‘A Menu Would be Sweet’: A Framework Analysis of the Disclosure and Supports Experiences of Higher Education Students with Neurodivergent or Mental-health Conditions

Abstract

Background

Neurodivergent students experience less success than non-neurodivergent students and underutilise available supports, as do students with mental-health conditions (MHCs). While autistic students’ disclosure and supports experiences have been examined, less is known about students with other/multiple neurodivergent conditions and non-neurodivergent students with MHCs.

Method

We captured diagnoses, disclosure experiences, and supports used and wanted from 131 neurodivergent and 41 non-neurodivergent Australasian students via a mixed-methods survey. We compared groups quantitatively, and qualitatively using framework analysis.

Results

More neurodivergent students disclosed to their institutions (47–19%), accessed supports (55–38%), and used more supports than non-neurodivergent students with current MHCs. Only neurodivergent students endorsed themes of ‘shame’, ‘identity and transparency’, ‘diagnosed during higher education’, and ‘why discontinued’, while more non-neurodivergent students queried ‘is disclosure worth it’, having ‘found ways to compensate’. Neurodivergent students contributed five times as many comments, and the majority wanted supports led by neurodivergent mentors/facilitators.

Conclusion

Neurodivergent students reported more experiences of stigma and discrimination, including from peers, which may impact whether and where they seek support. Disclosure-related processes and costs impacted differently, yet both groups wanted more kindness and flexibility from educators. Registration processes need simplification, and new supports must be co-designed to improve student outcomes.

Lay Abstract

Students with neurodivergent or mental-health conditions (MHCs) are less likely to complete higher education than non-neurodivergent students. Success for students with disabilities is associated with accessing supports, yet many do not use them. Research into disclosure and support experiences has focused primarily on autistic students already registered for supports. Knowing more about neurodivergent students’ experiences more broadly, including those who have not disclosed, may help institutions improve supports. We surveyed neurodivergent students and non-neurodivergent students with MHCs in Australia or New Zealand. Over half of neurodivergent students accessed supports compared to two-fifths of non-neurodivergent students with MHCs, but there were no group differences in disclosure timing, helpfulness, and future intentions. Both groups mentioned themes of practical and emotional support, advocacy, stigma and discrimination, kindness, and flexibility. Neurodivergent students used more supports and shared five times as many comments about their experiences. They also reported unique challenges, such as stigma from peers, feelings of shame, and lack of support contributing to dropping out of their courses. Neurodivergent students were more likely to seek support from staff than peers, and found the registration process harder, sometimes due to unequal documentation requirements. Many of the supports neurodivergent students and those with MHCs want are affordable, easy to implement, and could benefit many students. Easier registration processes, more peer-connection opportunities and staff training on neurodiversity, and mental health and disability inclusion are required. Future supports should be co-designed to ensure diverse student experiences and needs are addressed.

Keywords

neurodivergent students higher education disclosure supports mental-health conditions autism ADHD AuDHD (autism and ADHD)framework analysis

Academic success in higher education (HE) for students with disabilities is associated with accessing supports (Moriña & Biagiotti, 2022; Newman et al., 2021), but usage remains low among these students (Lyman et al., 2016; Newman & Madaus, 2015). Enrolments are increasing for students with disabilities (Cadby et al., 2024; National Center for Education Statistics, 2019), including neurodivergent¹ students. The neurodivergent literature largely focuses on autistic students, identifying low rates of supports use (Anderson et al., 2018; Ballantine et al., 2023; McPeake et al., 2023; Nelson et al., 2023) across a range of academic, assessment, and non-academic supports (Anderson et al., 2017; Cage et al., 2020; Lowinger, 2019; Pinder-Amaker, 2014). Research into support use by students with attention deficit/hyperactivity disorder (ADHD) is emerging, although it tends to focus on interventions (e.g. cognitive behavioural therapy mentoring) (Anastopoulos & King, 2015) or student characteristics (Clince et al., 2016; DuPaul et al., 2017; Elias & White, 2018) rather than support usage or experiences. Given increasing enrolments and shared transdiagnostic features among neurodivergent students (Michelini et al., 2024), the scant data on support experiences across a range of neurodivergent conditions is concerning.

Students with mental-health conditions (MHCs) are another growing cohort in tertiary education (Lipson et al., 2019; Orygen, 2017). A recent meta-analysis found a pooled depression prevalence of 25% among undergraduate students internationally (Sheldon et al., 2021), while more than 60% of college students in the United States met criteria for an MHC in 2020–2021, including 35% with anxiety (Lipson et al., 2022). Despite students with MHCs being eligible for supports, low support use is reported (Huang et al., 2018; Kennedy et al., 2025a; Oswalt et al., 2020). Furthermore, the intersection between neurodivergence and MHCs is increasingly recognised, with 72–81% of neurodivergent students reporting a current MHC (Accardo et al., 2024; Kennedy et al., 2025b). Such high rates of MHCs among neurodivergent students could lead institutions to assume existing supports will suit both neurodivergent and non-neurodivergent students. However, whether non-neurodivergent students with MHCs consider different factors to neurodivergent students when making disclosure and support-access decisions is unknown; a better understanding of potential differences could help improve institutions’ support offerings.

Despite growing enrolments of students with neurodivergent conditions or MHCs, they experience lower completion rates compared to students without neurodivergence or MHCs (Daffner et al., 2022; Eisenberg et al., 2009; Lee et al., 2015; Salzer, 2012). Recent large-scale Australian studies found students with disabilities or MHCs were 4–8% more likely to drop out than students without these conditions (Li & Carroll, 2020; Zając et al., 2024), while a large Dutch study found completion rates for autistic bachelor-degree students were lower than students with other or no health conditions (Bakker et al., 2023). That both neurodivergent students and those with MHCs face low completion rates and support access may be related to the invisible nature of their challenges. Students with invisible disabilities represent a hidden population, whereby underreporting may lead institutions to assume there are fewer students eligible for supports than in actuality (Grimes et al., 2019; Vincent & Ralston, 2023).

To access HE supports, students generally need to register and disclose their condition to their institution's disability support services. However, low disclosure rates of 16–50% have been reported in eligible HE students with disabilities, autism, ADHD, specific learning disorders (SpLD), motor disorders, and MHCs (Barnard-Brak & Kudesey, 2022; Evans et al., 2023; Gruttadaro & Crudo, 2012; Kennedy et al., 2025a; Newman & Madaus, 2015). Reasons reported for not disclosing include wanting to try on one's own (Cai & Richdale, 2016), concerns about how educators will react (Spoulos, 2006), being unaware of eligibility (Grimes et al., 2017), avoiding high documentation costs (Nuske et al., 2023), or finding the registration process too difficult (Mullins & Preyde, 2013). Additionally, students may choose non-disclosure if they believe benefits from accessing supports will inadequately counterbalance the potential for stigma and discrimination (Grimes et al., 2020).

