Workers injured on the job may experience a greater mental health decline than those injured elsewhere

University of Manitoba-led research has found that individuals who experience workplace injuries face a greater relative decline in mental health outcomes compared with those injured outside the workplace. Findings suggest workplace-related factors and the compensation process may contribute to this trend, though further research is needed.

Workplace injuries pose a significant public health concern, affecting millions of workers globally each year. Previous research has linked these injuries to chronic pain, reduced mobility, and long-term disability. Mental health challenges—including depression, anxiety and substance-use disorders—are also common among injured workers.

In a study titled “Workplace Injury and Mental Health Outcomes,” published in JAMA Network Open, researchers conducted a retrospective cohort study using population-based administrative data from Manitoba, Canada.

Researchers examined 7,556 individuals with workplace injuries requiring surgery, matched 1:5 with 28,901 individuals from the general population based on age, sex, geographical region, and surgical procedure code. Individuals with burns, traumatic brain injuries, repetitive strain injuries, and chronic conditions were excluded due to the complexity of recovery timepoints.

Before injury, those with workplace injuries had lower rates of mental disorders than their non-workplace injury counterparts, including anxiety (adjusted rate ratio [ARR], 0.82; 95% CI, 0.77–0.87), depression (ARR, 0.78; 95% CI, 0.72–0.84), and substance abuse (ARR, 0.63; 95% CI, 0.55–0.72).

After injury, the adjusted rate ratio for anxiety was 1.00 (95% CI, 0.95–1.06), and for any mental disorder it was 0.96 (95% CI, 0.92–1.01). Meanwhile, lower rates of depression (ARR, 0.89; 95% CI, 0.82–0.95) and substance abuse (ARR, 0.83; 95% CI, 0.73–0.94) persisted. Essentially, the rates for anxiety and mental disorder matched the non-workplace group after injury, but because they started out lower, the relative change was larger in the workplace-injury group.

Study design limitations could not directly assess potential causal factors, but several workplace-related factors were considered. The psychological effects of returning to the site of injury, financial stress from lost income, challenges in navigating workers’ compensation claims and delayed return to workplace social groups could play a role.

Findings suggest the need for post-injury mental health support to mitigate these effects. Future research could also explore the underlying mechanisms driving these disparities, variations across occupational sectors, and strategies to improve post-injury mental health care and recovery outcomes for injured workers.

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