Background:

Disclosure of a mental health condition is a necessary first step to help-seeking in the workplace. A lack of disclosure limits opportunities to access workplace support that could allow employees to maintain performance in their role, or successfully return to work. Decisions to disclose, or not, are highly individual and require the consideration of multiple factors, which are often barriers, associated with a disclosure process, for example weighing up the risks and benefits. Decision aid tools offer a way to help people in making these complex decisions. Such an aid needs to be confidential, easily accessible, and easy to use, with the potential to access the tool on multiple occasions. Web programs are well suited to meet these requirements and if properly developed, can provide feasible, accessible, affordable and effective workplace interventions.

Objective:

The aim of this study is to gain insights from potential end-users, in this case both employees and organisations, into what type of components including; language, style, and content would avoid potential stigma, and ensure elements of clear value for users would be built into a web-based decision aid tool that aims to assist employees in making decisions about the disclosure of their mental health condition at work.

Methods:

This study used a participatory design approach to allow all stakeholders; developers, researchers, experts and end-users to collaborate in co-design the tool. During the user research phase of the development of the web-based tool a participatory design workshop approach was selected as a part of a larger study of focus groups. Australian employees and managers in rural, suburban, and urban locations took part in an exploratory qualitative study involving participatory workshops designed to elicit their perspectives and preferences for a decision aid tool.

Results:

A total of two workshops were conducted with n=13 participants. The majority were from the Transport Company (69%), male (62%), and had full-time employment (85%). Six employees had previous experience disclosing their own mental health condition and seven were in a supervisory role and had previously been disclosed to. In any co-design development, there are certain trade-offs that need to be made between the views of experts, developers, end-users, and the available budget. In this specific instance of a very delicate, personal decision, the end-users provided valuable design insights into key areas such as language, and were very antipathetic to a key feature, the avatar, thought desirable by experts and developers. We share our key findings including; 1) aspects of the tool where all stakeholders were in agreement, 2) aspects where some stakeholders disagreed and adaptations were implemented, 3) where disagreements were unable to be implemented due to financial constraints, 4) where misalignment between stakeholders lied and how to decide on a balance.

Conclusions:

The co-design with lived experience approach is useful for contribution on much of the design, language, and features. The key in this study was balancing the needs of the workers and the potential impacts for the mangers and organizations, while ensuring legislation and regulations requirements were upheld.