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Web-based decision aid tool for disclosure of a mental health condition in the workplace: a randomised controlled trial
  1. Elizabeth Stratton1,2,
  2. Isabella Choi1,2,
  3. Rafael calvo3,
  4. Ian Hickie1,
  5. Claire Henderson4,
  6. Samuel B Harvey5,6,7,
  7. Nicholas Glozier1,2
  1. 1 Brain and Mind Centre, Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia
  2. 2 School of Psychiatry, University of Sydney, Sydney, New South Wales, Australia
  3. 3 School of Electrical and Information Engineering, University of Sydney, Sydney, New South Wales, Australia
  4. 4 Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London-Fs Sandbox, London, UK
  5. 5 School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
  6. 6 Black Dog Institute, Sydney, New South Wales, Australia
  7. 7 St George Hospital, Sydney, New South Wales, Australia
  1. Correspondence to Mrs Elizabeth Stratton, University of Sydney, Sydney, NSW 2006, Australia; eodg5192{at}


Objectives 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.

Method 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.

Results 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 (F(1,104)=16.8, p<0.001) (d=0.49, 95% CI 0.1 to 0.9) and follow-up (F(1,104)=23.6, p<0.001) (d=0.61, 95% CI 0.1 to 0.9). At postintervention the READY group were at a later stage of decision-making (F(1,104)=6.9, p=0.010) which was sustained, and showed a greater reduction in depressive symptoms (F(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.

Conclusions 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.

Trial registration number ACTRN12618000229279.

  • decision aid
  • employee
  • mental health condition
  • disclosure
  • workplace
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  • Contributors ES, NG, CH and SBH contributed to the conception and design of the work. ES, IC and NG completed the analyses and interpretation of data and initial draft of this work. All authors revised the work critically, added to the interpretation of data and added important intellectual content and reviewed the final draft.

  • Funding This study was developed in partnership with Beyond Blue with donations from the Movember Foundation. ES, NG, SBH, RAC and IC all received funding from Beyond Blue and Movember Foundation via a grant to run this study.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the University of Sydney Ethics Review Board: 2017/740.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement All data relevant to the study are included in the article or uploaded as supplementary information.

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