Only half of workers with “invisible” disabilities disclose them to their employers. Here’s why.

How often do workers disclose mental health or neurological disorders to their employers?

Nearly 50 million American adults live with a mental, emotional, or behavioral condition. In addition, almost 5.5 million adults have autism. The National Institutes of Health estimates that more than half of all Americans will be diagnosed with a mental health disorder at some point in their lives.

Though many professionals today have long-term psychological or neurological conditions, not everyone feels comfortable sharing this with their employers. About half of workers with conditions like bipolar or a learning disability have shared with a peer at work, and about half have disclosed their conditions to management or human resources. About a third said they’ve told no one at work.

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Most respondents (57 percent) said they would feel more comfortable disclosing to a colleague than management. This makes sense, given that managers and human resources professionals would have more power over the individual’s employment and career growth prospects. Another 24 percent of employees reported that there was no one at work with whom they would feel comfortable talking about their mental health. There is still room for improvement when it comes to supporting workers with mental health and neurological conditions.

Which employees share about their conditions and why? How were their disclosures received? Did any employees regret their decision to disclose? These are just a few questions we sought to address through our research.

People with neurological disabilities are more likely to disclose their conditions at work.

Neurological conditions generally involve structural, biochemical, or electrical abnormalities in the brain. Mental health conditions, on the other hand, are characterized by disordered thoughts, emotions, and behaviors that don’t always have an identifiable neurological source. Some examples of neurological conditions are epilepsy, learning disabilities, attention deficit disorder (ADD), and autism. Mental health conditions include depression, bipolar disorder, or schizophrenia.

There are a couple of possible explanations for why respondents with neurological disorders were more likely to disclose their conditions to their employers. For example, employees with neurological disabilities may experience less stigma than those with mental health conditions.

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Research indicates that conditions that are perceived as controllable are more stigmatized. Although many mental health conditions are associated with biochemical imbalances in the brain, misconceptions persist about the degree to which they can be controlled. Attitudes like “mind over matter” and “where there’s a will, there’s a way” underscore the idea that people can overcome mental health conditions with willpower and a positive mindset. Neurological conditions, on the other hand, are generally accepted as beyond one’s control.

Employees with neurological conditions may also be more likely to disclose due to experience. Neurological conditions are more likely to be present at birth or in childhood. Consequently, employees with autism or learning disabilities could have more experience with self-advocacy and be more accepting of the necessity of disclosure.

These possible explanations are supported by the results of our study, which showed that employees who disclosed did so from a place of strategic empowerment or necessity. In addition, those who disclosed were more likely to feel optimistic about their disclosure based on past experiences.

Most workers who disclosed conditions felt supported by their employers.

Nearly 75 percent of employees who chose to disclose their mental health or neurological condition felt supported. These employees reported positive outcomes, including feelings of relief, a more conducive work environment, and stronger relationships with colleagues. For example, one respondent said, “I felt relieved at disclosing my condition as we have found solutions to make certain aspects of my work easier on me.”

Not all who disclosed had positive experiences, however. About 10 percent of workers who shared their conditions with HR or management said their employers were unsupportive. Some regretted their choice and felt more vulnerable as a result. These employees reported negative fallouts, such as bullying, reduced opportunities, and changes in how colleagues perceived them. They worried about being treated differently or seen as incompetent due to their disclosure. In addition, some respondents felt forced to disclose to receive accommodations or legal protection. For example, one employee responded, “I felt that I was forced to [disclose] so I was able to have job protection under ADA.”

The Americans with Disabilities Act (ADA) is a federal law that prohibits discrimination against individuals with disabilities. The ADA requires employers to provide reasonable accommodations to employees with physical, emotional, and neurological conditions. The ADA also offers legal protection for these individuals, including protection from retaliation by employers or colleagues.

Only one in five employees requested workplace accommodations for their conditions.

Although the ADA entitles workers with mental health and neurological conditions to accommodations such as flexible work schedules, only one in five of the employees in the study requested accommodations.

Some respondents stated that their disability did not affect them at work, and therefore, accommodations were not needed. Others doubted that their employers would provide the accommodations they needed. The table below outlines some common examples of how respondents’ employers responded positively and negatively to their disclosures.

For workers: Should you disclose your mental health or neurological condition to your employer?

The decision to disclose a mental health or neurological condition to your employer is guided by multiple factors, including workplace culture and personal preference. If your work performance is impacted by your conditions, or if you need certain accommodations in order to complete your tasks, it may be a good idea to have an open conversation with your manager or HR department.

