Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues:Position paper and future directions

Background As yet, little is known about the effects of mental health stigma on sustainable employment. This is surprising, as mental health stigma is common, and because people with severe and common mental disorders are 7 and 3 times more likely to be unemployed, respectively, than people with no disorders. As the global lifetime prevalence of mental disorders is 29%, the high unemployment rates of people with these health problems constitute an important and urgent public health inequality problem that needs to be addressed. Main text The aim of this position paper is to illustrate the assumption that stigma contributes to the unemployment of people with mental illness and mental health issues with evidence from recent scientific studies on four problem areas, and to provide directions for future research. These four problem areas indicate that: (1) employers and line managers hold negative attitudes towards people with mental illness or mental health issues, which decreases the chances of people with these health problems being hired or supported; (2) both the disclosure and non-disclosure of mental illness or mental health issues can lead to job loss; (3) anticipated discrimination, self-stigma and the ‘Why Try’ effect can lead to insufficient motivation and effort to keep or find employment and can result in unemployment; and (4) stigma is a barrier to seeking healthcare, which can lead to untreated and worsened health conditions and subsequently to adverse occupational outcomes (e.g. sick leave, job loss). Conclusions The paper concludes that stigma in the work context is a considerable and complex problem, and that there is an important knowledge gap especially regarding the long-term effects of stigma on unemployment. To prevent and decrease adverse occupational outcomes in people with mental illness or mental health issues there is an urgent need for high quality and longitudinal research on stigma related consequences for employment. In addition, more validated measures specifically for the employment setting, as well as destigmatizing intervention studies are needed

Lightweight two-stroke cycle aircraft diesel engine technology enablement program, volume 2

An experimental Single Cylinder Test Engine Program is conducted to confirm the analytically projected performance of a two-stroke cycle diesel engine for aircraft applications. Testing confirms the ability of a proposed 4-cylinder version of such an engine to reach the target power at altitude in a highly turbocharged configuration. The experimental program defines all necessary parameters to permit a design of a multicylinder engine for eventual flight applications

Lightweight two-stroke cycle aircraft diesel engine technology enablement program, volume 1

An experimental Single Cylinder Test Engine Program is conducted to confirm the analytically projected performance of a two-stroke cycle diesel engine for aircraft applications. The test engine delivered 78kW indicated power from 1007cc displacement, operating at 3500 RPM on Schnuerle loop scavenged two-stroke cycle. Testing confirms the ability of a proposed 4-cylinder version of such an engine to reach the target power at altitude, in a highly turbocharged configuration. The experimental program defines all necessary parameters to permit design of a multicylinder engine for eventual flight applications; including injection system requirement, turbocharging, heat rejection, breathing, scavenging, and structural requirements. The multicylinder engine concept is configured to operate with an augmented turbocharger, but with no primary scavenge blower. The test program is oriented to provide a balanced turbocharger compressor to turbine power balance without an auxiliary scavenging system. Engine cylinder heat rejection to the ambient air has been significantly reduced and the minimum overall turbocharger efficiency required is within the range of commercially available turbochargers. Analytical studies and finite element modeling is made of insulated configurations of the engines - including both ceramic and metallic versions. A second generation test engine is designed based on current test results

Psychometric properties of the Internalized Stigma of Mental Illness (ISMI-10) scale in a Dutch sample of employees with mental illness

BACKGROUND: Internalized stigma can have numerous negative effects on the well-being and employment of people with mental illness. Brief, valid, and reliable measures are needed to get a better understanding of self-stigmatization. The aim of this study is to translate the brief version of the Internalized Stigma of Mental Illness (ISMI-10) scale into a Dutch version and to assess the reliability and validity of this Dutch version in a sample of employees with mental illness. METHODS: The ISMI-10 was translated into Dutch using the forward-backward translation procedure. The sample consisted of 161 employees with mental illness. Internal consistency was evaluated and the retest reliability was tested with 68 respondents. The construct validity was evaluated by testing convergent and divergent validity. RESULTS: The Dutch ISMI-10 showed good internal consistency (α = 0.83) and good test-retest reliability (r = 0.73). The Dutch ISMI-10 demonstrated excellent convergent validity; high correlations were found between the Dutch ISMI-10 and hope (r = -0.54), anxiety and depression (r = 0.59), self-esteem (r = -0.56), and empowerment (r = − 0.59). Acceptable divergent validity was indicated; small correlations were found between the Dutch ISMI-10 and the physical functioning subscale (r = -0.27) and the role limitation due to physical problems subscale (r = -0.21), and medium correlations were found between the Dutch ISMI-10 and the general health subscale (r = -0.36). CONCLUSION: The Dutch ISMI-10 demonstrated adequate psychometric properties for assessing internalized stigma and can be used by researchers in Dutch speaking countries to get a better understanding of self-stigmatization among people with mental illness. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-022-04284-5

