Accommodation strategies

Safely support productivity for employees with mental health issues who are at work or returning to work. Engage employees in solutions related to performance and well-being.

Share on.articles

The goal of accommodation is to help employees who have a disability to remain productive and feel supported in their workplace. Developing sustainable solutions is more likely to happen by engaging employees to help determine what will work for them. The strategies shared here can help support the discussion with an employee that has a mental health related disability.

The following accommodation strategies:

  • Address mental health related concerns including more serious mental illness.
  • Are intended to support productivity and performance for an employee that is at work or returning to work.
  • Can be helpful even when the legal duty to accommodate is not applicable in the circumstances in your jurisdiction (stress, burnout, life challenges, etc.).
  • Generally cost little or nothing to implement except an investment of time to change a process or communication approach.

It is recommended that after you review the content in this section you also considerA tool to support employee success. This free resource can help clarify job expectations, identify employee abilities and develop accommodations when mental health is a factor.

Engaging the employee is key to success

Before implementing an accommodation plan, it helps to ensure the employee is engaged in the discussion to explore solutions that will effectively support their success at work. An employee's accommodation plan must address the specific workplace issues that impact their ability to perform the job.

The strategies that follow are only offered as suggestions for discussion and are not legal advice. You may have additional obligations to provide reasonable accommodation under relevant human rights, accessibility, or other legislation.

For more information see Developing employee plans for leaders.

General approaches

The following are approaches for supporting any employee including those with mental health issues such as depression or anxiety. 

Communication and supervision techniques

  • Modification of instruction and feedback. Written instructions may provide greater clarity as well as improve the employee’s ability to recall details.
  • Brief weekly meetings (e.g. 10 minutes or so), or more frequently if necessary. This is designated time for the supervisor and employee to talk about issues before they become serious. This should be a time to see how the employee is doing and if the accommodation plan is supporting their success at work.
  • Explore which management approaches may have a positive or negative effect on the employee. Consider tone of voice, choice of words, eye contact, body language, hand gestures, use of email or verbal communication, and other management style characteristics, including how feedback is provided.
  • Training approaches
  • Retraining or reorientation for any leave of 12 weeks or more.
  • Increased learning and re-learning time to support comprehension.
  • Individualized training approaches to help improve comprehension and retention.
  • Manager training as well as resources and support for providing more effective responses.
  • For more information, review Communicating with emotional employees.

Environmental needs

  • Modifications to factors in the physical environment, such as lighting, noise, clutter or scents. This can have an impact on employee well-being as well as the ability for an employee to do their job. See also exposure to distractions below.

Flexibility in job scheduling and duties

  • Graduated return to work if the employee has been on sick leave.
  • Start times or end times that help with the effects of medication, energy levels, or needing to attend medical appointments. You may even need to adjust their total work time for the week. For example, on a 24/7 shift rotation, it may be helpful to allow the employee to work every other day rather than shortening a 12-hour rotation. 
  • Split shifts may increase energy.
  • Breaksmore frequently throughout the day, but for the same total time (e.g. six 5-minute breaks rather than two 15-minute breaks).
  • Exchange of tasks with other employees that maintain the balance of work while capitalizing on the strengths of each employee. For example, one employee takes on more telephone work while another takes on more written correspondence.

Strategies for specific concerns

This set of strategies can help address specific work-related concerns that may be experienced by an employee with a mental health related disability. Choose the ones that are relevant to your workplace situation.

Adaptability and flexibility

Consider options related to:

Attention to detail

  • Provide training to improve quality of work.
  • Reduce or eliminate distractions.
  • Break large tasks into a series of smaller tasks.
  • Provide more time to attend to work requiring attention to detail.
  • Permit short breaks when concentration declines.
  • Give instructions and assignments in writing.
  • Create a checklist that includes each step of a task to be completed as quality control.
  • Exchange tasks with other employees that maintain the balance of work while capitalizing on the strengths of each employee.