Externalised stigma, a bias against a group based on past experiences/expectations, involves labelling, negative stereotyping, linguistic separation (‘us’ vs. ‘them’) and power imbalances (Andersen et al., 2022), and negatively affects college students with ADHD or depression (Thompson & Lefler, 2016). Stigma can lead to instances of discrimination (Lippert-Rasmussen, 2006), such as educators refusing to implement disability accommodations (Tan et al., 2023), or non-autistic undergraduates avoiding interactions with autistic peers (Lipson et al., 2020; Sasson & Morrison, 2019). Additionally, overt stigma is associated with increased internalised stigma, whereby a person absorbs stigmatising attitudes and stereotypes about themselves and/or their condition (Link et al., 1989) and is therefore less likely to seek support (Drapalski et al., 2013). Expectations of experiencing overt stigma, combined with internalised stigma, impacts disclosure decisions made by neurodivergent students and students with MHCs (Collins & Mowbray, 2005; Kranke et al., 2013; Salzer et al., 2008), reducing opportunities to receive adequate support.

Most research investigating disclosure and support in HE has recruited participants via institutions’ disability registers or intervention programmes (Anderson et al., 2018; Collins & Mowbray, 2005; Haynes-Buchanan, 2022). Thus, the experiences of students with neurodivergent conditions, MHCs, or both, who have not disclosed remains unknown. Improving supports for the growing number of students with neurodivergent and/or MHCs requires insights from students who have not accessed support, in addition to those who have registered with support services. We examined similarities and differences between neurodivergent students’ (with or without MHCs) and non-neurodivergent with MHC students’ disclosure and supports experiences, including those who had not disclosed to their institutions, across (1) disclosure rates and supports use, (2) experiences of and reasons for disclosure, and (3) experiences of supports.

Method

Participants

Adult (18+ years) neurodivergent and non-neurodivergent individuals who had attended HE between 2015 and 2021 in Australia or New Zealand were eligible to participate in an online study about their HE experiences. Both neurodivergent students, and non-neurodivergent students with a current diagnosed MHC, who were currently studying, had discontinued study, or had graduated from their course or programme were included in our study. There were 131 neurodivergent participants (Mdn_age = 28.0 years, 76.9% female) and 41 non-neurodivergent participants with an MHC (Mdn_age = 32.0 years, 75.6% female).

Measures

Demographics

Participants reported their age, sex, gender identity, country of birth, and current mental-health and neurodivergent diagnoses.

Disclosure

Participants reported if they had disclosed their diagnoses (neurodivergent and/or MHCs) to their HE institution. If yes, they reported their diagnoses and when disclosed, and could complete the open-ended question: ‘In what ways was it helpful/unhelpful to disclose your diagnoses to your higher education provider?’. If no, they could select their reason(s) for not disclosing: ‘fear of discrimination’, ‘stigma’, ‘felt it wouldn’t help’, ‘didn’t need to’, ‘didn’t want to do another assessment in order to register’, and ‘other’ (free text). We then asked all participants three open-ended questions: (1) ‘In the future, will you disclose your diagnosis to others?’ (2) ‘Please explain why you will/will not disclose your diagnosis in the future’, and (3) ‘Do you have any further comments to add about disclosing your diagnosis?’.

Supports

We asked all participants if they had accessed any supports during their HE studies. If yes, participants could select which supports they had accessed from a list of academic, assessment, and non-academic supports. For each support selected, participants indicated if it was helpful (yes/no). We then asked participants ‘What supports could have been helpful but are not/were not offered?’. Neurodivergent participants could also report whether they wanted neurodivergent-specific supports at their institution. If yes, they indicated preferences for peer/staff mentors, group/individual sessions, online/in-person delivery, and facilitators’ neurotype. Students who had discontinued their studies could also report why they dropped out of their course. All participants had the opportunity to convey any additional information about their HE experiences.

Procedure

This report is part of a larger study investigating HE experiences of neurodivergent and non-neurodivergent Australasian students. Group differences across person characteristics (disposition, demand and resource) and HE context factors, and detailed support use are reported elsewhere (Kennedy et al., 2025a, 2025b).

We developed an online survey in consultation with five neurodivergent student advisors. The La Trobe University Human Ethics Committee gave ethics approval (HEC21027). Advertising occurred via Facebook, Twitter (now X), LinkedIn, and email requests to neurodivergent organisations and HE institutions within Australia and New Zealand. We linked advertisements to a REDCap (Harris et al., 2019) survey that included a participant information statement and informed consent. Participation was anonymous and voluntary, with consent indicated by checking a box and continuing to the survey which took approximately 35 minutes to complete. Mandatory questions included survey eligibility, current or past HE enrolment, age, sex, gender identity, and neurodivergent conditions. After survey completion, participants could (1) provide contact details to enter a one-in-five chance to win an AUD$25 (Australian) or US$20 (New Zealand residents) Amazon gift card; (2) participate in a follow-up interview; and (3) receive a summary of results. Contact details could not be linked to participants’ survey responses. Data were collected between April and September 2021.

Data Analyses

Quantitative Analyses

We removed spurious submissions (determined via response times <15 minutes, highly patterned, and/or nonsense responses), leaving 172 valid surveys. Data were analysed using SPSS version 29 (IBM SPSS Statistics Version 29.0 [computer program]). Due to missing data, sample size is reported for each analysis. We examined group differences for categorical variables using chi-square or Fisher's exact test and report the effect size phi or Cramer's V values with 0.1 small, 0.3 medium, and 0.5 large effect sizes interpreted for df = 1 (Cohen, 1988). Due to normality violations and outliers (n = 2, neurodivergent), we used the Mann–Whitney U test to compare groups on age. An a priori power analysis for chi-square indicated a minimum sample size of N = 88 with effect size ω = 0.3, α = 0.05, df = 1 and power = 0.8 (Faul et al., 2009).

Qualitative Analyses

Framework analysis enables rigorous analysis of both a priori and emergent issues arising from data, as patterns and differences between participant groups are identified by summarising and presenting data in charted form (Gale et al., 2013; Ritchie & Spencer, 1994). We analysed participants’ open-ended survey responses (504, with 2.3% of neurodivergent and 11.9% of non-neurodivergent students making no comments) using the five steps of the framework analysis method: familiarisation; framework identification; indexing; charting; mapping and interpretation (Goldsmith, 2021; Ritchie & Spencer, 1994). For the current study, LJK (neurodivergent) read all open-ended responses multiple times to understand the breadth of data variation, created an initial coding framework by combining a priori (initial survey questions), and emergent concepts from the data, and used this framework to code 20% of the data in NVivo R1 (NVivo R1 [computer program]). KEG (neurodivergent) used this initial framework to code data for 10% of the participants. Both researchers conferred to revise the coding framework, which LJK then used to code the remaining data. While systematically applying (indexing) the revised framework to the full dataset, we identified further framework refinement opportunities. Discussions between all researchers led to the creation of a third and final hierarchical coding framework to which LJK coded all data. In the charting stage, LJK abstracted, summarised, and charted themes to two matrices (disclosure and supports) using Microsoft Word. Finally, we analysed patterns in the data by reviewing the matrices and drawing connections and relationships between codes and neurotypes. The overarching research questions and quantitative analysis results influenced this process. Typographical and spelling errors within quotations were corrected for clarity. We used the Strobe checklist for reporting cross-sectional studies (Von Elm et al., 2007) when writing our report.

