Feb 09, 2023, 5:00 am UTC

4 min

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Mental Health @ Work: To disclose or not to disclose?

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The COVID-19 pandemic is spurring employees to rethink their relationship with work. They need and expect mentally healthy workplaces. 

Employers are beginning to respond to those needs and expectations. 

In the Harvard Business Review, health psychologist Kate Toth summed up what employees want: 

“I expect empathy and support in recognizing that I am a whole person, and need authentic care as a human being. A manageable workload would be where I would start,” said Toth, Director of Learning & Development at YMCA WorkWell, a Canadian organization that helps leaders promote workplace health and well-being.

But talking about mental health at work still carries enormous risks, especially for people with serious mental illnesses.  

New research, by Toth and others, suggests the benefits of disclosure may outweigh the risks. It shows that disclosure can have a positive impact on a person's psychological well-being. It can also foster a culture of openness, lead to job accommodations, and garner social support — factors that ultimately help employees with mental health conditions recover and succeed.  

15% of working-age adults have a mental disorder at any point in time.

Why most people still don’t disclose at work 

Disclosure isn't the norm. Most people conceal mental health problems from their managers and colleagues even when opening up could lead to job accommodations that would help them succeed.  

What is driving this choice to conceal rather than reveal? The fear of stigma and discrimination. People fear being stereotyped or perceived as incompetent on the job. They fear being ostracized by their colleagues. And, they worry about losing opportunities for advancement or their livelihoods.  

Research suggests people with mental health conditions are right to be wary. Stigma and discrimination against people struggling with psychological disorders persist in the workplace — and can act as barriers to mental wellness and recovery. Common stereotypes associated with people with serious mental illnesses such as schizophrenia, depression, and bipolar disorder include unpredictability and dangerousness, laziness, and character weakness. 

But as the new research looking at the disclosure experience of employees shows, experiencing mental health stigma and discrimination isn't universal. Most employees actually have a positive experience. 

What are the upsides to disclosure?  

A recent Dutch study led by Evelien Brouwers, professor of mental health and sustainable employment at Tilburg University, asked about 300 workers, the majority of whom identified as female, about the consequences of their decision to disclose a mental health issue at work. Eighty-eight percent of workers who revealed their mental illness to a manager had a positive experience, mainly because they received managerial support. Twelve percent reported having a negative experience, such as not having managerial support or losing their job. (The majority workers who chose not to disclose, citing a preference to deal with their mental health issues independently, also said they had a positive experience at work.)   

Though the results suggest that disclosure is positive for most employees, the researchers caution that the results may be specific to the Dutch context, where employers are incentivized to prevent workplace disability.  

In another study, researchers looked at the factors influencing the decision to disclose a mental health condition at work and what happens afterward. They conducted extensive interviews with 28 people who had started a new job in the past 12 weeks and had a mental health diagnosis, such as depression, anxiety, schizophrenia, or bipolar disorder. They focussed on the workers' goals, their disclosure strategies, and the short- and long-term impact of disclosure on the individuals themselves and their relationship with others. The research team was led by Toth at YMCA WorkWell.

Like the Dutch study, the Canadian one also found that disclosure was positive for most participants.

For example, a 28-year-old woman with bipolar disorder who made a partial disclosure at work said:  

"...we need some work accommodations, but that doesn't mean we're less intelligent, less hard-working than other people. So I see things really differently than I did at the beginning ... but in the end, the conclusion is rather positive, to have dared to talk about it."  

Shortly after disclosure, about 80 percent of participants felt a psychological and physical release, and greater comfort at work and in their social interactions. They also reported feeling self-confident and self-accepting.

In the long term, most participants reported an increased feeling of belonging, work satisfaction, and greater trust between them and their immediate supervisors.   

The study was small, but the results serve as a reminder that there is still much work to be done to ensure workers feel safe to disclose a mental health condition at work — and reap the potential rewards of doing so.   

Women in Leadership: In a Swedish study, women managers were less likely to alienate and discriminate against employees with depression. They were also more likely to make temporary changes to support the recovery of a staff member.  

Disclosure Tips: What, when and how much should you disclose?  

Remember, disclosing a mental health condition at work isn't the right choice for everyone despite the positive experience of workers in these studies. There are many unique and intertwining factors to take into account: the culture and climate in a person's workplace; their gender, age, marital status, or support network; their previous experiences with mental health stigma and discrimination; and, the stress of concealing an invisible disability. 

If you've weighed the risks and benefits and decided to disclose, here's some advice from Boston University's Center for Psychiatric Rehabilitation.  

  • Know your legal rights to accommodation in your jurisdiction, for example, under the American Disabilities Act or Canadian Human Rights Act. Research the policies your company has in place. For example, do they include disability in their diversity statements? Is there an Employee Assistance Program or Resource Group?   
  • Plan your disclosure: Think about what, when, and to whom you will disclose.   
    • Who: Who will you disclose to? Your supervisor, a disability officer, or someone representing your employee assistance program? And, who will do the talking during disclosure: you or a delegate such as a therapist or a career coach?   
    • What: How much do you plan to share about your condition, diagnosis, and the limitations you have? Share how your disability impacts your tasks rather than the details of your diagnosis or symptoms. What accommodations would you like, for example, changes to your work hours or the option to work remotely from time to time?   
    • When: Experts also suggest disclosing before you begin experiencing difficulties on the job. Pick a time to speak to your supervisor when you have their undivided attention.  

  • Practice your disclosure, keeping your supervisor's style and organizational norms in mind.   
  • Share resources with your employer that will help them respond effectively. Look for them at organizations like the Job Accommodation Network (USA) or Mental Health Works (Canada).  

  • Find support outside the workplace. There are peer-led group programs, such as Honest, Open, Proud, to support people with mental illness in their disclosure decisions and in coping with stigma.  

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