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Mental illness disclosure in organizations: defining and predicting (un)supportive responses

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Abstract

Employees with a mental illness regularly encounter situations where they must make decisions regarding the extent to which they discuss their stigma. Past research has found links between positive disclosure experiences and positive well-being and job-related outcomes for the individual disclosing. However, research on stigma disclosure has not yet defined what differentiates a supportive response from an unsupportive one, and there is evidence to suggest that people are unsure of how to best respond to a disclosure. In a series of three studies, we sought to develop a better understanding of mental illness disclosure at work. First, we created a typology of supportive and unsupportive responses to disclosure via critical incidents gathered from working adults with a mental illness. Second, we surveyed working adults with and without a mental illness to examine if they perceive the supportiveness of responses differently. Third, in an experimental study, we examined which methods of disclosure are most effective in eliciting a supportive response. This work identifies several types of supportive (e.g., providing emotional support) and unsupportive (e.g., denial of symptoms) responses to mental illness disclosure and finds that individuals without a mental illness have a reasonable understanding of what an individual with a mental illness would also identify as supportive/unsupportive responses. We also find that downplaying one’s mental illness will likely lead to a less supportive response.

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Authors and Affiliations

  1. Department of Psychology, University of Maryland, 4094 Campus Drive, MD, 20742, College Park, USA

    Sara E. Barth & Jennifer L. Wessel

Authors
  1. Sara E. Barth
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  2. Jennifer L. Wessel
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Correspondence to Sara E. Barth.

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Appendices

Appendix 1: Study 2 Survey

Task Introduction (Confidant Version)

In this study, I’d like you to read the following scenario. After reading this scenario, you will be presented with a series of mini follow-up scenarios. You will read these and then answer questions about the entire scenario.

Imagine that you are at work and a coworker comes to you one day wanting to discuss something with you. You have worked with this coworker for a while and have a relationship with them at work, but your relationship does not extend much beyond the boundary of work. In this discussion, your coworker reveals that they have depression. Upon hearing this, you react in the following way…[shown response #1, #2, #3 etc.]:

Confidant Responses (Confidant Version)

Emotional Support: “You asked them questions about their diagnosis. You showed caring and compassion towards them and you wanted to provide a listening ear and comfort if they needed it.”

Appraisal Support: “You shared with them that you have had a similar experience with depression and the two of you discuss the symptoms that you have both experienced.”

Informational Support: “You encouraged them to ‘speak up,’ communicate assertively and ‘act tough’ when challenges arise.”

Instrumental Support: “You told them that you have a family member who is a mental health professional who would be happy to speak with them. You then made sure that they had your family members contact information in case they wanted to contact them.”

Insulting behavior: “You acted as if they were going to lose it or do something outrageous. You asked them, ‘what do you have to be so depressed about?’”

Denial of Symptoms: “You expressed that you do not believe their symptoms are real and said that ‘everyone gets depressed.’ You thought their symptoms were just an excuse.”

Avoidance: “You tried to avoid further discussion. You quickly looked away, brushed it off, and tried to change the subject.”

Denial of Assistance: “You denied the existence of any problems they might be experiencing, told them to get over it, and did not express a willingness to help them in any way.”

Task Introduction (Discloser Version)

In this study, I’d like you to read the following scenario. After reading this scenario, you will be presented with a series of mini follow-up scenarios. You will read these, and then answer questions about the entire scenario.

Imagine that you have a depression diagnosis and are currently working within an organization. How imagine that there is a coworker who you want to disclose this diagnosis to. You have worked with this coworker for a while and have a relationship with them at work, but your relationship does not extend much beyond the boundary of work. Imagine that one day you go to them and disclose your depression diagnosis. Upon hearing this, they react in the following way… [shown response #1, #2, #3, etc.]:

Confidant Responses (Discloser Version)

Emotional Support: “They asked you questions about your diagnosis. They showed caring and compassion towards you and they wanted to provide a listening ear and comfort if you needed it”.

