Disclosing non-visible disabilities in educational workplaces: a scoping review

Abstract Introduction a sizable proportion of the working population has a disability that is not visible. Many choose not to disclose this at work, particularly in educational workplaces where disability is underrepresented. A better understanding of the barriers and facilitators to disclosure is needed. Sources of data this scoping review is based on studies published in scientific journals. Areas of agreement the reasons underpinning disclosure are complex and emotive-in-nature. Both individual and socio-environmental factors influence this decision and process. Stigma and perceived discrimination are key barriers to disclosure and, conversely, personal agency a key enabler. Areas of controversy there is a growing trend of non-visible disabilities within the workplace, largely because of the increasing prevalence of mental ill health. Understanding the barriers and facilitators to disability disclosure is key to the provision of appropriate workplace support. Growing points our review shows that both individual and socio-environmental factors influence choice and experience of disclosure of non-visible disabilities in educational workplaces. Ongoing stigma and ableism in the workplace, in particular, strongly influence disabled employees’ decision to disclose (or not), to whom, how and when. Areas timely for developing research developing workplace interventions that can support employees with non-visible disabilities and key stakeholders during and beyond reasonable adjustments is imperative.

Introduction: a sizable proportion of the working population has a disability that is not visible.Many choose not to disclose this at work, particularly in educational workplaces where disability is underrepresented.A better understanding of the barriers and facilitators to disclosure is needed.
Sources of data: this scoping review is based on studies published in scientific journals.
Areas of agreement: the reasons underpinning disclosure are complex and emotive-in-nature.Both individual and socio-environmental factors influence this decision and process.Stigma and perceived discrimination are key barriers to disclosure and, conversely, personal agency a key enabler.
Areas of controversy: there is a growing trend of non-visible disabilities within the workplace, largely because of the increasing prevalence of mental ill health.Understanding the barriers and facilitators to disability disclosure is key to the provision of appropriate workplace support.
Growing points: our review shows that both individual and socioenvironmental factors influence choice and experience of disclosure of nonvisible disabilities in educational workplaces.Ongoing stigma and ableism in the workplace, in particular, strongly influence disabled employees' decision to disclose (or not), to whom, how and when.

Introduction
People with disabilities are one of the world's largest minority groups. 1 Unfortunately, many continue to be overlooked, including in workplace settings. 2In the UK, one in five working-age adults report a disability, chronic health condition or neurodivergence. 3Over the last decade, an increasing proportion of working-age adults report having a long-term health condition or disability.This upward trend is understood to be driven by increasing rates of 'nonvisible' disabilities (e.g.mental health conditions). 3,4on-visible disabilities refer to physical, mental or neurological conditions that pose challenges to an individual's movement, senses or activities, but may not be immediately or obviously observed. 4xamples include mental health conditions, autism, sensory processing difficulties, cognitive impairment (e.g.dementia and traumatic brain injury), 'nonvisible' physical health conditions (e.g.chronic pain, diabetes), hearing loss and low or restricted vision.Various terms have been used to describe this broad category of disabilities (including, hidden, invisible and non-visible disability).In the context of this study, we use the term non-visible disability in line with UK government guidance. 5isabled people, including those with non-visible disability, continue to face significant and diverse barriers to full participation in employment and inclusion at work. 4 ,6-8 The disability employment gap (i.e. the difference in employment rates between disabled and non-disabled people) is pervasive and exists globally. 6In the UK, for example, 52.7% of disabled people were employed in 2021, compared with 81% of non-disabled people. 3There exists a 'disability disclosure gap' in the workplace, which is also sizable and, for many, a significant barrier to the promotion of their health, inclusion at work and quality of life. 9A 2017 survey conducted in the USA observed that 30% of employees reported a disability, chronic health condition or neurodivergence, but only 3.2% disclosed this to their employer. 10esearch from the UK shows that around 40% 11 ,12 of disabled workers felt uncomfortable discussing their disability at work, reporting concerns regarding career progression and anticipated stigma. 11raditionally, much of the literature on employment and disability has not focused on the disclosure of non-visible disability to employers. 13Particularly when employees are seeking workplace accommodations and adaptations. 13However, growing evidence highlights the personal and emotive nature of disability disclosure in the workplace, and there is an increased understanding of the personal and system-level barriers and facilitators.This knowledge demonstrates the importance of employees' personal experience and impact of this on the disclosure process.Existing reviews have explored disclosure considerations, although this has typically been focused on specific conditions (e.g.mental ill health 14 ) rather than across the wider category of non-visible disabilities.This approach misses shared experiences across non-visible disabilities and health conditions.The current review will help to address this gap in knowledge.
The education sector has been selected, as it is characterized by an underrepresentation of disabled employees as compared with other sectors.In the UK, 23% of working age people reported a disability. 15In contrast, only 6.3% of academics and 8.5% of non-academics, in 2021/2022, declared having a disability. 16The School Workforce Census in 2023 found that disability data were not obtained for over half of teachers (53%), with reporting rates found to be substantially lower than other protected characteristics (e.g.gender and age). 17Similar trends have been found internationally for education (e.g.Canada 18 and Australia 19 ).
Therefore, we focus our review on educational workplaces to explore disabled employees' experiences, within an industry characterized by challenges surrounding inclusion and representation.Empirically, this review will contribute to our understanding of the barriers and facilitators to disability disclosure at work surrounding non-visible conditions uniquely and how these are experienced by disabled employees in educational workplaces.