Decision making

  • Identify and address the potential impact of errors in judgment.
  • Create checklists to guide judgment in routine tasks.
  • Create a list of areas where decisions should be discussed.
  • Address areas where judgments must be discussed.

Degree of self-supervision

  • Create detailed task lists and timelines.
  • Have frequent check-in opportunities.
  • Discuss priorities and direction for dealing with conflicting priorities.
  • Organize outcome measurements by task, day, week and month.
  • Have a list of alternate supervisors or co-workers to contact when necessary.

Degree of supervisor responsibility

  • A list of specific behaviours that can assist in effective supervision of others.
  • Discuss supervisory behaviours that may be interpreted by others as problematic.
  • Develop strategies to deal with stress in the workplace.
  • Have a mentor to call about challenging situations.
  • Identify particularly challenging work relationships and brainstorm alternative responses to these individuals.
  • Reduce or remove supervisory responsibilities.

Exposure to confrontational situations

  • Review policies and practices related to confrontational situations in the workplace with the employee.
  • Educate employees on potential confrontational situations and recommended responses.
  • Provide simulation training on confrontational situations to which employees are exposed.
  • Provide or increase support for the employee in situations that are potentially confrontational.
  • Exchange tasks with other employees that maintain the balance of work while capitalizing on the strengths of each employee.
  • Allow more frequent breaks.

Exposure to distractions

  • Provide a quieter workspace with fewer distractions.
  • Permit the use of headphones to listen to calming sounds or music.
  • Permit wearing of earplugs to reduce noise distraction.
  • Where possible, allow exposure to natural lighting in the work area.
  • Encourage less clutter in the work area.
  • Ask employees to minimize use of scents if this has been identified as a medical issue.
  • Consider modifications that reduce exposure to specific stimuli.
  • Consider requests for some or all of the work to be done at home.

Tolerance of stressful situations

  • Discuss the best way to provide instructions and feedback when in an emotionally stressful situation at work.
  • Address the best way to personally cope in stressful situations at work and how to provide or increase support in situations that are emotionally stressful.
  • Provide genuine praise and positive reinforcement during the workweek.
  • Allow for reasonable time off to attend counselling sessions or medical appointments.
  • Allow reasonable phone calls to access necessary emotional support during the workday.
  • Provide supportive employment services or a work coach.
  • Allow for more frequent breaks.
  • Provide learning opportunities that focus on building resilience, emotional intelligence, civility, and respect.

Exposure to distressed people

  • Help develop in emotional intelligence and resilience.
  • Consider how to provide or increase support in situations that may be stressful.
  • Provide regular and genuine praise and positive reinforcement.
  • Allow reasonable time off to attend counselling sessions or medical appointments.
  • Provide supportive employment services or a work coach.
  • Allow more frequent breaks.
  • Provide an opportunity to debrief and share strategies for dealing with distressed people.

Overlapping tasks

  • Modify workplace processes to focus on one task at a time, if practical.
  • Provide clear, specific and measurable expectations for all tasks.
  • Create a list of all tasks to review to help establish priorities.
  • Consider opportunities to improve efficiency on specific tasks.
  • Provide training on time management skills.
  • Consider job-sharing arrangements.
  • Remove any non-essential functions of the job.
  • Manage expectations by helping the employee develop a schedule that indicates the amount of time you and the employee feel should be spent on required tasks each week; review this against the actual time spent and make adjustments for future work as required.

Problem solving and analysis

  • Create a decision-tree template to assist with problem solving or analytical thinking.
  • Create a list of situations that would indicate the need to reach out for assistance in analysis or problem solving.
  • Have regular check-ins during the decision making process.


  • Encourage the use of recording devices to provide playback of information discussed at meetings if appropriate.
  • Allow the use of digital organizers or handwritten notes as ongoing to-do lists, marking off items as they are completed.
  • Provide instructions and assignments in writing to help provide clarity and improved ability for recall.
  • Set up regular reminders of upcoming milestones, appointments or deadlines.
  • Arrange regular meetings between supervisor and employee to set priorities and keep work on track.
  • Provide retraining and/or reorientation.
  • Use individualized training approaches, such as increased learning time, reading materials in advance, or applied learning to help improve comprehension and retention.

