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      To Disclose or Not to Disclose: A Multi-stakeholder Focus Group Study on Mental Health Issues in the Work Environment

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          Abstract

          Purpose Whether or not to disclose mental illness or mental health issues in the work environment is a highly sensitive dilemma. It can facilitate keeping or finding paid employment, but can also lead to losing employment or to not being hired, because of discrimination and stigma. Research questions were: (1) what do stakeholders see as advantages and disadvantages of disclosing mental illness or mental health issues in the work environment?; (2) what factors are of influence on a positive outcome of disclosure? Methods A focus group study was conducted with five different stakeholder groups: people with mental illness, Human Resources professionals, employers, work reintegration professionals, and mental health advocates. Sessions were audio-taped and transcribed verbatim. Thematic content analysis was performed by two researchers using AtlasTi-7.5. Results were visually represented in a diagram to form a theoretical model. Results Concerning (dis-)advantages of disclosure, six themes emerged as advantages ( improved relationships, authenticity, work environment support, friendly culture) and two as disadvantages (discrimination and stigma). Of influence on the disclosure outcome were: Aspects of the disclosure process, workplace factors, financial factors, and employee factors. Stakeholders generally agreed, although distinct differences were also found and discussed in the paper. Conclusion As shown from the theoretical model, the (non-)disclosure process is complex, and the outcome is influenced by many factors, most of which cannot be influenced by the individual with mental illness. However, the theme ‘Aspects of the disclosure process’, including subthemes: who to disclose to, timing, preparation, message content and communication style is promising for improving work participation of people with mental illness or mental health issues, because disclosers can positively influence these aspects themselves.

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          Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace

          Background Stigma and discrimination present an important barrier to finding and keeping work for individuals with a mental health problem. This paper reviews evidence on: 1) employment-related disclosure beliefs and behaviours of people with a mental health problem; 2) factors associated with the disclosure of a mental health problem in the employment setting; 3) whether employers are less likely to hire applicants who disclose a mental health problem; and 4) factors influencing employers' hiring beliefs and behaviours towards job applicants with a mental health problem. Methods A systematic review was conducted for the period 1990-2010, using eight bibliographic databases. Meta-ethnography was used to provide a thematic understanding of the disclosure beliefs and behaviours of individuals with mental health problem. Results The searches yielded 8,971 items which was systematically reduced to 48 included studies. Sixteen qualitative, one mixed methods and seven quantitative studies were located containing evidence on the disclosure beliefs and behaviours of people with a mental health problem, and the factors associated with these beliefs and behaviours. In the meta-ethnography four super-ordinate themes were generated: 1) expectations and experiences of discrimination; 2) other reasons for non-disclosure; 3) reasons for disclosure; and 4) disclosure dimensions. Two qualitative, one mixed methods and 22 quantitative studies provided data to address the remaining two questions on the employers perspective. Conclusions By presenting evidence from the perspective of individuals on both sides of the employment interaction, this review provides integrated perspective on the impact of disclosure of a mental health problem on employment outcomes.
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            The influence of chronic health problems and work-related factors on loss of paid employment among older workers

            With an ageing society and increasing retirement ages, it is important to understand how employability can be promoted in older workers with health problems. The current study aimed to determine whether (1) different chronic health problems predict transitions from paid employment to disability benefits, unemployment and early retirement, and (2) how work-related factors modify these associations.
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              Use of content analysis to conduct knowledge-building and theory-generating qualitative systematic reviews

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                Author and article information

                Contributors
                e.p.m.brouwers@tilburguniversity.edu
                Journal
                J Occup Rehabil
                J Occup Rehabil
                Journal of Occupational Rehabilitation
                Springer US (New York )
                1053-0487
                1573-3688
                13 August 2019
                13 August 2019
                2020
                : 30
                : 1
                : 84-92
                Affiliations
                [1 ]GRID grid.12295.3d, ISNI 0000 0001 0943 3265, Department Tranzo, Tilburg School of Social and Behavioral Sciences, NETHLAB, , Tilburg University, ; P.O. Box 90153, 5000 LE Tilburg, The Netherlands
                [2 ]GRID grid.12295.3d, ISNI 0000 0001 0943 3265, Department Human Resource Studies, Tilburg School of Social and Behavioral Sciences, NETHLAB, , Tilburg University, ; Tilburg, The Netherlands
                [3 ]GRID grid.5012.6, ISNI 0000 0001 0481 6099, Department of Psychiatry and Neuropsychology, , Maastricht University, ; Maastricht, The Netherlands
                [4 ]Phrenos Center of Expertise, Utrecht, The Netherlands
                [5 ]Parnassia Group, The Hague, The Netherlands
                Article
                9848
                10.1007/s10926-019-09848-z
                7031172
                31410722
                6e0ca967-373b-4a91-9478-b4453039490f
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

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                © Springer Science+Business Media, LLC, part of Springer Nature 2020

                Occupational & Environmental medicine
                discrimination,stigma,employment,mental illness,disclosure
                Occupational & Environmental medicine
                discrimination, stigma, employment, mental illness, disclosure

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