Stigma in the Workplace
Many people think that depression is due to personal weakness or is otherwise not a “real” health condition. In fact, depression is a serious health concern that results from biochemical, environmental, and genetic factors, just like most other health problems. The difference between conditions like depression and heart disease is that people with depression experience stigma for their illness because of misconceptions about its causes and treatments.
People experience stigma when they are labeled as being “different” in a negative way and this can extend to outright discrimination. a Stigma can affect how other people respond to someone who is depressed, and also how a person with depression views him or herself, just as discrimination can affect external notions about and self-perceptions of marginalized groups in society.
Many people with depression feel uncomfortable asking for help because of concerns about how friends, family, co-workers, or supervisors will react. This discomfort in asking for help is the primary harm of stigma because it is a major barrier to people receiving treatment. Among adults with depression, only 58% receive treatment.b
Personal attitudes can inhibit treatment as much as expected stigma from others:
- Self-stigma of depressed workers can also vary according to the type of mental health professional they see—greater embarrassment has been associated with psychiatrists, and to a lesser extent with psychologists, counselors, and general practitioners.c Expectations of negative responses from the mental health professionals themselves have been associated with workers’ avoidance of treatment.
- These stigmatizing beliefs about mental health professionals can be problematic, especially when treatment options are limited in terms of cost and access.
- Therefore, a supportive social context in the workplace including depression awareness is necessary for optimal recognition and treatment of symptoms, and consequently, for minimizing the harm done to productivity and cost-effectiveness.
- Combating depression in the workplace does not stop at initiation of treatment, though. Failure to follow through on treatment can lead to absenteeism, presenteeism, and employee turnover.
- Patients’ attributions of the cause of their depression have been associated with their adherence to treatment (i.e., the degree of stigma they perceive negatively affects their treatment).d
- Patients’ perceived stigma has also been associated with drug treatment non-adherence and discontinuation of psychiatric treatment.e,f
- Stigma’s felt effects on employees with depression make it important to maintain a culture of acceptance, understanding, and confidentiality for the duration of treatment and beyond, not just after symptoms have been recognized.
The existence of stigma in the workplace, however, should present employers with an opportunity to educate employees, managers, and supervisors about the symptoms and consequences of depression and resources available for appropriate and effective treatment.
The truth is that depression is an illness that requires treatment, the same as other health conditions. Addressing stigma in the workplace will increase the likelihood that people will seek and receive the treatment they need so they can continue working and maintain the quality of their work.
a Conceptualizing stigma. Annual Review of Sociology, 2001:27: 363-85.
b See the US Department of Health and Human Services Report “Healthy People 2010” at www.healthypeople.gov
c Barney, L. J., K. M. Griffiths, et al. (2006). "Stigma about depression and its impact on help-seeking intentions." The Australian and New Zealand Journal of Psychiatry 40 (1): 51-4.
d Elkin I, Yamaguchi JL, Arnkoff DB, et al: “Patient-treatment fit” and early engagement in therapy. Psychotherapy Research 9:437–451, 1999
e Sirey J.A., Bruce M.L., Alexopoulos G.S., et al: Perceived stigma as a predictor of treat- ment discontinuation in young and older outpatients with depression. American Journal of Psychiatry 158:479–481, 2001
f Sirey J.A., Bruce, M.L., Alexopoulos G.S., et al: Perceived stigma and patient-rated severity of illness as predictors of antidepressant drug adherence. Psychiatric Services 52:1615–1620, 2001
