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Interview with Dr Doron Samuell, psychiatrist and behavioural scientist

Dr Doron Samuell

There are deep, systemic problems with the way we manage mental health claims, according to Dr Samuell. He wants to see more evidence-based care and better systems to manage work injury mental health cases.

In this interview, Dr Doron Samuell, psychiatrist and behavioural scientist, reflects on the lack of appropriate research to inform the management of compensable mental health claims.  

He suggests that some people who submit claims for psychological injury may not have a diagnosable psychological disorder, although they are experiencing considerable distress. Workers compensation schemes require claimants to have a diagnosis, and this can push distressed people into "sickness roles," which actually worsen psychological health. Once a person has a diagnosis, they may next have unnecessary treatment, for example antidepressant medication, which has side effects. This leads to frustration, because medication, and even talk therapy, can't address the real source of the problem, which is often social rather than psychological. 

Workers compensation systems also expose claimants to indignity, which again increases distress. 

Rather than being led by ideology, Dr Samuell says systems should utilise the principles of behavioural economics, focusing on all the contact points between people and the system and trying to pinpoint which of these cause difficulties and delays. Systems should then design interventions to ease those sticking points and measure the impacts of the interventions with a/b type testing. Only once this kind of research has been conducted will we really understand the problems, and be able to develop workable solutions.