A Civil Service organisation: Reasonable adjustments for obsessive compulsive disorder (OCD)

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.

Jessica was officially diagnosed with obsessive compulsive disorder (OCD) last year, although she suspects she has had OCD since she was a teenager. For most of her life, she has been finding her own ways of coping.

Jessica said: "I always knew that my brain just functioned differently to other people."

The most frustrating part of it all was the diagnosis process. It took a long time. On receiving her diagnosis, Jessica started looking for ways to help her manage her OCD at work.

Jessica was open with her employer, and worked with Occupational Health, her manager and her team to create an environment where it was easy to talk about her OCD.

Jessica let people at work know that she was going through the diagnosis process. Getting support while getting her diagnosis was important. It was an emotional subject for her. As her manager was aware that her energy and ability to cope changed over time, she felt supported to take extra time to complete tasks or use a quiet space to take some time out to decompress.

The diagnosis helped Jessica talk more directly about the way she was feeling and what support she needed to operate at work, rather than people making assumptions about the support needed.

Before requesting adjustments, Jessica researched what options might be open to her on the web and read about what others in her situation had found useful. She reflected on what would work best for her before she asked for what she wanted. By the time she presented the adjustments to her employer, she knew they would work well for her and could explain why this would be the case.

Jessica asked for a headset to help reduce noise and distraction and to work from home 3 days a week. She also let her employer know an adjustment could work one day but not the next, so she would benefit from a flexible approach.

Jessica's manager was always there to listen. They signposted to the right resources within the organisation and talked through how the adjustments could work. Her manager offered to refer her for an occupational health assessment. While she did not take up the offer, she felt supported that this could be taken up if it was needed.

Jessica found her manager was able to empathise because she had a disability herself, so was very patient. Jessica felt there was never a need to prove anything and felt her needs were accepted at face value.

Her manager was also proactive in her approach. For example, one day there was a noise in the office, which the manager recognised would be distracting for Jessica. Her manager told her to work from home and not to worry about coming in until the noise was fixed.

Jessica's OCD makes it difficult for her to get started in the morning. It can take a little bit more time to ease into the day. One adjustment that her team supported was not to schedule any meetings before 10am.

As Jessica was supported by her manager and team, she felt empowered to tell her colleagues that she needed to switch off and finish early for the day if she could not focus any longer. People at work accepted that. Whilst this might not be possible in all situations, Jessica was in a lucky situation where the team had been okay with this arrangement as she delivered the work that was expected of her over the week.

Communication style was also very important. Jessica finds it difficult when she is overloaded with information, finding long presentations or lengthy emails difficult to engage with. It was easier for her to process if there were short bursts of information. She was honest with her colleagues and communicated when she found things difficult because of the way they had been presented and asked them to try other ways.

Jessica also asked not to have chat messages directed to her during meetings as she needed to focus and listen to what was being said and this stops her brain from wandering.

The Civil Service have Workplace Adjustments Passports. This means that when an employee moves across the Civil Service, they can take their adjustments with them as they move to the new department.

When Jessica moved to a new organisation, she did not have her Workplace Adjustment Passport as she was still trialling her adjustments. However, she was able to have conversations with her new manager that were led by her to get the adjustments in place.

While Jessica's line managers were responsible for her getting the adjustments she needed, she felt supported to access an occupational health assessment or self-refer to the employee assistance programme (EAP) if she ever needed more support.

Jessica tried self-referral to the employee assistance programme while waiting for NHS treatment, but she needed treatment that was outside of the core offer. She stayed on the waiting list for high-intensity cognitive behavioural therapy. Employers need to recognise that finding and accessing the right support can take time. There are long waiting lists for mental health services across the UK. Where possible employers should signpost or offer suitable external services.

Employee involvement in decision making is key. Some managers might feel they should have all the answers, but the person will have a better idea of what they need to help them work well.

The team took time to adjust and respond to Jessica's needs. Jessica finds informal communication methods, such as instant messenger or unplanned conversations, difficult. She had to keep reminding her team of her need for short and task focused emails. Arranging team meetings to raise awareness of individual needs, with the person's consent, or having short summaries for team members can be helpful.

As a line manager herself, Jessica learned that if someone discloses or needs support, to encourage them to access a service, especially an employee assistance programme, quickly so they can get the support while it's still low intensity.