Mental Health, Employment, and the ADA

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Mental Health, Employment, and the ADA

An ADA Knowledge Translation Center Research Brief

Rob Gould

Mariana Torres Garcia

Sarah Parker Harris

Amy Satterthwaite

Gus Budiarta

Mark Harniss

Department of Disability and Human Development

University of Illinois at Chicago

2025

What is the ADA?

The Americans with Disabilities Act (ADA) is a civil rights law passed in 1990 (and amended in 2009) that prohibits discrimination against individuals with disabilities. The ADA provides a legal framework to challenge discrimination and ultimately aims to establish that individuals with disabilities have the same rights and opportunities as everyone else. It applies to all facets of public life including employment, state and local government, commercial facilities, and telecommunications. The ADA provides a basis for legal action, but measures are still needed to fulfill its larger goal: assure equality of opportunity, full participation, independent living, and economic self-sufficiency for all individuals with disabilities. (Parker Harris et al., 2019)

Mental Health and the ADA

Individuals with mental health conditions face a variety of challenges in the workplace that their coworkers do not, and these barriers affect their ability to have a positive, successful employment experience. As of 2020, 52.9 million people are estimated to have a mental health condition. This is approximately 21% of the population. Individuals with a mental health condition that that substantially limits one or more major life activity are protected under the jurisdiction of the ADA, however, the unemployment rate for individuals with psychiatric disabilities is 3-5 times higher than those without psychiatric disabilities (Chow & Cichocki, 2016).

Research About the ADA, Mental Health, and Employment

Disclosure and Accommodations

Disclosure of a mental health condition is extremely important for satisfactory work performance because an employer is not required to provide accommodations unless they are made aware of a disability and need for services. Deciding against disclosure of a psychiatric disability is associated with high levels of self-regulation, less available resources for work tasks, and leads to decreased employee engagement (Smith, 2019). In fact, in a study examining individuals with mental health conditions’ likelihood of disclosure, researchers found that clients who disclosed in their first job had significantly better work outcomes, including an average job tenure more than twice as long when compared to those who did not disclose, even with greater support needs. Additionally, disclosure was found to increase understanding and improve relationships at work, maintain productivity, create a positive work environment, and assist an individual to reach their full potential (DeTore, 2019).

Following disclosure, an employer’s attitude, emotional support, and ADA knowledge is pertinent (Dong et al., 2021). Both employers and employees require applicable knowledge to create a safe and supportive work environment and successful employment experience. Negative attitudes from others within workplace culture, as well as overt discrimination and previous refusal of support, result in a lower likelihood of individuals seeking and receiving accommodations (Dong et al., 2021). A study on accommodations in the workplace found that employees with mental health conditions should be educated and trained to navigate the system, manage stigma, and participate in groups related to self-confidence, self-advocacy, and accommodation requests for an optimal employment experience (Syma, 2019) and underdeveloped self-advocacy skills are also considered a barrier to requesting accommodations (Dong et al., 2021).

Stigma and Discrimination

Stigma and discrimination play a large role in the employment realm for individuals with mental health conditions. In interviews of human resource directors and employers regarding employees with depression, researchers found stereotypes, organizational burden, and normalization attitudes are associated with stigma at work (Florence & Marc, 2021). Additionally, a focus group study found that effects of stigma include increased chances of gossip and unpleasant jokes by coworkers, lower performance expectations of the employee, too great of a focus on what goes wrong at work and attribution of mistakes to the mental illness, and expectations that the discloser perform better than others to be seen and treated as equal (Brouwers et al., 2020).

Lack of Employer Support

Related to stigma and discrimination, lacking employer support serves as a barrier to employment for individuals with mental health conditions. For example, in a study of medical professionals’ ability to seek mental health services, physicians reported that employers directly and indirectly prevented complaints. Authority figures often had uncooperative, inflexible, and oppositional attitudes regarding their employees seeking services, as well as low tolerance for physicians expressing asserting their rights under the ADA (Lawson & Boyd, 2018).

