Mental Health At Work: Accommodations and Leaves

Tasha Patterson@Work

Accommodations and Leaves for Mental Illness

Mental Illness Leaves and AccommodationsBy Jenny Haykin, MA, CRC

Integrated Leaves & Accommodations Program Manager
Puget Sound Energy

Although the stigma of mental illness is declining with greater awareness, it is still common for employees not to disclose this type of health issue.

Employers are not obligated to offer accommodations or leave when the need is not known. However, overlooking negative changes in employee performance or behavior can be detrimental, both to the employee and the organization. At the same time, regarding an employee as disabled grants them discrimination defense rights under the Americans with Disabilities Act (ADA). So what is the best approach for employers?

Intervening early can reduce the risk of an employee continuing to decline. When an employee begins showing early signs of worsening performance or behavior that lasts more than two weeks, prepare for a private conversation between the employee and supervisor. It can start with “I’ve noticed that _________, and I am concerned about you.” Whatever fills in the blank — such as coming in late, missing deadlines, or unprofessional behavior — should be stated as objectively as possible. However the employee responds, carefully articulate what the performance or conduct expectations are, show an interest in helping the employee get back on track, and offer resources.

If the employee denies a problem, the supervisor can say, “Then you may not need these resources, but I am sharing them with you so that you are aware of them.” Resources can include the company employee assistance program, reasonable accommodations, and state and federal leave options. Recap the conversation in writing to the employee, through an email or company mail, to create a written record that the employee was notified of the laws and resources.

When an employee does disclose a mental health issue, they may be much more open to learning about resources. If the employee states the mental health issue is impacting their ability to work, the employer is officially on notice and obligated to inform the employee of their potential rights under leave and disability laws.

If a disabling mental health issue is known that might benefit from accommodations other than leave, it can be helpful to know what the restrictions are. Having a healthcare provider complete a Cognitive and Behavioral Capacities Evaluation Form can help when employees seek accommodations.1 After receiving the completed form, begin the interactive process in a meeting with the employee to discuss the limitations and accommodation possibilities.

The employer has the right to choose between effective, reasonable accommodations. If the chosen accommodation differs from the employee’s preferred accommodation, help the employee understand the business reasons. If an accommodation does not work, continue efforts to find an effective solution as long as the employee is engaged in the process. If it appears no reasonable options can be identified — the employee is becoming unable to perform the job, or can’t meet conduct and performance standards — offer leave before disciplinary actions are warranted.

Leave through the Family and Medical Leave Act and state laws can help the employee who needs time off intermittently or continuously for treatment and recovery. If leave is exhausted but still needed, leave as a reasonable accommodation under the ADA can be explored with information about the employee’s further leave needs.

Intervene early, provide clear job expectations, and keep employees informed of their legal rights and resources. Employers can use these strategies both to comply with the laws and to help employees through a difficult time.


  1. Download the Cognitive & Behavioral Capacities Evaluation Form and the Cognitive and Behavioral Job Analysis Form.