Disclosure of Serious Mental Illness in the Workplace

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Disclosure of Serious Mental Illness in the Workplace Abstract When a person with serious mental illness (SMI, defined as schizophrenia spectrum or bipolar disorder) is hired into a competitive job (defined as one that pays at least the minimum wage and is not set aside for persons with disabilities), they face a decision regarding whether or not to disclose their mental illness at work. Disclosure is required to obtain reasonable accommodations (such as flexible schedules, or time off for medical appointments) under the Americans with Disabilities Act (ADA), but the decision to disclose is risky. Sometimes, disclosure is an empowering act that results in necessary job accommodations, as well as greater support from supervisors and coworkers. Then again, disclosure can lead to discrimination, harassment, isolation, negative stereotyping, and even job loss. Despite the importance of the decision, there is very little evidence on disclosure of serious mental illness in the workplace. We do not know what motivates a worker to disclose, what determines the outcomes of disclosure, or how disclosure plays out in real-world employment settings. The proposed project is designed to address this critical gap in our knowledge, by gathering both quantitative and qualitative data on the process of disclosing SMI at work. We plan to survey 1,000 persons with SMI who have worked in a competitive job after onset of mental illness. We will screen for our target population by piggybacking on a large on-going national health survey (the PULSETM). We will follow up with a telephone survey designed to capture relevant quantitative data on the factors that determine the decision to disclose (or not to disclose) SMI at work, and the impact of that decision on employment outcomes and service engagement. We will then conduct in-depth interviews with a select subset of our study population, to obtain detailed qualitative evidence on individual experiences of disclosure that have led to positive or negative outcomes, with the goal of informing best practices for disclosure decisions. One of the primary outputs of the project will be a set of manuals on workplace disclosure of SMI, for consumers and behavioral health providers. The manuals will provide evidence, based on our results, to assist consumers and their providers in optimizing their individual decisions regarding workplace disclosure of SMI. As such, the project has tremendous potential to empower consumers to manage the disclosure process in ways that increase the likelihood of effective job accommodations and employment success