Development and preliminary evaluation of a decision aid for disclosure of mental illness to employers

ObjectiveMany mental health service users delay disclosing to employers or never do so due to previous experience of, or anticipation of discrimination. However, non-disclosure precludes requesting ‘reasonable workplace adjustments’. Service users may experience conflicting needs and values in deciding whether to disclose. No evidence-based interventions exist to support this decision.MethodsA decision aid (CORAL, or COnceal or ReveAL) to support mental health service users in reaching disclosure decisions was developed and subjected to preliminary evaluation (n = 15).ResultsThe majority found the decision aid quick (60%) and relevant (60%) and would recommend it (80%). Eighty percent reported that they would definitely or probably use it in making disclosure decisions. Forty percent each were positive or neutral on its ease of use. Semi-structured interviews revealed a demand for more information on the legal implications of disclosure. The mean level of ‘decisional conflict’ regarding disclosure reduced from 52.0 to 35.5 and mean Stage of Decision-making Scale score from 4.6 to 4.3.ConclusionThe results suggest that the CORAL decision aid is feasible, relevant and valuable in supporting decisions about disclosing a mental illness to an employer.Practice implicationsThe decision aid could be deployed in routine care without significant resource implications.