Saturday, 15 January 2005 - 2:00 PM

This presentation is part of: Recovery from Severe Mental Illness

To Tell or Not to Tell: Disclosure of a Psychiatric Condition in the Workplace

The Americans with Disabilities Act of 1990 (ADA) is designed to protect people with mental and physical disabilities from disability-based discrimination in all aspects of employment. To qualify for these protections, an employee must disclose, in his or her own language, the disabling condition to the employer. This qualitative study explored dilemmas of self-presentation that are encountered by individuals with mental illness who are employed. How a person with a non-visible condition, such as a mental illness, develops a balancing strategy that acknowledges both a motivation for some transparency as well as a need for protection against stigma has been a central focus of this exploratory study.

Using a purposive sampling strategy, semi-structured interviews were conducted with 20 individuals (10 men; 10 women) with psychiatric diagnoses who were employed in independent service sector jobs for at least one year. Data were analyzed using a grounded theory approach to develop conceptual understandings of the following: motivations for workplace disclosure; liabilities of disclosure; personal strategies for stigma management; self-presentational skills that suuport the projection of a more holistic self within the workplace. Participants were surveyed for their knowledge and use of the ADA for anti-discrimination protection. The consultative services of three individuals with mental illness, who were not study participants, served to strengthen the research design and to validate analytic summations for credibility and completeness. These consultants assisted the researcher in the design of interview questions, and in the examination of selected interview transcripts for coding accuracy. The researcher conducted subject check interviews with five study participants to further validate the research findings.

Results suggest that earlier negative work experiences involving disclosure of a mental illness continue to inform participants’ decision-making around revelations in the present. Participants with longer experiences of living with mental illness tend either towards increased circumspection in relation to the sharing of their conditions or incorporation of information about their diagnoses into larger, more complex understandings of self that emphasize their multiple strengths and competencies. Normalizing narratives increasingly replace illness narratives as participants gain self-presentational skills in recovery. Some participants mention greater control in their social interactions at work and greater ability to cope with mental illness labeling stigma because of their improved capacity to describe themselves more holistically. Though sample size precludes generalization about gender and disclosure, women in the study were more inclined than men to disclose their mental health conditions to co-workers or their clients for purposes of emotional connection, mentoring, or extending hope to the targets of their disclosures. Many participants regard the ADA with skepticism, due to their assessment of workplace problems stemming from its use, as well as their knowledge of larger political and economic factors that make the law appear risky to embrace. Implications for policy and practice are discussed.

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