Results

Participant demographics and current self-reported diagnosed MHCs are presented in Table 1. Most participants were female and born in Australia. There were no group differences for age, sex, current gender identity, or country of birth. For neurodivergent students, 75.6% reported one or more MHC and, by definition, all non-neurodivergent students had at least one MHC. Nearly half of neurodivergent (45.0%) and non-neurodivergent (48.8%) students had two or more MHCs. There were no group differences in current MHCs between neurodivergent and non-neurodivergent students with MHCs (see also Supplemental Table 1). The three most common MHCs for both neurodivergent and non-neurodivergent students were anxiety, depression, and post-traumatic stress disorder (Table 1). Among the neurodivergent students, the three most common neurodivergent conditions were ADHD, autism, and SpLD (Table 2).

Table 1.

Demographics and Between Samples Comparisons (N = 172).

	Neurodivergent		Non-neurodivergent		Statistics
	N	Median	N	Median
Age	130	28.00	41	32.00	U = 3042.5, z = 1.37, p = .172
	N	n (%)	N	n (%)
Sex at birth	130		41		χ² = 0.53, df = 2, p = .873, V = .047^a
Female		100 (76.9)		31 (75.6)
Male		29 (22.3)		10 (24.4)
Prefer not to disclose		1 (0.8)		0 (0.0)
Current gender identity	130		41		χ² = 1.68, df = 4, p = .801, V = .118^a
Female		88 (67.7)		31 (75.6)
Male		30 (23.1)		9 (22.0)
Genderqueer		8 (6.2)		1 (2.4)
Trans, different identity		3 (2.3)		0 (0)
Prefer not to disclose		1 (0.8)		0 (0)
Country of birth	130		41		χ² = 0.47, df = 2, p = .789, V = .053
Australia		85 (65.4)		29 (70.7)
New Zealand		28 (21.5)		8 (19.5)
Other		17 (13.1)		4 (9.8)
Current student status	130		41		χ² = 2.58, df = 3, p = .452, V = .131
Currently studying		82 (63.1)		30 (73.2)
Currently deferred		5 (3.8)		2 (4.9)
Completed		37 (28.5)		9 (22.0)
Did not complete		6 (4.6)		0 (0)
Current mental-health conditions^b	99		41
Anxiety		76 (76.8)		34 (82.9)	χ² = 0.65, df = 1, p = .419, Φ = .068
Depression		51 (51.5)		18 (43.9)	χ² = 0.67, df = 1, p = .412, Φ = −.069
Post-traumatic stress disorder		23 (23.2)		7 (17.1)	χ² = 0.65, df = 1, p = .419, Φ = −.068
Obsessive compulsive disorder		13 (13.1)		6 (14.6)	χ² = 0.06, df = 1, p = .813, Φ = .020
Bipolar disorder		10 (10.1)		1 (2.4)	χ² = 2.87, df = 1, p = .175, Φ = .130^a
Schizophrenia		0 (0)		1 (2.4)	χ² = 2.47, df = 1, p = .293, Φ = .132^a
Other^c		9 (9.1)		2 (4.9)	χ² = 0.77, df = 1, p = .508, Φ = −.071^a
No. of mental-health conditions^d	99		41		χ² = 1.39, df = 2, p = .500, V = .100
One		40 (40.4)		21 (51.2)
Two		39 (39.4)		13 (31.7)
Three or more		20 (20.2)		7 (17.1)

MHC: mental-health condition; PTSD: post-traumatic stress disorder; HE: higher education; OSFED: other specified feeding or eating disorder.

Fisher's or Fisher–Freeman–Halton exact test was used when >20% of cells have expected count less than 5.

Current MHC comparisons compared neurodivergent students with MHCs to non-neurodivergent students with MHCs.

Other current mental-health conditions reported by participants included borderline personality disorder (3), complex PTSD (2), depression due to medication (1), eating disorder not otherwise specified (1), epilepsy (1), (hypermobility spectrum disorder, postural orthostatic tachycardia syndrome, anaphylaxis, asthma, fibromyalgia, irritable bowel syndrome (1)), OSFED atypical anorexia nervosa (1), and suspected anxiety and depression not formally diagnosed (1). All participants reporting an ‘other’ MHC also had one or more of the MHCs listed in the table.

Nine non-neurodivergent students had completed their studies at the time of taking the survey – while we cannot be certain they had their current MHCs while they were studying, examination of their responses indicated they were reflecting on the impacts their MHCs had on their HE experiences of disclosure and supports.

Table 2.

Neurodivergent Students Diagnoses and Subtypes (N = 131).

Diagnosis	Subtype	n
Attention deficit/hyperactivity disorder	Combined type	30
	Predominantly inattentive type	26
	Predominantly hyperactive-impulsive	2
	Not sure	21
	Total ADHD	76
Autism	Autism spectrum disorder	35
	Autistic disorder	10
	Asperger’s disorder	10
	High-functioning autism	8
	Not sure	3
	Total autism	56
Specific learning disorder	Dyslexia	11
	Dysgraphia	4
	Dyscalculia	5
	Dyslexia, dysgraphia, and dyscalculia	2
	Not sure	2
	Total SpLD	16
Communication disorders	Social-pragmatic communication disorder	6
	Speech–sound disorder	5
	Language disorder	4
	Child-onset fluency/stuttering disorder	2
	Total communication disorders	12
Motor disorders	Developmental coordination disorder	13
	Tourette's disorder	4
	Provisional tic disorder	2
	Total motor disorders	19
Other neurodivergent conditions	Early-stage dementia (and autism)^a	1
	Borderline personality disorder (and ADHD)^a	1
	Epilepsy (and ADHD)^a	1
	Irlen syndrome and Mal de Debarquement syndrome^b	1
	Neurological impairment^b	1
	Non-verbal learning disorder^b	1
	Total other conditions	6

Subtype totals may differ from neurodivergent condition totals as some participants endorsed having more than one subtype. The total number of conditions exceeds the number of participants as 40 participants had more than one condition.

ADHD: attention deficit/hyperactivity disorder; SpLD: specific learning disorder.

One autistic participant and two participants with ADHD reported having another condition (dementia, borderline personality disorder, and epilepsy) outside our definition of neurodivergent condition. They are listed here due to participants describing them as such.

Three participants reported only having conditions not classified as DSM-5 neurodevelopmental disorders (‘Irlen syndrome and Mal de Debarquement syndrome’, ‘neurological impairment’, and ‘non-verbal learning disorder’). Excluding them from statistical analyses did not alter the results, thus, due to their self-identification as neurodivergent, they were retained in the analyses.

Disclosure

More neurodivergent students disclosed their diagnoses to their institution than non-neurodivergent students (Table 3). There were no group differences for disclosure timing, whether disclosure was helpful, nor future intentions to disclose. Framework analysis of participants’ open-ended disclosure responses identified five themes and eight subthemes; see Figure 1 and Table 4.

Figure 1.

Thematic Map for Disclosure Themes and Subthemes.

Table 3.

Disclosure Comparisons (N = 172).