Research questions/objectives
The research question is 'What are the views and experiences of employees relating to non-visible disability disclosure in education workplaces?'.The study objectives are: • To explore the approaches and rationales of disability disclosure decisions.• To explore any perceived barriers and enablers of non-visible disability disclosure.• To explore disabled employees' experiences during and following disclosure of a non-visible disability.

Methods
A scoping review was undertaken to map the literature on staff disability disclosure in education workplaces.The review is guided by scoping review aims and methodology as described by Arskey and O'Malley. 20Findings will identify any gaps in the literature and support the summary and dissemination of research to policymakers, employers and employees in education settings.

Search strategy
Searches were conducted in seven health and education databases including: MEDLINE, ERIC, PsycINFO, APA PsycArticles Full Text, Scopus, Embase and Educational Administration Abstracts.Google Scholar was also searched for any additional articles that may not have been listed in the selected databases.Research terms and strategies were established by the study team and refined with support from a university information specialist.Included articles were published between 2003 and 2023.The search language was limited to English.Further details and searching hits can be found in Appendix 1.

Study selection
The studies were selected based on inclusion and exclusion criteria determined a priori.Relevant articles were focused on the disclosure of non-visible disabilities as defined by the UK Parliament, 4 where disclosure was the focus of the paper.

Collating, summarizing and reporting results
Scoping reviews establish a thematic construction from the extant literature in a narrative and descriptive manner. 22A narrative review was conducted for knowledge synthesis.This approach enables the opportunity to explore relationships in the data and compare findings using different methodologies.
The scoping review objectives guided the analysis of the included papers, focusing on several key aspects related to invisible disability disclosure.These aspects included formal and informal methods of disclosing non-visible disabilities, examining both positive and negative experiences associated with disability disclosure, identifying facilitators and barriers influencing the disclosure process and understanding the reasons behind individuals' decisions to either disclose or not disclose their disabilities.

Study inclusion
The initial search yielded a total of 2531 records from various databases, and an additional 106 records were identified through Google Scholar and reference lists, bringing the combined total to 2637 records.After removing duplicates, 1899 unique records remained for further assessment.The title and abstract review were conducted on all 1899 records, and 1816 were excluded during this stage with reasons specified.The primary reasons for exclusion were non-relevant content with disability disclosure (1494 records), studies focusing on the student population (162 records) and studies not related to education workplaces (148 records).Additionally, 12 studies were excluded as it focused on individuals with visible disabilities.
Following the title and abstract review, 83 records were selected for full-text review.During this phase, 66 records were excluded based on predetermined criteria.The main reasons for exclusion at this stage were studies not related to education workplaces (28 records), studies focusing on the student population (17 records), studies focusing on the prevalence, 7 studies not related to disability disclosure. 6Furthermore, seven studies one review focused on visible disabilities were excluded.
Ultimately, 17 studies met the inclusion criteria and included in the scoping review.Figure 1 represents the flow of screening process.

