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Decision aid on disclosure of mental health status to an employer: feasibility and outcomes of a randomised controlled trial

  • Claire Henderson (a1), Elaine Brohan (a1), Sarah Clement (a1), Paul Williams (a1), Francesca Lassman (a1), Oliver Schauman (a1), Lisa Dockery (a1), Simone Farrelly (a1), Joanna Murray (a2), Caroline Murphy (a2), Mike Slade (a3) and Graham Thornicroft (a3)...

Abstract

Background

Many mental health service users delay or avoid disclosing their condition to employers because of experience, or anticipation, of discrimination. However, non-disclosure precludes the ability to request ‘reasonable adjustments’. There have been no intervention studies to support decisionmaking about disclosure to an employer.

Aims

To determine whether the decision aid has an effect that is sustained beyond its immediate impact; to determine whether a large-scale trial is feasible; and to optimise the designs of a larger trial and of the decision aid.

Method

In this exploratory randomised controlled trial (RCT) in London, participants were randomly assigned to use of a decision aid plus usual care or usual care alone. Follow-up was at 3 months. Primary outcomes were: (a) stage of decision-making; (b) decisional conflict; and (c) employment-related outcomes (trial registration number: NCT01379014).

Results

We recruited 80 participants and interventions were completed for 36 out of 40 in the intervention group; in total 71 participants were followed up. Intention-to-treat analysis showed that reduction in decisional conflict was significantly greater in the intervention group than among controls (mean improvement −22.7 (s.d. = 15.2) v. −11.2 (s.d. = 18.1), P = 0.005). More of the intervention group than controls were in full-time employment at follow-up (P = 0.03).

Conclusions

The observed reduction in decisional conflict regarding disclosure has a number of potential benefits which next need to be tested in a definitive trial.

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Copyright

Corresponding author

Claire Henderson, Health Service and Population Research Department P029, David Goldberg Centre, King's College London, Institute of Psychiatry, De Crespigny Park, London SE5 8AF, UK. Email: Claire.1.Henderson@kcl.ac.uk

Footnotes

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Declaration of interest

None.

Footnotes

References

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Decision aid on disclosure of mental health status to an employer: feasibility and outcomes of a randomised controlled trial

  • Claire Henderson (a1), Elaine Brohan (a1), Sarah Clement (a1), Paul Williams (a1), Francesca Lassman (a1), Oliver Schauman (a1), Lisa Dockery (a1), Simone Farrelly (a1), Joanna Murray (a2), Caroline Murphy (a2), Mike Slade (a3) and Graham Thornicroft (a3)...
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