TY - JOUR
T1 - Decision (not) to disclose mental health conditions or substance abuse in the work environment
T2 - a multiperspective focus group study within the military
AU - Bogaers, Rebecca
AU - Geuze, Elbert
AU - van Weeghel, Jaap
AU - Leijten, Fenna
AU - Rüsch, Nicolas
AU - van de Mheen, Dike
AU - Varis, Piia
AU - Rozema, Andrea
AU - Brouwers, Evelien
N1 - Funding Information:
Acknowledgements We thank the people who participated in this study and shared their personal experiences with us, giving us insight into this important topic. We also thank the providers of the funding for this research, the IMPACT PhD Program 2018 of Tilburg University and a grant from the Dutch Ministry of Defence.
Publisher Copyright:
©
PY - 2021/10/27
Y1 - 2021/10/27
N2 - OBJECTIVES: Many workers in high-risk occupations, such as soldiers, are exposed to stressors at work, increasing their risk of developing mental health conditions and substance abuse (MHC/SA). Disclosure can lead to both positive (eg, support) and negative (eg, discrimination) work outcomes, and therefore, both disclosure and non-disclosure can affect health, well-being and sustainable employment, making it a complex dilemma. The objective is to study barriers to and facilitators for disclosure in the military from multiple perspectives.DESIGN: Qualitative focus groups with soldiers with and without MHC/SA and military mental health professionals. Sessions were audiotaped and transcribed verbatim. Content analysis was done using a general inductive approach.SETTING: The study took place within the Dutch military.PARTICIPANTS: In total, 46 people participated in 8 homogeneous focus groups, including 3 perspectives: soldiers with MHC/SA (N=20), soldiers without MHC/SA (N=10) and military mental health professionals (N=16).RESULTS: Five barriers for disclosure were identified (fear of career consequences, fear of social rejection, lack of leadership support, lack of skills to talk about MHC/SA, masculine workplace culture) and three facilitators (anticipated positive consequences of disclosure, leadership support, work-related MHC/SA). Views of the stakeholder groups were highly congruent.CONCLUSIONS: Almost all barriers (and facilitators) were related to fear for stigma and discrimination. This was acknowledged by all three perspectives, suggesting that stigma and discrimination are considerable barriers to sustainable employment and well-being. Supervisor knowledge, attitudes and behaviour were critical for disclosure, and supervisors thus have a key role in improving health, well-being and sustainable employment for soldiers with MHC/SA. Furthermore, adjustments could be made by the military on a policy level, to take away some of the fears that soldiers have when disclosing MHC/SA.
AB - OBJECTIVES: Many workers in high-risk occupations, such as soldiers, are exposed to stressors at work, increasing their risk of developing mental health conditions and substance abuse (MHC/SA). Disclosure can lead to both positive (eg, support) and negative (eg, discrimination) work outcomes, and therefore, both disclosure and non-disclosure can affect health, well-being and sustainable employment, making it a complex dilemma. The objective is to study barriers to and facilitators for disclosure in the military from multiple perspectives.DESIGN: Qualitative focus groups with soldiers with and without MHC/SA and military mental health professionals. Sessions were audiotaped and transcribed verbatim. Content analysis was done using a general inductive approach.SETTING: The study took place within the Dutch military.PARTICIPANTS: In total, 46 people participated in 8 homogeneous focus groups, including 3 perspectives: soldiers with MHC/SA (N=20), soldiers without MHC/SA (N=10) and military mental health professionals (N=16).RESULTS: Five barriers for disclosure were identified (fear of career consequences, fear of social rejection, lack of leadership support, lack of skills to talk about MHC/SA, masculine workplace culture) and three facilitators (anticipated positive consequences of disclosure, leadership support, work-related MHC/SA). Views of the stakeholder groups were highly congruent.CONCLUSIONS: Almost all barriers (and facilitators) were related to fear for stigma and discrimination. This was acknowledged by all three perspectives, suggesting that stigma and discrimination are considerable barriers to sustainable employment and well-being. Supervisor knowledge, attitudes and behaviour were critical for disclosure, and supervisors thus have a key role in improving health, well-being and sustainable employment for soldiers with MHC/SA. Furthermore, adjustments could be made by the military on a policy level, to take away some of the fears that soldiers have when disclosing MHC/SA.
KW - human resource management
KW - mental health
KW - occupational & industrial medicine
KW - qualitative research
KW - substance misuse
UR - http://www.scopus.com/inward/record.url?scp=85118883246&partnerID=8YFLogxK
U2 - 10.1136/bmjopen-2021-049370
DO - 10.1136/bmjopen-2021-049370
M3 - Review article
C2 - 34706950
SN - 2044-6055
VL - 11
JO - BMJ Open
JF - BMJ Open
IS - 10
M1 - e049370
ER -