Abstract
Mental health issues, such as depression, anxiety, and post-traumatic stress disorder, are increasing in the U.S. However, people diagnosed with mental illnesses often experience stigmatization and discrimination in their workplace. The chapter examines how people with mental illness make decisions around revealing and, importantly, concealing their mental illness in the workplace. The concepts stigma and communication privacy management theory are used to examine the challenges associated with living with mental illness in the workplace. A case study is used to illustrate these concepts and provide a pedagogical context in which the factors around concealing mental illness in the workplace are situated. Finally, an analysis of the case study is presented using the conceptual and theoretical frameworks applied in the present chapter.
TopIntroduction
Roughly one in five U.S. adults, or 51.5 million Americans, are struggling with a mental illness at any given time (National Institute of Mental Health, 2021). According to the CDC, the number of adults with symptoms of anxiety and depression rose sharply between 2020 and 2021, and 11.7% of adults struggling with mental health disorders reported an unmet healthcare need (Vahratian et al., 2021). While mental illness remains a common issue for many Americans, mental illness is also highly stigmatized and individuals struggling with mental illness report increased experiences of discrimination in the workplace (Thornicroft, 2006). Thus, individuals diagnosed with mental illnesses, such as depression, anxiety, post-traumatic stress disorder (PTSD), and bipolar disorders often face immense struggles when they decide to try to conceal their mental illness within their workplace to avoid potential stigmatization and discrimination.
Although individuals’ experiences with mental illness vary significantly by diagnosis and access to mental health resources, research examining these differences closely remains limited (Thornicroft, 2006). That is, some mental illnesses have more intense stigmas associated with them than others (e.g., schizophrenia), but research comparing levels of stigma by diagnosis is not well-developed. As such, it can be complicated to understand precisely how individuals make decisions about concealing or revealing mental illness because of the continued lack of community understanding regarding the nature of these lived experiences (Thornicroft, 2006).
This case study examines how individuals struggling with mental illness navigate the challenges of concealing or revealing their mental illness in the workplace. In particular, this case study will highlight the unique challenges associated with managing a mental illness condition in the workplace and how communication theories can be applied to understand the experiences of employees diagnosed with a mental illness.
Mental Illness and the Workplace
Many individuals struggling with mental illness face the challenge of deciding whether they should or should not disclose their diagnosis in the workplace (Wheat et al., 2010). Although some countries have legislation protecting individuals with mental illness (e.g., Americans with Disabilities Act in the U.S; Equality Act 2010 in the U.K.), many of these laws do not cover all mental illness diagnoses and require individuals to disclose their mental health conditions to their employers to receive workplace accommodations. As such, for many individuals living with a mental health condition, revealing their mental health condition in the workplace is a difficult decision that can leave them in the position to be stigmatized and/or discriminated against if their condition is revealed (Thornicroft, 2006). Research indicates that individuals have a variety of motivations for revealing and concealing personal health information in their workplace (Smith & Brunner, 2017; Westerman et al., 2015, 2017). Further, employees diagnosed with mental health conditions often have additional concerns regarding disclosing their mental health condition in the workplace, including fear of not being hired, unfair treatment, loss of credibility, and lack of protection (Brohan et al., 2012). Indeed, in their systematic review of research examining mental illness disclosures in the workplace, Brohan et al. (2012) noted that disclosure and concealment of mental health conditions in the workplace are complex decisions that are informed primarily by “stigma and discrimination” (p. 11).
Key Terms in this Chapter
Invisible illness: A health condition in which the individual does not visibly exhibit symptoms.
Mental Illness: A variety of conditions that impact one’s mental health and wellbeing, often by influencing one’s mood, emotions, and/or behaviors.
Discrimination: Unfair treatment of individuals based on an aspect of one’s identity (e.g., race, gender, mental health diagnosis).
Disclosure: The act of revealing private information to another individual.
Stigma: Any attribute that leads others to regard one as being lesser or disgraced in society.
Private Information: Any information that can make an individual feel vulnerable if it is revealed to another individual.