Appraisal Support: “They shared with you that they have had a similar experience with depression and the two of you discuss the symptoms that you have both experienced.”

Informational Support: “They encouraged you to ‘speak up,’ communicate assertively and ‘act tough’ when challenges arise.”

Instrumental Support: “They told you that they have a family member of theirs who is a mental health professional who would be happy to speak with you. They then made sure that you had their family members contact information in case you wanted to contact them.”

Insulting behavior: “They acted as if you were going to lose it or do something outrageous. They asked you, ‘What do you have to be so depressed about?’”

Denial of Symptoms: “They expressed that they do not believe your symptoms are real and said that ‘everyone gets depressed.’ They thought your symptoms were just an excuse.”

Avoidance: “They tried to avoid further discussion. They quickly looked away, brushed it off, and tried to change the subject.”

Denial of Assistance: “They denied the existence of any problems you might be experiencing, told you to get over it, and did not express a willingness to help you in any way.”

Response Evaluations: To be answered after reading each confidant response

Please answer the following questions in relation to this reaction:

  1. 1.

    To what extent was this reaction supportive?

1

2

3

4

5

Not at all supportive

Slightly supportive

Moderately supportive

Very supportive

Extremely supportive

  1. 2.

    To what extent was this reaction negative?

1

2

3

4

5

Not at all negative

Slightly negative

Moderately negative

Very negative

Extremely negative

  1. 3.

    To what extent was this reaction helpful?

1

2

3

4

5

Not at all helpful

Slightly helpful

Moderately helpful

Very helpful

Extremely helpful

  1. 4.

    To what extent was this reaction useful?

1

2

3

4

5

Not at all useful

Slightly useful

Moderately useful

Very useful

Extremely useful

  1. 5.

    To what extent was this reaction well-intentioned?

1

2

3

4

5

Not at all well-intentioned

Slightly well-intentioned

Moderately well-intentioned

Very well-intentioned

Extremely well-intentioned

Appendix 2: Study 3 Survey

Task Introduction

In this study, I’d like you to read a scenario. After reading this scenario you will be presented with a series of questions about it. Please answer these questions carefully and honestly

Vignette

Imagine that you are at work and a coworker comes to you one day wanting to discuss something with you. You have worked with this coworker for a while and have a relationship with them at work, but your relationship does not extend much beyond the boundary of work. In this discussion your coworker reveals that they have depression. In revealing that they have depression your coworker explains that… [see Disclosure Manipulations below]:

Disclosure Manipulations

Claiming with high affective content

“Although it can be difficult at times to not feel depressed, I know that living with a mental illness has made me stronger than I would have been otherwise. I know that some people may think I am less able to do my job because I have depression. This view makes me sad and at times nervous to tell people about my depression. However, I really feel like there is nothing I cannot do at this point and I hope that others see that in me as well.”

Claiming with low affective content

“Although it can be difficult at times to not feel depressed, I know that living with a mental illness has made me stronger than I would have been otherwise. I know that some people may think I am less able to do my job because I have depression but I really feel like there is nothing I cannot do at this point and I hope that others see that in me as well.”

Downplaying with high affective content

“Although people with depression may have difficulty, I try not to let having depression define who I am as a person. Some people may view me differently because of my depression. This view makes me sad and at times nervous to tell people about my depression. However, everyone has their own things they have to deal with in some form or another. I try not to see it as a big deal and hope that others don’t define me by my diagnosis.”

Downplaying with low affective content

“Although people with depression may have difficulty, I try not to let having depression define who I am as a person. Some people may view me differently because of my depression. However, everyone has their own things they have to deal with in some form or another. I try not to see it as a big deal and hope that others don’t define me by my diagnosis.”

Control

Imagine that you are at work and a coworker comes to you one day wanting to discuss something with you. You have worked with this coworker for a while and have a relationship with them at work but your relationship does not extend much beyond the boundary of work. In this discussion your coworker reveals that they have depression.

