title: Development and preliminary evaluation of a decision aid for disclosure of mental illness to employers.
abstract: OBJECTIVE
  Many mental health service users delay disclosing to employers or never do so due to previous experience of, or anticipation of discrimination. However, non-disclosure precludes requesting 'reasonable workplace adjustments'. Service users may experience conflicting needs and values in deciding whether to disclose. No evidence-based interventions exist to support this decision.
  
  
  METHODS
  A decision aid (CORAL, or COnceal or ReveAL) to support mental health service users in reaching disclosure decisions was developed and subjected to preliminary evaluation (n=15).
  
  
  RESULTS
  The majority found the decision aid quick (60%) and relevant (60%) and would recommend it (80%). Eighty percent reported that they would definitely or probably use it in making disclosure decisions. Forty percent each were positive or neutral on its ease of use. Semi-structured interviews revealed a demand for more information on the legal implications of disclosure. The mean level of 'decisional conflict' regarding disclosure reduced from 52.0 to 35.5 and mean Stage of Decision-making Scale score from 4.6 to 4.3.
  
  
  CONCLUSIONS
  The results suggest that the CORAL decision aid is feasible, relevant and valuable in supporting decisions about disclosing a mental illness to an employer.
  
  
  CONCLUSIONS
  The decision aid could be deployed in routine care without significant resource implications.
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, UK.
authors.forename: Elaine
authors.initials: E
authors.lastname: Brohan
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, UK. Electronic address: Claire.1.henderson@kcl.ac.uk.
authors.forename: Claire
authors.initials: C
authors.lastname: Henderson
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, UK.
authors.forename: Mike
authors.initials: M
authors.lastname: Slade
authors.affiliation: King's College London, Health Service and Population Research Department, Institute of Psychiatry, London, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Thornicroft
mesh_terms: D000328:Adult; D003376:Counseling; D003657:Decision Making; D003661:Decision Support Techniques; D004651:Employment; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D028642:Persons with Psychiatric Disorders / Q000523:psychology*; D008875:Middle Aged; D015203:Reproducibility of Results; D063508:Social Discrimination / Q000523:psychology; D014342:Truth Disclosure; D017132:Workplace
keywords: Decision support techniques; Disclosure; Employment; Mental health