Stratton Elizabeth, Einboden Rochelle, Ryan Rose, Choi Isabella, Harvey Samuel B, Glozier Nicholas
Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.
School of Psychiatry, University of Sydney, Sydney, NSW, Australia.
Front Psychiatry. 2018 Dec 19;9:684. doi: 10.3389/fpsyt.2018.00684. eCollection 2018.
Deciding to disclose a mental illness in the workplace requires thoughtful informed decision making. Decision aids are increasingly used to help people make complex decisions, but need to incorporate relevant factors for the context. This study aimed to identify factors and processes that influence decision making about such disclosure to inform the development of a disclosure decision aid tool for employees in male dominated industries. We invited 15 partner organisations in male dominated industries to facilitate the recruitment of employees who either had disclosed a mental health condition in their workplace; or occupied a position to whom employees disclosed to focus groups addressing the aims. The majority of the organisations had explicit policies that employees must disclose and so were unable to be seen countenancing non-disclosure as an option. Two focus groups were conducted ( = 13) with mainly male (62%), full-time employees (85%), and both disclosed (46%) and authority (54%) groups. Six themes, all barriers, were identified as influencing decision making processes: knowledge about symptoms, and self-discrimination (internal), stigma and discrimination by others, limited managerial support, dissatisfaction with services, and/or a risk of job or financial loss (external). Decisions to disclose mental health conditions, even by those who had done so, appear driven entirely by consideration of negative aspects. This suggests that anti-discrimination policy, legislation, awareness campaigns, and manager training have yet to change negative perceptions, and that any decision aid tool needs to incorporate counterfactual positive aspects that appear not to be an important consideration in such male dominated workplaces. There is a disconnect between organisational policies favouring disclosure and employees favouring non-disclosure that has caused tension within the organisational culture. Decision aid tools may assist employees with an active disclosure without waiting for an event to occur, giving the control of the decision back to the employee.
决定在工作场所披露精神疾病需要经过深思熟虑并做出明智的决策。决策辅助工具越来越多地被用于帮助人们做出复杂的决策，但需要纳入与具体情境相关的因素。本研究旨在确定影响此类披露决策的因素和过程，以为男性主导行业的员工开发一种披露决策辅助工具提供信息。我们邀请了15个男性主导行业的合作伙伴组织，以协助招募那些要么在工作场所披露过心理健康状况的员工；要么担任员工会向其披露情况的职位的人员，参加针对研究目标的焦点小组讨论。大多数组织都有明确的政策，要求员工必须披露，因此无法被视为支持不披露这一选项。我们进行了两个焦点小组讨论（n = 13），参与者主要是男性（62%）、全职员工（85%），包括已披露者（46%）和有决定权者（54%）。确定了六个主题，均为障碍，影响决策过程：对症状的了解以及自我歧视（内部）、他人的污名化和歧视、有限的管理支持、对服务的不满以及/或者工作或经济损失的风险（外部）。披露心理健康状况的决定，即使是那些已经披露的人做出的决定，似乎完全是出于对负面因素的考虑。这表明反歧视政策、立法、宣传活动和管理者培训尚未改变负面看法，而且任何决策辅助工具都需要纳入在这种男性主导的工作场所似乎并非重要考虑因素的反事实积极方面。支持披露的组织政策与员工倾向于不披露之间存在脱节，这在组织文化中造成了紧张关系。决策辅助工具可能有助于员工主动披露，而不必等待事件发生，将决策控制权交回给员工。