Characteristics of included studies
The included studies were conducted across five countries: eight studies were from the USA, 13 ,23-29 four from the UK, 30 -33 three from Canada, [34][35][36] one from New Zealand 37 and one from Germany. 38The publication years of the studies ranged from 2009 to 2023.Detailed characteristics of each study can be found in Table 1.

Approaches and rationales of non-visible disability disclosure
Across the 17 studies, 12 explored the approaches used by employees in educational workplaces to The study advocates for a more holistic approach to rebuilding higher education to support access for disabled individuals.
7][28][29]32,33,35,36 Observed across the studies, the employed approaches used for disability disclosure were diverse, included a variety of stakeholders (line managers, co-workers, students and their parents) and did not always include interacting with established human resource (HR) and/or in-house occupational health (OH) systems.We categorized these approaches as either formal 13,[24][25][26][27][28]35 or informal 13,23,26,29,[32][33][34][35][36] forms of disability disclosure at work.We define a 'formal' disclosure approach as one that refers to explicitly informing the employer or institution about one's disability through official channels or documentation. For employees in ducational workplace settings, this process was characterized by following a formal HR procedure 8 and a formal meeting with management 13,25,26,28,35 to discuss workplace accommodations and adaptations.In contrast, we define informal disclosure as sharing information about one's disability outside of formal HR/OH systems.For employees in educational workplace settings, this disclosure process was characterized by selectively revealing their disabilities to trusted colleagues, students and their parents.13,23,26,27,29,32,35,36 Ten studies explore the rationales for disclosure amongst employees in educational workplace settings.13,[24][25][26][27][28][29]32,33,35 The rationale discussed were multifaceted (influenced by both current and past experiences) and often characterized by instrumentaland/or emotional-directed coping strategies.The main reported reason for formally disclosing a disability to an employer was to access reasonable workplace accommodations.13,[24][25][26]35 Across both formal and informal forms of disclosure, the other rationales discussed for disability disclosure by employees in education workplaces were the need/want for peer and emotional support 13 ,24,26,28,32 at work, and the desire to raise awareness and promote increased inclusion within and across their work environment.13,25,27,[33][34][35] These stated rationales were characterized across formal and informal forms of disclosure.This suggests, perhaps, that in educational workplaces, employees' disclosure of non-visible disability (within and outside HR systems) is important beyond just accessing reasonable adjustments and securing instrumental needs.It may also yield psychological value through increased opportunities for emotional support, and positive feelings associated with being agents of positive change.
A stated rationale, unique to formal disclosure, was reporting a past positive experience in disclosing their disability in the workplace. 35This highlights the importance of considering employees culmination of experiences in the workplace, both past and present, and how this may influence decision-making process and employee behaviours regarding disability disclosure.Potentially unique to employees in educational workplace settings-who chose not to formally declare their disability to their employer-was the nature of the disability itself, 23,29 and their perceptions regarding its attached social stigma and anticipated workplace discrimination post-disclosure.
Among those studies that explored positive experiences 13,23,25,27,30,33,35,36,38 during or following disclosure, they were-typically-characterized by disabled employees feeling as though their instrumental and emotional needs were actively considered and addressed by their workplace.This included employees in educational workplace settings considering that their act of disclosure resulted in workplace accommodations and adaptations that met their expressed needs, 13,23,27,30,33 and were implemented in a timely and responsive manner with the necessary resources. 13,35Disabled employees who felt they received support and understanding from their supervisor and colleagues 13,23,27,33 expressed this as a positive experience.In the study by Wood and Happe, 30 some (but not all) participants who disclosed their autism at work felt as though they received better understanding and appreciation from the school community and families, leading to a more autism-friendly and accommodating work environment.In England's 27 (2002) autobiographical study, a professor reported positive experiences following formal disclosure because of support obtained from colleagues, and the instrumental support from a professional mentor in obtaining requested reasonable adjustments and gaining emotional support.Price et al. conducted a survey of college and university staff with a mental health condition across the USA.They found participants reported varied levels of support from their managers and colleagues with a generally positive reception of their disclosure. 13A higher number of people reported positive experiences with colleagues and chairs, whereas a lower number reported positive experiences with HRs. 13 Hiscock and Leigh 33 found support after dyslexia disclosure encompassed positive colleagues and student feedback including their understanding and perceptions towards teaching with dyslexia.This positive feedback led to an inclusive and supportive working environment.These positive experiences amongst disabled employees in educational workplace settings appear to be shaped by two key considerations.First, the importance of workplace accommodations and reasonable adjustments tailored to the unique needs and expressed wishes of the disabled employee, which are enacted upon by the organization in a purposeful, timely and responsive manner.Second, the importance of also considering what job resources (e.g.mentoring and coaching) and forms of social support (e.g.peer support network, sensitive and informed line managers) can support the disabled employee-during and following-their disability disclosure.
