par De Greef, Vanessa ;Hamarat, Natasia
Référence Santé mentale au Québec, 50, 1, page (43-63)
Publication Publié, 2025-03-01
Article révisé par les pairs
Résumé : • Introduction The disclosure of mental health issues in the workplace highlights tensions between the need to adapt working conditions and the risk of stigmatization affecting the individuals concerned. This research examines the barriers and facilitators shaping this disclosure process within a collaborative framework involving the employee, colleagues, management, and health profes-sionals, using an interdisciplinary approach that combines law and sociology. Method This study is part of an action-research initiative conducted in Belgium since 2018, aimed at developing a support system based on the Individual Placement and Support (IPS) methodology, intended for workers on long-term sick leave related to moderate to severe mental health conditions. It draws on three sets of data: a focus group conducted in 2023 on workplace accommodations for individuals living with mental health conditions, bringing together professionals from mutual insurance funds, employment support specialists, and experts by experience; a series of interviews conducted between 2023 and 2024 with employers and employees participating in the Belgian IPS program; and focus groups held in 2017 that explored the dynamics of professional reintegration, bringing together professionals involved in return-to-work processes, legal experts, and mental health practitioners to offer a more institutional perspective. Following a co-constructive approach with stakeholders, the research adopts a critical stance toward the tensions and limitations inherent in current legal, orga-nizational, and practical frameworks. Thematic analysis of the data was combined with a review of Belgian, European, and international standards to shed light on common challenges across different occupational health systems. Results The disclosure of mental health issues in the workplace goes beyond an individual decision (“to disclose or not to disclose”) and is embedded in complex social dynamics. Stigma, rooted in everyday social interactions, affects not only the employees directly concerned but also the professionals supporting them. Moreover, the legal framework reveals an imbalance: the right to privacy is better established than the right to workplace accommodations, which may limit the responsibilities of employers and other actors. A strictly individualized approach to these issues tends to obscure the need for broader engagement among workplace stakeholders. The Belgian case highlights promising practices, particularly within the IPS program, where job coaches play a key role: they help clarify individual needs, support the implementation of concrete accommodations, and contribute to sharing the burden of disclosure among different actors. However, these efforts remain hindered by weak inter-institutional coordination and the lack of shared trust frameworks for the exchange of sensitive information. Discussion The findings call for a collective approach that goes beyond individual handling of disclosure and workplace accommodations. Shared professional confidentiality emerges as a key tool for balancing confidentiality and collaboration, particularly in supported employment. This approach could help build a climate of trust and enable more sustainable and collectively supported adaptations. Conclusion Stronger individual and collective acknowledgment of the right to adapt work conditions, combined with effective integration of shared professional confidentiality, could contribute to more inclusive work environments. Awareness efforts, training programs, and enhanced coordination between stakeholders are essential to consolidate the innovative approaches implemented, particularly within the IPS program.

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