Time pressures

  • Review assigned tasks to establish a reasonable amount of time required for completion. Ensure that all parts of the process are included.
  • Develop a process that establishes and monitors daily or weekly timelines for the completion of assigned tasks.
  • Establish regular times to check in with the employee throughout more complex tasks or projects.
  • Clearly define priorities.
  • Where possible, avoid assigning tight deadlines or provide sufficient resources to effectively meet that deadline, especially in the early stages of an accommodation or return to work.
  • Facilitate clear communication and collaboration to ensure timely completion of each team member’s responsibility within a project.
  • Discuss the best way to give feedback during times of pressure.

Working relationships

  • Define requirements and limitations for an acceptable working relationship and how employees will be held accountable for this type of behaviour.
  • Outline clear and measurable expectations for respect in the workplace for all employees.
  • Define how success will be measured (i.e., no critical comments in team meetings, no outbursts, etc.).
  • Provide training to all staff on building a socially supportive workplace.
  • Provide training for managers and supervisors to increase their capacity to model effective communication in the workplace.
  • Develop processes and strategies to deal effectively with conflict.
  • Provide open and honest feedback.
  • Allow employees the option of not attending work-related social functions.
  • Consider resources that can help develop the ability to engage more effectively with others in the workplace.

Physical demands

  • Consult with an ergonomist to ensure best practices are being used to adjust work areas for physical function or limitations.
  • Provide supports to allow for physical limitations.
  • Allow for short breaks to restore energy and focus.
  • Allow for the exchange of tasks with other employees that maintains balance of work while capitalizing on the physical abilities of each employee.

Work endurance

  • Provide supports to help improve the employee’s endurance (e.g., making water and healthy snacks available at all times; if safe, allowing headphones for music, etc.).
  • Allow for the exchange of tasks with other employees to maintain the balance of work while capitalizing on the strengths of each employee.
  • Allow the employee to do intense tasks when energy is high and easier tasks when energy is low.
  • Ensure reasonable breaks during and between shifts.
  • If possible, remove the employee from the after-hours/on-call list.
  • When possible, allow for more frequent, shorter breaks to restore energy and focus.
  • Regularly check in with the employee to assess fatigue levels.

Degree of isolation

  • Provide the opportunity to interact frequently with other team members via online technology.
  • Conduct regular team building activities through online webinars or live meetings.
  • Bring remote team members together in a single location for meetings/events.
  • Provide regular, positive feedback acknowledging the employee’s contributions and value.
  • As a perk or bonus, provide memberships that would allow more social interaction.
  • Allow time in the work-week to attend business, volunteer and other functions that provide social interaction.

Problematic substance use and addiction

  • Avoid organizing work-related networking activities that include alcohol, gambling or other common addictions.
  • Consider offering only non-alcoholic beverages at work-related events.
  • For more information, see Impairment and addiction response for leaders

Potential for crisis

If there’s potential for an employee to experience a crisis at work involving severe anxiety, flashbacks or emotional breakdown, you should work with the employee to develop a plan for how you are to respond and who you should call. For additional information, you and the employee may want to review Psychosis and how to help in a crisis.

Strategies for more serious illness

Serious mental illnesses such as schizophrenia may impair a person's ability to think clearly due to delusions, hallucinations or thought disorders that may leave them fearful and withdrawn. However, there are new treatment approaches that are continually improving the functioning and wellness for people who experience these symptoms. There are cases where employees who are experiencing serious mental illness can be accommodated to do their job. The  tips below support the employer and employee during this process.

Tips for accommodation success

Strategies for accommodations that support the success of an employee with serious mental illness aren’t very different than those that would be provided for any employee experiencing a mental health concern. With serious mental illness however, it is critical to also develop a detailed, written workplace plan to respond in the event of a relapse. In addition, steps should be taken to connect the employee to appropriate supports and resources within and outside of the organization, like community agencies and benefit providers.

