Psychiatric diagnosis and other predictors of experienced and anticipated workplace discrimination and concealment of mental illness among mental health service users in England
This study aims to examine whether psychiatric diagnosis is associated with likelihoods of experienced and anticipated workplace discrimination and the concealment of psychiatric diagnoses.
5924 mental health service users in England were interviewed as part of the Viewpoint survey between 2009 and 2014 using the Discrimination and Stigma Scale. Associations of psychiatric diagnosis with experienced and anticipated work-related discrimination or the concealment of mental illness were examined with the use of logistic regression models.
25.6% of the participants reported experiencing discrimination in at least one work-related domain, contrasting with the 53.7% who anticipated workplace discrimination and the 72.9% who had concealed their mental illness. There was strong evidence that patients with schizophrenia and schizoaffective disorder had a decreased risk of experienced discrimination in keeping a job compared to those with depression, anxiety disorder, bipolar disorder or personality disorder. Furthermore, patients with depression were more likely to report anticipated discrimination in applying for education or training compared to those with schizophrenia and schizoaffective disorder. In addition, patients with depression were more likely to conceal their mental illness compared to those with schizophrenia and schizoaffective disorder and bipolar disorder.
This study suggests that psychiatric diagnosis is a predictor of experienced and anticipated workplace discrimination and the concealment of mental illness and that more support is needed for employees with common mental disorders and their employers to enable better workplace outcomes for this group.
KeywordsStigma Discrimination Workplace Mental health service users Disclosure
Compliance with ethical standards
Conflict of interest
On behalf of all authors, the corresponding author states that there is no conflict of interest.
- 1.Health and Safety Executive (2016) Self-reported work-related ill health and workplace injuries in 2015/16. http://www.hse.gov.uk/statistics/causinj/. Accessed 07 Aug 2017
- 2.Organisation for Economic Cooperation and Development (2014) Mental health and work: United Kingdom. OECD Publishing, Paris. https://doi.org/10.1787/9789264204997-en. Accessed 05 Aug 2017
- 4.The Schizophrenia Commission (2012) The abandoned illness: a report by the schizophrenia commission. http://www.rethink.org/media/514093/TSC_main_report_14_nov.pdf. Accessed 05 Aug 2017
- 7.Lasalvia A, Zoppei S, Van Bortel T, Bonetto C, Cristofalo D, Wahlbeck K, Bacle SV, Van Audenhove C, Van Weeghel J, Reneses B, Germanavicius A (2013) Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 11(9860):55–62CrossRefGoogle Scholar
- 9.Farrelly S, Clement S, Gabbidon J, Jeffery D, Dockery L, Lassman F, Brohan E, Henderson RC, Williams P, Howard LM, Thornicroft G (2014) Anticipated and experienced discrimination amongst people with schizophrenia, bipolar disorder and major depressive disorder: a cross sectional study. BMC Psychiatry 29(1):157CrossRefGoogle Scholar
- 10.Brouwers EP, Mathijssen J, Van Bortel T, Knifton L, Wahlbeck K, Van Audenhove C, Kadri N, Chang C, Goud BR, Ballester D, Tófoli LF (2016) Discrimination in the workplace, reported by people with major depressive disorder: a cross-sectional study in 35 countries. BMJ Open 6(2):e009961CrossRefGoogle Scholar
- 11.Thornicroft G (2006) Shunned: discrimination against people with mental illness. Oxford University Press, OxfordGoogle Scholar
- 23.Tyler DI (2013) Revolting subjects: social abjection and resistance in neoliberal Britain. Zed Books Ltd, LondonGoogle Scholar
- 34.Social Exclusion Unit (2004) Mental health and social exclusion. Office of the Deputy Prime Minister, London. http://www.nfao.org/Useful_Websites/MH_Social_Exclusion_report_summary.pdf. Accessed 07 Aug 2017
- 35.Henderson C, Brohan E, Clement S, Williams P, Lassman F, Schauman O, Dockery L, Farrelly S, Murray J, Murphy C, Slade M (2013) Decision aid on disclosure of mental health status to an employer: feasibility and outcomes of a randomised controlled trial. Br J Psychiatry 203(5):350–357CrossRefGoogle Scholar
- 54.NHS Information Centre (2013) Mental Health Bulletin: annual report from MHMDS returns—England, 2011–12. http://digital.nhs.uk/media/22473/Mental-Health-Bulletin-Annual-report-from-MHMDS-returns-England-2011-12-Report/Any/ment-heal-bull-mhmds-anua-retu-2011-12-bulletin. Accessed 03 Aug 2017
- 56.National Collaborating Centre for Mental (2014) National Institute for Health and Clinical Excellence: guidance, psychosis and schizophrenia in adults: treatment and management: updated edition. National Institute for Health and Care Excellence (UK), London. https://www.nice.org.uk/guidance/cg178/evidence/full-guideline-490503565. Accessed 08 Aug 2017
- 57.Becker DR, Drake RE (2003) A working life for people with severe mental illness. Oxford University Press, OxfordGoogle Scholar
- 59.Bevan S, Gulliford J, Steadman K, Taskila T, Thomas R, Moise A (2013) Working with schizophrenia: pathways to employment, recovery & inclusion. The Work Foundation. https://councilfordisabledchildren.org.uk/sites/default/files/uploads/documents/import/working_with_schizophrenia.pdf. Accessed 08 Aug 2017
- 63.Grambal A, Prasko J, Kamaradova D, Latalova K, Holubova M, Marackova M, Ociskova M, Slepecky M (2016) Self-stigma in borderline personality disorder–cross-sectional comparison with schizophrenia spectrum disorder, major depressive disorder, and anxiety disorders. Neuropsychiatr Dis Treat 12:2439CrossRefGoogle Scholar
- 66.Office for national statistics (2017) UK labour market: July 2017. Office for National Statistics, Newport. https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/bulletins/uklabourmarket/latest#unemployment. Accessed 08 Aug 2017
- 71.Smart L, Wegner DM (2000) The hidden costs of hidden stigma. The social psychology of stigma. Guilford Press, New York, pp 220–242Google Scholar
- 75.Anfossi A (2017) The current state of recovery colleges in the UK: final report. 2017. ImROC & Nottinghamshire Healthcare NHS Foundation Trust, NottinghamGoogle Scholar