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

Published online by Cambridge University Press:  02 January 2018

John Fenton
Affiliation:
American University of the Caribbean
Dee O'Hanlon
Affiliation:
Chiltern Community Mental Health Team, Amersham
Danny Allen
Affiliation:
North Wycombe Community Mental Health Team, 1 Cedar Avenue, Hazlemere, High Wycombe, Bucks HP15 7DW
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Abstract

Aims and Method

To ascertain employers' attitudes to interviewing and hiring job applicants with a history of mental illness and, in particular, to assess the potential effect on job prospects for applicants with 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 were medical opinion regarding an applicant's fitness to work and their employment and sickness records. In about three-quarters of small companies and half of large companies, questions about mental illness are simply never asked.

Clinical Implications

Approved social workers have no reason to caution people assessed under the Mental Health Act 1983 that being detained could harm their job prospects.

Type
Original Papers
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © Royal College of Psychiatrists, 2003

It is good practice for approved social workers to advise a patient that there could be implications for the future should they be detained under the Mental Health Act 1983. This research was motivated by the fact that, in our experience, it is quite common for social workers to tell patients who have been ‘sectioned’ that detention under the Mental Health Act 1983 could adversely affect their visa and employment prospects. In fact, there is clear evidence that in the vast majority of cases, visa applications are not affected by being ‘sectioned’ (Reference Allen and AllenAllen & Allen, 1994).

Although there is research showing ways of improving employment outcomes for persons with severe mental illness (Reference Lehman, Goldberg and DixonLehman et al, 2002), we could find no information in the literature about the attitude of employers towards employing someone with a history of mental illness. The only information we found was a letter by Laird (Reference Laird1990) indicating that a person was less likely to get a job if they had a criminal record than if they had a history of mental illness. There was no reference to detention under mental health legislation.

Method

We wanted to compare small companies, where it was less likely that there would be access to an occupational health service, with larger ones. We obtained details of 83 companies with between one and ten employees and sales of less than £100 000, and 91 companies with between 100 and 1000 employees in the High Wycombe area. The questionnaire was divided into three sections. The first section determined when, if at all, an employer would ask a prospective employee if they have a history of mental illness. The second asked how the employer would proceed if a prospective employee were to give a history of mental illness. The third section asked which factors would influence an employer in respect of appointing someone; one of the options in this section was ‘previous compulsory admission under the Mental Health Act’.

Results

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

Table 1. Summary of results

Surveys (n=174)Small companiesLarge companiesTotalPercentage of total
Surveys mailed8391174100.00
Returned but not completed6063.45
Not returned545911364.94
Completed and returned surveys23325531.61
Questions revealing mental illness (n=55)
Asked before interview34712.73
Asked during interview36916.36
Asked after interview16712.63
Not asked17163360.00
Response to applicant revealing mental illness (n=55)
Refuse to interview1235.45
Refer to occupational health09916.36
Request general practitioner report10182850.91
Ask applicant about mental health14132749.09
Not pursue the issue1123.64
Factors influencing appointment to job (n=55)
Employment record17264378.18
Sickness record15233869.09
Diagnosis9112036.36
Mental Health Act admission8122036.36
Medical opinion regarding fitness to work1528437.18
All of the above6101629.09

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 reply would be less likely to adopt good practice with regard to screening job applicants.

The most interesting finding is that, in about three-quarters of 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 response is primarily one of seeking more information. Most companies will wish to discuss matters relating to mental health with the applicant. Large companies are more likely to utilise their occupational health doctors — this was the only significant difference between the two types of company in our research. Small companies, by contrast, are more likely to ask the applicant directly about their mental health. Furthermore, just over half the companies indicated that they would also want to speak with the applicant's general practitioner.

When it comes to factors influencing job appointment, employers across the board are more concerned with a prospective employee's employment and sickness record than with their mental health history. All companies are interested in medical opinion about an applicant's fitness to work, with large companies putting more weight on this. About a third of companies are influenced by a history of hospital admission under the Mental Health Act 1983 and similar numbers are influenced by the applicant's diagnosis. However, for those companies indicating that an applicant's history of mental illness was relevant in their decision-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 measures companies' 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 for cautioning patients that detention under the Mental Health Act 1983 might be deleterious to their chances of employment. In fact, one might speculate that, as detention could facilitate early treatment, such detention could actually improve work prospects by shortening the overall time a person is off sick.

Declaration of interest

None.

References

Allen, D. & Allen, K. (1994) Do patients who have been on ‘sections’ get refused visas? Psychiatric Bulletin, 18, 216217.Google Scholar
Armitage, P. (1971) Statistical Methods in Medical Research. Oxford: Blackwell Scientific Publications.Google Scholar
Laird, M. (1990) Hiring former patients. Hospital and Community Psychiatry, 41, 332333.Google Scholar
Lehman, A. F., Goldberg, R., Dixon, L. B., et al (2002) Improving employment outcomes for persons with severe mental illness. Archives of General Psychiatry, 59, 165172Google Scholar
Figure 0

Table 1. Summary of results

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