Table 1 Cost-Benefit Analysis of Disclosure in Psychosis
From: Impacts of stigma and discrimination in the workplace on people living with psychosis
Benefits of Disclosure | Benefits of Non-Disclosure |
|---|---|
Would help the employer to understand unexplained absences from work Access to provision of employment support including ESP and employer support Employer empathy and understanding; leniency if time is needed off work Co-workers may be more understanding Personal preference to be upfront Promotes sustainable work-through enabling employer education as well as contact and communication between employer and case managers if needed Would promote attitudinal change Relief at not having to fabricate reasons for attendance at appointments. | Improved chances of gaining interviews and securing employment Greater need to extend yourself which may help to build resilience. “…if you don’t disclose then you tend to push through that a bit more and stretch yourself.” |
Costs of Disclosure | Costs of Non-Disclosure |
Stigma-people look at you and think you are a little bit different; categorisation, labelling, stereotyping (preconceived ideas), being judged, changed perceptions (de-valued, less respect) Discrimination- restricts employment opportunities (ability to secure interview, gain jobs); risks of being viewed and treated differently in the workplace including coming under closer surveillance and being subject to bullying (name-calling, baiting, loss of employment); loss of business “And then I find after I’ve got the job they watch me like a hawk. And I’ve found a few jobs they actually bait me to see how I’ll go…” Negative reaction from employer-behaviour attracts closer scrutiny from employer; employer may look for problems; misinterpretation of behaviour and moods, perception that they need extra support and are harder to accommodate People have less regard for you or hold you at a distance Can affect social relationships in the workplace-can affect acceptance by co-workers (concerns about contagion), difficulty making friends. Avoidance. Rejection (due to fear). People “hold you at a distance”. Separation. Self-victimisation “…if you do disclose, I think it’s too easy just to become like a victim...I’ve got this condition, I’m not feeling too good, I’ll have a day off.” Compromise professional registration Inability to control extent of disclosure within the workplace including how many people “need to know”. Not knowing what to divulge and what not to and how this information may be used against you later | Requires additional effort to fill unexplained gaps in resumé Increased pressure due to need to maintain constant state of vigilance to guard secrecy and hide the condition from others; need to prove you are as good as everybody else; difficulty explaining treatment needs; difficulty explaining inability to function; fear of inability to sustain work or relapse requiring time off work Unexplained “drugged out” appearance Employer unaware of need for empathy and support - may affect sustainability of employment Employer less sympathetic in event of needing time off work or support to return to work following relapse- affects sustainability of work. Precludes informal collegial support. Inability to access relevant employment support, particularly during periods of exacerbation or relapse Employer unprepared to deal with situation appropriately Employer may mistakenly think they are lazy, unreliable or refuse to give a reference Perpetuation of stereotypes and lack of opportunity to challenge prevailing attitudes Unsuitable or unsustainable work -setting themselves up to fail, exploitation Dismissal for false declaration |