To disclose or not to disclose? Mental health service users’ and practitioners’ views of practitioners’ own self-disclosure of mental health difficulties: A mixed-methods study

TL;DR

This study explores how mental health professionals sharing their own mental health struggles affects their relationships with patients and highlights the benefits and challenges of such self-disclosure.

Contribution

The study introduces new insights into the role of self-disclosure by mental health practitioners in fostering therapeutic relationships and addressing stigma.

Findings

Self-disclosure by practitioners can promote recovery and balance power dynamics in therapeutic relationships.

Stigma persists among mental health professionals regarding mental health difficulties.

Practitioners with more experience are more likely to self-disclose, influenced by team culture and confidence.

Abstract

Mental health practitioners’ self-disclosure of their mental health difficulties to service users is increasingly relevant as mental health services move away from dominant biomedical approaches towards relationship-centred care. Yet, this area is under-researched. This paper reports on research undertaken using an explanatory sequential design with 83 mental health practitioners and 68 mental health service users taking part in an online national survey in England, with five practitioners and five service users (none known dyads) then taking part in semi-structured telephone interviews to discuss their views and experiences in greater depth. The study found that mental health practitioners’ self-disclosure could provide a valuable contribution to service users’ care. Self-disclosure offered benefits for both practitioners and service users, such as promoting recovery, facilitating interactions and balancing power differentials; however, stigma remained an issue within the mental health workforce. There was a notable discrepancy in the (perceived) rationale for disclosure between practitioners and service users, and in the way psychiatrists in particular perceived and were perceived to perceive self-disclosure. The findings suggest that practitioners are more likely to disclose the longer they have been practising, suggesting that team culture, confidence and professional capability are influential. There is a need for reflective supervision and clear guidance around self-disclosure, alongside an ongoing drive to challenge stigma, so that practitioners with lived experience of mental health problems are empowered and supported around their disclosure for the benefit of service users.

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