Take Home Messages:

People with work injuries indicate a peer support group can provide emotional, procedural and social support, as well as assist with advocacy.
 

Why the research matters:

Some injured workers take longer than normal sick leave. This is a significant cost to the person and the system, as well as increasing the chance of poorer long term health for the employee. Identifying barriers and ways of overcoming obstacles to return to work is useful.
 

What the research involved:

The study evaluated the reasons some employees turned to peer support groups, to identify what needs were being met through peer groups.  If workers in high need groups can be supported with their social issues and other needs it may lead to better return-to-work outcomes.

37 members of three peer support groups were interviewed. A peer support group in this area is a group of injured workers who get together and discuss their medical and personal problems. The group gives recognition, advocacy, practical support and useful advice to its members.

Summary of research findings:

Four types of peer support were identified:

1.    General Support:

 The researchers found that injured workers joined peer support groups when they felt misunderstood and unfairly treated when they had tried unsuccessfully to navigate health and government systems. Many felt:

• Their providers and families did not understand how difficult it was to manage their injuries and re-employment efforts
• They were worried about the compensation process because their benefits had or were about to be cut for reasons they did not understand or because they were judged to be in non-compliance with compensation regulations

Because case managers interacted with workers mostly by telephone or mail, these injured workers felt that not meeting case managers in person limited their understanding about workers’ predicaments. One said:

“Then they decided it was time for me, against the doctor’s order, to do the 9:45 shift. . . They pretty much bullied me into it. I don’t have a choice. .  I don’t know exactly what they wanted from the doctor, but every two to three months he was writing [WCB] a personal letter about my injury and explaining that I’m not going to get any better, in fact I’m going to get worse.” 
 

2.   Personal Advocacy

A second area of peer support help was in personal advocacy which means having someone with direct experience of work injury to be on the ‘side’ of the injured worker. This was useful because:

Workers could identify with the personal advocacy role of the peer support group

• Individual peer helpers could be allies and personal advocates who cared and believed in them
• Peer helpers were not distracted by competing commitments such as unions, employers and compensation officials 
   

3.   Social Support

A third dimension of workers with injuries peer support that provided insight into return to work was social support within an empathetic community. This was because: 

• Many injured workers felt depersonalised and rejected because of their situations
• At the peer support meetings they felt more than’ just a number’ in a compensation file and could empathise with others with similar injuries and feelings
• They could talk with mutual trust about difficult medical problems they were having and this gave them confidence to access professional treatment later because they were no longer so embarrassed talking about their medical problems
• The peer group gave injured workers pride in themselves when they were no longer the breadwinner and had less valued social roles in the family and community
• It also helped prevent potential suicides as peer support counsellors were able to put in place supportive networks
• In some cases, financial help was available from group voluntary contributions to help with one –off crisis needs
  

4.  Procedural Support

Fourthly, injured workers often found they did not know how to interact with the systems involved with return to work, particularly how workers’ compensation regulations required knowledge of rules and processes. The peer support workers could sift through the workers’ personal accounts and tell them what was important for the intervention:

• How to keep a paper trail (expenses documentation)
• Time taken to get claims assessed
• Workers and employer responsibilities
• How to control anger so as to communicate effectively with compensation managers

As one of the workers said:

“She’s been the person who said to me, ‘No this is too personal. Write down what you need said. But I’ll put it in a format that it’s not accusatory.”

In addition, peer helpers often developed strategies to manage barriers to return to work and provided mediation and prevented bullying from employers pushing some people into returning to work too soon.
 

Original research:

Unexpected barriers in return to work: lessons learned from injured worker peer support groups.

MacEachen E, Kosny A, Ferrier S.

Work. 2007;29(2):155-64.

Link to PubMed abstract