	Neurodivergent		Non-neurodivergent		Statistics
	N	n (%)	N	n (%)
Disclosed to HE institution	131		41		χ² = 11.36, df = 1, p < .001, Φ = −.26
Yes		61 (46.6)		7 (17.1)*
No		70 (53.4)		34 (82.9)
Was it helpful to disclose?	61		7		χ² = 0.46, df = 2, p = 1.000, V = .11^a
Yes		41 (67.2)		5 (71.4)
No		6 (9.8)		0
Not sure		14 (23.0)		2 (28.6)
When did you disclose?	60		7		χ² = 1.32, df = 2, p = .665, V = .14
When first enrolled		28 (46.7)		2 (28.6)
Later		21 (35.0)		4 (57.1)
During a crisis		7 (11.7)		1 (14.3)
Will you disclose in the future?	131		38		χ² = 1.00, df = 1, p = .317, Φ = .07
Yes		97 (74.0)		25 (65.8)
No		34 (26.0)		13 (34.2)

HE: higher education.

Post-hoc standardised residuals lie outside ±1.9. ^a Fisher's or Fisher–Freeman–Halton exact test was used when >20% of cells have expected count less than 5.

Table 4.

Framework Analysis Chart of Disclosure Responses.

		Neurodivergent (N = 131)			Non-neurodivergent (N = 41)
		No. of comments	No. of students	% of N	No. of comments	No. of students	% of N
Access support before a crisis
	Practical support	59	48	36.6	9	8	19.5
	Emotional support and understanding	34	30	22.9	6	6	14.6
Stigma and discrimination
	Advocacy	35	32	24.4	10	10	24.4
	Fear of	37	29	22.1	7	7	17.1
	Experienced	33	24	18.3	4	4	9.8
	Shame	10	9	6.9	0	0	0.0
Identity, honesty, transparency		23	19	14.5	0	0	0.0
Too hard
	Costs and processes	9	8	6.1	2	2	4.9
	Is it worth it?	13	11	8.4	11	10	24.4a
Diagnosed during HE		11	9	6.9	0	0	0.0
Total		264	124b	94.7	49	32b	76.2

HE: higher education.

Subtheme mentioned by a greater proportion of non-neurodivergent students.

Number of students who made at least one comment about disclosure.

As there were no quantitative differences in disclosure and supports variables between neurodivergent students with or without MHCs, and few differences in the proportions of students providing quotes, the remainder of the results are reported for neurodivergent students as a single group. Three group comparisons for all results are available in the Supplemental materials. Quotations from neurodivergent participants indicate whether they also had an MHC [ND + MHC] or not [ND − MHC].

Theme 1: Access Support Before a Crisis

Accessing supports was the most common reason for disclosing a neurodivergent or MHC and had both practical and emotional elements.

Practical support . Neurodivergent students disclosed to access disability support services; obtain learning-access and inclusion plans; negotiate special consideration/provisions for assessments such as assignment extensions, extra time, a reader, or separate rooms for exams; and receive accommodations in learning materials and teaching styles. Some neurodivergent students were disappointed with what eventuated: ‘[disclosure] is good for extensions, that's all …[they] won't convert my readings to pdf due to budget cuts, tutors don't get it … and instructions are always unclear’ [ND − MHC-819]. A smaller proportion of non-neurodivergent students mentioned access to extra time, extensions, special consideration, and curriculum modifications as benefits of disclosure.

Emotional support and understanding . Disclosure was important for some neurodivergent students to help staff ‘understand how to … get the best out of me’ [ND + MHC-33], to ensure trust, and to adjust others’ expectations. For example, one student disclosed for ‘understanding … I actually didn't need the extra time but it really helped to know it was there and I was taken seriously’ [ND − MHC-46]. Another student disclosed so they could ‘mask less [and reduce] fatigue … so people don’t [always] expect me to socialise and participate’ [ND + MHC-837]. However, disclosure backfired for one student, ‘I disclosed [ADHD] to my University because I thought it would mean … more understanding of the challenges I face. This has not been the case’ [ND + MHC-994]. A smaller proportion of non-neurodivergent students also disclosed to help others understand ‘about absences, time off, flexibility etc.’ [NN-109].

Theme 2: Stigma and Discrimination

Participants frequently mentioned concerns about stigma and discrimination as reasons for and against disclosure, including advocacy motivations, fear of and experiences of stigma and discrimination, and internalised stigma and shame.

Advocacy . A quarter of neurodivergent participants disclosed to reduce stereotypes and misinformation, educate others, and normalise neurodiversity. Altruistic motives were often a factor, as ‘when people [understand] ADHD, they are more positive and helpful. If I have to be the first one … at least those that come after won't have to’ [ND − MHC-997]. Similarly, another student disclosed to help ‘raise awareness … ADHD is so unrecognised in women, I want other women to know they can seek support’ [ND − MHC-826]. Non-neurodivergent participants also disclosed their condition(s) to educate others, reduce stigma, and ‘encourage people to look after themselves and their friends when it comes to mental health’ [NN-109].

Fear of stigma and discrimination . Some neurodivergent students struggled to balance fear and advocacy: ‘[disclosure] may help others to understand me and … help advocate for others. However, I also fear negative stereotyping and discrimination’ [ND + MHC-55]. Some were unsure they could trust ‘the university or … other students … [and feared] being thought of as lazy’ [ND + MHC-849]. Four psychology students did not disclose due to the ‘highly competitive field … I [believed] if I disclosed anything that I could be doing myself a disservice’ [ND + MHC-767]. Some non-neurodivergent students also had concerns about maintaining privacy, disclosing only when necessary as it is ‘best to keep your flaws to yourself’ [NN-432].

Experienced stigma and discrimination . Neurodivergent students felt they were judged and discriminated against after disclosing to their institution: ‘There is so much stigma attached to ADHD … we are thought of as lazy, uninterested, disorganised, unmotivated, unintelligent, and careless. So much more needs to be done to educate teaching staff’ [ND + MHC-994]. Similarly, participant ND + MHC-55 was ‘continually shocked by the misconceptions and stigma … [and] awful discriminatory remarks from both academics and students, e.g. calling autistic people weird, stating neurodivergent individuals don't belong in certain fields, and talking about autistic clients as difficult or unpleasant to work with.’ Participant ND + MHC-333 warned others to be, ‘very selective about who you divulge this information to, as it can and will be used against you’.

Stigma and discrimination came from peers as well as staff: ‘I was treated differently and judged by other students … people make assumptions that are not necessarily true … [and can be] quick to blame the person … instead of taking responsibility for their own actions’ [ND + MHC-172]. Non-neurodivergent students provided only four brief comments about experiences of stigma, for example, ‘treated differently, loss of opportunities’ [NN-850].

Shame . Neurodivergent students expressed feelings of internalised stigma and shame, including being ‘abnormal’ [ND + MHC-438] and ‘a burden to others’ [ND + MHC-431]. Disclosure raised inner conflicts for some: ‘there is [an] internal diatribe in my brain between knowing that I need differential treatment … to succeed, and just wanting to be like everyone else … so I'm quite conflicted’ [ND + MHC-331]. Not wanting to use conditions as an excuse was mentioned by four participants, with one explaining: ‘People say that I am “intelligent”, studying at a high level and “analytical” so they don't “see” how [ADHD] impairs how I get through university … Disclosing my struggles has made me feel like I am making it up or looking for a reason to excuse my academic difficulties’ [ND + MHC-851]. In contrast, feelings of shame were not mentioned by non-neurodivergent students.

