Work Related Mental Injury

1. Work Related Mental Injury Dr Kris Fernando National Psychology Advisor Peta Levin, Branch Psychology Advisor, Dunedin Service Centre Presentation to NZCCP March 2011

2. Agenda • Recap on mental injury • Definition and Cover criteria • Work-related mental injury • Cover criteria, definitions • Reports

3. Recap on mental injury Cover is available for mental injury: • because of physical injuries for which the person has cover including injury from accident, treatment injury etc • sensitive claims • work related mental injury Note: criteria must be considered in all cases Sections 21 and 21B of the Act provide details

4. Mental Injury: Definition • mental injury defined in the AC Act 2001 • Section 27: Mental Injury means a clinically significant behavioural, cognitive, or psychological dysfunction • Recognised psychiatric/psychological condition: • Qualified person to provide assessment and report - Criteria

5. Sensitive Claims • Section 21: Cover for mental injury caused by certain criminal acts • No physical injury required • Does require that an act be performed on the client / victim by another person, and • A causal link between the act and the mental injury • The act is of a kind described in Schedule 3, major sex crimes such as sexual violation and indecent assault and others

6. Mental Injury as a consequence of physical injury • Section 26(1)(c) • mental injury suffered by a person because of physical injuries suffered by the person • Note: Woodd and other cases • ACC provides cover for mental injury if there is a direct causal link to a physical injury for which the person has cover • Referred under Psychological Services 6 hours – MIO1 form

7. Work-related Mental Injury • Section 21B introduced in 2008 • When the mental injury is caused by exposure to a traumatic event in the course of employment • Came into force on 1 October 2008 • Psychiatrists – mental injury reports

8. WRMI: Background • Experiencing traumatic events can affect people from no impact to severe long-term problems • Prior to 1 October 2008 there was no ACC cover for mental injury caused by exposure to a sudden traumatic event at work • Inconsistent with a number of overseas jurisdictions • High profile cases (milk tanker driver, train driver)

9. When: Date of injury • WRMI: the date on which the person first receives treatment for that mental injury “as that mental injury” • Same provision for sensitive claims • Note: for WRMI the date of first treatment must be after 1 October 2008

10. Who & Where: Relation to work • A person has cover for mental injury if: • they suffer the mental injury inside or outside New Zealand, and • It is caused by an event that meets criteria of ‘work-related personal injury: section 28(1) • Section 28(1) • At work • On a meal break / rest break • Travelling to or from work • Travelling from work to get treatment for a work-related personal injury

11. What: Defining the event • Section 21 (7) An event is: • Sudden event or a direct aftermath of a sudden event • Example: train driver witnesses a suicide and emergency workers who attend • A series of events from the same cause or circumstance that comprise a single event • Example: shop keeper accosted by an armed thief, bound and forced into a cupboard until the next day • Not a gradual process • Example: office worker with constant work demands

12. Cause: Sudden and traumatic • A sudden traumatic event that could reasonably be expected to cause mental injury in people generally • By that we mean: • outside the range of ‘normal’ experience • capable of provoking extreme distress in most people • involves a real threat of significant harm • would induce feelings of horror, alarm and shock in most people.

13. Causes injury in “people generally” • could reasonably be expected to cause mental injury in people generally • Does not mean: • people with similar underlying mental health conditions, or • people in similar occupations, or • the individual client

14. Causal link: Event to injury • The person has been directly exposed at work to a sudden traumatic event that could reasonably be expected to cause mental injury to the general population. • Does this person have a clinically significant behavioural, cognitive, or psychological dysfunction? • Was this mental injury caused by the sudden traumatic event ? • And, would this event cause a mental injury in people generally?

15. Reports: ACC 4247 • Psychiatric Assessment Report - Work-Related Traumatic Event • Guidelines for completion • Section A: Key terms and specific guidelines • Section B: ACC 2447 Guidelines for completion • Normal distress vs persistent dysfunction • Collateral information • Pre and post injury impairments • Causal link vs final straw • Routine assessment

16. Exclusions to WRMI • Not at work • Event not directly experienced, seen, or heard • Person not in close proximity to the event • Temporary distress or no mental injury • Mental injury not caused by the event • Event is not significant enough to cause a mental injury in the general population • Gradual process

17. Contact Details • Kris Fernando kris.fernando@acc.co.nz • Peta Levin peta.levin@acc.co.nz • Duncan Frazer duncan.frazer@acc.co.nz • Peter Jansen peter.jansen@acc.co.nz

18. Branch Advisory Psychologists Vas Ajello vas.ajello@acc.co.nz Whangarei/Henderson Ann Galloway ann.galloway@acc.co.nz Auckland/Nth Harbour Duncan Frazer duncan.frazer@acc.co.nz Counties Manukau/IA/LS Rachel Vaughan rachel.vaughan@acc.co.nz NP/PN/Mast.Wanganui Erin Eggleston erin.eggleston@acc.co.nz Rotorua/Whakatane/Taurang Jane Lennan jane.lennan@acc.co.nz Hamilton/Gisborne/Haw Bay Christ Huelsmann christoph.huelsmann@acc.co.nz Well/Porirua/Hutt/Nelson Gillian Pow gillian.pow@acc.co.nz Sensitive Claimss Fran Brinn frances.brinn@acc.co.nz Sensitive Claims Annie Maillard annie.maillard@acc.co.nz Greymuth/Nthwood/Christchurch Jim Hegarty jim.hegarty@acc.co.nz Tim/Dun/Alex/ Peta Levin peta.levin@acc.co.nz Dunedin Service Centre