Mental Health Factors in Work Related COVID-19 and Return to Work

Key takeaways

Can addressing mental health factors improve return to work after work related COVID-19? In this peer reviewed study coauthored by Ascellus Behavioral Health clinicians, 80% of 103 frontline workers returned to work within 12 weeks after receiving a psychological evaluation and at least three sessions of work focused cognitive behavioral therapy. Work relevant functioning improved 40% and adaptive daily functioning improved 31%.

Because the study was retrospective and had no untreated comparison group, it shows an association between psychological care and recovery. It does not prove that therapy alone caused the improvement.

Original study title

Addressing Mental Health Factors to Improve Outcomes in Work-Related COVID-19: A Retrospective Study of Frontline Workers

Published in

Journal of Occupational and Environmental Medicine

Publication date

August 1, 2022

Journal citation

J Occup Environ Med. 2022;64(8):e443 to e451. DOI: 10.1097/JOM.0000000000002575

Study authors and affiliations

Daniel B. LeGoff, PhD: Lead author and licensed psychologist who served as a clinical neuropsychologist at Ascellus Behavioral Health at the time of publication. He is now a clinical neuropsychologist with Northeast Neuropsychology.

Jacob Lazarovic, MD, FAAFP: Board certified family physician who served as a consulting physician to Ascellus Behavioral Health at the time of publication. He is now Chief Medical Officer of 3motionAI and previously served as Chief Medical Officer of Broadspire.

Miranda Kofeldt, PhD: Clinical psychologist who served as Vice President, Clinical Operations at Ascellus Behavioral Health at the time of publication. She continues to serve in that role today.

Hiren Ghayal, PsyD, MBA: Licensed clinical psychologist who served on the Ascellus Behavioral Health clinical team at the time of publication. He is now Director, Clinical Services and Quality Assurance at Ascellus Behavioral Health.

Aimee Peters, MS, LCSW: Licensed clinical social worker who served as Chief Clinical Innovation Officer and later Senior Advisor at Ascellus Behavioral Health. She is now Chief Clinical Officer at Ria Health.

What did the frontline worker COVID-19 study examine?

The researchers asked whether addressing mental health factors could help frontline essential workers whose recovery from work related COVID-19 had been delayed. They focused on psychosocial stressors and mental health concerns that can slow the return to work process, even while a worker continues to receive routine outpatient medical care.

How was the study conducted?

This retrospective analysis included 103 frontline workers. Each received a standardized psychological evaluation and at least three sessions of work focused cognitive behavioral therapy. The researchers compared recovery and work status before and after treatment and reviewed how participants rated their work related and everyday functioning.

What were the key findings?

The authors reported a 40% improvement in work relevant functioning and a 31% improvement in adaptive daily functioning. Duration of recovery and time to return to work were both reduced, and 80% of participants returned to work within 12 weeks despite differences in their presenting problems and course of illness. These figures describe this study group and should not be presented as expected results for every claim.

Why do these findings matter for workers’ compensation claims?

When a worker’s physical recovery and readiness to return to work seem out of step, the missing piece may be psychological. A focused evaluation can identify stress, anxiety, or depressed mood that is slowing recovery and point to an appropriate treatment path. The study has since been cited in later research on frontline worker mental health, including a 2023 study in Frontiers in Public Health.

Summary of the frontline worker COVID-19 study

Frontline workers whose COVID-19 recovery had stalled showed meaningful gains after a psychological evaluation and brief work focused cognitive behavioral therapy. Functioning improved, and 80% returned to work within 12 weeks. For claims teams, the takeaway is clear: when physical recovery and work readiness do not line up, look for mental health barriers early and consider a focused evaluation.

The published paper includes the full methods, outcome measures, and the authors’ discussion of the study’s limitations. Read the full study in the Journal of Occupational and Environmental Medicine.

Have a claim where recovery has stalled? Learn how Ascellus Behavioral Health addresses mental health barriers to recovery through its treatment for mental health conditions, or see when to refer an injured worker. Related Ascellus research: neurocognitive screening in post COVID workers’ comp claims and screening and brief therapy for work related concussions.

Frequently asked questions

Why consider mental health support in a work related COVID-19 claim?

Stress, anxiety, or depressed mood can affect functioning and work readiness even while medical recovery is underway. In this study, workers received a psychological evaluation and brief work focused therapy alongside their usual outpatient medical care.

What is work focused cognitive behavioral therapy?

Work focused cognitive behavioral therapy is a short, goal directed form of CBT that targets the thoughts, emotions, and behaviors getting in the way of a safe return to work. In this study, workers completed at least three sessions.

Do the return to work results apply to every frontline worker?

No. The 80% return to work figure describes the 103 workers in this retrospective study. It should not be treated as a forecast for a different worker or a guarantee of therapy results.

What mental health factors can delay return to work after COVID-19?

The study focused on psychosocial stressors and mental health concerns such as stress, anxiety, and depressed mood. These factors can slow recovery and make a return to work harder, even when a worker is receiving routine medical care.

Where can claims teams find mental health support for a stalled workers’ comp claim?

Ascellus Behavioral Health partners with adjusters, nurse case managers, and employers to find and address the mental health barriers that slow recovery. Services include a psychological diagnostic evaluation, psychiatry evaluation and medication management, and work focused treatment for mental health conditions, all built around a safe return to work. If stress, anxiety, or low mood is holding a claim back, contact Ascellus to make a referral.