Show Notes:

Today we are kicking off a new month with a new series and we’re focusing on how to survive and support sanity while off work. This is a topic that I have become very familiar with thanks to my extensive work as part of the WorkSafeBC provider network for almost a decade, as well as my work with clients through ICBC and other long term disability groups. I have walked alongside so many clients who have struggled with the experience of being off work, and I know that some of you listening may have taken leaves from work in the past, are on a leave right now, or are considering taking a leave. I know that many are struggling to stay at work right now given the ongoing degree of pressure and demand along with short staffing and high exposure, so this topic feels particularly relevant right now. I’m going to try to make this series applicable to any off work experiences – whether that’s for a mental health concern, or a physical injury, or even a maternity leave. You know I love practical, so my goal is to make this as practical and useful as possible. We’re going to call out the stumbling blocks that commonly show up when people are off work, especially when it’s for an extended period of time, and we’re going to talk about what to focus on and prioritize in an effort to keep your sanity and use the time off to recover well. 

Our focus for this episode is to call out the common challenges facing those who are off work. I have seen these be fairly consistent regardless of the type of injury or reason for being off work, although certainly exacerbated by mental health concerns or injuries that restrict motivation or limit access to supports. 

·        Self-motivation or internal-motivation. The truth is, our culture and society have been shaped to drive external motivation. We have been trained from really young to be up at a certain time to get to school, where an adult directs our time and attention, and tells us when we get to eat and play and even go to the bathroom. We come home to adults who tend to direct our steps – put your shoes away, do your homework, eat your dinner, get ready for bed… Our experience of self-directed time through a significant part of our lives is really contained to a handful of hours spread throughout the day where we get to make some autonomous choices based on our interests. Even as adults, our time is directed by when I need to be at work, the expectations of my workplace which are externally determined and directed, and the obligations of home and adult life impose some amount of demand on our “off time” which continues to restrict our self-determined time to a pretty limited span. So, to be off work tends to shine a light on how we have failed to train ourselves to choose, direct and motivate our own time. Without an imposed routine carved out FOR us by work schedules and adult life demands, we can be left feeling like we’re floundering. 

·        Everything takes longer than expected. The reality is that the process of working with insurance providers is SLOW. Sometimes painfully slow. The layers of bureaucracy are heavily present and people are often surprised by the delays and the complexities in decision making and access to needed assessments, services and supports. Many people find that the pace further degrades their symptoms, leaving them suffering and lacking the support they need when they need it most. The truth is this is the nature of the beast, and only so much can be done about it. There are shortages in health and limited specialists and that is just the tip of the iceberg. The key here is knowing that the pace is slow. If you can walk in knowing that this is likely to be the case, it will hopefully shape more reasonable expectations. Talking with others you know about their experiences can help shape your expectations and help you get a sense of what “normal” looks like where you live. I will also say that this is a really good reason to be somewhat pro-active about the decision to go off work if it is for mental health related concerns. Often those struggling with depression, anxiety, posttraumatic stress, and so on, wait and waffle in the uncertainty of whether they really NEED to go off for some time before making the decision when things feel REALLY bad. Believe me, I get that it’s not an easy decision to make, but if we leave it until we are at our very lowest low and then the process takes time and ADDS stress, it is going to feel further harmful rather than helpful. If we can give ourselves permission to put the process in motion a little sooner, we may not be in such dire straights and desperation for support from a system that has difficulty meeting that degree of need quickly enough. Many of those I work with reflect this and share that they wish they had gone off sooner – both in terms of having a bit more left in the tank to face the challenges of the system when going off, as well as having a little less cumulative impact to work through to come out the other side. 

·        Confusion, uncertainty and fear of the big bad insurance company. The reality is that entering this kind of system puts a lot of power into the hands of people who don’t know you – and that can be terrifying. I’m not going to sugar coat it, this is absolutely a legitimate feeling and concern. Decisions around diagnoses, approved limitations and restrictions and determinations around return to work can be huge, life-altering decisions – and in this process many of these are out of your hands. The system is broken in a lot of different places, and so there are often challenges with clear communication, clarity of expectations, and a sense of next steps. This would be hard for anyone, regardless of the type of injury, but for those off for mental health related concerns or injuries impacting cognitive function such as head injuries, this can feel completely overwhelming. I see this a lot in my work – a client who is wrestling with severe anxiety or posttraumatic stress being left waiting with little information or communication is a situation that is going to obviously lead to worsened symptoms. The nature of the process can, in its own right, undermine the wellness of the person who is supposed to be focused on recovery. 

I wish I had some quick-fix tips to make this particular piece easier. I don’t, unfortunately, but I can offer a couple of reflections. My experience working in insurance-affiliated care for a little over a decade is that I have seen more humanity in decisions than I expected to. I have connected with many claim managers who have shown tremendous empathy, who have worked diligently to advocate for workers, and I have even seen some bend the rules to benefit workers who really need that bit of extra support. I wish I could say this is a universal expectation you can have, but while it may not be universal I have seen it be far more common than I think most people expect when they are dealing with an insurance company. I have also seen a lot of growth in understanding within these companies. More and more of them are implementing mental health departments with staff getting specialized training in understanding and working to support people through mental health work-related concerns. As this has expanded I have seen the result of this being better care for those experiencing mental health related injuries. I have also seen greater understanding of what healing and recovery look like. For example, back in the day, it was somewhat frowned on for workers who were off work to participate in hobbies and activities – because if you can do that, why can’t you go to work?! But over the last several years, and I think through education ...