Theme 3: Identity Honesty and Transparency

Neurodivergent students described their condition as an important part of who they are, not something to be ashamed of, and disclosed to ‘engage with others meaningfully’ [ND + MHC-1000]. Another disclosed ‘because it is just as much a part of who I am as being female or Pakeha [Māori for white person] or any other defining trait. And if someone judges me for it, they aren't going to be someone I want to spend time with anyway’ [ND + MHC-130]. Impulsivity was also key for three participants: ‘I don't want to hide … and … always try to hold myself back. I don't want to … fight that type of impulsivity when I'm in a social situation’ [ND + MHC-833]. Non-neurodivergent students did not mention this theme.

Theme 4: Too hard

For some, disclosure decisions were impacted by difficult processes, while others questioned whether it was worthwhile.

Costs and processes . Neurodivergent students described difficulties knowing where and how to disclose: ‘there was no obvious way to disclose at uni’ [ND + MHC-852], while ND − MHC-991 would like ‘an easier application process for applying for accommodations’. Participant ND + MHC-341 described an ‘exhausting process at times getting all the paperwork sorted’. Prohibitive costs and psychiatrists’ waitlists were mentioned several times: ‘sadly I am not in a financial position to talk to my psychiatrist about it right now’ [ND + MHC-951]. The documentation barrier was poignantly described by participant ND + MHC-851, who, despite already receiving a clinical psychologist's diagnosis of ADHD, had been told they needed ‘to wait for a neuro-cognitive assessment which is costly … ($1200-$3500) [with] extensive waitlists of 6–18 months. I need the support now … I feel invisible, treated like I'm wasted potential and not understood. Talking about my struggles and not getting any traction on support is so draining that I feel like it was better to not say anything at all’. Conversely, only two non-neurodivergent students briefly mentioned the cost of documentation as a barrier to registering for support.

Is it worth it? Neurodivergent students questioned whether the effort would ‘be beneficial’ [ND + MHC-32], with one feeling disclosure was ‘a bit pointless as everything is overly self-directed, [e.g.] people with ADHD need accountability buddies’ [ND − MHC-819]. This ambiguity was also mentioned by non-neurodivergent students with many disclosing only when necessary: ‘I'm actually unsure whether I will [disclose in the future] …. There are consequences to disclosure and there are consequences for not disclosing’ [NN-303].

Theme 5: Diagnosed during HE

Only neurodivergent students mentioned this theme, expressing regret for not understanding earlier why they found HE so hard: ‘I was diagnosed mid-year after my first semester. My first semester was a mess, once I had my diagnosis, I disclosed it’ [ND − MHC-29]. Similarly, ND + MHC-849 wished, ‘I had been diagnosed [ADHD] earlier. I wish I had been diagnosed with depression earlier too’.

Existing Supports

More neurodivergent students accessed HE supports than non-neurodivergent students, but this difference was not significant. The number of supports accessed differed between the student groups, with a smaller proportion of non-neurodivergent students accessing one or more supports (Table 5). Framework analysis of the open-ended supports responses identified four themes and eight subthemes; see Figure 2 and Table 6.

Figure 2.

Thematic Map for Supports Themes and Subthemes.

Table 5.

Supports Comparisons (N = 172).

	Neurodivergent		Non-neurodivergent		Statistics
	N	n (%)	N	n (%)
Have you accessed supports in HE?	131		41		χ² = 3.17, df = 1, p = .075, Φ = .14
Yes		72 (55.0)		16 (39.0)
No		59 (45.0)		25 (61.0)
HE supports usage	131		41		χ² = 9.32, df = 2, p = .009, V = .23
None		59 (45.0)		25 (61.0)
Low (1–3)		36 (27.5)		2 (4.9)^a
High (4–12)		36 (27.5)		14 (34.1)

HE: higher education.

Post-hoc standardised residuals lie outside ±1.9.

Table 6.

Framework Analysis Chart for Support Responses.

		Neurodivergent (N = 131)			Non-neurodivergent (N = 41)
		No. of comments	No. of students	% of N	No. of comments	No. of students	% of N
Culture and relationships
	Kindness and understanding	16	13	9.9	5	4	9.8
	Peer groups and mentoring	14	13	9.9	5	5	12.2a
	Proactive check-ins	8	8	6.1	1	1	2.4
Study related
	Flexibility	51	48	36.6	6	6	14.6
	A menu would be sweet	21	20	15.3	3	3	7.3
	Executive functioning	14	14	10.7	1	1	2.4
	Graduate research and placements	11	8	6.1	2	2	4.9
	I found ways to compensate	6	6	4.6	3	3	7.3a
Mental health related		16	16	12.2	2	2	4.9
Why discontinued		6	6	4.6	0	0	0.0
Total		163	105b	80.2	28	21b	51.2

Subthemes mentioned by a greater proportion of non-neurodivergent students.

Number of students who made at least one comment about supports.

Theme 1: Culture and Relationships

We categorised participants’ comments about institutional culture and relationships into the subthemes kindness and understanding, peer groups and mentoring, and proactive check-ins.

Kindness and understanding . Of the 13 neurodivergent students who mentioned this, only three felt staff were understanding: ‘the staff member … was fantastic’ [ND − MHC-845]. More participants felt staff ‘don't seem to care’ [ND + MHC-310], and wanted ‘more kindness from teachers who didn’t understand [or] like me’ [ND − MHC-705]. Specifically, students wanted staff to: be ‘better equipped to deal with a wider range of students’ [ND − MHC-845], ‘know what ADHD even is’ [ND + MHC-995], have ‘far more awareness of Autism’ [ND + MHC-852], and be available to ‘answer questions about how uni “works”’[ND + MHC-833]. Non-neurodivergent students also mentioned themes of kindness, with only two feeling ‘comfortable to ask questions without judgement’ [NN-317]. A lack of understanding was more commonly noted, with ‘staff ill-equipped to deal with [mental health] disclosures … [and] inconsistencies in … expectations … It's a complete mess at my uni to be honest’ [NN-303].

Peer groups and mentoring . Neurodivergent students wanted mentoring advice for ‘transitioning to uni [academically and] navigating a whole new [social] space’ [ND − MHC-29], and ‘how to get the most out of study with individual brain quirks’ [ND + MHC-716]. Online peer-support spaces, ‘somewhere to ask … about things [and] … accountability buddies or body doubles’ [ND + MHC-831] were requested, and buddy–mentor systems ‘to help me feel more supported and connected to the university, … I would have hated it at first, but it would have been really beneficial for me’ [ND + MHC-849]. Students felt institutions should initiate these supports, rather than telling already struggling students, ‘if you want a peer-support group … you are responsible for creating it’ [ND + MHC-716]. Non-neurodivergent students also wanted ‘more ways to connect with others that were a bit more low-key/quieter’ [NN-832], with two participants requesting ‘peer support groups’.

Proactive check-ins . Seven neurodivergent students suggested accessibility advisors should make: ‘regular contact … to help identify any current issues and what may be available to assist’ [ND + MHC-23], ‘more active follow ups’ [ND + MHC-344], ‘to see how I was coping’ [ND + MHC-310], ‘weekly check-ins with accountability’ [ND + MHC-716], and ‘consultation to inform/help navigate what supports were possible/relevant for me’ [ND + MHC-818]. Only one neurodivergent student felt their institution did this well, receiving ‘significant contact from the disability unit [via] phone calls and emails throughout my course to assist if I was struggling’ [ND + MHC-347]. In contrast, only one non-neurodivergent student wanted more ‘consistent processes for the disability advisor’ [NN-303].

