Specific Adjustments - Mental Health

Managing for mental health

Policies and procedures

  • Does your organisation have a stated objective to promote the mental and physical well-being of employees through awareness raising activity and/or training / staff induction? 
  • Is there a person with a clear lead for workplace health? 
  • Does your organisation have a mental health policy? 
  • Is mental health specifically covered in relevant policies e.g. health and safety, flexible working, work-life balance, equal opportunities, diversity? 
  • Are you aware of your duties under the Equality Act 2010 which includes disability provisions? 
  • Are you aware of your duties under health and safety legislation? 
  • Are you familiar with your organisation’s policy around sickness absence? 
  • Are there any policies or procedures around planning and monitoring the return to work from sickness? 
  • Do you evaluate the effectiveness of the above policies?

Management practice

Using normal management processes

  • Do you have regular work-planning and appraisal sessions so that you can spot any mental health conditions in the early stages? 
  • Do you specifically check on the well-being of employees in these sessions? E.g. excessive travelling, long hours, pressures at home such as moving house, getting married, having children, bereavements etc? 
  • Do employees know that they can talk to you confidentially if they have a problem? 
  • Do you conduct employee attitude surveys? 
  • Do you conduct exit interviews when people leave? 
  • Is there a system to ensure that the organisation addresses feedback from attitude surveys and exit interviews?

Risk assessment

  • Do you carry out regular stress risk assessments? 
  • Are work teams involved in identifying problems and solutions in their area? 
  • Do you ensure any actions are implemented following risk assessments? 
  • Do you ever seek expert professional guidance in conducting risk assessments?


  • Do you monitor other factors that might indicate high levels of stress / mental health conditions e.g. levels of complaints from patients, clients or employees, accidents, levels of harassment or bullying? 
  • Do you monitor sickness absence and is there any analysis of this data? 
  • Do you monitor positive outcomes of workplace interventions?
  • Do you monitor and evaluate interventions implemented following risk assessments regularly?

Sickness absence/return to work

  • Do you have clear procedures about contact with employees when they are off sick? Are the relevant unions / employee representatives involved? 
  • Do you have provision for people to come in informally when they are off sick and is this carried out in a sensitive way? 
  • Do you have return to work interviews after any kind of sickness absence? 
  • Do you plan the return to work with the employee and involve any other relevant professionals e.g. occupational health, GP, HR, workplace counsellor, union? 
  • Does the line manager take responsibility for co-ordinating the return plan and / or is there a system for ensuring that it is co-ordinated? 
  • Do you discuss with the employee how any adjustments / absence will be communicated to peers or clients?

Managing people with an ongoing problem

  • Are you aware of employees or colleagues who have had a mental health condition? 
  • Has any attempt been made to learn from their experience – good or bad? 
  • Where you have employees with an ongoing mental health problem are you aware of their coping strategies and their wishes about how you can help in the event of a relapse? 
  • Are you aware of local schemes that offer support to employers in recruiting and supporting employees with known mental health conditions?

Knowledge of mental health

  • Could you list the early signs of stress / mental health conditions? 
  • Have you or other managers received any training in: mental health awareness and "people skills" such as listening, open questions, offering support? 
  • Do you provide guidance, support or training to managers on return to work for mental health issues? 
  • Has your organisation undertaken any programmes to raise awareness / tackle stigma around mental health?

Support for staff

  • Do you provide support to employees? E.g. in house counselling / welfare service, occupational health advice, Employee Assistance Programmes. 
  • Do you make staff aware of this support? 
  • Do you have information available to give to employees about other local sources of information / support? E.g. Citizens Advice Bureau, local mental health organisations, external counselling provision.

Returning to work and reasonable adjustments

Most people who experience an episode of distress or mental ill-health recover completely and can resume work successfully. Effective planning between the individual and the line manager will maximise the chances of success. So will support and monitoring at the early stages of return. You have made an investment in that individual and in most cases, a planned return to work will be more cost effective than early retirement.

In larger organisations managing mental health and employment including the recovery process will not just be down to the individual line manager but will involve collaborative working between other services, the GP, occupational health and HR.

This section offers advice on planning the return to work and monitoring how things are going.


Planning the return

  • You should develop, in discussion with the employee, a return to work action plan. Discuss whether any adjustments need to be made to ease their return (see below for some ideas). 
  • You should discuss with the employee any factors at work that contributed to their absence that could realistically be changed or accommodated. 
  • You will also need to discuss honestly the things you can change and those you can’t. Some organisational factors are out of your control. Can they be mitigated? 
  • You can then agree how their progress will be monitored. 
  • Before they return, brief the employee on what’s been happening – social life as well as work developments.

Returning to work: What to do when an employee returns to work

Above all make sure you and the team make the person feel welcomed back. You might consider a mentoring scheme with another employee so that the person returning can talk to someone who isn’t their manager.

Remember to;

  • make sure the employee doesn’t return to an impossible in-tray, thousands of emails or a usurped workspace. 
  • be realistic about workloads - be aware that some people will wish to prove themselves and may offer to take on too much. Instead, set achievable goals that make them feel they are making progress. 
  • take the time to have frequent informal chats so there is an opportunity to discuss progress/problems without a formal (and possibly intimidating) session. Do ensure however that the employee does not feel that their work and/or behaviour is being overly monitored or scrutinised.


  • making the person feel they are a special case - this can cause resentment both with the individual and with peers, and 
  • failing to deal with their work whilst they have been off work. Check whether a backlog of unfinished work has built up and deal with this also.

Managing reactions from colleagues and clients

Fear, ignorance and hostility from colleagues and service users can be a source of great distress. Many people who have experienced mental health conditions describe this as an area 
of stigma and discrimination. A key theme of this resource has been the need for both managers and employees to think about how communications will be managed.

Usually, stigmatising behaviour arises more from fear and ignorance than ill will. People are not sure what to say and find it easier to avoid the individual or not to mention mental health.

It is advisable to;

  • try to talk to the employee and agree who will be told what, by whom and when. Think about the language you use. Be clear about confidentiality and boundaries 
  • be guided by the employee’s wishes. Some people are prepared to be more open than others. Encourage the person to talk if they wish but don’t pressurise them to do so 
  • treat people returning from absence due to mental ill health in the same way as those with physical ill health 
  • watch out for hostile reactions - stamp out any hurtful gossip or bullying promptly, this is your duty under the Equality Act 2010, and 
  • treat mental health issues in a matter-of-fact way - they are common and should not be a source of office gossip or conjecture

After a time, ask the employee how they are getting on with peers/clients. Review if there is any support that you can give, and consider mental health awareness raising for all.


  • shrouding the issue in secrecy, and 
  • making assumptions about workloads and capacity to cope

If the return to work is not successful

In this scenario, try to go through the reviewing progress, options for making further adjustments and talking to the employee. Then talk realistically with the employee about the best way to move forward. For example, if all reasonable adjustments have been made in the current post, it may be necessary to consider transfer to another job.

Use normal procedures if it is a performance, attendance or conduct issue rather than one relating primarily to health or disability, and if matters cannot be resolved then you may have to move to termination. You should help the individual to move on with dignity and issues such as health related pension benefits (e.g. medical retirement) should be fully explored.