128 6 CHAPTER 6 A crucial decision for workers with MI, which affects the way the work environment responds to them, is the decision to disclose MI to a supervisor or not. Disclosure has been believed to positively impact sustainable employability and well-being through receiving workplace support and work accommodations, and non-disclosure can lead to a missed opportunity for this support (20-22). However, a longitudinal study among unemployed people showed that those who were more reluctant to disclose their MI to (potential new) employers, were more likely to have found a job after six months (23). Additionally, disclosure to a supervisor can lead to stigma and discrimination (2426). For example, of those who reported a negative disclosure experience in a study among Dutch workers, a quarter reported that they had been treated differently due to their disclosure (27). In sum, disclosure decisions can both lead to positive and negative outcomes. The question whether the (non-)disclosure decision and disclosure experiences are positive or negative for sustainable employability and well-being at work is important, yet under researched. The direct association between mental health disclosure to a supervisor and sustainable employability and well-being at work has, to the knowledge of the authors, not been examined in one study before. Most models on mental health disclosure end at the disclosure decision. They do not include consequences of disclosure, such as sustainable employability (28, 29), or do not focus on disclosure in the workplace (30). A more complete model of disclosure, which does include consequences of disclosure in the work-context, is the mental health condition decision-making process from antecedents to outcomes model (31). This model proposes that the short-term outcomes of disclosure are alleviation of inhibition, social-support, and changes in social information. The longterm outcomes include empowerment, individual outcomes (e.g. career development), dyadic outcomes (e.g. trust) and social contextual outcomes (e.g. experience of stigma). However, this model does not include the direct association between disclosure and sustainable employability and well-being at work, only the indirect association. Additionally, it should be noted that the data supporting this model is of qualitative nature. Associations should also be tested with quantitative data to further examine associations between disclosure and sustainable employability and well-being at work. It is plausible that the decision to disclose or not is an even more prominent dilemma in high-risk occupations, such as the military. People in military professions are expected to be strong, and not to show weakness, possibly making disclosure harder (21, 24, 32). For example, in a study in the German military, a soldier indicated “If I hear that this battalion commander is mentally ill … as a subordinate, honestly, I’d say ‘What kind of guy is that?’ … He must be a warrior, he must not be soft.” (33). Additionally, previous research on disclosure in the military has also shown that military personnel fear that disclosure will lead to them not being considered fit for high-risk occupations, and there is a fear of negative career consequences such as loss of employment, not
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