Theme 2: Study Related

Flexibility . Flexibility was the biggest issue for neurodivergent students. For assessments, students appreciated smaller/quieter exam rooms, additional time and rest breaks, and assignment extensions. Students also wanted alternatives to role-play assignments, more individual assessments, a chance to clarify quiz-question meanings, exemptions from ‘participation-grade assessments as they discriminate against those who can’t make it to campus’ [ND + MHC-990], more formative assessments, weekly exams instead of end-of-semester, and extra time automatically applied. They also wanted marking rubrics for all assessments, additional explanation of assessment expectations, staggered or flexible deadlines, and ‘proofreading [and] a thesaurus in close-book exams’ [for dyslexia, ND + MHC-990]. Participant ND − MHC-171 suggested ‘stop the clock’ time instead of extended time ‘to take a break/walk around the room/go to toilet [and not] affect how long I have to actually work on the exam’. Participant ND + MHC-833 wanted ‘guidance for doctors [writing] requests for missed assessment deadlines’, stating there were only ‘three assessments in my whole time at uni that didn't feel like an active attempt to prevent people with ADHD from succeeding’.

The teaching and study-related supports neurodivergent students wanted to include small-group, face-to-face tutorials; lecture transcripts, and recordings with adjustable-speed playback and closed captions; subject content in multiple formats (e.g. visual, auditory and text); and ‘documents [converted] to PDF so the speech option will work’ [ND − MHC-819]. Others wanted subject- or unit-based student liaisons, help with notetaking, ‘tools to help structure writing’ [ND + MHC-851] and ‘tutors who replied to emails’ [ND + MHC-721]. Sensory-related requests included ‘quiet places to study’ [ND + MHC-849], ‘sensory-friendly workspaces [and] accommodations for auditory processing disorder’ [ND + MHC-852]. Some wanted ‘more courses online’ [ND − MHC-553] while others complained about, ‘not making everything only online’ [ND + MHC-713]. Longer teaching periods and ‘virtual alternatives to professional study visits’ [ND − MHC-722] were also requested. Disappointingly, one participant commented, ‘all of the above [supports] were either not offered or … because I seem so articulate and “functioning”, they were denied to me’ [ND + MHC-702].

Non-neurodivergent students appreciated ‘visual information … practical activities [and] repetition … in different formats to help me make sense of the information’ [NN-317]. They also wanted more ‘taped lectures’ [NN-441], ‘staggered assessment deadlines’ [NN-884], more time to complete assessments, and ‘additional tutoring sessions’ [NN-846].

‘A menu would be sweet’ . Twenty neurodivergent students were unsure what supports were available: ‘other students with similar diagnoses … were given support … where/how did they find out about it?’ [ND + MHC-848]. Similarly, ND + MHC-323 said, ‘nothing was “offered” to me. Having a “menu” of options available … without having to fight tooth and nail … would be pretty sweet’. Participant ND + MHC-1000 clearly illustrated this difficulty: ‘they told me to let them know what I needed. I had no idea. I asked for one-on-one support and they said there was no money. [So] I paid for support privately’. Other students highlighted access complexity: ‘I was bad at navigating [access due to] my stress and ADHD…[it] needs to be simpler … one room [that is always] staffed’ [ND + MHC-142]. Similarly, ND + MHC-716 wanted ‘more than one [part-time] disability support officer who … has three [other] roles’. Participant ND + MHC-344 found ‘supports were hard to organise due to my neurodivergence and things quickly went back to how it was before’. Others lamented the ‘hands off nature and disorganisation’ [ND + MHC-829] and found supports were ‘very vague … It feels as if there isn't much that can be offered’ [ND + MHC-700]. One student poignantly contrasted access difficulties with the scale of what they required, ‘it's really hard to ask for help when you already exist in the fringes of society … When help can be accessed, it's surprising how little intervention is needed … For me, just a few simple strategies [balanced] out the disadvantages I face’ [ND + MHC-319]. In contrast, only three non-neurodivergent students briefly mentioned being unsure of what supports were available.

Executive functioning . Neurodivergent students wanted help with task and time management, planning, and understanding instructions. For ND + MHC-695, ‘organisational skills and accountability, administered with humour, would be the best’, while ND + MHC-951 explained, ‘‘I often rely on the adrenaline that comes with a very near or overdue deadline in order to start on a project.’ Help with perfectionism and over-researching was also wanted, due to a ‘tendency to spend hours upon hours researching, editing the same sentence/paragraph which I often chuck out [and] start over. [I wrote] 3 different essays for one assignment because I developed an aversion [and] couldn't look at them anymore. This has been so bad that I've just not submitted anything … I want to stop but feel this incessant need for it to be perfect to meet my own/others expectations’ [ND + MHC-817]. Only one non-neurodivergent student requested organisational skills training.

Graduate research and placements . Neurodivergent students expressed frustration with a lack of supports for graduate-research students (i.e. doctoral and masters-by-research students) and those undertaking placements. Participant ND − MHC-997 felt many ‘students would benefit from more support … It was failing placement that lead to my diagnosis. Have … drop-in session[s] … covering … things like how to … fill in the paperwork, how to seek & receive feedback, how to set your own learning objectives … [with] consideration given to neurodivergence’. Placements were not mentioned by non-neurodivergent students; however two mentioned the supports gap for graduate-research students, with ‘supervisor wearing the brunt of the discussions’ [NN-303], while another felt the PhD environment ‘exacerbates mental health issues’ [NN-953].

‘I found ways to compensate’ . This subtheme was mentioned by a greater proportion of non-neurodivergent students, who knew help was available, but ‘did not access supports because I had found ways to compensate for my differences’ [NN-932]. Neurodivergent students endorsed not accessing supports as they had ‘developed good strategies’ [ND + MHC-719] or ‘manag[ed] with online studying’ [ND + MHC-121]. Another student thought existing supports wouldn’t help as ‘extra time would just mean that I push out until the end of the new deadline’, and described ‘excelling’ in education when learning was paper based but ‘struggled’ when using computers due to ‘perfectionism … and the opportunity [for] too much over-researching’ [ND + MHC-695].

Theme 3: Mental Health Related

Neurodivergent students wanted ‘better individual counselling …[not] told my issues were too complex’ [ND + MHC-26], ‘specific counselling by someone with knowledge of neurodiversity’ [ND + MHC-145], ‘drug and alcohol counselling within the uni’ [ND + MHC-341], and ‘emotional support dogs on campus’ [ND − MHC-826]. Others thought counselling would be helpful ‘but the [waiting time] while in crisis is not adequate’ [ND + MHC-841]. Students wanted better screening to avoid ‘years of … struggles that being undiagnosed yet “smart” inflicted upon me’ [ND + MHC-817], and initial failure: ‘when I first went to uni I was undiagnosed and failed spectacularly. I was offered counselling … but [wish] they had [screened] for ADHD’ [ND + MHC-993]. Only two non-neurodivergent students briefly mentioned wanting ‘spaces to talk about mental health’ [NN-694].

