The economic costs of mental health‐related discrimination

Osumili, Beatrice; Henderson, Claire; Corker, Elizabeth; Hamilton, Sarah; Pinfold, Vanessa; Thornicroft, Graham; McCrone, Paul

doi:10.1111/acps.12608

Cited by 10 publications

(10 citation statements)

References 17 publications

(31 reference statements)

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“…Further, WHPP emphasizing individual responsibility also lead to employees with overweight and obesity being targeted by stigma and discrimination. Both are associated with several unwarranted outcomes, such as decreased mental and physical health (Pascoe and Smart Richman, 2009 ; Puhl and Suh, 2015 ), increased healthcare costs (Osumili et al, 2016 ), and underperformance (Glover et al, 2017 ). Thus, if not implemented carefully, WHPP might have negative rather than the expected positive effects.…”

Section: Discussionmentioning

confidence: 99%

“…We propose and test that such framing of responsibility within WHPP forms a potent foundation for weight stigma and discrimination in the workplace. Since experiences of stigma are associated with decreased mental and physical health (e.g., Puhl and Suh, 2015 ) and with an associated increase in healthcare costs (e.g., Osumili et al, 2016 ), WHPP might form a cause of what they aim to cure. The current investigation tests the influence of both the presence and focus (individual vs. organizational responsibility) of WHPP on weight stigma and discrimination.…”

Section: Introductionmentioning

confidence: 99%

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The Impact of Workplace Health Promotion Programs Emphasizing Individual Responsibility on Weight Stigma and Discrimination

2018

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Over time, there has been a steady increase of workplace health promotion programs that aim to promote employees' health and fitness. Previous research has focused on such program's effectiveness, cost-savings, and barriers to engaging in workplace health promotion. The present research focuses on a downside of workplace health promotion programs that to date has not been examined before, namely the possibility that they, due to a focus on individual responsibility for one's health, inadvertently facilitate stigmatization and discrimination of people with overweight in the workplace. Study 1 shows that the presence of workplace health promotion programs is associated with increased attributions of weight controllability. Study 2 experimentally demonstrates that workplace health promotion programs emphasizing individual rather than organizational responsibility elicit weight stigma. Study 3, which was pre-registered, showed that workplace health promotion programs emphasizing individual responsibility induced weight-based discrimination in the context of promotion decisions in the workplace. Moreover, focusing on people with obesity who frequently experience weight stigma and discrimination, Study 3 showed that workplace health promotion programs highlighting individual responsibility induced employees with obesity to feel individually responsible for their health, but at the same time made them perceive weight as less controllable. Together, our research identifies workplace health promotion programs as potent catalysts of weight stigma and weight-based discrimination, especially when they emphasize individual responsibility for health outcomes. As such, we offer valuable insights for organizations who aim to design and implement workplace health promotion programs in an inclusive, non-discriminatory way that benefits all employees.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Impact of Workplace Health Promotion Programs Emphasizing Individual Responsibility on Weight Stigma and Discrimination

2018

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“…The association is found for reduced productivity at work, for those who are employed, as well as impairment in other critical domains like parenting and other caretaker roles. Impairment due to discrimination would add to the economic costs of discrimination, such as increased health care costs (Evans-Lacko et al, 2014; Osumili et al, 2016), suggested by prior studies. Additional studies are needed to determine the extent to which these associations reflect causal relationships.…”

Section: Discussionmentioning

confidence: 99%

Associations of Perceived Discrimination With Impaired Functioning in a Population Sample With Psychological Distress

Breslau¹,

Wong

Burnam

et al. 2018

Psychiatry

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Objective To test associations between perceived discrimination based on mental health status and impaired functioning in a population sample with psychological distress. Methods Interviews were conducted with a sample of respondents to the California Health Interview Survey with mild, moderate, or severe psychological distress. Perceived discrimination was assessed using 14 items covering four domains in which discrimination is reported: social, partner, institutional, and work. Associations of perceived discrimination scores (total score and domain scores) with impaired functioning, measured by the likelihood and number of days out of role, were estimated with statistical adjustment for demographic characteristics and serious psychological distress. Results Discrimination domain scores are significantly correlated (r ranging from .34 to .65). Total discrimination score is associated with having days out of role (OR = 1.20, 95% CI = 1.10–1.30) and with number of days out of role (5.5 days) after adjustment for demographics and psychological distress. The high correlation among the domain scores makes the attribution of association to particular domains uncertain. Removal of the effect of discrimination using model-based simulation reduces past-year days out of role by 39.4 (SE 11.3) days. Conclusions This observational study supports the suggestion that discrimination against people with mental illness contributes to their impaired functioning in a diverse range of social roles. The results provide preliminary evidence that reduction in discrimination against people with mental illness could improve social functioning and work productivity. Correlations among domain scores make it difficult to draw conclusions about domain-specific associations.

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“…Also using data from the Viewpoint survey, Osumili et al [12] found that individuals who reported experiences of discrimination in healthcare settings had higher costs of health service compared with those who did not. They also found that people who reported experiences of discrimination in relationships had higher healthcare costs than those who did not.…”

Section: Introductionmentioning

confidence: 99%

Does mental health-related discrimination predict health service use 2 years later? Findings from an Australian national survey

Reavley

Morgan

Petrie

et al. 2019

Soc Psychiatry Psychiatr Epidemiol

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Stigma and discrimination are central concerns for people with mental health problems. The aim of the study was to carry out a follow-up survey of a national survey of experiences of avoidance, discrimination and positive treatment in people with mental health problems in order to explore how those experiences relate to health service use. Methods In 2017, telephone interviews were carried out with 655 Australians aged 18+, who had participated in a 2014 survey and reported a mental health problem or scored highly on a symptom screening questionnaire. Questions covered mental health, disclosure, health service utilisation, and experiences of avoidance, discrimination and positive treatment in a variety of different settings. Regression analyses were used to assess the extent to which count of settings of experiences of avoidance, discrimination or positive treatment at baseline (2014) or follow-up (2017) predicted health service use at follow-up. Results An increase in past experiences of discrimination was associated with a greater number of visits to hospital or specialist doctors and an increase in positive treatment was associated with a greater number of visits to a mental health professional. Increases in both positive and negative experiences were associated with greater healthcare costs, but the costs were greatest for discrimination at follow-up (concurrent discrimination), primarily due to the cost of nights in hospital. 3 Conclusions While both discrimination and positive treatment are associated with greater healthcare costs, concurrent experiences were shown to be more important correlates of health service use than past experiences. Moreover, those in supportive environments may be more willing to engage in earlier evidence-based treatment for mental health problems.

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The economic costs of mental health‐related discrimination

Cited by 10 publications

References 17 publications

The Impact of Workplace Health Promotion Programs Emphasizing Individual Responsibility on Weight Stigma and Discrimination

The Impact of Workplace Health Promotion Programs Emphasizing Individual Responsibility on Weight Stigma and Discrimination

Associations of Perceived Discrimination With Impaired Functioning in a Population Sample With Psychological Distress

Does mental health-related discrimination predict health service use 2 years later? Findings from an Australian national survey

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