Psychiatric Bulletin (2003) 27: 177-178. doi: 10.1192/pb.27.5.177
© 2003 The Royal College of Psychiatrists
Psychiatric Bulletin (2003) 27: 177-178
© 2003 The Royal College of Psychiatrists
Does having been on a ‘section’ reduce your chances of getting a job?
John Fenton, Medical Student
American University of the Caribbean
Dee O'Hanlon, Approved Social Worker
Chiltern Community Mental Health Team, Amersham
Danny Allen, Consultant Psychiatrist
North Wycombe Community Mental Health Team, 1 Cedar Avenue, Hazlemere,
HighWycombe, Bucks HP15 7DW
Declaration of interest
None.
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Abstract
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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.
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Introduction
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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’
(Allen & Allen, 1994).
Although there is research showing ways of improving employment outcomes
for persons with severe mental illness
(Lehman 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
(1990) 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.
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Method
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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’.
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Results
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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, Armitage,
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).
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Discussion and conclusion
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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.
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References
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ALLEN, D. & ALLEN, K. (1994) Do patients who have
been on ‘sections’ get refused visas? Psychiatric
Bulletin, 18,
216
-217.[Abstract/Free Full Text]
ARMITAGE, P. (1971) Statistical Methods in
Medical Research. Oxford: Blackwell Scientific
Publications.
LAIRD, M. (1990) Hiring former patients.
Hospital and Community Psychiatry,
41,
332
-333.
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, 165-172[Abstract/Free Full Text]
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Abstract
Introduction
