Returning to work after a brain injury or psychological injury

Work gives many of us income, routine, purpose and connection. After a brain injury or a psychological injury, getting back to work can feel daunting. A planned return to work after brain injury or mental health injury is often possible, although it may look different from before.

This article covers the common barriers, how a graded return works, useful workplace adjustments, and how a neuropsychological or psychological assessment can help you, your doctor and your employer plan well.

Why returning to work matters

The Australasian Faculty of Occupational and Environmental Medicine’s Health Benefits of Good Work initiative is based on evidence that good work is beneficial to health and wellbeing, while long-term work absence, work disability and unemployment generally have a negative impact. That does not mean rushing back. It means planning a return that is safe, realistic and supported.

It is also normal for this to take time. A systematic review in the journal Brain Injury pooled older studies and found that about 40% of people with an acquired brain injury had returned to work 1 to 2 years after injury. Changes in job or job demands were common. For psychological injuries, Safe Work Australia reports that the median time off work for mental health claims was almost 5 times longer than for other injuries and diseases in 2023 to 2024.

Common barriers after a brain injury

A brain injury can affect skills that work depends on, even when you look well:

• Fatigue: mental effort can be exhausting, and tiredness often builds across the day and week.
• Slower thinking: tasks take longer, especially under time pressure.
• Attention: open-plan offices, phones and interruptions become harder to manage.
• Memory: forgetting instructions, meetings or where you were up to.
• Planning and organising: juggling priorities, starting tasks and managing deadlines.
• Emotions and behaviour: irritability, lower frustration tolerance or reduced confidence.
• Awareness: some people find it hard to notice their own changes, which is part of the injury, not a personal failing.

Common barriers after a psychological injury

After a psychological injury, such as depression, anxiety or post-traumatic stress, barriers often include:

• low energy, poor sleep and trouble concentrating
• anxiety about returning to the place or people linked to the injury
• avoidance, which can grow the longer someone is away
• unresolved conflict, or loss of trust, with a manager or colleagues
• worry about what others know or think

Going back to the same workplace

If the injury is linked to events at work, a few steps can make the first days easier:

• a short meeting or visit before your first day, so the return is less of a shock
• agreeing what colleagues will be told, and what you would like to keep private
• clear changes to the situation that contributed to the injury, where possible
• a named person you can go to if things become difficult

Treatment for the underlying condition comes first. Evidence-based therapy can run alongside a gradual return, and the two often support each other.

Planning a graded return

A good return to work plan is written down, agreed by everyone involved and reviewed often. It usually covers:

1. Medical clearance: your doctor outlines what you can and cannot do yet, often on a certificate of capacity if you have a compensation claim.
2. Starting point: hours, days and duties to begin with, such as three short days a week on lower-pressure tasks.
3. Steps up: a timetable for increasing hours and duties, with room to slow down if symptoms flare.
4. Adjustments: changes to the job or environment (see below).
5. Contacts: who you talk to at work, and how often you meet to review progress.

Useful workplace adjustments

• a quieter workspace, headphones or the option to work from home some days
• written instructions, checklists and meeting notes
• one task at a time, with fewer interruptions
• scheduled breaks, and demanding tasks placed at the time of day when you have most energy
• extra time for complex work, and fewer tight deadlines at first
• a delay on safety-critical tasks, such as driving or operating machinery, until cleared

Employer obligations

If you have a workers compensation claim, your employer has legal duties. In Victoria, for example, WorkSafe explains that employers must provide suitable employment to an injured worker with an incapacity for work for 52 weeks after the injury, plan the return to work, consult with the worker, and appoint a return to work coordinator. Other states and the Comcare scheme have their own rules.

Managing energy and fatigue at work

Fatigue is one of the most common reasons a return to work stalls. Some strategies that often help:

• Pace, do not push: stop for a short break before you are exhausted, rather than after.
• Plan the week: spread demanding tasks out, and avoid stacking meetings back to back.
• Protect recovery time: keep evenings and weekends lighter while you build up hours, so you have energy for work.
• Look after the basics: regular sleep, meals, movement and limited alcohol make a real difference.
• Track and adjust: a simple diary of energy, symptoms and tasks helps you and your doctor fine-tune the plan.

How assessments help

神经心理学评估

A neuropsychological assessment measures attention, memory, processing speed, language and problem-solving, and looks at fatigue, mood and sleep. The results can be matched to the demands of your job. For example, a person might have strong reasoning skills but slow processing speed, which points to adjustments such as reduced time pressure rather than a change of role.

With your consent, the report can be shared with your doctor, rehabilitation provider and employer, so everyone works from the same information. Repeat assessments can track change over time and help decide when to step up duties.

心理评估

For a psychological injury, a psychological assessment clarifies the diagnosis, what is keeping symptoms going and which treatment is likely to help. It can also identify workplace factors that need to change for a return to be sustainable.

Vocational rehabilitation

Specialist vocational programs can help with a return to the same job, a new role or retraining. In NSW, for example, icare’s brain injury services include a Vocational Intervention Program for eligible participants.

Invictus Health 能提供哪些帮助

Our neuropsychologists provide 神经心理学评估 that include practical recommendations for work, and our psychologists offer 心理咨询 in person in Preston or by telehealth. Neuropsychology reports are reviewed by Dr Judy Tang OAM.

When conflict is getting in the way of a return, our mediation service includes return to work mediation. For employers, our workplace programs include Mental Health First Aid and resilience training. You are welcome to ask us which service fits your situation.

This article is general information. Talk with your doctor, employer, insurer or a qualified professional about your situation. If you are in danger, call 000. For 24-hour crisis support call Lifeline on 13 11 14.