The cause of low mental health disclosure rates: "Fear of appearing weak" or poor publicity?

Yesterday, The Times Higher Education (THE) published an article suggesting that the low number of students and staff disclosing mental health problems could be explained by “a fear of appearing weak”. I’m not sure that’s a good explanation.

Firstly, the context — The article refers to a report from the Equality Challenge Unit (a charity that, according to its website, “works to further and support equality and diversity for staff and students in higher education”) highlighting that just 0.7% of students and 0.2% of staff are reporting a mental health problem. Even using conservative estimates about the prevalence of mental health problems, there is clearly a very significant number of students and staff that are not disclosing their condition.

The consensus is that stigma prevents disclosure, and that if people feel less stigmatised then the number reporting their conditions will grow. That may be true. But there’s a question in this discussion that needs more attention: Why should they disclose?

If the sector believes that students and staff will benefit from disclosing a mental health problem to their institution then they need to explain how. And it would follow that if the numbers still aren’t increasing then it’s because students and staff don’t think the advantages are significant enough. Or they still know nothing about them.

The ECU’s report states that students with a disability who access Disability Support Allowance don’t only benefit financially, but are also more likely to receive a first class or upper-second class degree. If institutions want more DSA uptake then they need to publicise this, and use it as a way of communicating the benefits of disclosure. They can start by addressing the issue of most students and staff not knowing that they would be entitled to DSA due to confusion around the use of the word ‘disability’. Or by developing, and making available to all staff and students, a university-wide mental health policy – as recommended in the Royal College of Psychiatrists’ report into student mental health.

Stigma is a part of this. But stigma should not be used by policy-makers as a way of shifting responsibility away from their role. If institutions want more of their members to disclose a mental health problem then it’s up to them to give good reasons for doing so. Gary Loke doesn’t seem to understand this:

Gary Loke, head of policy at the Equality Challenge Unit, said the survey showed that many people in the academy with mental illness were suffering in silence.

“If you do not disclose you have a problem, universities cannot help you,” he said. “Institutions are generally very supportive to disabled staff, but people need to feel they can come forward and talk about their mental health problems.”

You may mean well, Gary, but the bigger question to answer is this: how will universities help those that talk about their mental health problems? And what exactly do you mean when you say that institutions are “generally” very supportive? The burden of responsibility for low disclosure rates does not end with those that are not disclosing;  institutions must work on creating settings in which people feel inclined to disclose.

The cause of low mental health disclosure rates: "Fear of appearing weak" or poor publicity?

Yesterday, The Times Higher Education (THE) published an article suggesting that the low number of students and staff disclosing mental health problems could be explained by “a fear of appearing weak”. I’m not sure that’s a good explanation.

Firstly, the context — The article refers to a report from the Equality Challenge Unit (a charity that, according to its website, “works to further and support equality and diversity for staff and students in higher education”) highlighting that just 0.7% of students and 0.2% of staff are reporting a mental health problem. Even using conservative estimates about the prevalence of mental health problems, there is clearly a very significant number of students and staff that are not disclosing their condition.

The consensus is that stigma prevents disclosure, and that if people feel less stigmatised then the number reporting their conditions will grow. That may be true. But there’s a question in this discussion that needs more attention: Why should they disclose?

If the sector believes that students and staff will benefit from disclosing a mental health problem to their institution then they need to explain how. And it would follow that if the numbers still aren’t increasing then it’s because students and staff don’t think the advantages are significant enough. Or they still know nothing about them.

The ECU’s report states that students with a disability who access Disability Support Allowance don’t only benefit financially, but are also more likely to receive a first class or upper-second class degree. If institutions want more DSA uptake then they need to publicise this, and use it as a way of communicating the benefits of disclosure. They can start by addressing the issue of most students and staff not knowing that they would be entitled to DSA due to confusion around the use of the word ‘disability’. Or by developing, and making available to all staff and students, a university-wide mental health policy – as recommended in the Royal College of Psychiatrists’ report into student mental health.

Stigma is a part of this. But stigma should not be used by policy-makers as a way of shifting responsibility away from their role. If institutions want more of their members to disclose a mental health problem then it’s up to them to give good reasons for doing so. Gary Loke doesn’t seem to understand this:

Gary Loke, head of policy at the Equality Challenge Unit, said the survey showed that many people in the academy with mental illness were suffering in silence.

“If you do not disclose you have a problem, universities cannot help you,” he said. “Institutions are generally very supportive to disabled staff, but people need to feel they can come forward and talk about their mental health problems.”

You may mean well, Gary, but the bigger question to answer is this: how will universities help those that talk about their mental health problems? And what exactly do you mean when you say that institutions are “generally” very supportive? The burden of responsibility for low disclosure rates does not end with those that are not disclosing;  institutions must work on creating settings in which people feel inclined to disclose.