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The Royal College of Psychiatrists Improving the lives of people with mental illness
Work and mental health

The costs and benefits of ‘reasonable adjustments’

‘The nature of work is changing, and UK business needs to come out of the dark ages and realise that it cannot continue to use working practices that originate from the 19th century. It needs to modernise, change its approach, retrain its management, and understand the benefits of new smarter working practices’
-Lord Digby Jones of Birmingham

The Equality Act 2010 replaced the Disability Discrimination Act 1995 and 2005, as of October 2010.  It means that employers and service providers have to make reasonable changes to ensure that people with a disability are not disadvantaged substantially compared with non-disabled people.  This may mean making adjustments to policies and practices in your workplace, some of which are put in place specifically for an individual employee.  These changes are known in law as ‘reasonable adjustments’. 


In most cases making a reasonable adjustment is not difficult and often costs very little.  These adjustments are more likely to be effective for you and your employee if you work together and in partnership with your occupational health advisor and your employee’s GP or other health and care professionals.  It is also worth remembering that many people without a disability or without a mental health problem need to make changes to their work patterns and conditions.  Some people need more flexible working conditions because they have caring responsibilities, others with long term or fluctuating health conditions also need to make changes to the way they work. 


Some mental health conditions can be episodic and so it may be better to agree adjustments when they are needed rather than agreeing one or more specific adjustments that will apply all the time.  It is now increasingly common for people who have contact with mental health services to have completed a Wellness and Recovery Action Plan (WRAP) or an ‘Advance Statement’.  If your employee has one of these it may help you decide and agree the changes that will be needed to assist them in their work.


Examples of reasonable adjustments include:

  • Flexible conditions – flexible start times to avoid travelling during difficult times or in difficult conditions such as rush hour, part-time working, rest breaks, working from home
  • Higher levels of supervision and support – here your employee works with a mentor or buddy to help them to set priorities or identify and complete ‘bite size’ tasks
  • Changes to your employee’s role or reallocating some work tasks – to reduce stress and accommodate any limitations such as stepping back from a high pressured management or project management role
  • Physical changes to the work environment – changing the office lighting or partitioning the work space to help make it easier to stay focused on tasks.  Some people like a busy, noisy work environment, others find lack of contact with others is detrimental
  • Adaptive devices – such as electronic and graphic organisers which can be set to remind your employee of tasks or to take a break
  • Enabling time off  - either set times or more flexibility to attend therapeutic sessions, treatment, assessment and/or rehabilitation
  • Identify training needs and provide support to develop skills – this can be of the individual and their colleagues; e.g. specific job requirements and/or around skills enhancement such as communication skills or time management

Whatever the reasonable adjustments you and your employee identify and agree on, it’s important to realise that finding the right adjustments could take time to get right and to make a difference.  You may want to review the reasonable adjustment agreement after a set time to see if further changes need to be made.  You might also have to be persistent and tenacious in finding and making the changes that make the difference to your employee. 

You will need to reassure your employee that their personal information will be kept confidential.  You should also agree with your employee on what work colleagues and clients (where relevant) will be told as part of developing and agreeing the reasonable adjustments or in creating your Wellness and Recovery Action Plan (WRAP).


Links to resources


This section of the website explains the term ‘reasonable adjustment’ and includes links to specific guides for line managers.  This page on the website includes the link to the publication ‘We can work it out’.  This is a line manager’s guide to reasonable adjustments for mental illness.

Small change, big difference a Cabinet Office publication  produced with Rethink.  



This is an initiative to tackle stigma and discrimination surrounding mental health issues in England. The campaign aims to create a society where people who experience mental health problems enjoy the same rights and opportunities as other people.  The website has links specifically for employers.  The line managers resource is a practical guide to managing and supporting people with mental health problems in the workplace. 


Examples of reasonable adjustments’.  This part of the website includes useful examples of changes to work and work patterns. 

Employers’ Forum on Disability

Employers' Forum on Disability is an employers' organisation focused on disability as it affects business. The forum includes employers from multinational corporations, Small and Medium sized Enterprises and the public sector.


Non-visible disabilities line manager guide’ includes extensive examples of ‘reasonable adjustments’.


This 'Tailored adjustment agreement' template is intended to be a living record of reasonable adjustments agreed between a disabled employee and their line manager.

The purpose of this agreement is to:

  • Ensure that both parties, the individual and the employer, have an accurate record of what has been agreed.
  • Minimise the need to re-negotiate reasonable adjustments every time the employee changes jobs, is re-located or assigned a new manager within the organisation.
  • Provide employees and their line managers with the basis for discussions about reasonable adjustments at future meetings.

This is a live document and should be reviewed regularly by both the employee and manager and amended as appropriate.


Realising ambitions: Better employment support for people with a mental health condition

Rachel Perkins, Paul Farmer and Paul Litchfield

Department for Work and Pensions, December 2009

This review was commissioned by the Secretary of State for Work and Pensions to look at mental health and employment and to identify how Government could help people with mental health conditions fulfil their employment ambitions. Chapter 4 includes examples of ‘reasonable adjustments’ that have enabled people with a mental health condition to prosper at work. 



This booklet ‘Flexible working and work-life balance includes examples of flexible working such as term time working, job shares and changes to shift and rota patterns.  It includes advice for employees on how to apply for flexible working.  The booklet includes examples of flexible working from situations such as returning to work after maternity leave which might be useful in discussions with your employees, especially where you or they have limited experience or knowledge of mental ill-health. 



The Mental health in the workplace: an employer's guide’ includes a section on supporting employees to stay in the workplace. 

The Staying in employment’ booklet by Alison Cobb and Kaaren Cruse, is written primarily for people who experience mental distress, or are living with a mental health diagnosis.  It includes sections on making changes to the workplace such as the work environment or working practice.  It also includes information and advice on getting support for putting the adjustments needed in place which may be useful for employers when discussing and agreeing reasonable adjustments with your employees. 


Chartered institute of Personnel and Development (CIPD)

Stress and mental health at work factsheet, September 2010

This comprehensive factsheet also includes a short section on adjustments at work. 


Work Life

The health conditions part of the website includes a link to an American publication called Working with MS’.  This includes tips and techniques for developing adjustments or accommodations or different job duties.  There is a five point plan to help identify the tasks and activities that your employee can do and those which s/he may experience difficulties with and how best to negotiate for the adjustments needed.