SUMMARY: Helping employees who have a disability remain productive is the objective of accommodation. Developing sustainable solutions is more likely to happen by engaging employees in committing to what will work for them. The strategies shared here can help support the discussion with an employee with 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.
  • Can be helpful even when the legal duty to accommodate is not applicable in the circumstances in your jurisdiction (e.g. stress, burnout or life challenges, etc.).
  • Generally cost little or nothing to implement, except an investment of time, or a change in process or communication approach.

It is recommended that after you review the content in this section you also consider Supporting Employee Success – A Tool to Plan Accommodations that Support Success at Work. This free resource can help clarify job expectations, identify employee abilities and develop accommodations when mental health is a factor.

Engaging the employee in the discussion is key to success

Before implementing any accommodation plan, ensure that 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 his or her 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 or other legislation.

For more information see Developing a Workplace Plan.

Accommodation strategies that may apply for all concerns

The following are some management approaches for supporting any employee and can become even more relevant when supporting an employee with a mental health related disability.

Communication and supervision techniques

  • Modification of instruction and feedback. Written instructions may provide the employee with clarity and improved ability to recall them.
  • Brief weekly meetings, or more often if necessary (e.g. 10 minutes or so). 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 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.

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 the 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 affects of medication, energy levels, or needing to attend medical appointments. Can be the same total work time. 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.
  • Breaks more 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.

Accommodation 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

  • Flexibility around hours of work.
  • Flexibility around deadlines.
  • Flexibility around the time of day that tasks are completed.

Attention to Detail

  • Removal of any nonessential functions of the job.
  • 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.
  • Allow more time for work requiring attention to detail.
  • 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.

Exposure to Emotionally 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 emotionally 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.

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.
  • Management 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.

Recall

  • 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.

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.

Potential for Crisis

If there is potential for an employee to experience a crisis at work involving severe anxiety, flashbacks or emotional breakdown, 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 Mental Health First Aid.

Accommodation strategies for more serious mental 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 following information and strategies are provided to support the employer and employee during this process.

Angela
Angela: Working successfully with Schizo-Affective Disorder


Benefits of employment and return to work

Work brings clear health benefits for 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.

Tips for accommodation success

Strategies for accommodations that support the success of an employee with serious mental illness are not 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. Community agencies and benefit providers are good places to start.

In addition to the accommodation strategies described above, supervisors may want to consider the following strategies to ensure that the employee with serious mental illness feels 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 is preferable to do this when the employee is well.
  • 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.

Having a 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.

Reviewing the approaches described in Developing a Workplace Plan and Accommodation can be a starting point. The following questions 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 kept to 10 minutes in length to make it manageable for everyone. If a longer meeting is necessary, it can be scheduled.)

Addressing co-worker concerns

Considering co-worker’s concerns can be done while respecting the privacy of the individual with serious mental illness. Following are some steps that help build a workplace culture where all employees are treated with civility and respect:

  • Educate all employees on your accommodation process.
  • Provide awareness education about mental illness to all employees.
  • Share Mental Health First Aid 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.

Resolving conflict provides an approach for addressing co-workers concerns in a way that respects everyone involved and can be used even when one party may have a mental illness.

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

The free video based resource Managing Mental Health Matters provides training to help managers develop the competency to have effective discussions around performance, conflict, return to work and accommodation.

Additional Resources

The following are links to resources that may be of interest to you. If you click on a link you may be entering a third party website not maintained or controlled in any way by us or our affiliated companies. For more information, see Legal and Copyright.

Making Work Work
A free resource designed to enable and support discussions about how stress, anxiety, depression and other mental health conditions affect someone at work. It is intended to aid communication, understanding and support. Provided with permission of Mindful Employer (UK).