The Equal Opportunities Commission (EOC) today (28 February 2023) released the findings of the “Study on Perceptions of Stigmatization and Discrimination of Persons with Mental Illness (PMIs) in the Workplace” (the Study). 

The Study found that 81.7% of the employed persons considered that discrimination against PMIs in Hong Kong was very prevalent or quite prevalent. The most observed situations of workplace discrimination against PMIs were “having fewer opportunities for promotion” (71.3%) and “not hired because of mental illness” (68.3%). 

78.5% of the PMIs reflected that the discrimination against PMIs in Hong Kong was very prevalent or quite prevalent, and especially among people who are diagnosed with anxiety (88%), and bipolar disorder (83.3%). The most commonly observed situations of workplace discrimination against PMIs were “having fewer opportunities for promotion” (71.3%), “not getting hired because of mental illness” (67.5%), “being paid less than others because of mental illness” (65.5%), and “being assigned to job duties, work location or work shifts that are worse than other employees” (60.2%). 

A total of 36.2%, 32.8% and 32.8% of the PMIs reported that they experienced discrimination during the hiring, employed and quitting processes respectively over the past five years. Further, 45.3% and 12.5% of the PMIs experienced discrimination in at least one of three processes and all three processes respectively. However, most of the PMIs did not take action against mental illness discrimination in the workplace because they deemed it unnecessary or worried about their future employer’s view on such actions.

Commissioned to the Department of Psychology of The Education University of Hong Kong, the Study was carried out with a mixed-method design in which quantitative and qualitative data were collected. Responses from 858 participants consisting of 593 employed persons and 265 PMIs were obtained through a face-to-face questionnaire survey from May to November 2020, while 50 employers and supervisors in managerial positions participated in the in-depth interviews from February to July 2021.

According to the Study, the common stigmatization towards PMIs reported by the employed persons was that they were worried that PMIs would harm others (55.7%), they would try to keep a distance from PMIs (46.5%) and were afraid of being alone with PMIs (43.4%). 

Ms Doris TSUI Ue-ting, Acting Head (Policy, Research and Training) of the EOC said, “We can see from the Study that discrimination against PMIs in Hong Kong is prevalent and workplace discrimination against PMIs still exists. According to a survey on mental health published in 2015, a total of 13% of Hong Kong residents were PMIs. Therefore, we should attach great importance to eliminate the stigma attached to persons with different mental conditions and prevent discrimination against them.”

The EOC is tasked to enforce the Disability Discrimination Ordinance (DDO) in Hong Kong. DDO ensures PMIs are protected against disability discrimination, harassment and vilification in prescribed areas of activities, including employment. A total of 310 complaints lodged under the DDO between 2018 and 2022 were about psychiatric conditions, with 75% of them related to employment.

Though a majority of the employed persons (91.9%) and PMIs (77.7%) knew that Hong Kong has the DDO in place to prevent discrimination against people with disabilities in the workplace. Nevertheless, many employers and supervisors interviewed by the Study expressed that they did not have a written anti-discrimination policy in their organisations and did not establish a formal system for reporting and handling discrimination-related complaints. Ms Tsui said, “Although it is not a legal requirement for companies to formulate an anti-discrimination policy, establish a complaint handling mechanism or provide staff training on DDO, employers who take preventive and remedial measures may rely on them as ‘reasonably practical steps taken’, forming part of the defense against vicarious liability in legal proceedings. Employers are welcome to make reference to the EOC’s Code of Practice on Employment under the DDO in which employers should adopt good management practices throughout the employment cycle within organisations.”

The Study also revealed that among the 265 responding PMIs, 18.9% of them encountered difficulties when applying for sick leave for seeking mental illness advice. Among those who encountered difficulties, 49.0% of them disclosed their reason for taking leave to their supervisors or colleagues.

A total of 85.9% of the PMIs expressed that it was necessary for companies to provide mental health support to employees. However, only 12.5% of the PMIs reported that the company for which they were currently working or the last company they worked for have provided such support. 48.7% of the PMIs did not express their needs to employers/supervisors because they were afraid of being labeled and discriminated against by the company/supervisors. 

However, PMIs who received more support from supervisors and colleagues reported higher psychological well-being, better social and occupational functioning and symptom recovery, and lower emotional distress and internalised stigma. Therefore, disclosing mental health status in the workplace might enable PMIs to obtain support, take sick leave and get treatment, but it could also increase their risk of being discriminated. 

From the perspective of many employers and supervisors, PMIs were less capable of controlling their behaviors and emotions. They indicated that PMIs were more suitable for job positions which did not require working with others. For industries that involved contact with many customers/clients, employers and supervisors tended to be hesitant in considering PMIs for the position which reflected that discrimination against PMIs was very prevalent in customer service or people-oriented industries. 

Some employers indicated that measures like flexible work arrangements for PMIs were often regarded as unfair treatment towards other employees. Therefore, they articulated that there was no special arrangement for PMIs due to equal treatment for everyone. This illustrated the misconceptions among employers and supervisors about the definitions of discrimination and workplace accommodation. Ms Tsui reiterated, “Equal treatment for all could in some cases lead to indirect discrimination due to overlooking the disability condition of PMIs. Employers should understand the meaning of reasonable accommodation under the DDO and differentiate a particular need/arrangement resulting from a disability condition.”

Recommendations

Based on the observations from the quantitative and qualitative studies, the research team proposed five recommendations on public education, anti-discrimination policy, special work arrangements, staff training and resources for mental health support.

• Public education initiatives should be launched to promote awareness and understanding of disability discrimination and the DDO in Hong Kong.
• The Government should consider providing more resources and assistance to facilitate the development of discrimination-related policies and measures for supporting PMIs’ recovery in the workplace.
• Employers are suggested to offer reasonable work accommodations to employees as a mental health-friendly employment practice. They should ensure that employees with mental health conditions can attend medical appointments and apply for sick leave.
• Training workshops for employed persons should regularly be provided by mental health associations and NGOs to debunk common myths, clarify misconceptions, promote mental health awareness, and teach communication skills.
• Employers are encouraged to provide an employee assistance programme as a mental health first aid for employees who experience personal, mental or emotional problems. The Government may consider either providing financial subsidies or centralised support services for subscription to the programme by small and medium enterprises.

Please refer to the following link for the details of the findings and recommendations of the Study: https://www.eoc.org.hk/en/policy-advocacy-and-research/research-reports/2023-1.

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Equal Opportunities Commission
28 February 2023
 

Ms Doris TSUI Ue-ting, Acting Head (Policy, Research and Training), Equal Opportunities Commission (centre); Dr Kevin K. S. CHAN, Associate Professor and Head, Department of Psychology, The Education University of Hong Kong (EdUHK) (right); and Dr Henry C. Y. HO, Assistant Professor, Department of Psychology, EdUHK (left) presented the findings of the study at the press conference.