Psychosocial assessment of the high utilizer of occupational health services.

A small group of persons in ambulatory care settings report multiple symptoms and recurrent distress and utilize a high percentage of resources. Often these high utilizers are requesting help with a psychosocial problem through their symptoms. The psychosocial reason for high utilization of services may be a major psychiatric problem such as a somatization disorder or a depression/anxiety disorder. Most often, however, the person is seeking help with family or work stresses or is in need of information and/or reassurance. A careful assessment by the occupational health nurse can lead to a determination of an unmet psychosocial need. Direct help with this problem can break the cycle of multiple symptoms, distress, and utilization.