Adolescents with a diagnosable mental health disorder must often first disclose their mental health problems to a parent in order to obtain professional mental health treatment. The decision to disclose private, personal health information is the result of successful progression through disclosure decision-making processes fraught with barriers that can discourage disclosure; therefore, the current study explored adolescents’ perceptions of factors that facilitate or discourage disclosure of mental health information to parents. Thematic analysis of a series of focus groups with adolescents with and without a mental health disorder discovered several themes that describe factors adolescents consider in the disclosure decision-making process. Several identified themes are consistent with past research related to health-related disclosure decisions, but some themes suggest that the mental health disclosure decision-making processes of adolescents may be different than the decision-making processes of adults in other health contexts. Results of the study have implications for interventions associated with adolescents’ and parents’ mental health literacy, mental health stigma and communication about mental health issues.