Stigma as a barrier to sustainable employment and well-being of workers with mental health issues and illnesses - A mixed methods study in the Dutch military
Abstract
The current thesis showed that mental health stigma exists in the Dutch military and that this mental health stigma formed a major barrier for both treatment-seeking and disclosure of MHI to a supervisor and can negatively affect sustainable employment and well-being at work. Positive disclosure experiences were positively associated with multiple measures of sustainable employment and well-being at work, and these
positive experiences were defined by higher supervisor support and lower stigma-related experiences. Furthermore, military personnel indicated a strong preference to solve their own problems and the supervisor played a key role in facilitating both treatment seeking and disclosure. For the health, well-being, and sustainable employment of military personnel it is important that treatment-seeking and disclosure are facilitated
in a safe environment, where military personnel do not have to fear negative career consequences, social rejection, and discrimination.
The findings of the current thesis, together with findings from recent international research on destigmatizing interventions, provide valuable insights on how to facilitate treatment-seeking and disclosure in a safe environment. First, at the level of the individual, future intervention research must evaluate whether disclosure decision aids help protect military personnel with MHI from adverse consequences of disclosure and
decrease self-stigma. Additionally, interventions should align with the high preference for self-management. At the level of the supervisor, there is a high need for supervisor training on mental health literacy and on how to recognize, support, and effectively communicate with, personnel with MHI. Furthermore, at the level of the military organization, the structural and public mental health stigma could be targeted. Structural
stigma should be targeted through policy changes. The organization should have more awareness about the fear military personnel have that treatment-seeking and disclosure will have negative career consequences and take away this fear. Additionally, public stigma should be targeted through stigma awareness campaigns and mental health awareness training. Together this can facilitate early treatment-seeking and disclosure
in a safe environment, which optimizes the opportunities for recovery and the provision of workplace support and accommodations. This can also create positive disclosure experiences, which in turn can increase sustainable employment and well-being at work