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-to Tips for Employers

Developing Accommodations

Accommodations should be determined on a case-by-case basis and individualized for each employee, but there are procedures that can be used as a guide. Starting with a disclosure of disability or a request for an accommodation, open a dialogue with the person about the limitations experienced and brainstorm possible accommodations. Periodically reviewing and assessing the accommodations and performance is recommended. Many have found that the existence of a policy for developing and implementing accommodations and a specific procedure for resolving conflicts that might arise helps address many of the concerns about accommodating people with psychiatric or mental health conditions in the workplace.

  • Identify whether the employee has disclosed a disability and/or initiated a request for reasonable accommodations.
  • Define essential and nonessential functions of the job.
  • Assess required skills and competencies to perform the essential work functions. That is, what of the following are essential for the performance of the job:
    • technical skills/expertise
    • explicit expectations
    • general work skills/implicit expectations
  • Ask the employee what he or she thinks will help.
  • Evaluate the functional limitations of the employee.
  • Generate ideas for job accommodations.
  • Consult a job coach, employment specialist, state vocational rehabilitation counselor in your area if available.
  • Brainstorm strategies with the employee’s service providers (with permission).
  • Contact the Job Accommodation Network or 800-526-7234 for free technical assistance.
  • Select accommodations that are both reasonable and effective.


See our section on What Accommodations Work on the Job? as well as the U.S. Department of Labor’s Office of Disability Employment Policy ( for additional information about developing effective accommodations as well as publications that may be of interest (

Providing Feedback to an Employee Experiencing Work Performance Difficulties

This information is provided to assist an employer in discussing job performance difficulties with an employee who has a disability.

  • Ask the employee to give his or her perspective on their work performance. Encourage the employee to have a balanced perspective, identifying both strengths and weaknesses. In the initial attempts to gain a balanced perspective, have the employee focus more on his/her strengths rather than weaknesses. Use the following format, ask the employee to:
    • Provide an overall evaluation of performance
    • Discuss his/her strengths on the job, describing at least two,
    • Discuss his/her weaknesses on the job, describing at least one,
    • Discuss specific ways to improve performance that can include an accommodation.
  • Summarize what you heard the employee saying to demonstrate understanding of his or her perspective.
  • Identify and then share areas in which you agree with the employee’s perspective, starting with strengths. Then add your own points, which were not mentioned. Again, identify more strengths than weaknesses. The employer should:
    • Provide an overall evaluation of work performance
    • Discuss employee’s strengths on the job, describing at least two,
    • Discuss employee’s weaknesses on the job, describing at least one,
    • Discuss specific ways to improve performance that can include an accommodation.
  • To disagree with the employee’s perspective, it may be helpful to say, “ you think you did _____, what I see is ____.”
  • In particular, be specific about what the employee can do to improve performance on the job. It is helpful to know what to do going forward, and not just focusing on what didn’t go well before.

 Requesting Documentation

Sometimes employers may not be clear about whether someone is disclosing a psychiatric or mental health condition or requesting a reasonable accommodation. When the need for accommodation is not obvious, the employer can legally ask the employee to provide documentation. It is important to remember that the employer may not legally ask a job applicant before a job offer whether he or she has a disability or needs reasonable accommodations, unless that person has volunteered this information.

Once someone has told you that he/she has a disability or has requested a reasonable accommodation, you can move ahead to develop the accommodation(s). If you are unsure about whether the employee is someone who is covered under the ADA as someone with a disability, ask for documentation from a professional.

  • Describe why you need this information, i.e., to verify the existence of a work related disability and the need for accommodation.
  • Identify the types of professionals who can provide this information – the EEOC guidelines state that a therapist (licensed social worker, licensed clinical psychologist, psychiatrist), medical doctor or other primary health care professional, psychiatric nurses, licensed mental health counselors, rehabilitation counselor or other related professional may all be qualified to provide the requested documentation.
  • Describe the type of information that you need in the documentation. Under the guidelines, you can ask for the following types of information:
    • that the employee has a covered disability under the ADA (an impairment that substantially limits a major life activity),
    • functional limitations that the person experiences that are due to the disability, and;
    • suggested accommodations in the workplace.
  • If the information provided by the professional still does not clarify the situation for you, you may ask the employee to meet with a professional of your choice to verify the disability and/or need for accommodation.

The Job Accommodation Network can provide additional information about these steps ( or 800-526-7234).

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.