Theme 4: Why Discontinued

Finally, six neurodivergent students felt insufficient support and ‘challenges due to neurodiversity and mental health’ [ND + MHC-818] contributed to their course discontinuation. Three participants mentioned problems with executive functioning, e.g. ‘over-researching then missing deadlines’ [ND + MHC-695] and ‘paralysed by perfectionism … hard to filter out information … over-researched topics’ [ND − MHC-141]. The remaining three wanted more course flexibility, mental-health support, and assistance after being ‘bullied’ by a tutor [ND + MHC-537]. With better supports, these students may have continued their studies. As no discontinued non-neurodivergent students completed the survey, comparisons could not be drawn.

New Supports

Neurodivergent students were asked questions about new neurodivergent-specific supports, with 82% wanting them. Students were flexible in their preferences with ‘both structured and unstructured’ programmes, ‘either individual or group’ sessions, ‘either student-peers or staff’ mentors, and ‘either online or in-person’ delivery the most endorsed options. The only strong preference (62%) was for neurodivergent mentors/facilitators (Table 7). Neurodivergent students also requested additional supports such as placement support, accountability buddies, neurodivergent drop-in centres, and study groups.

Table 7.

Neurodivergent Students’ Preferences for New Supports (N = 131).

		%
Programme preferences
	Structure mentoring programmes	30.5
	Unstructured social groups	31.3
	Both unstructured and structured	57.3
Session preferences
	Group	4.8
	Individual	31.7
	Either individual or group sessions	63.5
Mentor preferences
	Student-peers	20.0
	Staff	21.0
	Either student-peers or staff	59.0
Delivery mode preferences
	Online	9.5
	In-person	37.1
	Either online or in-person	53.3
Should mentors/facilitators be neurodivergent?
	Yes	61.9
	No	2.9
	Either	35.2

Discussion

Our study investigated the disclosure and supports experiences of Australian and New Zealand HE students with neurodivergent or MHCs. We examined potential differences across (1) disclosure rates and supports use, (2) reasons for and experiences of disclosure, and (3) experiences of supports. A greater proportion of neurodivergent students disclosed to their institutions, accessed supports, and used more supports than did non-neurodivergent students with MHCs. However, there were no group differences in disclosure timing, helpfulness, and future intentions. Framework analysis of qualitative responses highlighted group differences in the themes endorsed by students. Only neurodivergent students referred to ‘internalised stigma/shame’, ‘identity, honesty and transparency’, ‘diagnosed during HE’, and ‘why discontinued’, however, proportionally more non-neurodivergent students than neurodivergent students endorsed ‘is it worth it?’ and ‘I found ways to compensate’. Notably, neurodivergent students provided over five times more comments than non-neurodivergent students, and generally of much greater length.

Practical Versus Emotional Considerations

While both groups of students disclosed their condition(s) to gain practical support, neurodivergent students provided many more comments about disclosing to access emotional support and understanding. Autistic people are less likely to receive social support from friends than those who are non-neurodivergent (Goldsmith, 2021) and non-neurodivergent students are more likely to seek support from their peers than neurodivergent students, who more often seek support from counselling and disability support staff (Kennedy et al., 2025a). Such differences may account for greater emotional support needs in neurodivergent students. For example, only neurodivergent students in the current study expressed a desire for proactive check-ins from disability support staff. This may stem from neurodivergent students being less likely to recognise when self-advocacy is required, and having lower self-advocacy skills than non-neurodivergent students (Santhanam & Wilson, 2024), with known impacts in other areas such as healthcare (Dern & Sappok, 2016). An automated monthly message to registered students could provide timely support-option reminders to students and may also improve students’ perceptions of care and belonging at their institution.

While stigma and discrimination fears were mentioned by both groups, there were notable differences, with neurodivergent students concerned about being thought incompetent or lazy, while non-neurodivergent students wanted to keep their ‘flaws’ private. Neurodivergent students reported experiencing stigma and discrimination far more often than non-neurodivergent students, and only neurodivergent students mentioned stigma and discrimination from peers. This is consistent with studies reporting peer-based stigma and discrimination by autistic students (Goddard & Cook, 2021; Sarrett, 2018; Tan et al., 2023) and those with ADHD (Spoulos, 2006). Such experiences likely impact where neurodivergent students seek support, with recent evidence they are more likely to seek support from HE staff than peers compared to non-neurodivergent students, for whom the opposite was true (Kennedy et al., 2025a). This may also be related to non-neurodivergent students having wider social networks than neurodivergent students (Gurbuz et al., 2019) and therefore potentially more friends who accept them without stigma. Relatedly, themes indicating internalised stigma/shame were only mentioned by neurodivergent students, who raised inner conflicts between needing help yet not wanting to ‘use’ their condition as an excuse for academic difficulties. These comments indicate internalised ableism, where subconscious assumptions that people with disabilities are inferior are applied to oneself (Bogart & Dunn, 2019), generating feelings of shame (Campbell et al., 2022), which further discourages disclosure (Botha et al., 2022).

Only neurodivergent students commented on identity, honesty, and transparency with some feeling neurodiversity was a defining part of their identity and not something to be ashamed of. This heterogeneity within neurodivergent populations means care must be taken to consult widely when designing supports for disparate student needs. Suggested strategies for reducing internalised stigma/ableism have included reframing language, building community (Botha et al., 2022), and bolstering positive self-identity through supportive peer networks (Jóhannsdóttir et al., 2022). With approximately one-tenth of neurodivergent and non-neurodivergent students in the current study requesting more peer-support spaces and buddy–mentor opportunities, connecting students experiencing internalised stigma with those who take pride in their neurodivergent status may help students navigate both academic and social demands of HE.

Another key difference was the impact of disclosure-related processes and costs, with neurodivergent students reporting difficulties managing appointments with multiple professionals, high costs, and extensive wait times to obtain documentation needed for support registration. While this may be related to neurodivergent individuals’ self-advocacy challenges in healthcare (Mason et al., 2019) and educational settings (Pfeifer et al., 2020), inequitable registration procedures for neurodivergent students (Levi, 2017; Nuske et al., 2023) contrast markedly to individuals with MHCs, where a letter from a general practitioner may suffice. While requesting recent documentation makes sense for MHCs that can be episodic or transient, neurodivergent conditions such as autism, ADHD, or dyslexia are considered lifelong. The request for recent evidence of students’ eligibility is frequently cited as a legislative requirement in Australia, however, the Australian Government's HE Disability Support Program guidelines only require ‘evidence’ of a student's disability and support needs and do not specify recency (Australian Government, 2025). Thus recency requirements are an institutional policy, not a legal requirement. Some countries are removing recency requirements (AHEAD, 2012) while others allow institutions to determine student eligibility as they see fit (Tertiary Education Commission New Zealand, 2024; Tertiary Education Commission New Zealand, n.d.). Given the disparities in documentation and effort for support registration, it was ironic that a greater proportion of non-neurodivergent (24%) than neurodivergent (8%) students questioned whether disclosure was ‘worth it’.

Supports

This is the first study comparing students with neurodivergent or MHCs regardless of disclosure or registration status. Over half of neurodivergent and about two-fifths of non-neurodivergent students accessed one or more supports, with neurodivergent students using significantly more supports.

