Disclosure, Discrimination, and Identity among Working Professionals with Bipolar Disorder or Major Depression

Abstract

This chapter presents the results of an analysis of in-depth interviews with a snowball sample of 45 people who identified as working professionals diagnosed with bipolar disorder or major depression. It explores three dimensions of their experience: disclosure versus concealment of their diagnosis on the job, exposure to discrimination in the workplace based on their mental illness diagnosis, and identity strategies they used to manage the status inconsistency between being a professional and having a mental illness diagnosis. The findings reveal how people learn to calculate when it is safe to disclose their diagnosis on the job, especially after experiencing discriminatory treatment such as being fired or demoted. They also indicate that applying for workplace modifications to accommodate symptoms of mental illness may be met with unprofessional and unsupportive reactions on the part of managers, Human Resources professionals, and coworkers, which could explain in part why so few participants in this sample sought them. When it comes to balancing inconsistent statuses, the findings demonstrate how people distance themselves from their mental illness identity in favor of the more prized status of working professional as a means of self-preservation. The chapter concludes with a call for sweeping changes in workplace culture to minimize fear and shame and maximize inclusion of people diagnosed with mental illness, allowing them to flourish in careers in which they may realize their full potential.

Workers’ Perspectives on Workplace Disclosure of Serious Mental Illness and Their Employers’ Responses

“…The current study addresses important gaps in research on workplace disclosure of SMI by sampling both currently and formerly employed workers, from previously unstudied geographic contexts and a wide range of employment settings, and collecting data about their experiences in regular jobs. This is also one of the earlier studies to examine worker perspectives of their employers’ responses to disclosure (see also Elliott & Reuter, 2021). Compared to much prior work that was limited to disability-affirming contexts and settings, and focused on the employer perspective, the study identified considerable nuances in the contexts of disclosure and a wider range of employer responses: positive, negative, and ambiguous.…”

“…Prior research on disclosure has sampled current workers from single sectors or workplaces (Joyce et al, 2009; Toth & Dewa, 2014), or from mental health services agencies, where it is likely that some participants were in non-regular jobs that were obtained and/or supported by vocational services (Brohan et al, 2014; Bril-Barniv et al, 2017; Henderson et al, 2012). Prior research on employer responses has centered employer/supervisor voices (Kirsh et al, 2018; Peterson et al, 2017; Tse, 2004), or only focused on worker perspectives in the context of working professionals needing accommodations (Elliott & Reuter, 2021). We addressed these limitations by examining worker perspectives on disclosure and on their employers’ responses to disclosure among a sample of current and former workers with SMI in a wide range of professional, nonprofessional white-collar, and blue-collar regular jobs.…”

“…Several workers who requested accommodations also recounted negative responses to disclosure (stigma, threat-present, lack of respect for confidentiality). These results are not surprising, given that accommodations can impose burdens on supervisors/co-workers which may trigger resentment and negative, stigmatizing responses (MacDonald-Wilson et al, 2002;Elliott & Reuter, 2021;Peters & Brown, 2009).…”

“…On the negative side, many studies indicate that the majority of workers prefer not to disclose their illness at work because they anticipate that disclosure will result in discrimination (Brohan et al, 2014; Brouwers et al, 2019; Krupa et al, 2009; Peterson et al, 2011; Üçok et al, 2012). In a U.S. study of 45 working professionals diagnosed with bipolar disorder or major depression, for example, nearly half of workers said that they concealed their mental illness because they feared that disclosure would damage their reputation as a competent professional (Elliott & Reuter, 2021). Other reasons to prefer nondisclosure include workers’ preferences for privacy, or concerns that the individuals to whom they disclose will not respect their confidentiality (Donnelly, 2017; Henderson et al, 2012; Toth & Dewa, 2014).…”

“…Workers’ voices have been largely unheard in the literature on employer responses to disclosure. An exception is Elliott and Reuter’s (2021) study of working professionals diagnosed with bipolar disorder or major depression. Nine workers expressed a need for job accommodations, some of whom disclosed and others who did not.…”