A Civil Service organisation: Reasonable adjustments for ADHD and autism

The Civil Service delivers public services and supports the UK government to develop and implement its policies. The work the Civil Service does touches all aspects of life from education to environment, to transport and defence, employing over 500,000 individuals across its various departments.

Sasha had worked with the Civil Service for many years. She was recently diagnosed with attention deficit hyperactivity disorder (ADHD) and autism in her 40s. This took a toll on her mental health, as she faced a rollercoaster of emotions making sense of her new diagnosis and life going forward.

She is also an Open University student, which comes with its own challenges and anxieties around time management, and meeting essay deadlines.

At work, Sasha was juggling the demands of very reactive work where there was lots of fire fighting to get things done at the last minute.

She did not know it at the time, but she was also going through the menopause which she now recognises brought other challenges.

She felt as though everything had collapsed on top of her at once. She had to take some time off work for a few weeks because of the sensory overwhelm she felt.

Sasha put in place several strategies to help manage her mental health.

Sasha found that being quite a self-aware individual helped her notice when she had dark thoughts. She was able to challenge them and recognise her thoughts were just thoughts, not objective facts. She had sought out a menopause specialist who helped her develop techniques to challenge negative thoughts.

Sasha kept track of her symptoms and emotions on a spreadsheet which helped her see the patterns. This enabled her to manage any challenges better.

She developed her own strategy to help her colleagues communicate with her in a way that helped her work well. She used the 4 W's - the What, the Where, the When, and the Why. Using the 4 W's approach meant that instead of receiving long wordy emails with task instructions from colleagues, she received clearer instructions in short, task focused emails.

Sasha also got support from her manager and her trade union to put in place adjustments. These adjustments were related to supporting her neurodiversity but also helped her manage her mental health.

Sasha's organisation was able to provide an occupational health referral during which she discussed her challenges and the nurse helped to identify adjustments. The recommendations suggested Sasha works best from home and communications need to be unambiguous and clear about what is expected of Sasha in her role. These recommendations were set out in a report and could be referred to by her, and her trade union representative.

There are also staff support groups for neurodiversity, mental health and a newly set up group for menopause that Sasha was able to join. This gave her a chance to talk with colleagues, share experiences and develop awareness of different conditions through organised talks. The groups were also able to signpost to what was available in the organisation for support.

Sasha's manager helped her to focus on the things she was more confident in, such as spreadsheets, planning and visual tasks, and to reduce the number of people-related tasks. She described that this process of 'job crafting' – crafting work to suit needs and preferences – happened over time rather than through an official process.

She found the direct communication style of her manager worked well for her. They focused on the work itself and talked less about the "wordy policy side". Her manager also supported her in working more flexibly with a 9-day fortnight. This meant she could have every other Friday off, giving her time to have university meetings and also downtime away from work.

It took a few months to get the adjustments right. During this time Sasha had help from a trade union representative to keep on top of things.

Sasha asked her trade union representative for help. They helped to start the documentation of what sort of reasonable adjustments Sasha should have, such as noise cancelling headphones, working from home, a safe quiet space in the office to go to and mind mapping software.

While taking minutes in meetings to refer back to would have been a useful adjustment, due to the sensitive nature of her work and GDPR considerations, this was not possible. Sasha recognised not all adjustments are possible and what is possible depends on the organisation you are in.

Sasha's team were open to helping her work in a way that worked for her. She explained to them what happened when she felt stressed and that communicating by email and using the 4 W's was really helpful to her. Her team have also taken extra steps to provide feedback or send a message saying 'that was great and very helpful'. This goes a long way in supporting her mental health.

Some of the most effective adjustments happened organically when her manager and team supported her to work to her strengths. This meant Sasha was able to have more positive feedback on her skills rather than focusing on what she could not do, making her more confident in the workplace.

Every day work demands from senior staff members meant implementation of the adjustments was sometimes slow. It can be exhausting for an employee to have to chase up occupational health, HR or managers when actions have not been taken. It was helpful to have someone to help monitor the process and make sure the adjustments were put in place, in this case her trade union representative.

The nature of Sasha's work was more reactive and less process driven, so strategies and accommodations might not always be used by others in the team. This can make it harder for Sasha to get the support she needs to work well.

Managers are not always skilled or equipped to deal with neurodiversity and mental health. Sasha felt lucky that she could communicate easily with her manager. She recognised that this is not always the case. It's important to encourage managers to involve employees in the decision making of reasonable adjustments. This is because often managers will not have all the answers and the employees will have a better understanding of what adjustments work for them.