Withheld information on a pre-employment health check. Now what?

December 22, 2015 2:05 AM

I'm in the background check stage of a job in health care. I foolishly didn't disclose something from my medical history on my occupational health check. I would be grateful for any advice about what to do, but particularly from people based in the UK. This post discusses self-harm.

The job is in the NHS. I've got a conditional job offer, and the occupational health check is the last thing before getting a start date.

I filled in a preemployment questionnaire about my health. It specifically asked about mental health and self-harm. I ticked the box to say I had no experience of this, and did not disclose that I self-harmed as a 17/18 year old. This was short-lived during a stressful and isolating time, and I last self-harmed about 10 years ago - I then just stopped. I never got a diagnosis and I didn't see my GP or anyone else about it (I am aware that this might sound worse than saying that I sought help and have a diagnosis). In the intervening years I've developed different ways of coping and am a lot better at managing life's highs and lows. I don't think this problem is likely to recur, but I realize I should have been honest about it.

I have an appointment with occ health in the near future - I think this is mainly going to be checking immunizations. I would like to mention it then. However there is a scary disclaimer on the questionnaire I filled in which says that if you withhold information on it then you can lose your job or not be offered a job. I wonder how likely this is to happen to me? I know it is important to be honest - I am also worried about losing a job I need.

I am aware this is a very specific question & You Are Not My Occupational Health Nurse or HR Person. But I would really welcome another perspective on on this - my mind is churning over it ATM. Thank you.

posted by anonymous to Work & Money (15 answers total)

Don't mention it. Reframe it in your mind not as self harm, but as the coping mechanism you employed at the time. Now you have other coping mechanisms. You are awesome for developing coping mechanisms. Don't throw a rock in the way of the good path you have made for yourself.
posted by Thella at 2:14 AM on December 22, 2015 [16 favorites]

Don't disclose. It's long ago, resolved, and not relevant. Most importantly, it is undocumented, so there is no way for them to find out except from you, so there is zero risk of a rescinded offer or termination if you just carry on without saying anything.
posted by DarlingBri at 2:43 AM on December 22, 2015 [11 favorites]

I've worked in occupational health and welfare in the public sector in the UK and it's honestly not intended to be there to catch you out or trip you up, it's there so that if something pops up that has happened before, the people managing you know about it. If you are unlikely to self-harm again, don't disclose it. If you still struggle with mental health issues, you can disclose in the appointment and ask whether the occupational health professional feel they should be documented or not.

In the job where I did welfare stuff, I did disclose mental health issues on my questionnaire (not to the level of detail where I mentioned past self-harm, just that I had taken antidepressants). I worried that meant they wouldn't offer me the job, but it didn't, and when I had a depressive spell it meant the welfare officer who preceded me was able to look at my form and say 'you've struggled with this before, what helped then?'.

Honestly, recruiting is a pain in the bum, and expensive, and you would have to be doing something a lot worse than not mentioning an issue from 10 years ago to get a job taken away and for them to start the recruitment process all over again. But I completely understand the anxiety over it, and how worrying it can be. Feel free to memail if you want more reassurance.
posted by theseldomseenkid at 3:02 AM on December 22, 2015 [3 favorites]

I work in the NHS and I really don't think this will cause any problems. If you were failing to disclose a major mental health issue that could have an impact on your ability to perform your work then I would come clean but for something like this? Please don't worry!
posted by ozgirlabroad at 3:23 AM on December 22, 2015

For whatever it's worth, I'm in my mid-30s now, and I did self-harm as an adolescent, and haven't done so since then. I think adolescent hormones combine with adolescent lack of brain development in a bad way sometimes, and doing it as a teenager doesn't actually reflect your risk of relapsing 10+ years later. Growing out of self-harm is a known thing--the tl;dr is that nearly 10% of teenagers do it, but that 90% of those stop by their twenties.

They care about managing risk and making accommodations. If you want to talk about this outside of the context of whether or not you're really at risk of relapse, it might make more sense to bring it up with a therapist or just a trusted friend, just to take some time to process everything you went through back then. Honesty doesn't mean you necessarily need to bare all your most vulnerable bits to strangers who don't have any legitimate use for the information; you don't have to feel bad for failing some kind of moral obligation, here. I don't think it's necessarily helpful to downplay that it really happened, but you're very unlikely to relapse.
posted by Sequence at 3:44 AM on December 22, 2015 [1 favorite]

I can't speak to the UK/NHS/legal side of this, but want to weigh in that I self-harmed for a brief while as a teenager and, though I have plenty of other mental health stuff that I would need to disclose for a job like this, it wouldn't have even crossed my mind to mention that. In my case, it was, as Thella says, a brief coping mechanism I passed through and not part of a larger pattern of behavior; if it's the same for you, I wouldn't worry about it.
posted by thetortoise at 3:44 AM on December 22, 2015

The key points here are:

1. You have been 10 years with no self harm.
2. It was never documented to begin with.
3. It would not be a positive factor in the application factor.
4. You're stating that you've no reason to believe it will happen again.

