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

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

What Accommodations Work on the Job?

Types of workplace accommodations

The following are examples of types of accommodations that may be helpful to a person with a psychiatric or mental health condition. Each work situation must be considered on an individual basis to determine the best accommodation that does not pose undue hardship on the employer. In addition, accommodations cannot be imposed on an employee but must be requested and agreed to.

  • Restructure job tasks
    – reassign work tasks to better suit the person’s skills and abilities; divide larger assignments into smaller tasks
  • Adjust work schedules
    – provide time off for medical or psychiatric appointments,
    – adjust starting time because of morning drowsiness due to medications
  • Flexible leave
    – enable use of sick leave for mental health reasons,
    – extend leave without pay due to hospitalization
  • Specialized equipment & assistive devices
    – use e-mail to deliver daily instructions
  • Modify work sites
    – install wall partitions around workstation to minimize distractions, or provide quiet workspace
  • Provide accommodations in transportation or parking
    – assign parking space closer to building to manage symptoms relate to anxiety
  • Provide human assistance
    –provide job coach, mentor, or work buddies for guidance and support

Additional accommodations that may be helpful:

  • Using a Job coach assistance in hiring
    – help to arrange the interview,
    – help in completing job applications,
    – help before or during an interview
  • Using a Job coach for support on the job
    – enable on site support or training in job tasks
  • Provide flexible scheduling
    – allow changes in the start or end of the workday hours,
    – provide flexible part-time hours,
    – allow more frequent breaks,
    – permit sick leave for mental health reasons
  • Changes in supervision
    – provide extra supervision hours,
    – involve a job coach in supervision meetings,
    – modify the way feedback and instructions are given
  • Changes in training
    – allow extra time to learn job tasks,
    – provide more assistance in orientation to job and tasks

The US Department of Labor, Office of Disability Employment Policy provides information about maximizing productivity and accommodating individuals with psychiatric conditions in the workplace. While not all employees need accommodations, individualized accommodations in consultation with the employee are the most beneficial (https://www.dol.gov/odep/pubs/fact/psychiatric.htm).

 

In addition to the accommodations described above, ODEP suggests the following:

Possible accommodations and modifications to the work environment:

  • Reduction and/or removal of distractions in the work area.
  • Addition of room dividers, partitions or other soundproofing or visual barriers between workspaces to reduce noise or visual distractions.
  • Private offices or private space enclosures.
  • Office/work space location away from noisy machinery.
  • Reduction of workplace noise that can be adjusted (such as telephone volume).
  • Increased natural lighting or full spectrum lighting.
  • Music (with headset) to block out distractions.

Possible equipment and technology that can be useful:

  • Tape recorders for recording/reviewing meetings and training sessions.
  • “White noise” or environmental sound machines.
  • Handheld electronic organizers, software calendars and organizer programs.
  • Remote job coaching, laptop computers, personal digital assistants and office computer access via remote locations.
  • Software that minimizes computerized distractions such as pop-up screens.

Management/Supervision

  • Implementation of flexible and supportive supervision style; positive reinforcement and feedback; adjustments in level of supervision or structure, such as more frequent meetings to help prioritize tasks; and open communication with supervisors regarding performance and work expectations.
  • Additional forms of communication and/or written and visual tools, including communication of assignments and instructions in the employee’s preferred learning style (written, verbal, e-mail, demonstration); creation and implementation of written tools such as daily “to-do” lists, step-by-step checklists, written (in addition to verbal) instructions and typed minutes of meetings.
  • Regularly scheduled meetings (weekly or monthly) with employees to discuss workplace issues and productivity, including annual discussions as part of performance appraisals to assess abilities and discuss promotional opportunities.
  • Development of strategies to deal with problems before they arise.
  • Written work agreements that include any agreed upon accommodations, long-term and short-term goals, expectations of responsibilities and consequences of not meeting performance standards.
  • Education of all employees about their right to accommodations.
  • Relevant training for all employees, including co-workers and supervisory staff.

The World Health Organization has additional information about mental health in the workplace including impact, issues and best practices (https://www.who.int/mental_health/media/en/712.pdf).

The Centers for Disease Control has written a good overview of how mental health issues and stress are affecting American workers can be found here: https://www.cdc.gov/workplacehealthpromotion/tools-resources/pdfs/WHRC-Mental-Health-and-Stress-in-the-Workplac-Issue-Brief-H.pdf.


Case Illustrations of workplace accommodations

A computer coder with severe anxiety, panic attacks and depression was forced her to take a medical leave of absence as her symptoms increased. She was extremely anxious about returning to work because she feared she might have difficulty remembering her job tasks and concentrating in a busy work area. Her office was located in the center of a space with cubicles, next to a noisy printer shared by others, and surrounded by private offices with doors that the executives occupied. Exploration of the reasons for her anxiety revealed that many people walked by her office and stopped to talk to her on the way to the printer or to assign her tasks, which interrupted her train of thought, as well as made her anxious because she did not feel comfortable talking to people. Her cubicle wall next to her desk was only three feet high, allowing visual contact with anyone that walked by.

Several accommodations were suggested. A full height partition next to her desk minimized visual distractions and casual conversation. Written instructions or use of e-mail was recommended for assigning her new tasks. Other memory aides were developed to help her remember certain job tasks. A graduated return to work helped to build her stamina and confidence.

An editor for a major publishing company who has a diagnosis of Bipolar Disorder has difficulty concentrating on his proofreading tasks due to his symptoms. He works in an open area with others.

The employer allows him to wear headphones playing soft music to minimize symptoms, helping him to concentrate. The headphones prevent other employees from hearing the music.

The same editor was hospitalized numerous times after being hired into a permanent position. This affected her ability to complete book projects with specific timelines.

The publishing company transferred her to doing contract editorial work which could be more short-term and time-limited, and reassigned work to other contract workers if a hospitalization reoccurred. She was allowed a graduated return to work after hospitalizations. She was also able to modify her work schedule on a weekly basis to attend therapy appointments during work hours, working extra hours on other days or evenings.

 


A variety of sources were consulted to develop this information, including: 1) the Job Accommodation Network (www.askjan.org). 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 https://askjan.org/publications/index.cfm; 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 Fossey, Journal of Occupational Rehabilitation, 197–206, https://link.springer.com/article/10.1007/s10926-014-9512-y and Work accommodations and natural supports for maintaining employment by Corbière and his colleagues. Psychiatric Rehabilitation Journal, 37(2), 90–98. https://doi.org/10.1037/prj0000033


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.