Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace

Abstract

BackgroundStigma and discrimination present an important barrier to finding and keeping work for individuals with a mental health problem. This paper reviews evidence on: 1) employment-related disclosure beliefs and behaviours of people with a mental health problem; 2) factors associated with the disclosure of a mental health problem in the employment setting; 3) whether employers are less likely to hire applicants who disclose a mental health problem; and 4) factors influencing employers' hiring beliefs and behaviours towards job applicants with a mental health problem.MethodsA systematic review was conducted for the period 1990-2010, using eight bibliographic databases. Meta-ethnography was used to provide a thematic understanding of the disclosure beliefs and behaviours of individuals with mental health problem.ResultsThe searches yielded 8,971 items which was systematically reduced to 48 included studies. Sixteen qualitative, one mixed methods and seven quantitative studies were located containing evidence on the disclosure beliefs and behaviours of people with a mental health problem, and the factors associated with these beliefs and behaviours. In the meta-ethnography four super-ordinate themes were generated: 1) expectations and experiences of discrimination; 2) other reasons for non-disclosure; 3) reasons for disclosure; and 4) disclosure dimensions. Two qualitative, one mixed methods and 22 quantitative studies provided data to address the remaining two questions on the employers perspective.ConclusionsBy presenting evidence from the perspective of individuals on both sides of the employment interaction, this review provides integrated perspective on the impact of disclosure of a mental health problem on employment outcomes.

Exploring experiences of and attitudes towards mental illness and disclosure amongst health care professionals: a qualitative study

“…Advantages to disclosure identified by participants are consistent with literature, namely increased understanding from colleagues (Brohan et al, 2012), and support (MacDonald-Wilson, 2005).…”

“…During interviews some participants stated that they had a diagnosed mental illness and it was apparent that many participants with a mental illness fear stigmatisation and discrimination from their colleagues, demonstrating that health professionals are not immune to stigmatisation in the workplace. Further, this fear may be a significant factor in preventing disclosure [as it is in other workplaces (Brohan et al, 2012)]. …”

“…However, disclosure allows the person access to support and reasonable adjustments under the Equality Act that could assist them in maintaining performance. Employees may also receive emotional support from colleagues; a common reason for disclosing (Brohan et al, 2012). It has been shown that a large number of different social, psychosocial and demographic factors affect the decision to disclose (Corrigan et al, 2015b).…”

What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies

“…The impact of anti-stigma interventions on help-seeking warrants further research. Disclosure issues were found to be a particular concern, and although other reviews have mapped out the benefits and harms of disclosure in employment contexts (Brohan et al 2012), we need to understand more about disclosure in relation to help-seeking. It would also be useful to investigate how different types of stigma may relate to other help-seeking barriers, such as wanting to deal with problems oneself, and low perceived need.…”

Narratives of Sick Leave, Return to Work and Job Mobility for People with Common Mental Disorders in Sweden

“…In a review of the literature about disclosure of mental illness in the workplace, it was concluded that there are several reasons for why people choose not to disclose their conditions. This included expectations or experiences of discrimination, feeling that the condition is a private matter, or feelings that others do not want to know about it; reasons for disclosing one's illness, on the other hand, was connected to being a role-model for others, to have work adjusted, being honest, receiving support, and because concealing illness is stressful [28]. The review also noted that feelings of emotional support were connected to disclosure, which was apparent also in the present study: most clearly in Anna's case, where her refusal to disclose her chaotic life situation caused her to become estranged from her colleagues and managers, which seemed to have obstructed her RTW.…”