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Disclosure of mental health problems: findings from an Australian national survey

Published online by Cambridge University Press:  11 January 2017

N. J. Reavley ,
A. J. Morgan  and
A. F. Jorm
N. J. Reavley*
Affiliation:
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
A. J. Morgan
Affiliation:
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia School of Psychology and Public Health, La Trobe University, Bundoora, Australia
A. F. Jorm
Affiliation:
Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
*
*Address for correspondence: N. J. Reavley, Centre for Mental Health, Melbourne School of Population and Global Health, 207 Bouverie Street, VIC 3010, The University of Melbourne, Melbourne, Australia. (Email: nreavley@unimelb.edu.au)
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Abstract

Aims.

The aim of the current study was to carry out a national population-based survey to assess the proportion of people disclosing mental health problems in a variety of settings. A further aim was to explore respondent characteristics associated with disclosure.

Methods.

In 2014, telephone interviews were carried out with 5220 Australians aged 18+, 1381 of whom reported a mental health problem or scored highly on a symptom screening questionnaire. Questions covered disclosure of mental health problems to friends, intimate partners, other family members, supervisors or other colleagues in the workplace, teachers, lecturers or other students in the educational institution, health professionals and others in the community. Other than for intimate partners or supervisors, participants were asked whether or not they told everybody, some people or no one. Multinomial logistic regression was used to model the correlates of disclosure in each setting.

Results.

For friends and family, respondents were more likely to disclose to some people than to everyone or to no one. In most other domains, non-disclosure was most common, including in the workplace, where non-disclosure to supervisors was more likely than disclosure. Disclosure was associated with having received treatment or with support in all settings except healthcare, while it was only associated with discrimination in two settings (healthcare and education).

Conclusions.

Disclosure of mental health problems does not appear to be linked to discrimination in most settings, and is typically associated with receiving support. Selective or non-disclosure may be particularly critical in workplaces, education and healthcare settings.

Keywords

Disclosurediscriminationmental disorderssupport
Type
Original Articles
Information
Epidemiology and Psychiatric Sciences , Volume 27 , Issue 4 , August 2018 , pp. 346 - 356
Copyright
Copyright © Cambridge University Press 2017 

