policy constraints which impact on their ability to manage their own lives successfully or otherwise. Thus the project sought to combine indigenous and non-indigenous knowledge through bringing together the three strands of work in the way described.A Community Reference Group guided the work of the project at all stages, endorsed the findings and drafted the recommendations. The two elders who had identified the need for the project formed the core of the group, and worked on the project from start to finish. At different times during the project, other community members joined the group to assist in its work, including training Aboriginal researchers, letting others know about the forums, discussing findings and drafting recommendations.<br /

Power and participation: enhancing service user agency in social care

The research explored how community services organisations could enhance service user agency through a participatory approach to service development. It demonstrates, theoretically and empirically, how participation can offer individual empowerment and wellbeing benefits to service users, and deliver insights for organisations and government into how they could improve their services

Narratives of under-representation: older Pakistani women’s accounts of their health and social care experiences

This research project explores older Pakistani women’s narratives of their interactions with health and social care systems. Initially situated in social work practice, the study developed from my experience working in an intermediate care facility. The project was located in a town identified as one of the most deprived in England in 2016, and where 10% of the population self-identified as Pakistani according to 2010 Census data. Rather than remain located in a specific service, the project evolved to take a broader approach; narrative interviews were conducted with eight older Pakistani women. The open question ‘please tell me about an encounter you have had with health or social care’ elicited a spectrum of responses. Transcripts were analysed using dialogic performance analysis and each interview was developed into a case study incorporating extracts of the original transcripts. Four themes were then constructed through thematic analysis of the narratives from each case study. The themes expose the intersectional nature of oppression and disadvantage experienced in interactions with health and social care services. This indicates that social class plays a substantial role in whether racial abuse and/or discrimination has an impact on an individual’s identity. Social class was also important in generating boundaries of space and place, with increased capital playing a key role in expanding the boundaries of ‘safe spaces.’ Racism was experienced by all participants and was generalised across numerous different fields, leading in many cases to an expectation of poor care provision. The implications of these findings are two-fold; primarily, those who experience the most intersectional oppression are most likely to have their identity affected by racial abuse and/or discrimination, therefore affecting their future interactions. Additionally, those experiencing significant intersectional disadvantage are less likely to encounter the white population outside of health and social care interactions. It is therefore in these exchanges that the impact on identity is played out, with potential consequences for the health of these individuals. Secondly, racist behaviour is generalised from one professional to whole professional groups, and from one field to another, contributing to the development of a system of representation. This indicates that any steps taken to adapt or improve the accessibility of individual services will have limited, localised impact at most. To facilitate more equitable distribution of health and care services, the emphasis needs to be on addressing intersectional oppression and discrimination on a societal level, with a focus on the limiting impact of socio-economic disadvantage and dismantling of oppressive representational system

Configuring the caller in ambiguous encounters: volunteer handling of calls to Samaritans emotional support services

This paper discusses volunteer strategies for handling and assessing calls to Samaritans emotional support services for the suicidal and despairing. It presents findings from the qualitative components of a two year mixed methods study based on an online caller survey, branch observations and interviews with volunteers and callers throughout the UK. A thematic analysis of the qualitative data analysis was undertaken using the principle of constant comparison. Many calls fell beyond the primary remit of a crisis service, and called for rapid attribution and assessment. Uncertainty about identifying ‘good’ calls and recognizing those which were not caused difficulty, frustration and negative attribution towards some callers. This paper presents our analysis of volunteers’ accounts of how they configure the caller in intrinsically uncertain and ambiguous encounters, and how such strategies relate to the formal principles of unconditional support and non-judgemental active listening espoused by the organization

The long arm of the law : abortion access for unaccompanied minors

In part one of this report, I use the ongoing legal case Garza v. Hargan as a framework for the discussion and analysis of laws and policies that govern abortion access for unaccompanied female minors in the United States. I give particular attention to the Office of Refugee Resettlement [ORR]’s history with faith-based NGOs, the evolution of abortion law as it pertains to this population and an analogous population (incarcerated women), and the more extreme measures taken by anti-abortion advocates and policymakers. I conclude with a consideration of the impact of ad-hoc policymaking, a reflection on the implications of the recent Supreme Court decision Obergefell v. Hodges, a detailed analysis of ORR’s current policies (their flaws and possible solutions) and a broader call to action. In part two, I include a functional document written in collaboration with an interested organization, to help certain interested parties quickly become educated about this issue and the Garza case, enabling them to engage in practical work from a well-informed foundationPublic Affair

Membrane protein nanoparticles: the shape of things to come

The use of styrene-maleic acid (SMA) for the purification of a wide range of membrane proteins (MPs) from both prokaryotic and eukaryotic sources has begun to make an impact in the field of MP biology. This method is growing in popularity as a means to purify and thoroughly investigate the structure and function of MPs and biological membranes. The amphiphilic SMA copolymer can effectively extract MPs directly from a native lipid bilayer to form discs approximately 10 nm in diameter. The resulting lipid particles, or styrene-maleic acid lipid particles (SMALPs), contain SMA, protein and membrane lipid. MPs purified in SMALPs are able to retain their native structure and, in many cases, functional activity, and growing evidence suggests that MPs purified using SMA have enhanced thermal stability compared with detergent-purified proteins. The SMALP method is versatile and is compatible with a wide range of cell types across taxonomic domains. It can readily be adapted to replace detergent in many protein purification methods, often with only minor changes made to the existing protocol. Moreover, biophysical analysis and structural determination may now be a possibility for many large, unstable MPs. Here, we review recent advances in the area of SMALP purification and how it is affecting the field of MP biology, critically assess recent progress made with this method, address some of the associated technical challenges which may remain unresolved and discuss opportunities for exploiting SMALPs to expand our understanding of structural and functional properties of MPs