Stigma and discrimination of mental health problems: workplace implications

There is a current policy spotlight on providing greater employment support for people with mental health problems [1,2]. The key role of occupational health professionals in helping employers and employees to negotiate common mental health problems in the workplace has previously been emphasized [3]. This editorial will focus on one key aspect of mental health problems in the workplace: stigma and discrimination. There is evidence that people with mental health problems report being turned down for a job because of their mental health problem [4,5] or stopping themselves from looking for work because they anticipate discrimination [6]. Disclosure of a mental health problem in the workplace can also lead to discriminatory behaviours from managers and colleagues such as micro-management, lack of opportunities for advancement, over-inferring of mistakes to illness, gossip and social exclusion [7]. A framework for understanding these phenomena conceptualizes stigma as comprised of the three problems of: knowledge (ignorance or misinformation), attitudes (prejudice) and behaviour (discrimination)[8]. We have recently used this framework to undertake a survey of employer's knowledge, attitudes and workplace behaviours [9]. Of the 502 employers who participated, a number of concerns were reported about hiring applicants with a mental health problem including: (i) symptom concerns such as threat to safety of other employees or clients (17%), person would be incapable of handling stress (14%) and strange or unpredictable behaviour (11%), (ii) work performance concerns, particularly impaired job performance (20%), (iii) work personality concerns, particularly absenteeism (29%) and (iv) administrative concerns including level of monitoring needed (7%) and negative attitude of other employees (2%).