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References

Alonso, J, Buron, A, Bruffaerts, R, He, Y, Posada-Villa, J, Lepine, JP, Angermeyer, MC, Levinson, D, de Girolamo, G, Tachimori, H, Mneimneh, ZN, Medina-Mora, ME, Ormel, J, Scott, KM, Gureje, O, Haro, JM, Gluzman, S, Lee, S, Vilagut, G, Kessler, RC, Von Korff, M, World Mental Health, C (2008). Association of perceived stigma and mood and anxiety disorders: results from the World Mental Health Surveys. Acta Psychiatrica Scandinavica 118, 305–314.CrossRefGoogle ScholarPubMed
Australian Bureau of Statistics (2014 a). ABS Census 2011 Table Builder. Australian Bureau of Statistics: Canberra.Google Scholar
Australian Bureau of Statistics (2014 b). Estimated Resident Population March 2014. Australian Bureau of Statistics: Canberra.Google Scholar
Australian Communication and Media Authority (2014). Communications Report 2013–14. Australian Communication and Media Authority: Canberra.Google Scholar
Bos, AE, Kanner, D, Muris, P, Janssen, B, Mayer, B (2009). Mental illness stigma and disclosure: consequences of coming out of the closet. Issues in Mental Health Nursing 30, 509–513.Google Scholar
Brohan, E, Henderson, C, Little, K, Thornicroft, G (2010). Employees with mental health problems: survey of U.K. employers’ knowledge, attitudes and workplace practices. Epidemiologia e Psichiatria Sociale 19, 326–332.Google Scholar
Brohan, E, Henderson, C, Wheat, K, Malcolm, E, Clement, S, Barley, EA, Slade, M, Thornicroft, G (2012). Systematic review of beliefs, behaviours and influencing factors associated with disclosure of a mental health problem in the workplace. BMC Psychiatry 12, 11.CrossRefGoogle ScholarPubMed
Brohan, E, Evans-Lacko, S, Henderson, C, Murray, J, Slade, M, Thornicroft, G (2014). Disclosure of a mental health problem in the employment context: qualitative study of beliefs and experiences. Epidemiology and Psychiatric Sciences 23, 289–300.Google Scholar
Brown, S, Inskip, H, Barraclough, B (2000). Causes of the excess mortality of schizophrenia. British Journal of Psychiatry 177, 212–217.Google Scholar
Corker, E, Hamilton, S, Henderson, C, Weeks, C, Pinfold, V, Rose, D, Williams, P, Flach, C, Gill, V, Lewis-Holmes, E, Thornicroft, G (2013). Experiences of discrimination among people using mental health services in England 2008–2011. British Journal of Psychiatry. Supplement 55, s58–s63.Google Scholar
Corrigan, P (2004). How stigma interferes with mental health care. American Psychologist 59, 614–625.Google Scholar
Corrigan, PW, Rao, D (2012). On the self-stigma of mental illness: stages, disclosure, and strategies for change. Canadian Journal of Psychiatry 57, 464–469.Google Scholar
Corrigan, PW, Morris, SB, Michaels, PJ, Rafacz, JD, Rusch, N (2012). Challenging the public stigma of mental illness: a meta-analysis of outcome studies. Psychiatric Services 63, 963–973.Google Scholar
Corrigan, PW, Michaels, PJ, Powell, K, Bink, A, Sheehan, L, Schmidt, A, Apa, B, Al-Khouja, M (2016). Who comes out with their mental illness and how does it help? Journal of Nervous and Mental Disease 204, 163–168.Google Scholar
Ellison, ML, Russinova, Z, MacDonald-Wilson, KL, Lyass, A (2003). Patterns and correlates of workplace disclosure among professionals and managers with psychiatric conditions. Journal of Vocational Rehabilitation 18, 3–13.Google Scholar
Friedrich, B, Evans-Lacko, S, London, J, Rhydderch, D, Henderson, C, Thornicroft, G (2013). Anti-stigma training for medical students: the Education Not Discrimination project. British Journal of Psychiatry. Supplement 55, s89–s94.Google Scholar
Griffiths, KM, Carron-Arthur, B, Parsons, A, Reid, R (2014). Effectiveness of programs for reducing the stigma associated with mental disorders. A meta-analysis of randomized controlled trials. World Psychiatry 13, 161–175.Google Scholar
Harangozo, J, Reneses, B, Brohan, E, Sebes, J, Csukly, G, Lopez-Ibor, JJ, Sartorius, N, Rose, D, Thornicroft, G (2014). Stigma and discrimination against people with schizophrenia related to medical services. International Journal of Social Psychiatry 60, 359–366.Google Scholar
Henderson, C, Williams, P, Little, K, Thornicroft, G (2013). Mental health problems in the workplace: changes in employers’ knowledge, attitudes and practices in England 2006–2010. British Journal of Psychiatry. Supplement 55, s70–s76.Google Scholar
