I have witnessed people I care about struggle with the dilemma of whether to disclose a diagnosis or psychiatric past to a co-worker, new friend, fellow student, teacher, boss, or prospective employer. It’s an incredibly difficult decision.
Last year I wrote about my father’s struggles with mental health. In an essay for the Huffington Post I described how he was hospitalized for bipolar disorder as a young man, and later struggled with depression and anxiety. Fortunately for him, the mental illness label did not stick, and he was able to have a productive and rewarding life as a business owner, artist, citizen, and father. Others in my family have had much more visible struggles with their mental health, having to deal with recurrent symptoms, hardships, and relapses that have caused them to be unfairly stigmatized. Not everyone in my family has had the advantages and opportunities that that my father and I were blessed with. Some labels are much harder to peel away.
In my family and through my work at Laurel House, I have witnessed people I care about struggle with the dilemma of whether to disclose a diagnosis or psychiatric past to a co-worker, new friend, fellow student, teacher, boss, or prospective employer. For my father, the choice was easy. Even if he had seen himself as a person with mental illness, he lived and worked in an era when problems of mental health were close-kept secrets never discussed in public. Those of later generations often agonize over this choice, wondering whom to tell, how much, and when.
As the Supported Employment Coordinator of Laurel House, Inc., my colleague Michael, LMSW, works with people who struggle with the dilemma of mental health disclosure and whether to share such personal information with an employer. Michael coaches people through every stage of the employment seeking, retention and advancement process, and has some great tips on how to handle the dilemma of disclosure. He never gives advice whether to disclose, but he does provide his clients with information that can help them make a decision.
“I don’t try to coach them,” Michael says of the participants in Laurel House’s IPS-model employment program. “Though I may reframe the issue of disclosure.” When they first come to him for help, many have not thought out all of the issues related to disclosure. But nearly all of Michael’s clients have strong concerns about stigma and discrimination. He starts by helping them identify what they believe are the pros and cons of disclosure. Although some participants have very specific concerns, such as worrying that co-workers will see them taking medication, the most typical responses fit into general categories, summarized below.
The biggest point in favor of disclosure is that it makes it easier for you to get the support you need. Being open about your diagnosis or some aspects of your mental health history enables you to:
Work openly with an employment specialist like Michael, who can help you to plan for, find and keep a job.
Explain gaps in your work history.
Invite your employment specialist, job coach, or other helpers into your workplace to support you on the job, or to intervene with bosses and co-workers on your behalf.
Ask your employer for medical leave or accommodations in your schedule related to your mental health.
Ask for specific workplace accommodations, such as on-site visits from an employment specialist, individualized training, or written job instructions for additional tasks that are not part of your normal workday.
Provide your boss and others in your workplace with information that can help them help you to be your most productive and successful on the job.
Be open about explaining habits or behavior that may concern your co-workers, such as verbal tics or the need to make frequent visits to the rest room.
Feel free to be yourself and avoid the potential bad feelings of having to hide your condition from your workplace friends and colleagues.
Influence workplace attitudes about mental health, making it easier for others to follow in your footsteps.
The biggest reason not to disclose is concern over negative consequences. Having a diagnosis or history of treatment is nothing to be ashamed of. However, stigma is real and acknowledging you have a mental health problem can negatively impact your career and reduce your chances of landing the job or promotion you desire. You may choose not to disclose out of concern that you will be:
Treated differently from other employees who are not identified with mental illness.
Judged on the basis of your diagnosis instead of your performance.
Shunned by co-workers who worry that you may be dangerous, violent, or untrustworthy.
Passed over for promotions, important assignments or opportunities to advance your career.
Considered intellectually challenged by co-workers who don’t understand the difference between a developmental disability and a psychiatric diagnosis.
Made fun of or harassed in the workplace.
These concerns are very real. In many cases, they are based on the firsthand experience of program participants. If asked, Michael will help a participant develop a specific response to one of these concerns. However, many ask him broader questions, such as, “should I tell my employer I have a mental illness?” An employment specialist can offer general guidelines, but the decision whether to disclose is too personal and too important to share with any but the closest loved one. What Michael does is help people develop strategies around the subject of disclosure.
One common strategy for people who have not worked in a while is to get back into the workforce as quickly as possible and worry about career considerations after they have re-established a work history. In these cases, a person may choose to disclose in order to find an employer who is sympathetic and open to making accommodations. This is also a good strategy for someone who has never worked before. Once you have filled the recent gaps in your resume, you may wish to start fresh with a new employer who does not know about your mental health history.
Michael observes that for many, disclosure is a “person by person, job by job” decision. Whatever you decide about disclosure, the choice is yours alone, though it usually helps to share your thoughts and concerns with someone you trust, whether that is a loved one, friend, or professional like Michael.
Jay Boll is Vice President of Laurel House, Inc., and Editor in Chief of www.rtor.org, a website for families that helps people find resources and support for their loved ones with mental health disorders. He writes about his family’s experience of mental illness in his blog The Family Side. In over 25 years at Laurel House, Jay has worked with hundreds of people living with serious mental health conditions and run multiple programs in psychiatric rehabilitation, including the Thinking Well program, which he adapted from the Neuropsychological Educational Approach to Cognitive Remediation (NEAR). Jay is a former Peace Corps Volunteer with five years of service developing housing, vocational training, and education programs for homeless youth in the Central American nation of Honduras. He has also lived and worked in Zimbabwe, Africa.
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