My clients often ask me about whether to disclose their mental health and/or substance use issues at work. They worry about discrimination and wonder whether they might be protected under the Americans with Disabilities Act (ADA). While every person and situation is different, there are some issues everyone with a significant mental health or substance use history should think about.

First, consider what I call “Emy’s Big Rule of Oopsy Daisy”: You can always say something later; you can never UNsay it. So when in doubt, don’t say anything. I recommend that before you speak with your employer, talk to your treatment team, supports, and even seek legal advice if necessary (see links at the end of this post). (There is one exception where you may want to speak up sooner rather than later, to be discussed below.)

Second, if you do choose to disclose, start with disclosing the minimum information to the fewest people. Some people, like managers and HR, are required to keep it confidential, but once out, information can spread faster than a cold in a daycare.

As I hope you know and have taken to heart, having a mental health issue or substance use problem is not your fault and absolutely nothing to be ashamed of. Got that? Repeat after me: “I have nothing to be ashamed of! Nothing!” Unfortunately, however, these issues are still quite misunderstood, and stigma runs rampant (this topic will show up in future blog posts), so disclosure opens you up to certain risks. The workplace may not be the place to fight that battle. Unless you really know what you are getting into and make a well-considered choice, opening yourself up to that sort of vulnerability on the job can be risky.

So given this, why disclose at all?

Well, sometimes, the fact of your mental health and/or substance use condition is going to come up anyway. In those situations, disclosure may be to your benefit. First, disclosing can get you accommodations that may help you to perform your job. Second, it can protect you from legal discrimination, including being fired.

This is where the ADA comes in. The Americans with Disabilities Act (ADA) prevents discrimination against people with disabilities, a category that was amended in 2008 to add people with mental health and substance use-related issues.

Does my mental health or substance use diagnose qualify me as having a disability under the ADA?

Maybe. The ADA does not list diagnoses but instead looks at functional impairment, history of impairment, or “being regarded as having such an impairment” (that one’s weird, right?). For more information regarding mental health and disability, check out this Factsheet about the ADA and mental health; for the more complicated substance abuse definitions, check out Substance Abuse Under the ADA and this Factsheet on the ADA and addiction.

Under the ADA, if you have a qualifying disability, you are entitled to “reasonable accommodations” to help you do your job. For example, if you have bipolar disorder and work a job with constantly changing round-the-clock shifts, it would be reasonable to request the accommodation of working only certain shifts so that you can get consistent sleep. If you are recovering from an opioid use disorder and need to go get your meds at certain times, you might request a schedule to accommodate that. The Job Accommodation Network (JAN) has a whole database of accommodations with creative solutions for all sorts of symptoms and issues that might come up–it’s worth checking out. So disclosing your disability can get you accommodations to help you do your job. 

The second reason you may want to disclose is to prevent discrimination or possible firing if you are having work-related problems that stem from your illness. The key here, though, is that you are only protected AFTER you disclose your disability to your employer. If you start missing work due to symptoms of major depression, for example, and only disclose your disability AFTER you get into trouble, your employer doesn’t have to take back any disciplinary action. So it is really important that you disclose BEFORE your symptoms start to get so bad that you are being written up or fired (this is that “exception” mentioned above).

As one would expect, there’s some “small print” regarding the ADA. One is pretty reasonable: you need to fully be able to do the job and meet productivity expectations (with or without accommodations) in order to be covered. The other is that the workplace itself needs to have a minimum number of employees to even be required to follow ADA guidelines (15 in a private business). So if you work for a tiny company, you may be out of luck.

If you choose to disclose, I recommend doing your homework on how to go about it. The National Alliance on Mental Illness (NAMI) and JAN: Disability Disclosure offer some tips on how to go about disclosing and to whom.

So these are the main issues around disclosure in the workplace. My overall advice, based on years of working with clients, is Emy’s Rule of Oopsy Daisy: when in doubt, don’t tell. You can always say something later; you can never UNsay it. If you do choose to disclose, share the minimum information with the fewest people.

The reasons to disclose mental health and/or substance issues at work involve protections under the ADA (if you and your situation qualify), and are especially helpful regarding accommodations, and protecting you should your symptoms be getting in the way of your job performance (but you need to disclose BEFORE it becomes a major problem).

Everyone’s situation is different; this is not legal advice. For further information, check out JANNAMI, or contact your local ADA Center toll-free at 1-800-949-4232.

 

For further reading, check out this fabulous article from University of Massachusetts Medical School.