Boston University Sargent College of Health & Rehabilitation Sciences
Center for Psychiatric Rehabilitation

Boston University Sargent College of Health & Rehabilitation Sciences
Center for Psychiatric Rehabilitation

How do psychiatric and mental health conditions interfere with work performance?

Psychiatric and mental health conditions may interfere with functioning in different ways. Often, the person themselves or the professionals working with them can describe the functional limitations that are specific to your employee. Please remember that since there are a lot of different types of psychiatric and mental health conditions, that this is not a complete list, nor do these limitations apply to everyone who has a psychiatric condition.

Functional limitations due to psychiatric disability 

The following is a list of some of the activities that people with psychiatric conditions may have trouble doing: 

  • Sustaining concentration– restlessness, shortened attention span, easily distracted, trouble remembering verbal directions

Example: An employee may have trouble focusing on one task for extended periods.

Possible solutions: Break large projects into smaller tasks, allow brief but more frequent breaks to stretch, walk around, get fresh air, assign tasks one at a time. 

  • Maintaining stamina– having energy to work a full day, combating drowsiness due to medications

Example: An employee may not be able to work a full 8-hour day.

Possible solutions: Part-time hours, rest breaks in middle of day, job sharing. 

  • Handling time pressures and multiple tasks– managing assignments & meeting deadlines, prioritizing tasks

Example: An employee may not know how to decide which tasks should be done first, or be able to complete tasks by the due date.

Possible solutions: Break larger projects down into manageable tasks, meet regularly to help the employee to prioritize tasks or to estimate time to complete project. 

  • Interacting with others – getting along, fitting in, talking with coworkers, reading social cues

Example: An employee may not talk with coworkers at breaks, or may have trouble reading the subtle social cues of the workplace.

Possible solutions: Establish a mentor or coworker buddy relationship to introduce the employee to others or to show the employee “the ropes.” 

  • Responding to negative feedback– understanding and interpreting criticism, knowing what to do to improve, initiating changes because of low self esteem

Example: An employee may not seem to understand the feedback given, or becomes upset when criticism is delivered.

Possible solutions: Arrange a meeting with the job coach and employee to facilitate feedback, use a feedback loop (ask employee’s perspective of performance, describe both strengths and weaknesses, suggest specific ways to improve), give employee the chance to read written feedback privately, and then discuss. 

  • Responding to change– coping with unexpected changes in work, such as changes in the rules, job duties, supervisors or coworkers

Example: An employee may take longer to learn new routines, or feel stressed when new supervisors or coworkers start work.

Possible solutions: Prepare employee for changes that will be happening, explain new rules or duties, make a special effort to introduce new staff to employee and orient new supervisors to employee’s needs. 

  • Screening out environmental stimuli – an inability to block out sounds, sights, or odors which interfere with focusing on tasks

Example: an employee may not be able to work next to a noisy printer or in a high traffic area.

Possible solutions: Move printer away from work area, allow employee to wear headphones playing soft music, install high partitions around desk. 

Why I need to know about functional limitations 

The ADA states that employers only need to provide accommodations to the known mental or physical limitations of someone with a disability that can be attributed to that disability. Employers are not required to accommodate limitations due to other characteristics, such as poor literacy skills (that are not due to learning disabilities), low educational levels or lack of credentials. You can ask the employee or a professional to document the types of functional limitations due to the disability that lead to the need for accommodations for that person. 

How I might recognize signs of psychiatric or mental health conditions in the workplace

While a single symptom or isolated event is rarely a sign opsychiatric or mental health condition, a symptom that occurs frequently, lasts for several weeks, or becomes a general pattern of an individual’s behavior may indicate the onset of a more serious mental health problem that requires treatment. Some of the most significant indications of possible concern include: 

  • marked personality change over time,
  • confused thinking; strange or grandiose ideas, 
  • prolonged severe feelings of depression or apathy, 
  • feelings of extreme highs or lows, 
  • heightened anxieties, fears, anger or suspicion; blaming others, 
  • social withdrawal, diminished friendliness, increased self-centeredness,
  • denial of obvious problems and a strong resistance to offers of help, 
  • dramatic, persistent changes in eating or sleeping habits, 
  • substance abuse, 
  • thinking or talking about suicide. 

These symptoms are not always readily apparent. Employers and supervisors may be able to notice significant changes in their employees’ work habits, behaviors, performance, and attendance, such as:

  • consistent late arrivals or frequent absences, 
  • low morale, 
  • lack of cooperation or a general inability to work with colleagues, 
  • decreased productivity, 
  • increased accidents or safety problems,
  • frequent complaints of fatigue or unexplained pains, 
  • problems concentrating, making decisions, or remembering things, 
  • making excuses for missed deadlines or poor work, 
  • decreased interest or involvement in one’s work. 

People who experience problems, such as those listed above, may simply be having a bad day or week, or may be working through a difficult time in their lives. A pattern that continues for a long period may, however, indicate an underlying mental health problem. 

Some research findings on types of functional limitations

One study conducted by the Center for Psychiatric Rehabilitation on Reasonable Workplace Accommodations for people with psychiatric conditions found that the most common functional limitations for employees who were receiving supported employment services included: 

  • Interacting with others– interviewing for the job, describing strengths and weaknesses, clarifying instructions, asking for help, starting conversations with coworkers 
  • Learning the job – remembering the routine, following instructions, learning new tasks 
  • Maintaining work stamina/pace – working 3 hours without breaks, standing for long periods, taking scheduled breaks, completing tasks in allotted times, managing time
  • Managing symptoms/tolerating stress – relaxing, recognizing stressors, managing negative feelings, managing internal distractions 

These functional limitations were accommodated in a variety of ways. Supported employment service providers were often very helpful to employers in identifying the limitations and suggesting effective accommodations. 

A variety of sources were consulted to develop this information, including: 1) the Job Accommodation Network ( They have numerous helpful publications about work, work limitations, and accommodations for specific conditions such as depression, anxiety, schizophrenia-spectrum disorders, “mental impairments” and others; 2) Center for Psychiatric Rehabilitation publications and experts; 3) the following scholarly publications: Workplace Accommodations for People with Mental Illness: A Scoping Review by McDowell and FosseyJournal of Occupational Rehabilitation197–206 and Work accommodations and natural supports for maintaining employment by Corbière and his colleagues. Psychiatric Rehabilitation Journal, 37(2), 90–98. 

Note: The information contained in these pages is for educational purposes only, and is not legal advice. Individuals should contact the appropriate legal resources for specific legal advice regarding their particular situations.