Employee decision-making about disclosure of a mental disorder at work

Kate E. Toth, Carolyn S Dewa

Research output: Contribution to journalArticlepeer-review

48 Scopus citations


PURPOSE: Fear of stigma may lead employees to choose not to disclose a mental disorder in the workplace, thereby limiting help-seeking through workplace accommodation. Research suggests that various factors are considered in making decisions related to disclosure of concealable stigmatizing attributes, yet limited literature explores such decision-making in the context of mental disorder and work. The purpose of this grounded theory study was to develop a model of disclosure specific to mental health issues in a work context.

METHODS: In-depth interviews were conducted with 13 employees of a post-secondary educational institution in Canada. Data were analyzed according to grounded theory methods through processes of open, selective, and theoretical coding.

RESULTS: Findings indicated that employees begin from a default position of nondisclosure that is attributable to fear of being stigmatized in the workplace as a result of the mental disorder. In order to move from the default position, employees need a reason to disclose. The decision-making process itself is a risk-benefit analysis, during which employees weigh risks and benefits within the existing context as they assess it. The model identifies that fear of stigmatization is one of the problems with disclosure at work and describes the disclosure decision-making process.

CONCLUSIONS: Understanding of how employees make decisions about disclosure in the workplace may inform organizational policies, practices, and programs to improve the experiences of individuals diagnosed with a mental disorder at work. The findings suggest possible intervention strategies in education, policy, and culture for reducing stigma of mental disorders in the workplace.

Original languageEnglish (US)
Pages (from-to)732-746
Number of pages15
JournalJournal of Occupational Rehabilitation
Issue number4
StatePublished - Dec 1 2014
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)


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