As someone who has hired hundreds of employees, and has a background in the mental health field, I put this squarely in the "nobody's business" box. Don't over think this, don't mention it to them.
posted by HuronBob at 4:52 AM on December 22, 2015 [8 favorites]

They aren't even supposed to ask health questions pre employment under the 2010 equality act...

https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/85013/employment-health-questions.pdf
posted by flink at 4:53 AM on December 22, 2015 [3 favorites]

And if you were self harming during a period of depression that lasted over 6 months then that was a period of disability and the law protects you, I believe. I personally wouldn't disclose.
posted by flink at 4:54 AM on December 22, 2015

It occurs to me that if they're expecting that everyone disclose mental health stuff from their teens, then probably lots of people are in violation of the policy, because I bet that a large percentage of people had mental health struggles that rose to the clinically diagnosable during their teens but did not receive treatment. Had a bad semester with difficulty going to school due to depression when you were sixteen? Cut yourself for a while at fourteen? Struggled with obsessive anxiety your senior year? All that stuff is super, super common and I cannot believe that they are interested in digging into it.

Plus, consider the media - "Perfectly capable employee sacked due to teenage depression for which they never saw a doctor" is precisely the kind of media attention that people don't want, because so many folks struggled with mental health stuff in their teens.
posted by Frowner at 6:06 AM on December 22, 2015

Sounds like none of their business to me. Agree w Frowner that they'd probably rather not know officially.
posted by STFUDonnie at 6:30 AM on December 22, 2015

I also vote not disclose, since you have dealt with it successfully. It's not relevant to the situation, in my opinion.

Recently I went through a medical eval and drug test for my new job. I answered honestly that I was on antidepressants because I am actively working with doctors on that issue at the moment. After the questionnaire I talked to a nurse in the clinic who went over my answers. She asked about it, and when I said I had been on the same dose for months, she said that was fine. She said she was mainly concerned if there had been some recent mental health episode or if I had recently started or changed antidepressants. I didn't ask a lot of questions but my take on it is, they want to know if you have an active health issue, physical or mental, that could affect your ability to do your job. And I don't think any of it is an absolute dealbreaker, either, I think it depends on the circumstance.
posted by cabingirl at 6:58 AM on December 22, 2015

I'm not in the UK, so I'm not familiar with the laws and regulations there (though, if they asked you to fill out the preemployment questionnaire before giving you a job offer, flink's link would indicate they shouldn't have asked you about it in the first place), but I think you may be letting your anxiety get in the way, here. I cannot see any reason why your current employer needs to know about risk behavior from your teenage years. If it were me, I would not disclose it in the upcoming appointment.
posted by jaguar at 7:10 AM on December 22, 2015

Also a UK answer here, they only need to know AFTER the job offer (as per the equality act) if you will be needing accommodations in order to successfully fulfill your role. That is not the case here and you shouldn't feel you should disclose. The equality act is exactly for this type of situation (among others) when you might have a health past that would make you seem like a not great hire... you really aren't obliged to disclose... but employers still try and ask.
posted by catspajammies at 10:01 AM on December 22, 2015

I'm a manager in the NHS, and I also have managed people with mental health difficulties in the NHS.

Occupational health want to know because they are paid (or contracted) to know about any health conditions or disabilities you have in order to advise the organisation about any ways your role needs to be adapted either to avoid aggravating a health issue or to provide reasonable adjustments for an ongoing disability.

Your employer cares about this for two reasons. Firstly, they do really care about your wellbeing (though sometimes in the NHS we forget to prioritise this in all the stress). Secondly, they want to minimise liability for causing your health to worsen and to make sure they comply with the law.

For these purposes, it's 100% legal for them to ask once you have already been offered the position (and you must have been otherwise they wouldn't be asking you to do occupational health screening). They could legally withdraw your offer as a result of not being able to clear you from an occupational health point of view, but this is likely to happen if you have an infectious disease where they cannot find a way to protect your patients, or if your disability would not allow you do to core parts of your job role, and this wasn't apparent at interview.

As a manager, I don't get told any details of your occupational health process unless you want to share them with me, I just get a certificate saying you are fit for the job role, or that you aren't, or that you are with these adjustments. If I really needed to I could then push back and say those adjustments aren't reasonable, at which point HR and the legal team get involved.

The key question for me is whether the issues you are thinking of disclosing are likely to come up again. It sounds to me very much like they won't, in which case I wouldn't disclose them. However, if you feel that they might, you need to disclose. If you disclose then they are much more likely to work with you if they do recur. In the worst case scenario if your issues recur and you haven't disclosed, but then it somehow comes out that you should have done then you could in theory be fired. I've never heard of this happening.

Read the question carefully though - most NHS occupational health people have changed their screens to ask if you have ever been diagnosed or treated for mental health conditions. If you haven't then you can answer no.

As a manager, I wouldn't care as it shouldn't affect your health at work!
posted by kadia_a at 11:46 AM on December 22, 2015