At a Policy Briefing on 14 October, the FSC and KPMG released a joint research paper that explores the body of evidence supporting the role psychosocial factors play in mental health conditions. 


Here, event speaker Jane Dorter, Head of Insurance Claims Solutions, KPMG Australia shares some key insights.


What is this research so important?


Mental health impacts 40 per cent of the community at any one time. Poor mental health imposes costs estimated at $60 billion annually on individuals and their families, workplaces, [and] the health and welfare systems, with mental health concerns the most common reason for patients to visit their GP. (Health of the Nation report published by the Royal Australian College of General Practitioners, 2019).

For each individual with a mental health issue there is a continuum of severity that we don’t always understand. This research aims to provide the evidence about the impact of psychosocial issues on mental health, and which factors contribute to a compounding affect that could risk a decline in an individual’s mental ill-health or extend the impairments suffered.

The research aims to identify and understand psychosocial factors in mental health conditions. Mental health is a major cause of disability claims in life insurance and this research is intended as guidance for life insurers to consider what is contributing to the impairment and absence from work. Early identification can potentially then inform prevention and early intervention support services, and this does not always look like a medical diagnosis.

Many individuals who initially present with a potential mental health concern may have primary or secondary psychosocial issues that require support. Support, specifically social, is identified as the most common psychosocial factor that can influence the prevention of a declining mental health condition.


What does the research mean for Australian workplaces?

Eight million working days are lost due to mental ill-health in Australia each year. The most widely acknowledged social and individual impact of mental health problems for adults are the flow-on effects of unemployment (financial, familial and social).

The research presents some workplace psychosocial predictors to assist life insurers consider what role they can play to influence issues such as job strain, organisational injustice, or work demands.

Implications that life insurers can start to deliberate on include; should insurers look to support line managers within employer organisations, accessing more training to detect and respond to early signs of psychosocial issues.

This collaboration may protect the mental health of workers through increased resources and early intervention treatment provided by both the mental healthcare sector and potentially life insurers.


What are some of the current gaps in preventive measures for mental health?


Policy and product that reinforces a medical model and therefore insists on a medical diagnosis can create adverse effects for people with insurance and a mental health condition. Some circumstances do not require a medical model of care. They do however require care.

Coordination of social care and even interpersonal care is vital to ensuring we get prevention in mental health right. There is a significant gap in our community health systems and the current healthcare model to provide for people that have psychosocial issues. They are not well supported as either a primary or secondary cause of impairment.

Insurers have the opportunity to work in both a multi-disciplinary and interdisciplinary approach with multi-sector providers to fill this gap. This is not just a benefit to insurance policy holders, but will benefit all Australians that currently fall into this vast 40 per cent bucket of mental health experience.

When we better understand the detail and complexities of what people are suffering, and collaborate across sectors and disciplines, we can solve this increasing problem. When we do this in a manner that is non-judgmental and accepts that people suffer with mental illness, mental health conditions and psychosocial issues, we avoid stigma and truly practice prevention.


Will KPMG continue to explore this area of research ongoing – and what will the focus areas be?


This area of research is relevant to all insurance schemes that operate within personal injury and illness provisions. Mental health is a complex issue, and many of the services and polices that exist within financial services are not designed to support the differences of each individuals presenting issue or condition. This can pose a risk by contributing to higher levels of stress as the person struggles to deal with the system itself.

Higher levels of stress can be experienced by having to continuously provide the burden of proof of disablement for claims eligibility, policy terms and operational processes that reinforce proof and extent of injury or illness can lead to distrust, perceptions of discrimination, and even greater levels of anxiety and depression.

Life insurers will benefit from understanding how their product design, claims process and overall system contribute to a customer’s mental health conditions.

Developing a psychosocial identification, and therefore a differentiation between a clinical diagnosis and sub clinical presentation, may allow for life insurance intervention to be tailored appropriately.

Development of a psychosocial pathway of intervention could be considered to test and validate, then eventually allow for delivery to people the right services at the right time across the mental health continuum.


To download a copy of the paper, see here.

To download the media release, see here

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