Research Insight Rethinking Secondary Psychological Injury

In 2025, Monash University released a significant report examining pathways to secondary psychological injury in Australia’s workers’ compensation system. The findings challenge a common assumption: that psychological injury following a physical claim is primarily an individual mental health issue. Instead, the research suggests it is often shaped by workplace systems, leadership behaviours, and the design of the return-to-work process itself. For organisations navigating increasing psychosocial risk obligations, this has important implications.

What Is Secondary Psychological Injury?

Secondary psychological injury refers to psychological symptoms — such as anxiety, low mood, sleep disturbance or withdrawal — that develop after a primary physical injury.

Critically:

  • It does not require a formal diagnosis.
  • It may significantly impair function and recovery.
  • In long-term claims (>2 years), stakeholders estimate the likelihood to be at least 80%.

This reframes psychological injury as something that can emerge during the rehabilitation journey — not just from the initial workplace event.

The System Factors That Matter Most The report highlights four key drivers:

1.

Uncertainty and Lack of Control

Workers frequently experience distress due to unclear recovery expectations, financial insecurity, or prolonged administrative processes.
Ambiguity fuels rumination — and rumination fuels deterioration.

Clear, evidence-based communication about recovery trajectories is protective.

2.

The Line Manager as the Primary Protective Factor

The supervisor’s early response has disproportionate influence.
Supportive communication promotes confidence and recovery.
Subtle dismissiveness or visible frustration can entrench distress.

Psychosocial risk management therefore includes equipping line managers to respond appropriately — especially in the first hours and weeks post-injury.

3.

Perceived Injustice and Administrative Friction

Repeated storytelling, delays in claim approvals, and feeling scrutinised create emotional load.

Reducing redundancy and simplifying processes is not just an efficiency measure — it is a mental health intervention.

4.

Pre-Existing Vulnerability

Workers with pre-injury mental health conditions are most at risk once a claim begins.

Early screening and proactive support models are more effective than reactive referrals once deterioration is established.

Implications for Early Intervention Models

The research reinforces several evidence-informed practices:

  • Provide clear recovery education to reduce fear and catastrophic thinking.
  • Avoid inadvertently reinforcing a “victim narrative” through overly conservative messaging.
  • Use structured screening tools (e.g., K6/10, DASS, Orebro) alongside clinical judgment.
  • Monitor social integration during modified duties.
  • Support supervisors in maintaining connection and inclusion.

This is not about turning physical injury management into therapy.
It is about designing systems that minimise preventable psychological harm.

Why This Matters for Psychosocial Risk Governance

Under contemporary WHS legislation, employers have a positive duty to manage psychosocial risks. Secondary psychological injury highlights an important reality:

Psychosocial risk is embedded within operational processes — including injury management and return-to-work systems.

Early, integrated, workplace-based intervention is protective. Delayed, fragmented or adversarial systems increase risk.

Organisations that proactively align rehabilitation processes with psychosocial risk principles will likely see:

  • Reduced claim duration
  • Lower secondary psychological injury rates
  • Improved return-to-work outcomes
  • Stronger trust between workers and leadership

A Practical Leadership Question

The Monash research invites a simple reflection: Is our injury management process reducing uncertainty and building confidence — or unintentionally amplifying distress?

For many organisations, the answer lies not in adding more policy — but in improving early communication, integration and leadership capability.

Full report

The full report is available here: https://www.safeworkaustralia.gov.au/doc/research-examining-pathways-secondary-psychological-injury

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