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.

Background

Stigma can be a barrier for workers experiencing a mental illness to access accommodations at work. However, work accommodations may be necessary to maintain a worker's ability to work. Therefore, it may be important to develop effective interventions to address workplace stigma.

Objective

To determine (1) what proportion of workers would probably disclose their mental health issue to their manager, (2) what are the motivating factors for the decision of whether or not to disclose, and (3) what would potentially change the disclosure decision?

Methods

A link to a Web-based questionnaire was sent to a nationally representative sample of 1671 Dutch adults over 18 years of age. The response rate was 74%. We focused on the 892 respondents who indicated they were either employed for pay or looking for employment, not in management positions, and never experienced a mental health issue. This group comprised 73% of the total sample. They were asked if they would disclose their mental health issue to their manager. For what reasons would they disclose/not disclose the issue? And, what could change their decision?

Results

We found that almost 75% of workers would disclose to their managers. The perceived relationship with their managers and feelings of responsibility to their workplaces were important contributors to the decision. A large minority of workers would not tell, preferring to deal with their issues alone. In addition, a significant proportion of workers would choose not to disclose fearing negative consequences.

Conclusion

Our results indicate that the majority of these Dutch workers would disclose a mental health issue to their managers. The relationship with the manager plays a central role. The advice from a trusted individual and the experiences of colleagues are also significant factors in the disclosure decision.

Stigma may negatively affect line managers' intention to hire people with mental health problems (MHP). This study aims to evaluate line managers' knowledge and attitudes concerning job applicants with MHP, and to assess which factors are associated with the intention (not) to hire an applicant with MHP. A sample of Dutch line managers (N=670) filled out a questionnaire on their knowledge, attitudes and experiences concerning applicants/employees with MHP. Descriptive analyses and multiple regression analyses were used. The majority (64%) was reluctant to hire a job applicant with MHP, despite the fact that only 7% had negative and 52% had positive personal experiences with such employees. Thirty per cent were reluctant to hire an applicant if they knew the applicant had past MHP. Associated with higher reluctance to hire an applicant with MHP were the concerns that it will lead to long-term sickness absence (β (95% CI)=0.39 (0.23 to 0.55)), that the employee cannot handle the work (β (95% CI)=0.16 (0.00 to 0.33)) that one cannot count on the employee (β (95% CI)=0.41 (0.23 to 0.58)) and higher manager education level (β (95% CI)=0.25 (0.05 to 0.44)). Conversely, associated with positive hiring intentions was being in favour of diversity and/or inclusive enterprise (β(95% CI)=-0.64 (-0.87 to -0.41)). As the majority of managers were reluctant to hire applicants with MHP, and even 30% were reluctant to hire applicants who had past MHP, these findings have major implications for social inclusion in the Netherlands, where about 75% of employees would disclose MHP at work.