Eye on Ethics: Social Workers and Self-Disclosure
By Frederic G. Reamer, PhD
Social Work Today
Vol. 21 No. 1 P. 32

Recently, the National Public Radio program Here & Now broadcast a compelling segment, “If You Have a Mental Illness, Should You Tell Your Employer?” During the segment, a guest who lives with bipolar disorder shared her ambivalence about telling employers about her mental health challenges. Understandably, she has concerns about how employers and fellow employees will treat her if they know details about her struggles.

Many clinical social workers are familiar with this scenario. In counseling sessions, clients and social workers often discuss the issue of client self-disclosure in the workplace, including potential benefits and risks. On the one hand, employees may want some details related to their mental health struggles known so that employers can provide reasonable accommodations and, perhaps, take them into consideration should they affect work performance. On the other hand, employees may want to avoid feeling overexposed in the workplace and minimize the risk of stigma that might accompany disclosures.

When Disclosure Decisions Hit Close to Home
But what if the employees who wrestle with these issues are social workers themselves? Just like any group of professionals, social workers may struggle with depression, bipolar disorder, anxiety, or substance use disorders, among others. Social workers who have behavioral health challenges may work in the very settings that address these issues, such as community mental health centers, family service agencies, inpatient and outpatient psychiatric clinics, and substance abuse disorder treatment programs.

The NASW Code of Ethics includes two standards that directly address social workers whose personal challenges may affect their professional work:

Social workers should not allow their own personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties to interfere with their professional judgment and performance or to jeopardize the best interests of people for whom they have a professional responsibility (standard 4.05[a]).

Social workers whose personal problems, psychosocial distress, legal problems, substance abuse, or mental health difficulties interfere with their professional judgment and performance should immediately seek consultation and take appropriate remedial action by seeking professional help, making adjustments in workload, terminating practice, or taking any other steps necessary to protect clients and others (standard 4.05[b]).

Ideally, social workers who live with mental health challenges are employed in settings in which employers fully grasp the nature of behavioral health issues, offer support, and provide reasonable accommodations. The reality, of course, is that not all settings approximate this ideal. Sadly, in some work settings social workers may have good reason to fear how their employers and colleagues would react to disclosures about their personal challenges.

Susan Goldberg, a Pittsburgh psychologist and lawyer who has conducted research on this phenomenon, acknowledges the complex choices that employees must make about self-disclosure and the lack of consensus about the wisest course of action. As Goldberg told her Here & Now audience, “We did research on people with psychiatric disabilities, and we found that the experts all had divergent ideas of [whether] to disclose or not to disclose for employment. Certain people, usually attorneys, said never disclose, and vocational rehab people said always disclose.”

Based on her research, Goldberg offers sage advice about factors to consider when contemplating self-disclosure in the workplace: “What we found that people with psychiatric disabilities did is figure out their own way. … Some people chose to disclose. Some people chose never to disclose. But what I found was generally the most successful was selective disclosure of person, place, time, and content.”

Social workers who consider self-disclosure in the workplace would do well to consider several factors, including the following:

• Pick the right person. First, try to identify a particular person in the workplace who is trustworthy and understanding. In a perfect world, all workplace colleagues, especially those who are in positions of authority, would handle such disclosures sensitively and responsibly. Unfortunately, that is not always the case. Prudent social workers must carefully consider which supervisors and administrators—particularly those in the organization’s human resources department—are likely to respond well.

• Pick the right time. Timing matters. Options include waiting to disclose until the social worker senses a need for workplace accommodation or disclosing in advance of any need for accommodation. This is an individual choice. Some employees prefer to give employers a “heads up” just in case issues arise in the future. Early disclosure can help avoid uneasy conversations with employers who express their wish that the social worker had spoken up sooner. Others prefer to wait in order to avoid feeling overexposed.

• Pick the right content. When social workers decide to share information about their mental health challenges with an employer, they need to decide how much and what kind of detail to include. One option is to be vague in order to protect one’s privacy. This might include saying something such as, “I have a health problem that, on occasion, might affect my work. I want you to know that I have this under control, although every once in a while I may need some flexibility and accommodation.”

Another option, particularly in work settings where discussion of individuals’ disabilities is common and routine, is to share more specific detail about the nature of the challenge.

Social workers must use their judgment about the relative benefits and risks associated with these options.

Legal Considerations
Social workers who consider disclosing their behavioral health challenges to employers should be aware of their rights under the Americans with Disabilities Act (ADA), a civil rights law that prohibits discrimination against individuals with disabilities in all areas of public life, including jobs, schools, transportation, and all public and private places that are open to the general public.

The purpose of the law is to ensure that people with disabilities have the same rights and opportunities as everyone else. The ADA gives civil rights protections to individuals with disabilities similar to those provided to individuals on the basis of race, color, sex, national origin, age, and religion.

The ADA specifically prohibits discrimination in employment. It also allows persons with disabilities to obtain work accommodations under certain circumstances. The ADA’s Title I, addressing employment, requires employers to make a reasonable accommodation to the known physical or mental limitations of a job applicant or employee as long as the accommodation does not create an undue hardship on the employer. The term reasonable accommodation is defined to include “job restructuring, part-time, or modified work schedules … and other similar accommodations for individuals with disabilities” (Section 101[9]).

It’s important for social workers to understand that the ADA contains a notice provision that authorizes accommodations only for disabilities known to the employer. According to the U.S. Equal Employment Opportunity Commission, “If you think you will need a reasonable accommodation in order to participate in the application process or to perform essential job functions, you should inform the employer that an accommodation will be needed. Employers are required to provide reasonable accommodation only for the physical or mental limitations of a qualified individual with a disability of which they are aware. Generally, it is the responsibility of the employee to inform the employer that an accommodation is needed.”

That is, an employee must disclose some aspect of his or her mental health condition to obtain a workplace accommodation. Again, social workers need to make personal decisions about the type and amount of detail to share.

Social workers know well that members of the profession are not immune from disability. Ideally, social workers who consider disclosing their mental health challenges to their employer will receive a kind, supportive, and accommodating response.

— Frederic G. Reamer, PhD, is a professor in the graduate program of the School of Social Work at Rhode Island College. He is the author of many books and articles, and his research has addressed mental health, health care, criminal justice, and professional ethics.