Do compensation processes impair mental health? A meta-analysis.
Nieke A Elbers1, Liesbeth Hulst, Pim Cuijpers
1Department of Law, VU University, Amsterdam, The Netherlands. n.elbers@vu.nl
Injury
|January 17, 2012
Summary
Victims in compensation processes report more mental health issues, with most differences present before claims begin. However, evidence quality is limited, requiring cautious interpretation of findings on mental health complaints.
Area of Science:
- Psychology
- Public Health
- Legal Medicine
Background:
- Compensation processes are linked to increased health complaints in victims.
- Prior research primarily examined physical health impacts of compensation.
- This meta-analysis specifically investigates the mental health effects of compensation.
Purpose of the Study:
- To systematically review and synthesize evidence on the association between compensation processes and mental health outcomes.
- To determine if involvement in compensation influences mental health complaints in victims of accidents or errors.
Main Methods:
- A systematic literature search was conducted across major databases (PubMed, EMBASE, PsycInfo, CINAHL, Cochrane Library).
- Prospective cohort studies published between January 1966 and June 2011 were included.
- Studies focused on compensation and mental health following traffic accidents, occupational accidents, or medical errors.
Main Results:
- Ten studies met the inclusion criteria.
- The compensation group exhibited significantly higher mental health complaints at baseline (SMD=-0.38, p=.01).
- Mental health improved less in the compensation group compared to the non-compensation group from baseline to follow-up (SMD=-0.35, p=.05).
Conclusions:
- Compensation involvement is associated with greater mental health complaints, largely present before claim initiation.
- Limited evidence quality necessitates cautious interpretation, with potential explanations including selection bias, anger, blame, secondary gain, and victimisation.
- Future research should address baseline differences, exposure assessment, and the impact of claim settlement and scheme design on mental health.
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