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June 24, 2024

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Health and safety considerations for neurodivergent employees  

In the second of two articles, Robert Manson MSc NEBOSH (Dip), Neurodiversity Occupational Consultant from consultancy firm Creased Puddle, highlights areas where a ‘blanket approach’ does not work for neurodivergent employees who can, as a result, be treated unfairly in the workplace.

While many organisations have started to adopt neuroinclusive practices, this has been mainly from a Human Resources perspective mainly in devising policies and procedures in the workplace. This would be seen in the health and safety world as ‘in place but not in use’.

There are numerous organisations and health and safety professionals who still need to fully understand how neurodiversity applies to health and safety and wellbeing in the workplace. Unfortunately, with this lack of knowledge and awareness they can take an unreasonable ‘risk averse’ approach. This often leads neurodivergent employees to be unfairly treated and discriminated against.

The good news is that some sectors such as the UK construction industry is making significant progress towards accommodating and supporting neurodivergent employees (1).

With increased awareness and further neuroinclusive practices health and safety processes are being challenged and this brings opportunities to review existing practices.

Driving at work

It has been shown in the past that drivers with ADHD ( Attention Deficit Hyperactive disorder) showed more violations, lapses of concentration and more risk-taking behaviours resulting in significantly more accidents (2). This concern among employers and health and safety professionals has resulted in some employees giving alternative work away from driving tasks. However, growing research has shown that those employees who take medication for ADHD has shown to result in much safer driving practices reducing the risk greatly and making them very proficient focussed and compliant drivers (3).

This shows that taking a blanket ban approach is not only discriminatory but also not risk based decision. Employers need to discuss and assess whether employees with neurodivergent conditions in fact pose any additional risk especially if they are taking medication for their condition

Drugs and alcohol Testing

Credit: Laurynas / Unsplash

Many employers have alcohol and drugs policies in place that are either for cause, following incidents or are random which are regular unannounced testing.

With the increase in neurodivergent diagnosis there are now many employees with ADHD that are now taking medication to support their condition.

ADHD medications are usually stimulants. Common options include Adderall XR, Vyvanse, and Concerta. However, people can also use nonstimulant drugs, such as Strattera or Intuniv XR. Medications can have short-, medium-, or long-acting effects (4). These medicines are not (as is sometimes believed) a ‘cure’ for ADHD, helping instead to improve concentration, reduce impulsivity and manage feelings of overwhelm.

Unfortunately, these medications will result in a ‘non negative’ result when undergoing a drugs test in the workplace. To avoid disciplinary process and a potential suspension it is advisable for those taking it to disclose this to the employer.

Some employees (or potential staff) may wish not to disclose their neurodivergent condition so a letter of confirmation that the employee is taking medication, from their GP, should be sufficient to avoid disciplinary action.

The ideal situation would be that employees disclose their conditions allowing employers to support them and take appropriate action which is properly risk assessed and a pragmatic approach is adopted to avoid discrimination.

Stress Risk Assessments

Nearly three-quarters (70 per cent) of neurodivergent employees experience mental health issues.  Half (50 per cent) reported feeling burnt out at work, compared to just 38 per cent of neurotypical employees (5).

Many neurodivergent employees also experience mental ill-health as a co-occurrent condition linked to ADHD and Autism.

Autism Spectrum Disorder (ASD) and Attention-Deficit Hyperactivity Disorder (ADHD) are both linked to mental health conditions such as stress, anxiety and depression (6).

With this increased risk for neurodivergent employees it is prudent that employers consider whether they are more at risk from work related stress.

It is a legal duty to protect workers from stress at work by doing a risk assessment and acting on it. You should assess the risk of stress, and its impact on mental and physical ill-health, in the same way as you assess other work-related health and safety risks (7).

Despite this requirement there are many organisations that that have yet to act on undertaking a stress risk assessment among their employees.

It is good practice to not only undertake team stress risk assessments on a regular basis but also on an individual basis with employees who are either at risk or are returning from sickness absence following work related stress. This includes neurodivergent employees who may be more at risk to work related stress leading to anxiety and depression.

It would be neuro-inclusive to embed questions that pose a high risk to those employees who have particular challenges with environmental and sensory challenges such as noise, lighting or smells in their workspace.

Health and Safety risk assessments

Credit: Alamy Stock

Risk assessments are there to help employers manage risks caused through work activity and a workplace risk assessment should be regularly reviewed. There is no legal requirement to carry out a separate risk assessment specific to a neurodivergent employee. However, if an employer becomes aware of a worker who is neurodivergent they should review their existing risk assessment to make sure it covers any risk to them.

For example, if an employee is dyspraxic then they may require further control measures due to their mobility and motor skills. Likewise, an employee with dyslexia may need further adjustments to read health and safety procedures or information.

Some employees with ADHD may not remember the safety protocols especially from verbal briefings and long protracted procedures.

Employers need to ensure employees with neurodivergent conditions whether disclosed or not, should be treated as a disability as they have protected rights under the Equality Act 2020.

Unseen disabilities can affect people in very individual ways and can often be supported through workplace adjustments so employers should not make assumptions about disabled people or introduce blanket policies

An unnecessary blanket policy would be banning all workers with the same health condition from doing particular tasks, despite the condition’s symptoms varying greatly in severity from person to person (8).

It may also be necessary to review those tasks which may fall under the criteria of being safety critical where the  health of an individual may compromise their ability to undertake a task which may impact others. Many organisations provide occupational health assessments to identify if the employee has any physical or mental conditions that may increase their risk for these types of tasks.

Robert Manson, Neurodiversity Consultant at Creased Puddle

Workplace needs assessments have an important role in identifying the strengths and challenges of neurodivergent employees and health and safety professionals may need to consider these much more going forward, along with the support of their occupational health team.

Whilst addressing these challenges, by taking a properly neuro-informed approach employers have an opportunity to develop a holistic multidisciplinary process bringing together the supportive pillars of Health and Safety, HR and Occupational Health.

The involvement and referral to specialised neurodivergent services play an important role in supporting both companies and employees to ensure that all are safe and well.

If you require any further information on supporting neurodiverse employees contact

Robert Manson MSc NEBOSH (Dip) Neurodiversity Occupational Consultant on [email protected]


  1. Construction News How the construction industry can better support neurodiversity. FEB 2024.
  2.   Groom,van Loon, daley, Chapman and Hollis (201 ) Driving behaviour in adults with attention deficit/hyperactivity disorder BMC Psychiatry, Vol 15, Article number 175.
  3. Accident Analysis & Prevention Volume 62, January 2014, Pages 415-425.
  4.    McMillen, M  2024) Will an Adderall Prescription Make You Fail Your Drug Test? Health Central. Feb
  5. Urquhart, J ( 2022) Majority of neurodivergent employees experiencing mental health issues, study finds. People Management. Sept 6th.
  6. Hargital, L.D. et al ( 2023). Attention-deficit hyperactivity disorder traits are a more important predictor of internalising problems than autistic traits. Scientific Reportsvolume 13, Article number: 31
  7. HSE (2024) Work-related stress and how to manage it
  8. HSE (2024) Employers’ duties in protecting disabled

What makes us susceptible to burnout?

In this episode  of the Safety & Health Podcast, ‘Burnout, stress and being human’, Heather Beach is joined by Stacy Thomson to discuss burnout, perfectionism and how to deal with burnout as an individual, as management and as an organisation.

We provide an insight on how to tackle burnout and why mental health is such a taboo subject, particularly in the workplace.


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