Accommodation strategies

The goal of accommodation is to help employees who have a disability to remain productive and feel supported at work. 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 who has a mental health related disability.

The following accommodation strategies:

• Address mental health related concerns including more serious mental illness.
• Are meant to support productivity and performance for an employee who is at work or who is 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 put in place, other than an investment of time to change a process or communication approach.

It's recommended that after you review the content in this section you also consider A 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 starting, ensure the employee is involved in the discussion to consider ideas that will effectively support their success at work. An employee's accommodation plan must address the specific work 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 other obligations to provide reasonable accommodation under relevant human rights, accessibility, or other legislation.

For more information see Developing employee plans for leaders.

General approaches

Below are approaches to support 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 remember details.
• Brief weekly meetings for 10 minutes, or more frequently if necessary. This is time for the supervisor and employee to talk about issues before they become serious. This is 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

• Physical modifications such as lighting, noise, clutter or scents 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 the employee’s 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, which may help with endurance.
• Frequent breaks throughout the day, but for the same total time (for example, six 5-minute breaks rather than two 15-minute breaks.
• Exchange of tasks with other employees that maintains the balance of work. Lean on the strengths of each employee. For example, one employee could take on more phone calls while the other takes on more emails.

Strategies for specific concerns

These strategies can address specific work concerns that impact an employee with a disability. Choose the ones that are relevant to the situation.

Adaptability and flexibility

Consider options related to:

• Hours of work.
• The need for work travel.
• Meeting deadlines.
• Time of day that tasks are completed.
• Other routines or procedures.
• See also Helping employees to manage change.

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 leaning 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

• Make a list of specific behaviours that can assist in effective supervision of others.
• Discuss supervisory behaviours that may be seen by others as problematic.
• Develop strategies to deal with stress at work.
• 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 at work 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 leaning 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 avoid using scents if this has been identified as a medical issue.
• Consider modifications that reduce exposure to specific stimuli.
• Consider requests for some or all work to be done at home.

Tolerance of stressful situations

• Discuss the best way to share instructions and feedback when in an emotionally stressful situation at work.
• Address the best way to personally cope in stressful situations at work.  Include how to get support in these situations.
• 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 increase 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

• Adjust work 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. This should include 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 recording devices that 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.
• Give 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 or reorientation.
• Use individualized training approaches. Consider increased learning time, sharing materials in advance, or applied learning to help improve understanding 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. If necessary, provide resources to effectively meet a deadline. This is helpful especially in the early stages of an accommodation or return to work.
• Clearly communicate each team member’s job expectations with a project to ensure timely completion. 
• Discuss the best way to give feedback during times of pressure.

Working relationships

• Define what behaviours are required for an acceptable working relationship. Share how employees will be held accountable for displaying negative or harmful behaviour.
• Outline clear and measurable expectations for respect at work for all employees.
• Define how success will be measured. Some examples include no critical comments in team meetings,  or no outbursts.
• Provide training to all staff on building a socially supportive environment at work.
• Provide training to managers and supervisors in effective communication to increase their ability to model it.
• 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 at work.

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 employees to exchange tasks with others to maintain balance of work while considering the physical abilities of each employee.

Work endurance

• Provide supports to help improve the employee’s endurance. Some examples can include making water and healthy snacks available at all times and, if safe, allowing headphones for music. 
• Allow employees to exchange tasks with others to maintain balance of work while considering the strengths of each employee.
• Allow the employee to do intense tasks when energy is high and easier tasks when energy is low.
• Ensure the employees takes reasonable breaks during and between shifts.
• If possible, remove the employee from the after-hours or 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 and 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 work-related functions that provide social interaction. These could include business events, volunteering, social events, etc. 

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, work with the employee to develop a plan for how you are to respond and who you should call. This could include incidents involving severe anxiety, flashbacks or emotional breakdown. For more 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 may impair a person's abilities at work, but there are cases where employees who are experiencing this can be accommodated to do their job. The tips below support the employer and employee during this process. 

Tips for accommodation success

Accommodations strategies that support the success of an employee with serious mental illness aren’t very different from those that would be provided for any employee experiencing a mental health concern. With serious mental illness, however, it is important to develop a detailed, written work plan to respond in the event of a relapse. 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 work 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 inform the development of a work 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 if the employee appears to be unwell. This could include contact information for family, friends, and health professionals. 
• 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 questions below can help employers establish a 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 actions 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 you’re 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 are you 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?
• You can offer to  check in consistently to ensure the employee is feeling supported. How often you do this is dependent on the health and functioning of the employee. No more than 5 working days should pass without a check in after you first develop a plan, and further apart once you see the employee is doing well. 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 discussed. Ensure you are respecting confidentiality when doing so. These are some steps that help build a work 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 at work.
• Do not force employees to attend all work-related social functions, so that those who are uncomfortable can choose to not attend.
• 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 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 foster engagement and loyalty to employers who choose to hire or retain those with serious mental illness.