Qualitative themes of culture and relationships were similarly endorsed, with both neurodivergent and non-neurodivergent students wanting more kindness and understanding when navigating supports and identifying a lack of knowledge in disability-support and teaching staff as key problems. Neurodiversity, mental-health, and disability-inclusion staff training is clearly needed, and should be added to existing training modules for cultural awareness, academic integrity, and online safety; modules are already available in some workplace and HE settings (Bolourian et al., 2024; Neurodiversity Hub, n.d.; Salerno-Ferraro & Schuller, 2025; Stairway to STEM, n.d.; Untapped, n.d.). Consideration should also be given to including such training in Graduate Certificates in Teaching and Learning and making module completion mandatory for existing educators.

Over one-third of neurodivergent but only one-seventh of non-neurodivergent students requested greater flexibility. Common assessment and academic adjustments mentioned included exam accommodations, assignment extensions, and materials in multiple formats, corroborating existing literature on adjustments commonly provided to autistic students and those with disability (Anderson et al., 2017; Edwards et al., 2022; Kennedy et al., 2025a). However, neurodivergent students’ desire for increased assessment flexibility requires careful consideration. The increasingly strained financial environment of the HE sector has exacerbated systemic pressures to reduce administrative loads (Bebbington, 2020), thus educators may struggle to find time to develop additional rubrics and train markers to grade fairly across multiple assessment formats. However, rather than responding to individual requests, broad implementation of universal design principles in the provision, teaching, and assessment of learning could increase flexibility (CAST, 2024) without excessive impacts on educators so that most students are better supported, regardless of their condition or disclosure status. Systematic application of Universal Design for Learning principles when creating or updating curricula will diminish the need to respond individually over time. Accessibility tools such as screen readers, automatic transcripts, and captioning are increasingly incorporated in software staples (Echo360, 2025; Microsoft, 2024; Zoom, 2024), and institutions’ assistive technology teams can help educators convert existing materials. Additionally, developing communities of practice for educators and support staff provides free upskilling opportunities (ADCET, n.d.).

Managing inherent course requirements with requested assessment alternatives is perhaps most problematic, especially within disciplines requiring demonstration of core competencies, such as role plays in medical, allied health and teaching fields. However, moving beyond static lists of inherent requirements and fixed methods to design more flexible ‘fitness to practice’ assessments may enable students to demonstrate readiness immediately before placements (Tai et al., 2024).

Implications for Institutions

Our findings suggest several avenues for institutions to improve experiences for students with neurodivergent or MHCs. Increasing peer connection and social opportunities should be a clear focus and supporting student-led initiatives can be very cost effective. Autistic-focused peer-mentoring programmes could be expanded to all neurodivergent students; however, more research is required to determine if their known benefits for autistic students (Accardo et al., 2019; Ames et al., 2016; Duerksen et al., 2021) may apply to students with other conditions such as ADHD and SpLD. Co-production working groups with neurodivergent students, educators, and professional-accreditation representatives could resolve tensions between inherent requirements and more flexible competency assessments without compromising student learning or institutional and accreditation requirements. By increasing the understanding of others’ perspectives, flexible innovation in designing suitable assessments is achievable. Existing resources for supporting students with disability on placement (Waters & Rath, 2022) should be reviewed and adapted to include neurodivergent students’ needs. Institution-wide awareness campaigns could help lower stigma and self-advocacy programmes encourage more eligible students to register for support. University counselling services could consider screening for neurodivergent and MHCs. Most importantly, institutions need to simplify registration processes, remove recency documentation requirements for lifelong conditions, and ensure student-facing communications are friendly and approachable. Finally, co-producing these initiatives will maximise effectiveness, efficiency, and acceptability.

Strengths and Limitations

Our study provides the first mixed-methods examination of disclosure and support experiences of students with neurodivergent and MHCs. Through framework analysis we identified important nuances in why eligible students are underutilising supports so that institutions can better allocate scare resources for maximum impact. While our study was adequately powered for quantitative analyses, we note our groups were unevenly sized with fewer non-neurodivergent participants and the neurodivergent group contained more students with ADHD and/or autism than other neurodevelopmental conditions. Inclusion of more participants with other neurodivergent conditions may elicit different experiences. Further, most participants in both groups were female; male students may differ in prevalence of specific conditions, experiences of disclosure and support access, and in help-seeking behaviours. Finally, while neurodivergent students provided considerably more and generally longer comments than non-neurodivergent students, this could be a function of greater familiarity with disclosure and support processes, greater support needs, or more experience participating in research. This may also reflect recruitment bias or that neurodivergent students experience more dissatisfaction with HE supports. Due to the less detailed information provided by non-neurodivergent students, some nuances to their experiences may be missing.

Conclusion

Our findings highlight that the accommodations and supports neurodivergent and MHC students want are often low cost, easy to implement/ and can benefit many students, akin to workplace supports for autistic adults (Chen & Yakubova, 2024). Although some commonalities were found, there were also clear differences in experiences of stigma, discrimination, and peer-based support. The feasibility of some accommodation requests requires careful consideration, and institutions must balance their obligations under human rights, disability discrimination, and education laws and standards (Commonwealth of Australia ; Commonwealth of Australia, 2005; Ministry of Education, 2020; New Zealand). Institutions need to ensure efforts to improve student outcomes are not ‘neurodiversity lite’ (Bottema-Beutel, 2024; Dwyer et al., 2024) or neuro-washing, whereby individuals and institutions claim to support neurodiversity but still expect neurodivergent people to adapt through individual interventions and therapies. Through systemic environmental change and co-production, HE supports can become neurodiversity affirming and thus enable more students to behave and learn authentically.

Supplemental Material

sj-docx-1-ndy-10.1177_27546330251352326 - Supplemental material for ‘A Menu Would be Sweet’: A Framework Analysis of the Disclosure and Supports Experiences of Higher Education Students with Neurodivergent or Mental-health Conditions

Supplemental material, sj-docx-1-ndy-10.1177_27546330251352326 for ‘A Menu Would be Sweet’: A Framework Analysis of the Disclosure and Supports Experiences of Higher Education Students with Neurodivergent or Mental-health Conditions by Lyndel J Kennedy, Amanda L Richdale, Katherine E Gore and Lauren P Lawson in Neurodiversity

Footnotes

Acknowledgements

We gratefully acknowledge the cooperation and participation of all participants involved in this study. We especially thank our neurodivergent advisors, colleagues, and family members for their insights and valuable feedback.

ORCID iDs

Lyndel J Kennedy

Amanda L Richdale

Katherine E Gore

Lauren P Lawson

Ethical Considerations and Informed Consent

Ethical approval was provided by La Trobe University Human Ethics Committee (HEC21027) and participants provided informed consent prior to completing the survey.

Author Contributions

This paper was written by a neurodiverse team. LJK, ALR, and LPL contributed to the study design. LJK (neurodivergent) developed the survey with neurodivergent advisors. LJK conducted the data analysis and wrote the article. KEG (neurodivergent) contributed to coding, theme identification, and article feedback. ALR and LPL contributed to data analysis and provided critical feedback. All co-authors have reviewed and approved this article before submission. This article has been submitted solely to this journal and is not published, in press, or submitted elsewhere.

Funding

The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: The research underpinning this publication was undertaken while completing a PhD at La Trobe University, Melbourne, Victoria.

Declaration of Conflicting Interests

The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Data Availability Statement

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical considerations.

Supplemental Material

Supplemental material for this article is available online.

Notes

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