Web-based decision aid tool for disclosure of a mental health condition in the workplace: a randomised controlled trial.

Abstract

Making decisions about disclosing a mental illness in the workplace is complicated. Decision aid tools are designed to help an individual make a specific choice. We developed a web-based decision aid to help inform decisions about disclosure for employees. This study aimed to examine the efficacy of this tool. We conducted a randomised controlled trial with recruitment, randomisation and data collection all online. Participants had access to the intervention for 2 weeks. Assessments occurred at baseline, postintervention and 6 weeks' follow-up. The primary outcome was decisional conflict. Secondary outcomes were stage and satisfaction of decision-making and mental health symptoms. 107 adult employees were randomised to READY (n=53) or the control (n=54). The sample was predominantly female (83.2%). Participants using READY showed greater reduction in decisional conflict at postintervention (<i>F</i>(1,104)=16.8, p<0.001) (<i>d</i>=0.49, 95% CI 0.1 to 0.9) and follow-up (<i>F</i>(1,104)=23.6, p<0.001) (<i>d</i>=0.61, 95% CI 0.1 to 0.9). At postintervention the READY group were at a later stage of decision-making (<i>F</i>(1,104)=6.9, p=0.010) which was sustained, and showed a greater reduction in depressive symptoms (<i>F</i>(1,104)=6.5, p=0.013). Twenty-eight per cent of READY users disclosed, and reported a greater improvement in mental health than those who did not disclose. READY provides a confidential, flexible and effective tool to enhance employee's decision-making about disclosure. Its use led to a comparative improvement in depressive symptoms compared with the current information provided by a leading mental health non-governmental organisation, without apparent harm. READY seems worth evaluating in other settings and, if these results are replicated, scaling for wider use. ACTRN12618000229279.