Acumen Health’s General Manager, Alastair Mould shares his thoughts and recommendations following Safe Work Australia’s research examining Pathways To Secondary Psychological Injury.
In workers’ compensation, we often talk about return to work as a functional milestone — hours increased, duties resumed, claim closed.
But Australia’s latest research into secondary psychological injury challenges that framing.
What it shows is that many workers don’t struggle to return to work because of the original injury alone. They struggle because the recovery system itself can become an additional source of psychological harm, undermining confidence, motivation and trust at the very point these are most needed for sustainable return to work.1
Secondary psychological injury doesn’t start at the injury, it starts in the journey
The Safe Work Australia–commissioned research defines secondary psychological injury as new or worsening mental health symptoms that arise during a workers’ compensation claim, rather than from the original physical injury.
The research found these injuries are more likely when a worker’s capacity to cope with stressors is reduced following injury, and the claims journey introduces new pressures — uncertainty, financial strain, unclear expectations and repeated administrative demands.
From a return to work perspective, this matters because coping capacity is not an abstract concept. It directly affects whether a person:
- feels safe attempting duties
- trusts advice and recommendations
- engages with rehabilitation
- believes recovery is achievable
When coping erodes, return to work becomes fragile, even if physical capacity improves.
Uncertainty is not neutral, it’s a psychosocial risk
One of the clearest findings in the research is the role of uncertainty.
Unclear claims processes, inconsistent communication, uncertain timelines and vague recovery expectations were repeatedly identified as drivers of psychological distress during claims.
From a system point of view, this uncertainty is often unintentional. From a worker’s point of view, it can feel destabilising, particularly at a time when income, identity and health already feel threatened.
For return to work outcomes, this uncertainty has consequences:
- hesitation to test capacity
- fear of making things worse
- disengagement from planning conversations
- prolonged absence even when work may be clinically appropriate
In other words, uncertainty acts like a psychosocial hazard, one that quietly delays recovery.
Human interactions shape recovery trajectories
The research also highlights something many practitioners intuitively know but systems often underestimate: interpersonal interactions matter.
The quality of communication and support from supervisors, claims managers and others in the system significantly influences psychological wellbeing during the claims process. Unsupportive or dismissive interactions increase the risk of secondary psychological injury, while clear, respectful communication supports recovery.
This has direct implications for return to work.
A worker who feels listened to is more likely to:
- raise concerns early
- engage honestly about capacity
- participate in graded return to work planning
- persist through setbacks
Return to work is not just a physical transition. It’s a relational process built on trust.
Not all claims carry the same risk and treating them as if they do creates harm
The research identifies higher risk for workers with preexisting mental health conditions and those experiencing long duration or complex claims, particularly if additional monitoring and support are not provided.
From a return to work lens, this reinforces a critical point: standardised processes don’t deliver standard outcomes.
Early identification of risk and tailored support are not about creating complexity. They are about preventing claims from deteriorating into long term disengagement, where return to work becomes harder for everyone involved.
Why this matters now
Safe Work Australia has positioned this research as informing the National Return to Work Strategy, and for good reason.
Secondary psychological injury doesn’t just affect individual wellbeing. It contributes to:
- longer recovery durations
- poorer return to work outcomes
- higher system costs
- reduced workforce participation
If we want return to work strategies that are genuinely sustainable, we need to look beyond functional capacity alone and examine how the recovery environment supports, or undermines, psychological safety.
A different way forward
What this research ultimately points to is a shift in thinking.
Return to work improves when:
- recovery expectations are clear
- communication is consistent and respectful
- psychosocial risks are identified early
- systems adapt to the person, not the other way around
Secondary psychological injury is not an inevitable byproduct of injury. It is often a signal that our systems need to recover too.
And when they do, return to work becomes not just more achievable, but more durable.
References:
1 Safe Work Australia (2025), Research examining pathways to secondary psychological injury, Monash University. www.safeworkaustralia.gov.au/sites/default/files/2026-02/research_examining_pathways_to_secondary_psychological_injury.pdf
Better return to work outcomes start with safer recovery systems.
Contact us to learn how we support psychologically safe recovery and sustainable return to work.
