Avoiding Psychiatric Disability Overdiagnosis (Part 2): Improving Diagnosis and Assessment of Mental Health Disorders and Psychiatric Work Disability

Given the increase in psychiatric occupational disability claims over the past 20 years, better patient psychiatric assessment and management is critical. To minimize iatrogenic psychiatric disability and maximize positive outcomes, it is important to understand the issues involved and establish better procedures for diagnosing conditions and assessing any associated impact on function. This second article in a three-part series focuses on ways to improve the diagnosis and assessment of mental health work disability.

Community mental health work – WHO recommendations and the perspective of people experiencing mental health problems

This article was written in response to the publication by the World Health Organization of a document containing recommendations and a toolkit for promoting mental health and addressing the problems of people with mental disorders (Mental Health Gap Action Programme – mhGAP). The conclusions in the WHO proposal were compared with the perspective of people in mental crisis, which was reconstructed through qualitative research (in the interpretative paradigm). The analysis of the empirical material, which consisted of 35 autobiographical narrative interviews with people who have experienced mental disorders, showed that the WHO proposals correspond to the needs declared by the people struggling with mental problems. The compliance concerns both the expected fields of action (fight against stereotypes, prevention, health promotion) and methods (activities in the residential environment of people in need of support). At the same time, however, the analysis revealed a number of elements worth noting when orienting future community mental health work. These elements include: the increasing role and importance of people experiencing mental disorders in the orientation of action, strengthening community co-creation with people experiencing a mental disorder, moving away from one-sided teaching and training towards collaborative learning.

Avoiding Psychiatric Disability Overdiagnosis, Part 1: General Disability and Occupational Disability—Going Beyond Medical Impairment Assessments

Claims of occupational psychiatric disability have increased considerably over the past 20 years. To avoid psychiatric disability overdiagnosis, it is important to improve the clinical assessment of mental health work disability. This article discusses general disability issues and their impact on individual well-being, social participation, and frequently associated poverty. It defines the difference between impairment assessment and disability assessment, explores three common disability models, and raises issues about psychiatric disability and its potential overdiagnosis.

THE RELATIONSHIP BETWEEN WORK-RELATED STRESS, BURNOUT AND AEROBIC CAPACITY AMONG PHYSIOTHERAPISTS

Medical professionals experience more work-related stress than other specialties, furthermore, many results of different researches have shown that the level of stress continues to grow. When stress persists, it becomes chronic and negatively affects a person’s physical and mental health. Work-related stress is associated not only with burnout, exhaustion, but also with increased morbidity, chronic diseases and especially with cardiovascular disorders. The aim of our research was to determine the relationship between work-related stress, burnout and aerobic capacity among physiotherapists. The research included 30 participants, who completed two questionnaires about stress and burnout and performed two tests for aerobic capacity evaluation. 80 percent of physiotherapists were experiencing low, medium or high level stress. Burnout was found in 23 percent of participants. 64 percent of subjects’ aerobic capacity was evaluated as average and 16 percent of subjects had poor and very poor aerobic capacity. 20 percent of the participants’ tonus of sympathetic part of autonomic nervous system was normal and they were considered healthy, but not physically trained. After statistical analysis there was no statistically significant relationship found between physiotherapists’ stress or burnout and aerobic capacity.