Absence from work may deprive an individual of psychological needs, such as social contact or collective purpose, which have been shown to be important for mental health. Poor social support, perceived negative support, a lack of social support or extended periods of loneliness may result in:

• Negative impacts on physical, psychological, or social wellbeing.
• Increased risk of psychiatric morbidity.
• Increased risk of mortality.
• Post-traumatic stress disorder (PTSD).
• Poor physical health.
• Increased risk of morbidity.
• Exacerbated vulnerability.

Furthermore, individuals absent from work (e.g., unemployed, recovering from an injury or reduced work capacity) may also experience:

• A loss of independence.
• Sense of burden.
• Social isolation.
• Difficulties in asking for support.
• Difficulties claiming independence or being supported by others.
• Limited support from social networks.
• Changes or loss of social roles (e.g., familial.
• Significant stress on relationships.

Consequently, social support plays a complex, yet key, role due to the multitude of people involved and the types of support provided as an individual recovers from an injury. Furthermore, research has suggested that injured workers may experience changes in their relationships or their roles within their existing social networks (e.g., family). Some relationships may break down, others may improve, or relationships may be lost altogether which can result in a lack of social support during the recovery process. More specifically, a study by Prang et al., (2017) found that in addition to life circumstances, geographic location was a barrier to accessing social networks and receiving adequate forms of social support. Individuals may also face other challenges during their recovery from an injury or illness such as fear-avoidance beliefs. Fear-avoidance beliefs may result in an individual doubting their abilities, withdrawing from social activities, or fearing the reactions of co-workers. Furthermore, fear-avoidance beliefs may negatively impact the quality of life, impede injury recovery or contribute to a decline in mental health (e.g., depression) therein creating a vicious cycle. More specifically, Watt et al., (2015) in their examination of psychosocial factors in the literature went as far as to say that “fear-avoidance beliefs may be the most powerful psychosocial predictor of disability with particular relevance in predicting prolonged work absence”. In addition to being injured, being unemployed may undermine an individual’s social support[8]. Prolonged absence from work may restrict an individual’s ability to access or engage in meaningful activities which may increase the risk of social isolation resulting in significant reemployment or RTW barriers. Furthermore, research has suggested that individuals experiencing job loss may also socially undermine themselves (e.g., displaying hostility to others) resulting in a less likelihood of gaining assistance from others. Socially undermining behaviours may negatively impact an individual’s job recovery efforts such as outcome expectations, self-efficacy, or goal attainment. Consequently, low self-efficacy may lead to negative thoughts and emotions, or stress, which may further impair an individual’s connection to social networks or distort their self-evaluations resulting in feeling like a burden, not asking for help, or not engaging in job-seeking activities such as networking.