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To Disclose or Not to Disclose: Mental Illness at Work

To Disclose or Not to Disclose: Mental Illness at WorkAbout half of the roughly 58 million Americans with mental illness are active in the workforce. Looking at the average company, you wouldn’t know it. Unless you work for an open-minded boss or a company that actively encourages people to come forward and get help, many workers keep their struggles with depression, anxiety, substance abuse and other issues silent for fear of losing their job, their credibility or opportunities to advance. Although nondisclosure is certainly understandable, there are risks and benefits to consider on both sides.

Safety in Silence

The majority of employees with mental illness exercise their right to remain silent (a right that ceases if you cannot safely and competently perform the basic requirements of your job). Why? In spite of growing awareness and anti-discrimination laws, the stigma of mental illness persists.

Most employers, like much of the public, still believe people with mental illness are dangerous, incompetent and untreatable, and become blind to their positive skills and attributes once a diagnosis is made public. Though they wouldn’t hesitate to accommodate a physical disability, such as confinement to a wheelchair or visual impairment, a survey by Shaw Trust showed that more than half of employers wouldn’t hire someone with a known mental disorder.

Although patently unfair and uninformed, the reality is you may face penalties for disclosure. In polls, people have reported being demoted, passed over for promotions and having job offers rescinded after disclosing a mental health disorder. Given these harsh realities, Bob Carolla, director of media relations for the National Alliance on Mental Illness, advises against disclosure to a manager whenever possible.

Even if you’d like to share your struggles, many companies don’t want to hear it. Employers may not want to get involved in your private health issues or have to act as counselors. Instead, they may refer employees to human resources, an employee assistance program, a free hotline or some other wellness initiative.

Rewards for the Brave of Heart

Just as some people feel empowered by keeping their mental health private, others find it liberating to be open with an employer. They take proactive steps to improve the situation for themselves and others and, in so doing, deliver a tough blow to the secrecy and shame that are prevalent among those with mental health issues. If they are rewarded with an employer who is supportive, disclosure can be highly therapeutic.

Another benefit of opening up: If you want to protect your legal right to any accommodations you might need under the Americans with Disabilities Act (ADA), you must disclose. The ADA requires employers to make reasonable accommodations for employees with disabilities. By staying silent, you run the risk of poor job performance being attributed to laziness or incompetence rather than a mental illness that can improve with treatment. If your employer terminates you, you have no redress. While only 14 percent of all charges filed under the ADA involve mental illness, you lose the possibility of protection if you choose not to disclose.

While many employers hold fast to old notions of mental illness, others recognize the incentives to encourage disclosure. Studies from the National Institute of Mental Health have shown that employers save money when they help valued employees get treatment. In addition to getting a more productive and loyal worker, they boost morale, reduce turnover and minimize their exposure to lawsuits. Most accommodations under the ADA, such as alterations in work schedules or job descriptions, allowing leave to see a therapist and training for supervisors, are inexpensive to implement (68 percent of all accommodations cost less than $500). Only by creating a supportive environment in which workers can be honest and get prompt treatment can disclosure be a win-win.

A Personal Choice

So should you tell your employer about your mental illness? The choice is yours, and should depend on the company you work for, the severity of your illness and your personal comfort level in sharing this information. Ask yourself: Does the company encourage flex time or offer employee assistance programs? Do other people in the company need similar accommodations? What is the personal toll of keeping your illness a secret?

If you decide to disclose, plan in advance what you will say and partner with your human resources department or an employee assistance program, if available, to negotiate any necessary accommodations. Ideally, you should disclose before serious problems arise that warrant termination. Be prepared to describe the skills and attributes that continue to qualify you for the job, as well as the limitations that may impact your performance. Have on hand a few resources your employer can refer to for more information about your condition.

If you decide not to disclose, make sure you get support elsewhere, whether through family, friends, a therapist or a support group. Monitor your symptoms, especially in times of stress, and follow through with your therapist’s recommendations for medications and other treatments.

Whether you disclose or not – and whether or not your employer supports you in managing your condition – it’s important to know that mental illness does not preclude career success. In fact, work can be central to restoring a sense of self-worth and stability to daily life. Many of the nation’s best and brightest have struggled with mental illness and gone on to enjoy rewarding and productive lives. With the right supports in place, you can, too.

To Disclose or Not to Disclose: Mental Illness at Work

David Sack, M.D.

Dr. David Sack is board certified in psychiatry, addiction psychiatry, and addiction medicine. As CMO of Elements Behavioral Health, he oversees a nationwide network of treatment centers including drug and alcohol rehab programs at The Ranch in Tennessee and The Right Step in Texas.

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APA Reference
Sack, D. (2017). To Disclose or Not to Disclose: Mental Illness at Work. Psych Central. Retrieved on April 3, 2020, from


Last updated: 22 Jun 2017
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