Holborn, AT, Reavley, NJ, Jorm, AF (2012). Differences between landline and mobile-only respondents in a dualframe mental health literacy survey. Australian and New Zealand Journal of Public Health 36, 192–193.Google Scholar
Hu, SS, Balluz, L, Battaglia, MP, Frankel, MR (2011). Improving public health surveillance using a dual-frame survey of landline and cell phone numbers. American Journal of Epidemiology 173, 703–711.CrossRefGoogle ScholarPubMed
Kessler, RC, Green, JG, Gruber, MJ, Sampson, NA, Bromet, E, Cuitan, M, Furukawa, TA, Gureje, O, Hinkov, H, Hu, CY, Lara, C, Lee, S, Mneimneh, Z, Myer, L, Oakley-Browne, M, Posada-Villa, J, Sagar, R, Viana, MC, Zaslavsky, AM (2010). Screening for serious mental illness in the general population with the K6 screening scale: results from the WHO World Mental Health (WMH) survey initiative. International Journal of Methods in Psychiatric Research 19 (Suppl. 1), 4–22.CrossRefGoogle ScholarPubMed
Lasalvia, A, Zoppei, S, Van Bortel, T, Bonetto, C, Cristofalo, D, Wahlbeck, K, Vasseur Bacle, S, Van Audenhove, C, van Weeghel, J, Reneses, B, Germanavicius, A, Economou, M, Lanfredi, M, Ando, S, Sartorius, N, Lopez-Ibor, JJ, G., T, Group, AIS (2012). Global pattern of experienced and anticipated discrimination reported by people with major depressive disorder: a cross-sectional survey. Lancet 381, 55–62.Google Scholar
Link, BG, Struening, EL, Rahav, M, Phelan, JC, Nuttbrock, L (1997). On stigma and its consequences: evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior 38, 177–190.Google Scholar
Morgan, AJ, Reavley, NJ, Jorm, AF, Beatson, R (2016). Experiences of discrimination and positive treatment from health professionals: a national survey of adults with mental health problems. Australian and New Zealand Journal of Psychiatry 50, 754–762.Google Scholar
Pandya, A, Bresee, C, Duckworth, K, Gay, K, Fitzpatrick, M (2011). Perceived impact of the disclosure of a schizophrenia diagnosis. Community Mental Health Journal 47, 613–621.Google Scholar
Reavley, NJ, Jorm, AF (2015). Experiences of discrimination and positive treatment in people with mental health problems: findings from an Australian national survey. Australian and New Zealand Journal of Psychiatry 49, 906–913.Google Scholar
Reavley, NJ, Ross, A, Killackey, EJ, Jorm, AF (2012). Development of guidelines to assist organisations to support employees returning to work after an episode of anxiety, depression or a related disorder: a Delphi consensus study with Australian professionals and consumers. BMC Psychiatry 12, 135.Google Scholar
Reavley, NJ, Ross, AM, Killackey, E, Jorm, AF (2013). Development of guidelines for tertiary education institutions to assist them in supporting students with a mental illness: a Delphi consensus study with Australian professionals and consumers. PeerJ 1, e43.Google Scholar
Reavley, NJ, Morgan, AJ, Jorm, AF (2016). Discrimination and positive treatment towards people with mental health problems in workplace and education settings: findings from an Australian national survey. Stigma and Health (in press).Google Scholar
Silton, NR, Flannelly, KJ, Milstein, G, Vaaler, ML (2011). Stigma in America: has anything changed?: impact of perceptions of mental illness and dangerousness on the desire for social distance: 1996 and 2006. Journal of Nervous and Mental Disease 199, 361–366.Google Scholar
Stuart, H, Patten, SB, Koller, M, Modgill, G, Liinamaa, T (2014). Stigma in Canada: results from a rapid response survey. Canadian Journal of Psychiatry 59, S27–S33.Google Scholar
Thornicroft, G, Brohan, E, Rose, D, Sartorius, N, Leese, M (2009). Global pattern of experienced and anticipated discrimination against people with schizophrenia: a cross-sectional survey. Lancet 373, 408–415.Google Scholar
Wahl, OF (1999). Mental health consumers’ experience of stigma. Schizophrenia Bulletin 25, 467–478.Google Scholar
Walker, ER, McGee, RE, Druss, BG (2015). Mortality in mental disorders and global disease burden implications: a systematic review and meta-analysis. JAMA Psychiatry 72, 334–341.Google Scholar
Wright, A, Jorm, AF, Mackinnon, AJ (2011). Labeling of mental disorders and stigma in young people. Social Science and Medicine 73, 498–506.Google Scholar
Yap, MBH, Mackinnon, AJ, Reavley, NJ, Jorm, AF (2014). The measurement properties of stigmatising attitudes towards mental disorders: results from two community surveys. International Journal of Methods in Psychiatric Research 23, 49–61.Google Scholar