Brohan E, Evans-Lacko S, Henderson C, Murray J, Slade M, Thornicroft G
Health Service and Population Research Department,Institute of Psychiatry, King's College London,UK.
Epidemiol Psychiatr Sci. 2014 Sep;23(3):289-300. doi: 10.1017/S2045796013000310. Epub 2013 Aug 6.
Aims. Decisions regarding disclosure of a mental health problem are complex and can involve reconciling conflicting needs and values. This article provides a qualitative account of the beliefs and experiences of mental health service users regarding disclosure in employment contexts. Methods. Total sample of 45 individuals were interviewed in two study phases. In phase one, semi-structured interviews were carried out with 15 mental health service users. The transcripts were analysed using interpretative phenomenological analysis (IPA). In phase two, identified themes were further explored through interviews with mental health service users (n = 30) in three employment contexts: in paid employment (n = 10); in study or voluntary work (n = 10); and currently unemployed (n = 10). These were analysed using directed content analysis. Results. Four super-ordinate themes were drawn from phase one analysis: (1) public understanding of mental health problems; (2) the employment context; (3) personal impact of labelling and (4) disclosure needs. These themes were reflective of the content of phase two interviews. Conclusions. Greater emphasis needs to be placed on considering the societal, employment and interpersonal influences which form the basis for disclosure beliefs and experiences.
目标。关于披露心理健康问题的决定很复杂，可能涉及协调相互冲突的需求和价值观。本文对心理健康服务使用者在就业背景下关于披露的信念和经历进行了定性描述。方法。在两个研究阶段对45名个体进行了总体抽样访谈。在第一阶段，对15名心理健康服务使用者进行了半结构化访谈。使用解释现象学分析（IPA）对访谈记录进行了分析。在第二阶段，通过对处于三种就业背景下的心理健康服务使用者（n = 30）进行访谈，进一步探讨了确定的主题：有薪工作（n = 10）；学习或志愿工作（n = 10）；以及目前失业（n = 10）。使用定向内容分析法对这些进行了分析。结果。从第一阶段分析中得出了四个上位主题：（1）公众对心理健康问题的理解；（2）就业背景；（3）标签化的个人影响；以及（4）披露需求。这些主题反映了第二阶段访谈的内容。结论。需要更加重视考虑构成披露信念和经历基础的社会、就业和人际影响。
