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Decision (not) to disclose mental health conditions or substance abuse in the work environment: A multiperspective focus group study within the military
Bogaers,Rebecca Geuze,Elbert Van Weeghel,Jaap Leijten,Fenna Rüsch,Nicolas van de Mheen,Dike Varis,Piia Rozema,Andrea Brouwers,Evelien
Bogaers,Rebecca
Geuze,Elbert
Van Weeghel,Jaap
Leijten,Fenna
Rüsch,Nicolas
van de Mheen,Dike
Varis,Piia
Rozema,Andrea
Brouwers,Evelien
Abstract
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.
Description
Funding Information: 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.
Date
2021
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Research Projects
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Keywords
AID, BARRIERS, FACILITATORS, HELP-SEEKING, ILLNESS, PERSONNEL, SOLDIERS, STIGMA, WORKPLACE, human resource management, mental health, occupational & industrial medicine, qualitative research, substance misuse, SDG 3 - Good Health and Well-being, SDG 4 - Quality Education, SDG 17 - Partnerships for the Goals
Citation
Bogaers, R, Geuze, E, Van Weeghel, J, Leijten, F, Rüsch, N, van de Mheen, D, Varis, P, Rozema, A & Brouwers, E 2021, 'Decision (not) to disclose mental health conditions or substance abuse in the work environment : A multiperspective focus group study within the military', BMJ Open, vol. 11, no. 10, e049370. https://doi.org/10.1136/bmjopen-2021-049370