Figure 1: Positive and negative drivers on the route to disclosure

Increase in risk factors for mental health problems

An individual experiences troubling symptoms

Reduced threshold for help-seeking

Public Health campaigns

Increased mental health literacy

The individual seeks medical advice about their symptoms

Increased service provision

Peer & social media influence

Decreased stigma

Less skilled clinicians making diagnoses

Increased awareness by clinicians

The individual is diagnosed with a mental health problem

Reduced threshold for diagnosis

Online application processes

The individual agrees with the diagnosis & adherers to appropriate treatment

Increased treatment availability

Regulatory changes & legal requirements

Decreased treatment effectiveness

Improved underwriting

The individual discloses diagnosis to insurers, workplace, etc.

Economic pressures

Increased disability & chronicity

Increased concerns about impact of non-disclosure

Increased occupational support available