Does having been on a 'section' reduce your chances of  getting a job?

AIMS AND METHOD

To ascertain employers' attitudes to interviewing and hiringjob applicants with a history of mental illness and, in particular,to assess the potential effect on job prospects for applicantswith a history of admission under the Mental Health Act 1983.A postal tick-box questionnaire was sent to 174 companies;there was a 32% response rate.

RESULTS

The main factors influencing employers' hiring decisions weremedical opinion regarding an applicant's fitness to work andtheir employment and sickness records. In about three-quartersof small companies and half of large companies, questionsabout mental illness are simply never asked.

CLINICAL IMPLICATIONS

Approved social workers have no reason to caution people assessedunder the Mental Health Act 1983 that being detained couldharm their job prospects.

Introduction

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Introduction

It is good practice for approved social workers to advise apatient that there could be implications for the future shouldthey be detained under the Mental Health Act 1983. This researchwas motivated by the fact that, in our experience, it is quitecommon for social workers to tell patients who have been ‘sectioned’that detention under the Mental Health Act 1983 could adverselyaffect their visa and employment prospects. In fact, there is clear evidence that in the vast majority of cases, visa applicationsare not affected by being ‘sectioned’ (Allen & Allen, 1994).

Although there is research showing ways of improving employmentoutcomes for persons with severe mental illness (Lehman et al, 2002),we could find no information in the literatureabout the attitude of employers towards employing someonewith a history of mental illness. The only information wefound was a letter by Laird (1990) indicating that a person was less likely to get a job if they had a criminal recordthan if they had a history of mental illness. There was noreference to detention under mental health legislation.

Method

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Method

We wanted to compare small companies, where it was less likelythat there would be access to an occupational health service,with larger ones. We obtained details of 83 companies withbetween one and ten employees and sales of less than £100000, and 91 companies with between 100 and 1000 employeesin the High Wycombe area. The questionnaire was divided intothree sections. The first section determined when, if at all,an employer would ask a prospective employee if they havea history of mental illness. The second asked how the employerwould proceed if a prospective employee were to give a historyof mental illness. The third section asked which factors would influence an employer in respect of appointing someone; oneof the options in this section was ‘previous compulsoryadmission under the Mental Health Act’.

Results

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Results

The main findings are summarised in Table 1. Values for P were calculated for the differences between the small and largecompanies for all results, using the standard error of thedifference between percentages (based on table 2.5, Armitage, 1971).The only significant difference found was that no small companies would refer to occupational health compared withnine (28%) large companies (P<0.001).

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Table 1. Summary of results

Discussion and conclusion

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Discussion and conclusion

This research is clearly based on a small sample size and therefore,one has to take into account the possibility of response bias.The likelihood is that those companies that did not replywould be less likely to adopt good practice with regard toscreening job applicants.

The most interesting finding is that, in about three-quartersof the small companies and half of the large ones in our sample,questions about mental illness were simply never posed. Also,when a history of mental illness is ascertained, the responseis primarily one of seeking more information. Most companieswill wish to discuss matters relating to mental health withthe applicant. Large companies are more likely to utilisetheir occupational health doctors — this was the onlysignificant difference between the two types of company inour research. Small companies, by contrast, are more likelyto ask the applicant directly about their mental health. Furthermore, just over half the companies indicated that they would alsowant to speak with the applicant's general practitioner.

When it comes to factors influencing job appointment, employersacross the board are more concerned with a prospective employee'semployment and sickness record than with their mental healthhistory. All companies are interested in medical opinion aboutan applicant's fitness to work, with large companies puttingmore weight on this. About a third of companies are influencedby a history of hospital admission under the Mental HealthAct 1983 and similar numbers are influenced by the applicant'sdiagnosis. However, for those companies indicating that anapplicant's history of mental illness was relevant in theirdecision-making process, the majority indicated that it was just one aspect of a multi-factorial hiring decision.

A major caveat would have to be that the questionnaire measurescompanies' stated intentions rather than their actual behaviour,which could, of course, be markedly at odds with this. Clearly,there is scope for research into this aspect.

In terms of our original motivation for carrying out the research,it would seem that there is currently no evidence base forcautioning patients that detention under the Mental HealthAct 1983 might be deleterious to their chances of employment.In fact, one might speculate that, as detention could facilitateearly treatment, such detention could actually improve work prospects by shortening the overall time a person is off sick.

References

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