Reasonable Adjustments for Mental Health at Work

If an employee has a mental health condition that qualifies as a disability, you have a legal duty to make reasonable adjustments. Here's what that means in practice.

The Legal Duty

Under the Equality Act 2010, employers must make reasonable adjustments when:

1. A provision, criterion or practice puts a disabled person at a substantial disadvantage
2. A physical feature puts a disabled person at a substantial disadvantage
3. A disabled person would be at a substantial disadvantage without an auxiliary aid

Failure to make reasonable adjustments is disability discrimination.

When Does a Mental Health Condition Qualify?

A mental health condition is a disability under the Equality Act if it has:

• Substantial adverse effect (more than minor or trivial)
• Long-term effect (lasted or likely to last 12 months+)
• On the person's ability to carry out normal day-to-day activities

Conditions That Often Qualify

• Depression
• Anxiety disorders
• Bipolar disorder
• PTSD
• OCD
• Schizophrenia
• Eating disorders
• Personality disorders

Day-to-Day Activities Affected

Consider impact on:

• Concentration and memory
• Learning and understanding
• Sleep
• Social interaction
• Perception of danger
• Physical coordination
• Continence
• Mobility

What If They're Taking Medication?

Assess the condition as if they weren't taking medication. Someone whose depression is controlled by medication still has a disability if, without medication, they'd have substantial difficulties.

Fluctuating Conditions

Conditions that come and go still qualify if:

• Effects are substantial when present
• They're likely to recur
• Would be long-term overall

When to Make Adjustments

You must make adjustments when you know (or should reasonably know) that an employee:

• Has a disability, AND
• Is at a substantial disadvantage because of it

Trigger Points

• Employee discloses a condition
• You observe difficulties
• Occupational Health advises
• Reasonable person would realise
• GP fit note mentions condition

You can't wait for formal diagnosis. If you know someone is struggling with their mental health in a way that affects their work, consider adjustments.

Examples of Reasonable Adjustments

Working Arrangements

Adjustment	When Helpful
Flexible start/finish times	Medication side effects, sleep difficulties
Working from home	Social anxiety, need for quiet
Part-time hours	Reduced energy, attending appointments
Predictable schedule	Anxiety, need for routine
Avoiding night shifts	Sleep disorders, medication timing
Phased return after absence	Gradual build-up of stamina

Workload and Tasks

Adjustment	When Helpful
Reduced workload temporarily	During difficult periods
Prioritised task list	Concentration difficulties
Breaking work into smaller tasks	Overwhelm, anxiety
Extending deadlines	Reduced capacity
Reallocating some duties	Specific triggers
Providing written instructions	Memory difficulties

Environment

Adjustment	When Helpful
Quiet workspace	Concentration, sensory sensitivity
Near exit/window	Panic attacks, claustrophobia
Private space for breaks	Need to decompress
Reduced open-plan time	Social anxiety
Consistent workspace	Need for predictability

Support

Adjustment	When Helpful
Regular one-to-ones	Check-ins, support
Clear expectations	Anxiety about performance
Advance notice of changes	Difficulty with uncertainty
Buddy system	Social support
Time off for therapy	Ongoing treatment
Access to EAP	Professional support

Communication

Adjustment	When Helpful
Written rather than verbal instructions	Memory, processing
Time to process before responding	Anxiety, cognitive difficulties
Avoiding put on spot in meetings	Social anxiety
Regular feedback	Reassurance, clarity
Sensitivity in absence discussions	Stigma concerns

What's "Reasonable"?

There's no fixed definition. Consider:

Effectiveness

Will the adjustment actually help remove the disadvantage?

Practicality

Can it be implemented? Is it operationally feasible?

Cost

What's the financial cost relative to your resources? (Small cost adjustments are almost always reasonable)

Disruption

How much would it disrupt the business or other staff?

Resources Available

What resources (financial, practical) do you have?

Nature of Role

Some adjustments may not work for certain roles (but explore alternatives)

Already Done

What have you already done? What else could you do?

Key point: The threshold is lower than many employers think. Most mental health adjustments cost nothing or very little.

The Process

1. Have a Conversation

When an employee discloses or you become aware:

• Find a private space
• Listen without judgment
• Ask what would help
• Don't make assumptions
• Agree next steps

Ask: "What adjustments would help you do your job effectively?"

2. Gather Information

If needed:

• Occupational Health referral
• Ask for GP/specialist input
• Research the condition
• Speak to Access to Work (government scheme)

3. Consider Options

• What has the employee suggested?
• What do OH recommend?
• What's worked elsewhere?
• What's feasible operationally?
• What would be effective?

4. Discuss and Agree

• Meet with the employee
• Discuss options openly
• Explain any constraints
• Agree specific adjustments
• Set review date

5. Implement

• Communicate to relevant people (with consent)
• Make practical arrangements
• Brief the team if appropriate
• Document what's agreed

6. Review

• Check if adjustments are working
• Adjust as needed
• Regular review (e.g., monthly initially)
• Respond to changes in condition

Documentation

Keep records of:

• Discussions held
• Information gathered
• Adjustments considered
• Adjustments agreed
• Reasons for any refused
• Reviews and changes

Good records protect you and ensure consistency.

Confidentiality

• Only share with those who need to know
• Get employee's consent before sharing
• Team doesn't need to know the diagnosis
• Frame as "we're making some adjustments to support X"
• Respect employee's wishes about disclosure

When You Can't Make an Adjustment

Sometimes a specific adjustment isn't reasonable. If so:

1. Explain why
2. Explore alternatives
3. Document your reasoning
4. Keep dialogue open

Valid reasons might include:

• Would make the role impossible
• Disproportionate cost for small employer
• Would significantly harm the business
• Health and safety risks

Invalid reasons:

• "We've never done it before"
• "Other staff might want the same"
• "It's not in the policy"
• "It might set a precedent"

Access to Work

The government's Access to Work scheme can help with:

• Funding for adjustments
• Support worker costs
• Travel costs
• Equipment
• Mental health support service

Employees apply directly. It can fund adjustments beyond what you'd normally provide.

Common Mistakes

1. Waiting for Formal Diagnosis

You must act on what you know. Don't wait for medical proof.

2. One Conversation Only

Mental health fluctuates. Keep dialogue open and review regularly.

3. Assuming What's Needed

Ask the employee. They know their condition best.

4. Treating as Absence Issue

Focus on enabling work, not policing sickness.

5. Ignoring Small Adjustments

The best adjustments are often simple and free.

6. Forgetting to Review

What works now may need changing. Build in reviews.

If Adjustments Aren't Working

If despite adjustments, the employee can't do the role:

1. Explore further adjustments
2. Consider redeployment
3. Get updated medical advice
4. Discuss openly with employee
5. Follow proper capability process
6. Dismissal only as last resort (and still may be discriminatory)

Take legal advice before dismissing someone with a disability.