ADA & Mental Health: Supporting Employees Returning from Treatment

by Eric Dyches | July 2025

When an employee returns from inpatient mental health care, it’s not only a sensitive moment — it’s a legal and ethical crossroads. Employers must tread carefully, balancing compliance with the Americans with Disabilities Act (ADA) and the practical needs of the business. At Impact HR, we believe compassion and compliance are not mutually exclusive — they’re essential partners.

The Situation: When Performance Becomes a Concern

Let’s say an employee returns to work after a mental health-related leave. You’re relieved to have them back — but something seems off. They’re not quite themselves. Communication is unclear. Tasks are incomplete. You want to help, but you’re not sure what’s legally appropriate to ask — or what steps to take next.

This is where the ADA interactive process comes in.

Step 1: Initiate the Interactive Process When observable challenges suggest a medical condition may be interfering with job performance, you are not only allowed but encouraged to initiate a private, supportive conversation.

You can say:

“We’re glad to have you back. We’ve noticed some challenges with your work lately, and we want to support you. Would you be open to talking about anything we can do to help you be successful in your role?”

This isn’t a diagnosis inquiry. It’s an observation-based conversation, focused on job-related functions. Keep it supportive, not disciplinary.

Step 2: Request Medical Documentation (If Needed)

If concerns persist, and it’s unclear whether the employee can safely perform their essential job functions, a fitness-for-duty evaluation may be appropriate. Employers may request medical documentation that confirms:

• If a medical condition is impacting their ability to work

• Any specific limitations

• Whether accommodations are recommended
  

What you can’t ask: a diagnosis or detailed history. What you can ask: information directly related to their ability to perform the job.

Step 3: Document Observations

Keep a factual, judgment-free record of what you observe. This could include communication breakdowns, missed steps, or safety concerns. Avoid assumptions and stick to what is objective and verifiable.

Step 4: Consider Reasonable Accommodations

If medical documentation supports that the employee can perform the job with accommodations, explore options such as:

• Adjusted schedules

• Reduced or modified workload

• Extra breaks or flexibility

• Temporary reassignment

  
  

If they cannot perform the job with or without accommodations, consider whether a leave of absence or job reassignment is possible. Termination should only be considered after the interactive process has been fully explored.

Step 5: Avoid These Common Pitfalls

• Do not ask about specific mental health diagnoses

• Do not jump to termination without documentation and discussion

• Do not allow gossip — maintain confidentiality

• Do not discipline for behavior potentially tied to a known condition without first exploring accommodation

The Bottom Line

Mental health matters. But so do performance and team integrity. The ADA provides a framework to support both. Compassionate communication, thoughtful documentation, and legal compliance allow you to honor the employee’s humanity and your organization’s operational needs. Need help navigating a tricky situation?

Contact: Eric Dyches | eric@impacthrgroup.com Let’s create workplaces that are both high-performing and human-centered.

This blog is for informational purposes only and should not be considered legal advice. For specific guidance, consult your HR advisor or employment counsel.