“When deciding to disclose, consider the timing and whom to tell. It might be most appropriate to share this information during a period of stability rather than during a crisis,” said Marcus Smith, a licensed clinical professional counselor and executive director in the behavioral health field. “Disclosing to a direct supervisor or human resources representative can ensure the conversation is handled with professionalism and confidentiality.”

Your employer may require documentation before providing accommodations. In many cases, a letter from a licensed health provider is sufficient. “One of the most common accommodations that workers with invisible conditions may request is a flexible work schedule,” said Dr. Michelle Dees, a board-certified psychiatrist. “Another accommodation could be modifications to the physical workspace, such as noise-canceling headphones or a quiet work area for someone with sensory processing issues. Other examples may include written instructions instead of verbal ones for someone with a learning disability.”

While the ADA requires employers to provide reasonable accommodations, they can refuse accommodations that result in undue hardship for the company. What constitutes reasonable versus undue hardship is open to interpretation, so before talking to your boss or human resources representative, think about which accommodation would be the most helpful and realistic.

When considering whether to disclose, remember that not all employers will be understanding and accommodating. “If your employer outright refuses to help or discriminates against you because of your condition, it would be best to seek legal advice or leave the job if necessary. There are many workplaces out there that value diversity and inclusivity, and will be more than willing to provide necessary accommodations for their employees,” explained Mary Lawrence, a licensed clinical social worker and clinical director at Acera Health.

For employers: How can you make your workplace safe and supportive for people with invisible disabilities?

Employees in the post-COVID era are increasingly seeking employers who prioritize mental health and work-life balance. “In 2020, mental health support went from a nice-to-have to a true business imperative,” write Harvard Business Review consultants Kelly Greenwood and Julia Anas. Companies that ignore this imperative do it at their own peril. Research shows that workplaces with employees with diverse physical and cognitive abilities have higher levels of employee engagement and company growth. Inclusivity is also a critical factor in employee retention.

One way to improve inclusivity is to create an environment that facilitates open communication. We asked employees with long-term conditions how their employers could create a safer and more supportive environment for disclosing neurological, psychological, and intellectual conditions. These were the top five suggestions from our respondents:

1. Enhance accommodations: Many respondents shared that employers should offer a wider variety of accommodations, including deadline extensions, additional sick leave, flexible schedules, and remote work options. Employers should discuss these accommodations with employees as part of the onboarding process.
2. Improve education programs: Employers need more effective and comprehensive education and awareness programs. For example, survey respondents suggested implementing comprehensive training for employees and management on various mental health and neurological conditions to foster understanding and reduce stigma.
3. Increase support: Employers need to prioritize the mental well-being of their employees. This could include having mental health professionals on staff, providing paid mental health days, and establishing and publicizing nondiscrimination policies. Other supportive programs include free counseling, time off for therapy appointments, and employee assistance programs.
4. Prioritize confidentiality and nonretaliation: To facilitate disclosure, employers must ensure that their employees’ health information will be kept confidential. Employers cannot share information about an employee’s condition without their explicit consent. In addition, employers must protect disclosing employees from negative consequences. This includes taking appropriate action if employees report harassment or discrimination due to their condition.
5. Implement inclusive policies and practices: Employers should establish workplace policies that recognize and accommodate the unique needs of individuals with mental health and neurological conditions. For example, having a dedicated human resources representative for disability services simplifies the process of requesting accommodations, as does having clear procedures.

In addition to the above, experts recommend thinking of inclusivity as a continuous process rather than a one-and-done project. Think of ways to consistently recruit and support employees with diverse perspectives and backgrounds. Hire leaders who value inclusion and diversity. Above all, keep an open mind and a willingness to listen.

Our data

In February 2024, business.com researchers conducted an online poll of 978 people employed full-time (75 percent) or part-time (25 percent). To participate, workers had to identify one of the following long-term health conditions: autism spectrum disorder, a neurological disability, a psychological disorder or mental health condition, or an intellectual or learning disability. No personal identifying information was collected. Forty-four percent of these workers also had physical disabilities, hearing or vision impairments. Sixty-eight percent of respondents were women, 31 percent were men, and fewer than one percent did not disclose their gender. Five percent of respondents were Asian, 13 percent were black, 70 percent were white, nine percent were of multiple ethnicities, and about four percent identified with another ethnicity or chose not to report. Participants ranged in age from 19 to 76, with a median age of 34.