Dependent Variables

Please rate each of the following reactions on how likely you would be to give this response if you were in this situation at work.

0

20

40

60

80

100

Unlikely to respond in this way

    

Very likely to respond in this way

  1. a.

    “You ask them questions about their diagnosis. You show caring and compassion toward them and you want to provide a listening ear and comfort if they need it.”

  2. b.

    “You share with them some of your own previous struggles and help them to verify that what they are going through is real.”

  3. c.

    “You encourage them to ‘speak up,’ communicate assertively and ‘act tough’ when challenges arise.”

  4. d.

    “You are patient and give them space to go about their day at a pace that works for them. You provide them with any resources that you know of.”

  5. e.

    “You act as if they were going to lose it or do something outrageous. You ask them, ‘what do you have to be so depressed about?’”

  6. f.

    “You express that you do not believe their symptoms are real and say that ‘everyone gets depressed.’ You think their symptoms were just an excuse.”

  7. g.

    “You try to avoid further discussion. You quickly look away, brush it off, and try to change the subject.”

  8. h.

    “You deny the existence of any problems they might be experiencing, tell them to get over it, and do not express a willingness to help them in any way.”

Appendix 3: Pilot Survey

Vignette

Imagine that you are at work and a coworker comes to you one day wanting to discuss something with you. You have worked with this coworker for a while and have a relationship with them at work, but your relationship does not extend much beyond the boundary of work. In this discussion, your coworker reveals that they have depression. In revealing that they have depression, your coworker explains that…[see Disclosure Manipulations below]:

Disclosure Manipulations

Claiming with high affective content

“Although it can be difficult at times to not feel depressed, I know that living with a mental illness has made me stronger than I would have been otherwise. I know that some people may think I am less able to do my job because I have depression. This view makes me sad and at times nervous to tell people about my depression. However, I really feel like there is nothing I cannot do at this point and I hope that others see that in me as well.”

Claiming with low affective content

“Although it can be difficult at times to not feel depressed, I know that living with a mental illness has made me stronger than I would have been otherwise. I know that some people may think I am less able to do my job because I have depression but I really feel like there is nothing I can’t do at this point and I hope that others see that in me as well.”

Downplaying with high affective content

“Although people with depression may have difficulty, I try not to let having depression define who I am as a person. Some people may view me differently because of my depression. This view makes me sad and at times nervous to tell people about my depression. However, everyone has their own things they have to deal with in some form or another. I try not to see it as a big deal and hope that others don’t define me by my diagnosis.”

Downplaying with low affective content

“Although people with depression may have difficulty, I try not to let having depression define who I am as a person. Some people may view me differently because of my depression. However, everyone has their own things they have to deal with in some form or another. I try not to see it as a big deal and hope that others do not define me by my diagnosis.”

Dependent Variables

[Response scale: 1 = strongly disagree, 4 = neither agree nor disagree, 7 = strongly agree].

  1. 1.

    The person in this scenario is claiming (accentuating positive aspects of their diagnosis, reframing negative stereotypes associated with their diagnosis) their identity as someone with a mental illness.

  2. 2.

    The person in this scenario is downplaying (lessening the undesirable characteristics associated with their diagnosis and shifting attention away from their diagnosis) their identity as someone with a mental illness.

  3. 3.

    The person in this scenario is talking about having a mental illness in an affective or emotional way.

Pilot Results

Table 6 Paired samples t-test results for claiming versus downplaying
Full size table
Table 7 Paired samples t-test results for high versus low affect
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Barth, S.E., Wessel, J.L. Mental illness disclosure in organizations: defining and predicting (un)supportive responses. J Bus Psychol 37, 407–428 (2022). https://doi.org/10.1007/s10869-021-09753-4

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  • DOI: https://doi.org/10.1007/s10869-021-09753-4

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