Workers' Decisions to Disclose a Mental Health Issue to Managers and the Consequences

Abstract

Background: Stigma can be a barrier to accessing effective interventions and work accommodations for mental illnesses. Fear of stigma's concomitant prejudice and discrimination can inhibit workers from asking for help. Thus, it may be important to develop effective interventions addressing workplace stigma. To identify important targets for these interventions, this study addresses three questions: (1) what proportion of workers experiencing mental health issues disclosed their mental health issue to their managers, (2) what factors did they identify as contributing to their disclosure decisions, and (3) what were the consequences of their decisions?Methods: The dataset is comprised of responses from respondents who were randomly drawn from a nationally representative sample of working Dutch adults who completed a web-based survey in February 2018. Respondents indicating they either had or have mental health issues were asked three sets of questions focusing on: (1) Did you disclose your mental health issue to you manager? (2) For what reasons did you disclose/not disclose the issue? (3) What were the consequences of your disclosure decision?Results: About 73% of respondents with lived experience with mental health issues told their managers about their mental health issue. The structure of the survey questions identified four groups of workers who either: (1) disclosed and had a positive experience (64.2%), (2) disclosed and had a negative experience (9.0%), (3) did not disclose and had a positive experience (22.6%), or (4) did not disclose and had a negative experience (4.2%).Conclusion: Our results reflect workers' diverse preferences for disclosing their mental health issues to their managers. Understanding both the factors that contributed to the decision to disclose and the consequences of disclosure decisions could help to better target workplace educational programs and interventions to address workplace stigma. Our findings suggest that addressing workplace stigma may not be as straightforward as requiring all employees to receive anti-stigma education. Rather, education should support workers to make the appropriate disclosure decision based on their workplace contexts. Future research is needed to understand the optimal ways for workers struggling with mental health issues to ask and receive help if they need it.

Expectations of Mental Illness Disclosure Outcomes in the Work Context: A Cross-Sectional Study Among Dutch Workers

“…Nevertheless, overall respondents tended to be optimistic about the outcomes of disclosure, for instance illustrated by the finding that in 11 out of 14 different circumstances, they would advise a good friend to disclose. The tendency for optimism found in this study was also found in two Dutch studies, where about 75% of workers with [19] and without [20] mental illness indicated they actually had or would disclose, respectively. The contradictory finding that respondents were generally positive in their expected disclosure outcome yet believed it could lead to discrimination in the form of job loss or career advancement is puzzling and needs to be studied in future research.…”

Decision (not) to disclose mental health conditions or substance abuse in the work environment: a multiperspective focus group study within the military

“…For example, a study among Dutch employees showed that compared with people who had disclosed their MHC/SA, those who had not were significantly younger. 22 However, generalisability was not the purpose of the study. As with other qualitative studies, the aim was to provide insight into a complex challenge of which more knowledge is urgently needed.…”

“… 21 Another study among Dutch workers found that of those who had disclosed MHC/SA, almost 50% indicated this was due to a good relationship with their manager, and the main reasons for reporting a positive or negative disclosure experience was due to whether support was received or not by the manager. 22 This indicates the importance of supervisor–worker relationships for disclosure. As research on the topic is scarce, and the decision to disclosure has major consequences for health, well-being and sustainable employment, it is important to further examine factors that influence disclosure.…”

Worker and manager perceptions of the utility of work-related mental health literacy programmes delivered by community organisations: a qualitative study based on the theory of planned behaviour

“… 67 Next was safety (n=12) in terms of being outside of workplace setting (n=6), confidential (n=5) and positive (n=1), which could help to overcome some workplace barriers such as fear of discrimination or repercussion on career. 12 15 Relatability (n=12) was reported next. This referred to COs being a non-clinical and less stigmatising setting (n=8) and including people to which participants could relate (n=4).…”

“… 10 11 Workplace barriers include mistrust of embedded programmes such as employee assistant programmes, fear of discrimination or repercussion on their career, limited confidence in managers’ capabilities surrounding disclosure and unsupportive organisational cultural norms. 12–15 Furthermore, structural barriers such as the unavailability of service providers outside working hours can also affect access to care. 11 …”