Many of the reviewed studies explored negative experiences 24,30,32,34,35 for disabled employees during and beyond disability disclosure.These negative experiences were characterized by challenges in accessing and obtaining requested reasonable adjustments. 24,35In particular, some of the key challenges highlighted included a perceived reluctance of supervisors or management to provide requested workplace accommodations (particularly changes in working patterns and hours 35 ), with lengthy waits for adjustments that were not necessarily aligned with what had been agreed. 24In Pionke's 24 case study the employee felt the wider context of the implemented workplace accommodation (e.g.access to an enclosed office) was not considered.Whilst they were provided with an enclosed office, it was physically located away from her department, resulting in decreased access to social and professional networks and, in turn, increased feelings of social isolation.In this same case, the disabled employee felt disenfranchised and 'othered' by management concealing her disability without her consent following her disclosure.A common experience observed across reviewed studies for disabled employees in educational workplace settings was encountering stigma and perceived discrimination following their disclosure from both colleagues 34 and managers. 30,32Often leading to feelings of invalidation 30,32 and 'othering', 24 feeling insecure or replaceable in their professional roles 30,32 or being fearful or risk to their career or reputation by disclosing. 34rceived barriers and enablers of invisible disability disclosure 'Enablers' of disability disclosure varied amongst employees with non-visible disabilities.The reasons for disclosure were often influenced by their perceived work environment, support systems and personal goals.Some disabled employees in the reviewed studies chose to disclose to raise awareness about disability issues and to advocate for better conditions for individuals with disabilities in the workplace. 13,26,27,34,35Believing that visibility and openness regarding non-visible disabilities may help to generate a more inclusive and supportive workplace culture.Disabled employees who felt supported, respected and secure in their jobs were more likely to disclose. 13,23,26,30,32,35,36A positive and inclusive work environment encouraged employees to feel comfortable sharing information about their disabilities. 13,23,30,32Some participants selectively disclosed their disabilities to a few co-workers they trusted and felt safe with. 35Selective disclosure allowed them to seek support and assistance without exposing themselves to potential risks that were perceived to be associated with broader or formal forms of disclosure.For some, disclosing their disability was a coping strategy to ensure that colleagues would understand their needs and potential challenges better, reducing misunderstandings or negative judgements. 13,23,26,32,33,35,37,38In several studies, participants felt sharing their diagnosis or health-related experiences with colleagues, students and parents would provide positive role models for others. 30 ,34They hoped to break stereotypes about non-visible disabilities and show that success and disability are not mutually exclusive.In a few studies, 25,26 participants also believed that disclosing their disability helped reduce stigma related to their disability and build trust and empathy with institution, 25,26 HRs. 26 Price's 13 study suggested that certain and clear disability disclosure processes may encourage faculty members to share their mental health disabilities with, particularly, HRs and managers.In certain cases, participants chose to disclose their disabilities, particularly their neurodiversity (e.g.autism) and specific learning differences (e.g.dyslexia), only to students and their families rather than their employer. 29,30This disclosure was driven by a desire to promote a deeper, more positive understanding of neurodiversity and specific learning differences, with the intention that this would assist others in similar situations.Job status also impacted on disability disclosure, since those with greater status and seniority felt more secure about their job and, therefore, more confident to disclose a disability. 32Barriers' to disability disclosure were prevalent and, broadly, influenced by individuals' want to keep their disabilities hidden because of fear of stigma, discrimination and ableism.One of the primary barriers to disability disclosure was the fear of negative consequences to career or professional reputation because of anticipated stigma and discrimination.13,25,26,35,36,38 Across the reviewed studies disabled employees reported being fearful of losing their job or being passed over for promotion 25 ,28,30,32,35 or fear of losing status and authority 29 as key barriers to disclosing.For example, Horton and Tucker 32 found that early career academics and researchers expressed insecurity and feelings of replaceability within their departments and institutions.
Fear of isolation in the working environment was also another reason to be reluctant to disclose, which may result from poorly implemented reasonable adjustments 3 or socially by feeling 'othered' through or by this declaration process. 24,36In several studies, the complexity, length and cumbersome nature of access reasonable adjustments and workplace accommodations were a key barrier to disability disclosure. 23,24,31,32,35,36,38In one study amongst librarians, many were reluctant-in particular-that gaining access to accommodation requests was contingent on the individual manager, with some reluctant to implement any discussed adjustments. 35Previous negative experiences with disability disclosure 29 ,31,35 , competitive working environments, 32 the fear of being seen to be taking advantage of system 23 and the fear of being viewed as incompetent 25,31,35,36,38 were other reasons for not disclosing disabilities in education workplaces.In a case study, 37 the participant did not see a pressing need to disclose his disability.They felt that their condition was not debilitating enough to warrant mentioning and preferred to manage their condition privately without seeking workplace accommodations.Maintaining personal privacy and boundaries was reported as reasons for not disclosing. 26,38Several studies 13 ,31,38 found that employees in education settings found it easier to disclose and discuss a physical disability that was visually apparent, as opposed to disabilities that were not visible to others.

