BACKGROUND: Implementing workplace accommodations is an effective means of retaining employees with mental health conditions. However, the process is poorly understood and poorly documented. OBJECTIVE: The purpose of this research is to explore the interactive process of negotiating workplace accommodations from the perspective of employees with mental health conditions and workplace stakeholders. METHODS: We interviewed employees across Canada who self-identified as having a mental health condition requiring accommodations, and six stakeholders at various workplaces across Canada who are involved in providing accommodations. Data were analyzed using a qualitative descriptive approach to identify key themes. RESULTS: The findings highlight that the process of negotiating accommodations is non-linear, interactive, and political. The process is shaped by organizational and political factors and collaboration between stakeholders. CONCLUSIONS: The negotiation process is a combination of social, relational and political factors. Clear and accessible accommodation policies, workplace awareness and specific workplace training on how to implement accommodations are needed to optimize the accommodation process for all involved.