Line managers' hiring intentions regarding people with mental health problems:A cross-sectional study on workplace stigma

Objectives Stigma may negatively affect line managers’ intention to hire people with mental health problems (MHP). This study aims to evaluate line managers’ knowledge and attitudes concerning job applicants with MHP, and to assess which factors are associated with the intention (not) to hire an applicant with MHP. Methods A sample of Dutch line managers (N=670) filled out a questionnaire on their knowledge, attitudes and experiences concerning applicants/employees with MHP. Descriptive analyses and multiple regression analyses were used. Results The majority (64%) was reluctant to hire a job applicant with MHP, despite the fact that only 7% had negative and 52% had positive personal experiences with such employees. Thirty per cent were reluctant to hire an applicant if they knew the applicant had past MHP. Associated with higher reluctance to hire an applicant with MHP were the concerns that it will lead to long-term sickness absence (β (95% CI)=0.39 (0.23 to 0.55)), that the employee cannot handle the work (β (95% CI)=0.16 (0.00 to 0.33)) that one cannot count on the employee (β (95% CI)=0.41 (0.23 to 0.58)) and higher manager education level (β (95% CI)=0.25 (0.05 to 0.44)). Conversely, associated with positive hiring intentions was being in favour of diversity and/or inclusive enterprise (β(95% CI)=−0.64 (−0.87 to −0.41)). Conclusions As the majority of managers were reluctant to hire applicants with MHP, and even 30% were reluctant to hire applicants who had past MHP, these findings have major implications for social inclusion in the Netherlands, where about 75% of employees would disclose MHP at work

Expectations of mental illness disclosure outcomes in the work context:A cross-sectional study among Dutch workers

Purpose The decision whether to disclose mental illness at work can have important positive and negative consequences for sustainable employment and well-being. The aim of the study is (1) to examine workers’ expectations of outcomes of mental illness disclosure in the workplace and to evaluate their expectations regarding which factors are of influence on these outcomes, (2) to identify distinct subgroups of workers, and (3) to characterize these subgroups in terms of personal, sociodemographic, and work-related characteristics. Methods In this cross-sectional survey study, a sample of 1224 Dutch workers was used. Latent Class Analysis (LCA) was used to identify classes of workers based on expected workplace mental illness outcomes. A three-step approach LCA was chosen to investigate whether the classes differed in characteristics. Results The majority of workers expected predominantly positive outcomes of workplace mental illness disclosure (e.g., being able to be one’s authentic self; 82.4%), even though they simultaneously expected disclosure to lead to advancement-related discrimination (e.g., lower chances of contract renewal; or getting a promotion; 68.4% and 57%, respectively). Six distinct subgroups of workers were identified based on expected workplace mental illness disclosure outcomes: two positive classes (50.1%), two negative classes (33.3%), and two classes who indicated not to know what the outcomes would be (16.7%). Significant differences between the classes were found on personal experience, work-related association with mental illness, gender, educational level, and workplace atmosphere. Conclusion The disclosure process is complex, as most workers were optimistic (i.e., expected generally positive outcomes) whilst simultaneously expecting workplace discrimination. Subgroup differences in expectations regarding workplace mental illness disclosure outcomes were found

Predicting Return to Work in Employees Sick-Listed Due to Minor Mental Disorders

Objective To investigate which factors predict return to work (RTW) after 3 and 6 months in employees sick-listed due to minor mental disorders. Methods Seventy GPs recruited 194 subjects at the start of sick leave due to minor mental disorders. At baseline (T0), 3 and 6 months later (T1 and T2, respectively), subjects received a questionnaire and were interviewed by telephone. Using multivariate logistic regression analyses, we developed three prediction models to predict RTW at T1 and T2. Results The RTW rates were 38% after 3 months (T1) and 61% after 6 months (T2). The main negative predictors of RTW at T1 were: (a) a duration of the problems of more than 3 months before sick leave; and (b) somatisation. The main negative predictors of RTW at T2 were: (a) a duration of the problems of more than 3 months before sick leave; (b) more than 3 weeks of sick leave before inclusion in the study; and (c) anxiety. The main negative predictors of RTW at T2 for those who had not resumed work at T1 were: (a) more than 3 weeks of sick leave before inclusion in the study; and (b) depression at T1. The predictive power of the models was moderate with AUC-values between 0.695 and 0.763. Conclusions The main predictors of RTW were associated with the severity of the problems. A long duration of the problems before the occurrence of sick leave and a long duration of sick leave before seeking help predict a relatively small probability to RTW within 3–6 months. High baseline somatisation and anxiety, and high depression after 3 months make the prospect even worse. Since these predictors are readily assessable with just a few questions and a symptom questionnaire, this opens the opportunity to select high-risk employees for a targeted intervention to prevent long-term absenteeism