115 5 DISCLOSURE IN THE MILITARY - A QUANTITATIVE STUDY DISCUSSION The current study aimed to examine beliefs, attitudes, and needs associated with (non-) disclosure to a supervisor in the military. Non-disclosure was associated with higher stigma related concerns, a higher preference for privacy and self-management, and a lower supervisor-employee relationship. A quarter of personnel with MHI had not disclosed their MHI to their supervisor, and those who had disclosed, appeared to do so after a considerable delay. Important reasons for disclosure were that personnel wanted to be their true and authentic self and thought disclosure was important due to the responsible nature of their work. To consider disclosure, most personnel indicated they would need a supervisor who shows understanding for MHI. Moreover, over 85% expressed a need for advice about the best ways to disclose. We identified that although the majority of personnel with MHI had disclosed to their supervisor, they appeared to do so after a considerable delay. Those who disclosed had higher symptom severity than non-disclosers and the majority disclosed because they had to call in sick (46.9%) or had needed treatment during work hours (69.0%). This appears to be even more so the case for military personnel, compared to civilians. A study on disclosure among Dutch workers in general showed that 15.6% disclosed due to having to report sick, and 39.9% disclosed due to needing treatment during work (18). This is in line with ‘the model of employee decision-making about disclosure of a mental disorder at work’, which proposes a default position of non-disclosure and that a triggering incident is needed for disclosure – in this case, having to call in sick or needing treatment (16). This late disclosure causes missed opportunities for workplace support and work accommodations which can prevent worsened symptoms and sick leave (1, 31, 32). Stigma related concerns form a barrier for (early-)disclosure. Half of those who had not disclosed, saw themselves as weak for having MHI, experienced shame, and a third feared gossip, negative career consequences, social rejection, and discrimination. These stigma related concerns were significantly associated both with non-disclosure intentions and decisions. Stigma has been found to be a barrier to disclosure before, both in military, other trauma-prone occupations, and civilian populations (5, 6, 16, 33, 34). When comparing the results of the current study to a study among Dutch civilian workers, it should be noted that of military personnel who had not disclosed, half reported seeing themselves as weak and being ashamed, compared to only 13.5% of civilians (18). Concerns about stigma thus appear to be stronger within the military setting compared to civilian settings. These higher concerns of stigma are likely caused by the military workplace culture and the responsible work nature, where people are expected to be ‘strong’ (6, 8). It should be noted that the study among civilians predominantly included females, while the
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