WorkCompWire
Full article on: workcompwire.com
Successful recovery from catastrophic workplace injuries requires person-centered care—not only due to the immense physical needs, but because of their often-traumatic psychological impact on both the patient and the family. Furthermore, pre-existing behavioral health issues, economic factors, and family needs also significantly influence the recovery trajectory. A management plan that accounts for this broader psychosocial picture can be the difference-maker in a successful outcome.
In fact, unaddressed behavioral health challenges increase the risk of prolonged recovery and drive workplace injury costs as much as 75% higher.1 “Behavioral health and psychosocial issues affecting home and family are highly interrelated. Understanding this correlation and overcoming these obstacles requires guidance from experienced behavioral and medical experts, combined with a whole-person approach that integrates families into recovery,” says Deborah M. Benson, PhD, ABPP, Vice President of Clinical Solutions for Paradigm. “For more than 30 years, Paradigm has pioneered a model of psychosocial support built on expertise and collaboration that puts injured workers and their families in the spotlight of care.”
Human-centered behavioral health and chronic pain management
Whether a catastrophic diagnosis is present or not, injured workers with primary and secondary behavioral health conditions, including chronic pain challenges, can benefit from enhanced support. To serve the needs of this sizable patient population, Paradigm’s Behavioral Health Clinical Management delivers a time-based, fixed-price, non-risk-bearing solution with goal-based behavioral care management for both acute diagnoses and delayed recovery.
First, experienced behavioral health and pain management clinicians assess and clarify the behavioral diagnosis and appropriateness of treatment. Using structured, interdisciplinary methods to identify and reach critical behavioral milestones, injured workers can improve their function and learn to self-manage residual symptoms. “Goals may include decreasing reliance on pharmacologic or interventional treatments, reducing cost and duration of disability, and achieving maximum medical improvement and release to return to work,” explains Dr. Benson.
The industry model for integrated, human-centric behavioral health expertise
When serious catastrophic injuries do happen, effective behavioral health care must treat the whole person and their family, while simultaneously interfacing with ongoing medical treatment. Psychosocial factors, including home, family, and economic dynamics, are often disrupted at the point when they are needed most to aid recovery. “Injured workers and families need support from people who not only understand these complexities, but have experience implementing an effective and clinically cohesive response,” says Dr. Benson.
Paradigm HERO Catastrophic® Outcome Plans incorporate fully integrated behavioral health professionals who work closely with medical experts to develop a person-centered recovery plan. The multidisciplinary Paradigm Management Team assigned to each case has access to an in-house roster of board-certified psychiatrists, psychologists, rehabilitation counselors, and applied behavior analysts who promote positive psychosocial adjustment and address potential barriers to recovery. Teams also interface with Community Support Specialists, master’s-level social workers and behavioral health professionals specially trained to match support and resources that meet the individual needs of the injured patient and family caregivers.
“Giving seriously injured workers the best chance at a better life takes holistic support,” says Emma Schedler, LISW, MSW, a Paradigm Community Support Specialist Team Manager. “It’s just as important for people to recover emotionally as it is physically. If someone is concerned with where to get their next meal or who is going to take care of their child, it will be harder for them to focus on physical therapy.” Community Support Specialists are assigned, based on their unique backgrounds and the specific case characteristics, to provide resources that best fit each individual patient, including working directly with injured workers and their families when needed, or matching patients with more formal mental health support and community resources.
Schedler understands the importance of acting early to eliminate barriers to access for emotional health support. “From the beginning, we’re working to build rapport and address both immediate and long-term needs. When we’re proactive, the family is more likely to accept help than taking steps to ask for it.” Help does not always mean formal professional interventions, such as mental health or substance abuse counseling, either. “Often, it can be as simple as providing healthy coping or problem-solving strategies that can aid with potential behavioral issues before they progress to the need for more formal care,” says Schedler. “It can also mean exploring options for additional support via community resources (e.g., support groups, housing), social service organizations (for food, financial, or childcare support), and extended family.”
This elevated level of support has a very real effect on outcomes. Analysis of Paradigm case data found that Community Support Specialist engagement was associated with lower-than-projected medical spend, higher release to return-to-work rates, less time to achieve targeted outcomes, and less utilization of professional mental health services over the course of recovery.
A behavioral health plan that puts people first
Effective behavioral and psychosocial care must account for issues existing prior to injury, as well as new or ongoing challenges. HERO Catastrophic Outcome Plans respond to the complex needs of each injured worker in every stage of recovery:
- Identify co-morbid conditions and vulnerabilities and strategize an effective response
Within the first two days of referral, the Paradigm Network Manager, an expertly trained catastrophic nurse case manager, conducts an on-site assessment to gather information on medical and psychosocial status. Co-morbidities—including addictions, mental health, and medical conditions—as well as language barriers, support systems, and socioeconomic factors for the patient and family are identified and incorporated into the plan. - Strategizing the best approach
Information gathered from the on-site assessment and medical records, establishment of a trusting relationship with the patient/family, and outreach to treating providers work to establish immediate needs and short- and longer-term goals. For acute cases, early intervention is critical to set the patient/family on a positive recovery trajectory. - Active management throughout recovery
Managing the risk of unaddressed behavioral health challenges requires comprehensive behavioral health monitoring throughout recovery. Continuous monitoring through structured interviews and standardized assessment tools helps identify mood, stress levels, pain, and vulnerability to substance misuse. If intervention is deemed necessary, Paradigm’s extensive provider network leverages evidence-based, outcomes-driven methods to keep recovery on track. - Adjusting to the ‘new normal’: ongoing support for long-term success
Paradigm’s HERO Catastrophic Outcome Plans provide actively tracked personalized milestones, including both functional and behavioral metrics. Reaching the guaranteed outcome requires achieving residential and/or community integration goals, having required stable and durable management protocols in place, and following a long-term care plan.
Life-changing results from human-centered care
Proactive, whole-person behavioral health support is fundamental to successful catastrophic and severe injury recovery. Paradigm offers expansive capabilities and expertise to meet the broad range of needs of the injured workers and families we serve. As Dr. Benson puts it, “Matching the right people and resources based on the unique characteristics of each case allows us to keep injured workers and their families on track with their recovery journey.”
Refer a case today: referrals.paradigmcorp.com
Sources:
1. American Hospital Association (AHA) Market Insights Behavioral Health Integration, 2019
Share
Share
Tweet
Email