There is a stigma such that people rarely disclose pre-existing
diagnoses at interview. I think the fear of the impact of
self-disclosure may be higher than the actual impact for minimally
stigmatised diagnostic labels. When I got a job a graduate job over a
decade ago I was honest about my diagnosis of depression. I didn't stop
me being selected out of the 4000 hopefuls who were offered a job at a
finance and direct marketing organisation. Were I to apply and say I had
"schizophrenia" the likelihood of me being selected above the other
candidates would be less but corporate graduate recruitment is very
different to the application procedures in the third sector. They use tests.
An interview usually consist of a formal interview and an assessment of
capability. For the roles I was looking at when I was at university the
standard was 3 stages after a CV application. The first stage was a
simple interview with someone from the company or a test for IQ and
other psychometrics. The next stage would usually be a full day of
assessment. The tests on the day were much harder, there would be more
interviews, case studies and exercises. In my experience the third stage
was an interview with a senior manager, and in my case it was the
Director of European Operations. I had no idea how I got the job but I
think it was because I score well on testing.
An individual can unintentionally discriminate on the grounds of mental
ill health because few people understand it. A very simple example is a
depressed individual going to a job interview. A depressed individual
may not speak well of their achievements nor recognise their own
strengths. They may value themselves less than a person who has
self-confidence. Their head may be don't, they may avoid eye contact,
their speech may be slowed and their answers short. They may not be
capable of raising a smile or holding up the mask to look like they're
friendly and happy. To an interviewer who is not mental health aware
that candidate will score poorly even if they give the best answers
because the reason many companies do interviews as well as testing is to
test out the personality and potential for organisational fit. The
bright, smiling, friendly, sociable person will be considerably advantaged.
Tests don't discriminate like people do. People use their own system to
work out if a person is smart or capable of doing a job. Unconscious
prejudices can influence their rational judgement as can conscious ones.
Tests don't see colour, gender, sexuality, physical or mental illness.
An example of the impact of prejudice is when Oxford University took the
names off the papers given to examiners on the theology course. Upon use
of this measure the percentage of women with First Class honours degrees
shot up to become equal to the percentage of men.
The tests used in corporate graduate recruitment can be sophisticated.
They look for performance and also attempt to assess personality type.
The assessment of personality type is not to exclude a certain type of
personality but to what sort of person they are so they can be deployed
to the correct role. The testing also attempt to elucidate the real
individual rather than their self-perception or the misperceptions of
the testers.
However they are still designed by humans which is why it has been noted
that IQ tests that show certain races to be less intelligent that the
general or White average may in fact be incorrectly assessing
intelligence and applying a Western paradigm. Time-based tests are known
to disadvantage people with dyslexia and I remember my GCSE exams
offered extra time.
Looking at mental health research on cognitive deficit shows significant
impact on the average. Depression, schizophrenia and schizoaffective
disorder are all associated with cognitive deficit and this is well
evidenced; the association with cognitive impairment and schizophrenia
is so strong there is a school of thought that this should be appended
to the diagnostic cluster of symptoms. Again the problem of measures of
cognition and value may be incorrect and fundamentally prejudiced
against the mentally ill. The relevance is the psychiatric measures and
the measures used in business are likely from the same research base,
though I'd expect the academic ones to be considerably more advanced and
accurate however I could be wrong. They will score a person experiencing
a period of depression or psychosis lower. From my personal experience
of psychiatric medication those too can impair cognition however I am
unaware of the research into this.
When that person is well they will regain their cognitive function (and
loose the benefits to cognition offered by states of mental illness) or
stops taking medication they will regain their function. Were they to
take the test again they would score higher. Two tests at two different
times would be better to confirm an individual's capability, just as it
has been shown that two consultations provide a higher level of accuracy
of diagnosis of depression in primary care.
One perspective may be to consider the result of an exam or test should
only be used when the individual is well and unmedicated and anything
less would be discrimination on the basis of mental illness. In my
personal opinion it is not so clear. The interplay of idealism and
practicality in regards to discrimination (irrespective of the law's
opinion) is a deeply complex issue. A person is a whole, both good and
bad. "Mental illness" is simply how society in 2010 makes a judgement on
the individual's being and explains why they are unwanted by society in
whatever time they live. This ideal extends to employers who need to
know the good and the bad, not only the good or only the bad. It is of
little value to test someone only when they are ill as much as it is of
little value to test them only when they are well.
The idealism is that most people can learn to do most jobs. I've always
like the way that story is told in the film Trading Places. In the film
a homeless bum and a rich banker swap lives. The banker quickly stoops
to the live of a bum and the bum becomes a success. The world will have
to change a lot for that to happen in reality.
Another problem is the impact of psychiatric mental illness, i.e. the
type of experience of life that involves inpatient care. I hesitate to
use the word "real" mental illness instead of the word "psychiatric" but
I would be accurate. A psychiatric crisis for most people doesn't
usually involve a swift return to employment and for some it can be so
severe that it is the last they are ever employed. Employers want people
with continuous work history and any breaks to be explained by
appropriate career breaks, not being sectioned then watching their
personality and self-esteem disintegrate before their very eyes as
happened to me after my first hospitalisation. I had to lie on
application forms after that happened and was advised to lie by my
psychiatrist. He was probably right in my best interests too because the
stigma of severe mental illness is exceptionally high. They were "career
breaks" and it was only when I worked at a mental health charity that I
could write the truth.
The solution for organisations who want the best people for the job
without discriminating eludes me. Mental health aware people are less
likely to discriminate and so mental health training looking at symptoms
rather than diagnosis could be a good way to change how people perceive
someone who is going through a period of unwellness.
Business theory on the way teams are formed and how personalities fit
together offer a lot of potential for the move towards less
discriminatory recruitment practice. I'm unaware of how these have
impacted in the real world but my (poor) understanding of the theory is
that people have different qualities that can be woven together into the
right team. A team made up of only Pragmatist Activist types would not
be a good team, but perhaps that might work with a Reflection
Theorist-type leader (I forget the correct Meyers Briggs terms). The
right mix is best.
Twisting this example slightly I think this shows how mentally ill
people could be valued and advantaged. This is not about positive
discrimination to counteract the impact of the disability. People with
mental illnesses could be genuinely valued. A bipolar type may be able
to react very quickly to changing demands. A depressive may be good at
problem solving. A paranoid person would be great at contingency
planning. A psychotic would be creative. A manic person would be a lot
of fun to be around. It is to see the value of the individual and how
they fit and can be fitted in. The series 24 revolves around a main
character who could never work in an office but Jack Bauer is amazing at
his job and runs around saving the day.
It's a shame that psychiatric research is psychopathology. It
desperately looks to understand what's wrong with a person with a mental
illness. It never looks to see what's right about them. There is a huge
body of research on cognitive impairment and mental illness. There's
considerably fewer psychosanological papers, i.e. psychiatric research
about positive mental health rather than mental illness. To substantiate
an employment system that looked to understand the value of the mentally
ill in the workplace (and in general society) the understanding of our
place in society needs to be established and that will take a massive
shift in the direction of psychiatry and psychiatric research.
The group most disadvantaged are those with severe mental illness. Last
year saw the body of useful employment advice on how to employ people
with mental health problems in the UK grow significantly.I looked for
employment advice for employing those with severe mental health
problems, specifically for someone with a diagnosis of schizoaffective
disorder, and the there's nothing in a cursory search of the top 5 links
from a Google search using a variety of keywords (a search that any HR
manager could do).
Bugger. I've totally gone off the subject on the last few paragraphs.
Think this one's a ramble.
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