Discussion and conclusion
The reasons underpinning disclosure are complex and emotive-in-nature.In educational workplace settings, there exists a disability disclosure gap. 16As non-visible disabilities can often be concealed by employees, the process of declaring and discussing this individual experience or health condition is highly sensitive 39 and, in turn, poses unique challenges to organizational leadership. 9For example, this impacts how employing organizations support open discussions surrounding inclusion, which, in turn, impairs opportunities to providing practical support regarding reasonable adjustments tailored to individual wants and needs. 9There is a growing trend of non-visible disabilities within the workplace.It is imperative, therefore, to understand the barriers and facilitators to disability disclosure within workplace settings.Particularly, in industries where disability is under-represented.This scoping review highlights the complex nature of disclosure of a non-visible disability within educational workplace settings.1][42][43] Our review observes both individual and socio-environmental factors appear to influence this decision and process.Ongoing stigma and ableism in the workplace strongly underpin disabled employees' decision to disclose (or not), to whom, how and when.These are prevalent themes observed across conditions, 41 as well as across sectors and workplaces 44 .
We conclude that the disability disclosure dilemma-that is the decision to disclose either formally to the organization through HRs systems or management or informally to co-workers-appears to include a personal process of risk evaluation shaped by ableism considerations.This observation is in line with the emerging literature, 40,43 which suggests that the decision to disclose includes careful consideration and balancing of perceived risks and costs in comparison to gains and benefits. 45hen gains and benefits (e.g.increased support and understanding, access to reasonable adjustments) appear to outweigh the potential risks and costs (e.g.feeling undervalued or insecure in their job or position) to the disabled employee, it is likely this will facilitate and enable disclosure (either formally or informally).
This process of risk evaluation is dynamic and influenced by both past experiences, but also by the changes in the individual's role in the organization (e.g.becoming more senior) or health condition (e.g.fluctuations or increased severity), changes in management perceptions and practices (e.g.line manager sensitivity training), evolving working conditions and culture (e.g.flexible work schedules) and availability of support networks (e.g.disabled staff network).Efforts in the education sector to facilitate an inclusive environment for individuals with a non-visible disability have typically focused on students, rather staff. 2,46Therefore, to ensure educational workplaces are inclusive and supportive of disability requires initiatives and supports that target both students and staff collectively and equitably.Both healthcare professionals and employers can play an important role in tackling low levels of disability disclosure in education settings (particularly those with non-visible disabilities) and supporting those who choose to disclose and seek workplace Recommendations are outlined in Fig. 2.

Fig. 1
Fig. 1 Search results and study selection.

Table 1
Characteristics of the included studies