time off for medical treatment

Sangie is right that this is not a simple situation. You've already mentioned reasonable adjustments, which your employer has an obligation to undertake under section 20 the Equality Act 2010. Strictly speaking in accordance with the legislation you don't need to ask for reasonable adjustments, but it is a very good idea to do so. Realistically there are two common adjustments that relate to absence management policies. The first, which has already been mentioned, is to adjust the threshold at which the policy kicks in. The second is to discount absences in their entirety that are caused by a disability. However, the duty is only to make reasonable adjustments, and what is or is not reasonable varies from case to case. Which is one of the reasons why it is important to engage with your employer, and if practicable it is a good idea to raise this with them before it becomes an issue.

There is, for the sake of completeness, a second relevant section of the Equality Act 2010, namely section 15, which deals with discrimination arising from disability. That is where an employer treats a disabled person unfavourably because of something arising from their disability. In cases such as this, it is not unusual for allegations to made that an employer has treated a person unfavourably (i.e. disciplined or dismissed them) because of something arising from their disability (i.e. absence). However, there is a defence to a section 15 allegation, namely that the employer must show that the treatment is a proportionate means of achieving a legitimate aim. Generally speaking managing absence is seen as a legitimate aim, and the question is therefore whether the application of that policy is a proportionate means of achieving that, and in that respect a lot of the practical arguments are very similar to those involving claims under section 20.

I appreciate that last paragraph is quite legal. In practice at this stage you really only need to be aware that the duty is to make reasonable adjustments, and the best thing for you to do is to engage with your employer in that respect.

From an employers perspective, they would just be concerned about how much more time off you would need and if this would have any long term impact on your ability to be present to work.

The threshold is there basically to serve as an alarm to look into why so much time off has happened and what the chances are of it happening again. Clearly this is something out of your control and you are doing the right thing in looking for different medication to resolve the reason for time off.

Best you can do is to have an honest discussion with your employer, state what you are doing and state that you are doing this to prevent further time off, although there may be initial side effects which may warrant some initial time off.

If you are a good employee and doing well, I can't see any employer wanting to discipline you for taking steps to reduce time off work as the cost and time of recruiting and training up would far outweigh any benefits of disciplining you. Saying that, if you are not performing well or if the company is looking to cut staff, they could well use this as a reason to look to manage you out of the business. Its a risk you take, but what is the alternative?

I can't advise on the work issues, but is a Psychiatrist managing medication or a GP? Usually Bipolar people can't take Antidepressants (I imagine some do, but I know they induce mania in many of us) . . if Lithium, can you try a different brand? I've not heard of heart problems & take Lithium with another mood stabiliser, so maybe other brands/types would be ok? I'd definitely see a Psychiatrist though if you don't already.

You have my sympathy though, i've just had medications increased & started & have really been hit hard by them, tho hopefully now i'm 3 weeks in i'm coming out of it, awful side effects x

I manage an individual with two health matters (one mental, one physical) that are acknowledged as life-disabling in line with the Equality Act. She has reasonable adjustments in place - last year it was that absences related to her disabilities were not counted towards the trigger for disciplinary activity; this year (due to a change in management approach) these absences are counted but she has a higher trigger level than the norm.

She has been quite open about her mental health, and has engaged with the management team at all levels to ensure that we manage her in an appropriate way, which includes a Wellness Recovery Action Plan document that helps us to identify triggers and symptoms, and which contains her preferences in terms of action to be taken.

Mental health conditions can be managed successfully at work.