In addition to the accommodation strategies described above, supervisors may want to consider the following strategies to ensure that employees with serious mental illness feel supported and that expectations are as clear as possible:

  • Develop a written workplace plan that includes the agreed upon accommodations, clear expectations of responsibilities, the consequences of not meeting performance standards, and the response for when the employee is not well. It’s preferable to do this when the employee is well. Developing employee plans for leaders can be a starting point.
  • A tool to support employee success can help inform the development of a workplace plan, while exploring psychological, emotional, and cognitive job demands.
  • Develop strategies to deal with behavioural or health problems before they arise, including who to call (family, friend, health professional, etc.) if the employee appears to be unwell.
  • Establish written long-term and short-term goals.
  • Provide written job instructions for additional tasks.
  • Encourage ongoing, open communication with the employee.
  • Provide positive praise and reinforcement.
  • Develop a procedure to evaluate the effectiveness of the accommodation.

Have a crisis response plan in place

The following questions can help employers establish a detailed response plan in case of crisis, emergency or threat of harm to the employee or others. They can also help address the broader issue of well-being and behaviour at work:

  • What checks and balances can we put in place to help you stay on track?
  • What should we be looking for that would indicate you are struggling?
  • How would you like to receive feedback on the work that you are doing?
  • If we think there may be performance issues, how can we discuss this with you in a way that is supportive and helpful?
  • What kind of errors might you be concerned about making and how can we help manage these?
  • What are the things that most stress or overwhelm you right now?
  • What are the things that may stress or overwhelm you in the future?
  • Let’s check in for a few minutes every days/weeks to ensure you’re feeling supported. (The number of days/weeks is dependent on the health and functioning of the employee. The maximum should be two weeks and it could be as much as daily, but these meetings should be kept to 10 minutes in length to make it manageable for everyone. If a longer meeting is necessary, it can be scheduled.)

Consider co-worker concerns

Co-workers’ concerns about an employee who is being accommodated can be considered while respecting confidentiality. These are some steps that help build a workplace culture where all employees are treated with civility and respect:

  • Review Managing co-worker reactions to accommodation.

  • Educate all employees on your accommodation process.

  • Share psychosis and how to help in a crisis to provide information about responding to a mental health crisis in the workplace.

  • Do not require employees to attend all work-related social functions so that those who are uncomfortable can choose to abstain.

  • Encourage all employees to move non-work-related conversations out of work areas to avoid the perception of gossip or conspiracy.

  • Provide awareness education about mental illness to all employees.

  • Conflict response for leaders provides an approach for addressing co-workers’ concerns in a way that respects everyone involved and can be used even when mental illness may be a factor.

  • Managing co-worker reactions to accommodation provides more information for situations when employees may have a strong reaction to the returning employee. It provides strategies that support the returning employee, but also helps protect or improve workplace mental health overall.

Some of the above content has been adapted from the work of Open Door Group.

Benefits of employment and return to work

Work brings clear health benefits of people with serious mental illness. As reported in Working with Schizophrenia: Pathways to Employment, Recovery and Inclusion, those in paid employment are over five times more likely to achieve functional remission than those who are unemployed or in unpaid employment. The report also states that a considerable proportion of working age people with a history of serious mental illness are able and willing to work.

Work can provide a sense of purpose, social connections and improved overall quality of life. Employment may also bring clear benefits in terms of loyalty and engagement to the employers who choose to hire or retain those with serious mental illness.

David Williams of Rainbow’s End describes his experience and the benefits of employing those who have a history of serious mental illness.
Contributors include.articlesCanadian Labour CongressDonna HardakerDr. David BrownDr. David PosenDr. Ian M. F. ArnoldHuman Resources Professional AssociationInstitute for Work and HealthJudy KerlingLyne WilsonM. Suzanne ArnoldMary Ann BayntonStéphane GrenierWorkplace Strategies team 2007-2021

Related articles.articles

Article tags.articles

Choose an option to filter.articles


To add a comment.comments