Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues: position paper and future directions

Abstract

Background: As yet, little is known about the effects of mental health stigma on sustainable employment. This is surprising, as mental health stigma is common, and because people with severe and common mental disorders are 7 and 3 times more likely to be unemployed, respectively, than people with no disorders. As the global lifetime prevalence of mental disorders is 29%, the high unemployment rates of people with these health problems constitute an important and urgent public health inequality problem that needs to be addressed. Main text: The aim of this position paper is to illustrate the assumption that stigma contributes to the unemployment of people with mental illness and mental health issues with evidence from recent scientific studies on four problem areas, and to provide directions for future research. These four problem areas indicate that: (1) employers and line managers hold negative attitudes towards people with mental illness or mental health issues, which decreases the chances of people with these health problems being hired or supported; (2) both the disclosure and non-disclosure of mental illness or mental health issues can lead to job loss; (3) anticipated discrimination, selfstigma and the 'Why Try' effect can lead to insufficient motivation and effort to keep or find employment and can result in unemployment; and (4) stigma is a barrier to seeking healthcare, which can lead to untreated and worsened health conditions and subsequently to adverse occupational outcomes (e.g. sick leave, job loss). Conclusions: The paper concludes that stigma in the work context is a considerable and complex problem, and that there is an important knowledge gap especially regarding the long-term effects of stigma on unemployment. To prevent and decrease adverse occupational outcomes in people with mental illness or mental health issues there is an urgent need for high quality and longitudinal research on stigma related consequences for employment. In addition, more validated measures specifically for the employment setting, as well as destigmatizing intervention studies are needed.

Work Ability, Burnout Complaints, and Work Engagement Among Employees With Chronic Diseases: Job Resources as Targets for Intervention?

“…Because of the cross-sectional design, we can only guess about the causes, but an explanation might be that because of their poorer well-being, employees with more severe mental chronic diseases receive more support from their supervisor or manager than the employees with less severe mental chronic diseases. Employees with a mental disorder especially are faced with stigma (van Vuuren et al, 2017;Brouwers et al, 2019;Brouwers, 2020), and perhaps more reluctant to share their chronic disease with their supervisor or manager. As not all employees tell their supervisor or manager about their mental chronic disease, it might as well be possible that for many employees their mental chronic disease is not known by the manager or supervisor as long it is not severe enough to interfere noticeably with work functioning.…”

“…Furthermore, the choice of workers not to disclose chronic diseases can be understandable (Brouwers et al, 2019;Brouwers, 2020); however, as a consequence, this prevents extra attention and effort by the supervisor or manager in managing more autonomy for these employees. Nevertheless, in work situations where an employee experiences a low level of autonomy, especially in the case that chronic diseases are disclosed, a very important question is what possibilities might be present to enhance the level of autonomy.…”

Barriers and facilitators for treatment-seeking for mental health conditions and substance misuse: multi-perspective focus group study within the military

“…Leaving mental health conditions and substance misuse untreated poses a threat to sustainable employment through a higher risk for sick leave and unemployment. 4,5 Beside negative consequences that affect well-being at an individual level, there are high economic costs involved when leaving these conditions untreated. 6 In order to reduce the treatment gap, it is essential to examine causes of non-treatment-seeking.…”

Labour Market Reintegration of Individuals with a Physical and Cognitive Disability by a Company-Based Work-Experience Program

“…A disability, or having either partially or fully recovered from a disability, brings more limited labour market chances compared with regular employees, by this we mean without disabilities (Brouwers, 2020;Burke et al, 2013;Cheatham & Randolph, 2020). Explanations for these lower prospects partly point to the general assumption of employers towards individuals with disabilities of being less productive (Unger, 2002;Lalvani, 2015;Scheid, 2005).…”