Unsupportive work environments are associated with low job satisfaction for individuals with mental health conditions (Thisted et al., 2017). Many employers view provision of accommodations for their employees as a burden (Dong et al., 2021) and simply expect their employees to “work hard” despite negative consequences of excessive work hours on individuals with mental health conditions (Lawson & Boyd, 2018). Participants in a study analyzing accommodation requests report a history of judgment from employers and negative health disclosure experiences inhibit seeking accommodations in the future (Dong et al., 2021).

Additionally, requesting accommodations can be a lengthy process entangled in bureaucratic obstacles. The absence of a dedicated contact person for the accommodation process and a lack of feedback on case progress can create confusion and deter individuals with mental health conditions from seeking services. When an employer forces its employees to complete arduous paperwork and navigate a difficult system, individuals with psychiatric disabilities may be unable to access accommodations integral to maintaining employment (Dong et al., 2021).

Conclusion

The ADA is a complex piece of legislation that protects against the numerous barriers to employment that individuals with mental health conditions face, however, challenges still exist. Recent research has focused on 1) disclosure and accommodations, 2) stigma and discrimination, and 3) lack of employer support, each of which play a role in job performance and the overall employment experience and for individuals with disabilities.

References

• Brouwers, E. P. M., Joosen, M. C. W., van Zelst, C., & Van Weeghel, J. (2020). To Disclose or Not to Disclose: A Multi-stakeholder Focus Group Study on Mental Health Issues in the Work Environment. Journal of Occupational Rehabilitation, 30(1), 84-92. 10.1007/s10926-019-09848-z
• Chow, C. M., & Cichocki, B. (2016). Predictors of Job Accommodations for Individuals With Psychiatric Disabilities. American Rehabilitation Counseling Association. 10.1177/0034355215583057
• DeTore, N. R., Hintz, K., Khare, C., & Mueser, K. T. (2019). Disclosure of mental illness to prospective employers: Clinical, psychosocial, and work correlates in persons receiving supported employment. Psychiatry Research, 273, 312-317. 10.1016/j.psychres.2019.01.017
• Dong, S., Eto, O., & Spitz, C. (2021). Barriers and facilitators to requesting accommodation among individuals with psychiatric disabilities: A qualitative approach. Journal of Vocational Rehabilitation, 55, 1-12. 10.3233/JVR-211157
• Florence, Y., & Corbière, M. (2021). Implicit and Explicit Attitudes of Employers Toward Hiring People Who Have Experienced Depression. Journal of Occupational Rehabilitation, 31(4), 903-915. 10.1007/s10926-021-09977-4
• Lawson, N. D., & Boyd, J. W. (2018a). Do state physician health programs encourage referrals that violate the Americans with Disabilities Act? International Journal of Law and Psychiatry, 56, 65-70. 10.1016/j.ijlp.2017.12.004
• Parker Harris, S., Gould, R., Ojok, P., Fujiura, G., Jones, R., & Olmstead IV, A. (2014). Scoping Review of the Americans with Disabilities Act: What Research Exists, and Where do we go from Here? Disability Studies Quarterly, 34(3), 10. 10.18061/dsq.v34i3.3883
• Smith, R. W., Hulett, A. L., & Maples-Keller, J. L. (2019). Personality testing and the Americans With Disabilities Act: An applicant/employee perspective. Industrial and Organizational Psychology, 12(2), 167-171. 10.1017/iop.2019.33
• Substance Abuse and Mental Health Services Administration. (2021). Key substance use and mental health indicators in the United States: Results from the 2020 National Survey on Drug Use and Health (HHS Publication No. PEP21-07-01-003, NSDUH Series H-56). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration. Retrieved from https://www.samhsa.gov/data/
• Syma, C. (2018). Invisible disabilities: perceptions and barriers to reasonable accommodations in the workplace. Library Management, 4010.1108/LM-10-2017-0101
• Thisted, C. N., Nielsen, C. V., & Bjerrum, M. (2018). Work Participation Among Employees with Common Mental Disorders: A Meta-synthesis. Journal of Occupational Rehabilitation, 28(3), 452-464. 10.1007/s10926-017-9743-9

SUGGESTED CITATION: Gould, R., Torres Garcia, M., Parker Harris, S., Satterthwaite, A., Budiarta. G., & Harniss, M. (2025). Mental Health, Employment, and the ADA (pp.1-7). Chicago, IL: ADA National Network Knowledge Translation Center