Reasonable adjustments for mental ill-health

Support is determined in context of the individual’s role, the wider context of the team’s objectives and operational practicalities. Any support must be reasonable, proportionate and effective.

Mental health fluctuates.  Many people recover fully from a period of mental ill-health. Even those living with long-term mental illl-health can do a lot to maintain wellbeing.

Here are some ideas for the individual and manager to consider:

Working hours or patterns

  • Changing start and finish times to help an individual who finds rush-hour travel stressful, or who experiences morning drowsiness as a side-effect of medication.
  • Dividing a break up into shorter, more frequent chunks.
  • Planning to use some annual leave for occcasional breaks throughout the year, even in term-time, to support wellbeing.
  • Allowing the individual to take annual leave at short notice if they are becoming stressed.
  • Allowing an individual to attend medical appointments, therapy or support groups during working hours.  This may be an important element of keeping an individual functioning well.  Discuss with HR whether the individual needs to make up the time later or whether time-off may be allowed.

It may be helpful for a manager to keep an eye on an individual’s working hours and support them in maintaining a good work-life balance. Working long hours may be a sign that someone is struggling with their workload.

Physical environment

  • Minimise visual distractions by using room dividers or partitions.
  • Minimise aural distractions by reducing the volume of telephone ring tones and discouraging loud talk. Would headphones help to reduce distractions?
  • If the individual works in an open plan office, consider whether there is anywhere private they can go if they need to concentrate or if they are distressed and need some privacy to recover or phone a family member for support. 
  • Provide a quiet space for breaks away from the main workspace.
  • Maximise natural light by seating the individual by a window.
  • Consider buying a lightbox for people with seasonal affective disorder.
  • Consider changes to the office layout:  people may be uncomfortable if they feel others can ‘sneak up’ unnoticed; others may welcome a more private spot.
  • Although it may not be practicable to provide a personal or smaller shared office, this may be extremely helpful for some individuals, who may find working in a large shared office extremely difficult.

Working practices

  • Agree an advance plan for any recurrence of mental ill-health.
  • Consider communication methods e.g.
    • using voice-mail to take messages (without slowing down the overall response time) if phone calls make a person anxious;
    • using email may give an individual time to give a more thoughtful response
  • Consider regular homeworking.  This may be helpful in reducing travelling, or allowing an individual to attend appointments then make up hours, but there is a risk that the individual may feel isolated from their colleagues.
  • Agree temporary changes to tasks when needed e.g. if someone is returning from a period of sickness absence. Can tasks be swapped within the team? Can “front-line” work be reallocated?
  • Restructure a job for a permanent change of tasks.
  • Agree an “early warning system.” Some people might want to ask a specific colleague to alert them if their behaviour starts to change in a way that suggests their mental health is deteriorating.  This could cue previously-agreed arrangements, such as reminders and help in contacting their GP.
  • Permission to take time out when distressed: this could just be a few minutes away from the workstation, going out for some air, or having a short rest.
  • Offer help with managing the workload e.g. prioritisation and planning. When an individual is unwell they may find it difficult to do things that they would normally achieve easily.
  • Some people may find it helpful to have a “work buddy”.
  • Offer mediation if there are difficulties between colleagues.
  • Where mental health difficulties are work-attributable, the Occupational Health Service may refer individuals for a short course of counselling.

Strategies to deal with concentration and memory difficulties

  • Rely on checklists, diary reminders and prompts even if you don't usually need to do so.  Go back to check instructions and processes, even for things that you 'should' know. Do not assume that you will remember accurately.
  • Do not rely on your memory, but write things down.  Reduce the demands on your working memory, so that you have more available capacity.
  • Make notes in conversations.  If you can, take the time to check with the other person that your notes are accurate. If you didn't do it at the time, you could send a short email to check your understanding of next actions. 
  • Get into the habit of summarising a discussion, so that everyone is clear on next steps.
  • Use the Pomodoro technique.  Identify the length of time for which you can concentrate (which is likely to be much shorter than when you are well) and break work into short chunks that can be completed in the designated period.  Set a timer, then concentrate hard until the alarm sounds.  At the end of the period take a mini-break, before starting on the next defined chunk.  This may be a helpful way to make progress, even when the size of a task feels overwhelming.
  • Capture ideas before they get lost.  Write them down, or make a spoken note on your phone or a digital voice recorder.
  • Plan your tasks to tackle more complex tasks when you are feeling at your best.
  • Prioritise, and recognise that you are likely to be working more slowly than at your peak.
  • Some people find text-to-speech software helpful when reading documents online (you can listen while tracking with your eyes) and it can also help you spot errors when proofreading.
  • Use visual tools, such as highlighters.  When comparing different versions of a Word document, some people find it helpful to temporarily change the background colour so that it is easy to see which is which.
  • Take the time to check your work.  If possible, come back to it later to do this.  If it is important, see whether a colleague is willing to check it.

Support from others

  • The manager and individual should discuss how best to work together. It may be helpful to increase the frequency of 1-1 meetings.
  • Permit a support worker to come in or to be contacted during work hours.
  • A ‘job coach’ may be funded by either a mental health voluntary organisation or by Access to Work.

Please contact the Staff Disability Advisor for advice: Caroline Moughton caroline.moughton@admin.ox.ac.uk