Social Psychiatry and Psychiatric Epidemiology

, Volume 42, Issue 9, pp 723–733 | Cite as

A cross-cultural study of employers’ concerns about hiring people with psychotic disorder: implications for recovery

  • Hector W.H. TsangEmail author
  • Beth Angell
  • Patrick W. Corrigan
  • Yueh-Ting Lee
  • Kan Shi
  • Chow S. Lam
  • Shenghua Jin
  • Kevin M.T. Fung



Employment discrimination is considered as a major impediment to community integration for people with serious mental illness, yet little is known about how the problem manifests differently across western and non-western societies. We developed a lay model based on Chinese beliefs and values in terms of Confucianism, Taoism, Buddhism, and folk religions which may be used to explain cross-cultural variation in mental illness stigma, particularly in the arena of employment discrimination. In this study, we tested this lay approach by comparing employers’ concerns about hiring people with psychotic disorder for entry-level jobs in US and China.


One hundred employers (40 from Chicago, 30 from Hong Kong, and 30 from Beijing) were randomly recruited from small size firms and interviewed by certified interviewers using a semi-structured interview guide designed for this study. Content analysis was used to derive themes, which in turn were compared across the three sites using chi-square tests.


Analyses reveal that employers express a range of concerns about hiring an employee with mental illness. Although some concerns were raised with equal frequency across sites, comparisons showed that, relative to US employers, Chinese employers were significantly more likely to perceive that people with mental illness would exhibit a weaker work ethic and less loyalty to the company. Comparison of themes also suggests that employers in China were more people-oriented while employers in US were more task-oriented.


Cultural differences existed among employers which supported the lay theory of mental illness.

Key words

psychotic disorder recovery employment cross-cultural differences lay theory 



This study was supported by a grant referenced AA014842-01 from the U.S. National Institute on Alcohol Abuse and Alcoholism, the National Institute of Mental Health, and the Fogarty International Center. We are also grateful to Natalie Slopen, Ellen Chan, Lin Lin, Xioalu Wang, Zhen Wang, Xiaopeng Rui, Bei Liu, Menglei Shi, Yang Ye, and Yi Wang for interviewing the employers.


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Hector W.H. Tsang
    • 1
    Email author
  • Beth Angell
    • 2
  • Patrick W. Corrigan
    • 3
  • Yueh-Ting Lee
    • 4
  • Kan Shi
    • 5
  • Chow S. Lam
    • 3
  • Shenghua Jin
    • 6
  • Kevin M.T. Fung
    • 1
  1. 1.Dept. of Rehabilitation SciencesThe Hong Kong Polytechnic UniversityHung HomHong Kong
  2. 2.The School of Social Service AdministrationThe University of ChicagoChicagoUSA
  3. 3.Institute of PsychologyIllinois Institute of TechnologyChicagoUSA
  4. 4.College of Arts and SciencesMinot State UniversityMinotUSA
  5. 5.Institute of PsychologyChinese Academy of SciencesBeijingChina
  6. 6.School of PsychologyBeijing Normal UniversityBeijingChina

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