FCE question
Tue, 03/03/2009 - 8:57am
If a possible need is identified, is it out of line to recommend evaluation from a mental health professional? ie: one year post severe MVA client admits severe depression and pulling away from all friends, family, and activity. Client states she feels like she needs to talk with someone.
Hello,
Our clinical advisor had this to say:
This is a tough spot. I will assume this situation arose during an FCE-not in some other situation. Believe it or not, I have found the FCE cases for this problem (vs. work conditioning or regular therapy) is a little easier to deal with. My first response to this situation would be to document was said, and during that process, advise the client to speak with their priest, family practice MD, and/or the case manager. A lot can be learned from the response of the client. You may hear that steps have been taken (medication, counseling, testing, etc.), they have a history of depressive disorder, concomitant factors (spouse dying), or that this is a new development. Depression after severe injuries is a fairly well accepted phenomenon, but if that is not the question you are asked to address, you may be better off talking with the insurance adjuster or case manager about what was said, and documenting your conversation. The downside to the population we deal with, is that some client's will-consciously or subconsciously, use a variety of tactics to stall or delay the resolution of a case. Given the fact that it is difficult to determine when someone is "cured" of depression, that it is fairly common in our society, and that most insurance companies will not appreciate you adding a diagnosis like this to the record, caution should be used.
Some steps you can take may include:
-Objectively document the event in the FCE.
-Suggest they speak with someone outside of the WC system. There are lots of free services they can pursue.
-Speak with the case manager or adjuster ASAP (after FCE) and document the essential details.
-Speak with the referring MD about your objective documentation.
Some interesting facts I quickly found online:
Depressive disorders affect approximately 18.8 million American adults or about 9.5% of the U.S. population age 18 and older in a given year. This includes major depressive disorder, dysthymic disorder, and bipolar disorder.
NIMH. ?The Numbers Count: Mental Illness in America,? Science on Our Minds Fact Sheet Series.
80% of depressed people are not currently having any treatment.
?National Healthcare Quality Report?, 2003.
Hope this helps!
Jenn