Presenteeism – The Hidden Cost of Poor Mental Well-being at Work

Many employees feel pressure to show up to work when they are not fully fit, leading to what’s known as "presenteeism". There is still a stigma around taking time off for stress or anxiety meaning presenteeism due to poor mental health is on the rise with severe consequences for both workers and companies.

According to Deloitte’s 2022 survey, presenteeism due to poor mental health accounts for 46% of total costs in the UK workplace. Overall, the cost to UK businesses is up to £24-28 billion and counting every single year. To put that into perspective, the UK government currently spends £32.4 billion a year on defence.

In this blog we explore why it is important to tackle presenteeism, how to spot that someone is not fit to work and ways an organisation can address the problem.

Consequences of presenteeism

If an employee is physically present but psychologically absent it can have negative effects on both the employer and the employee, often leading to worse problems. Five of the most common consequences are:

1. Lost productivity - When employees come to work while ill, their effectiveness suffers due to reduced energy and focus. This can lead to decreased output, missed deadlines, and lower quality of work.

2. Low morale - When employees feel pressured to work despite experiencing physical or emotional stress, they may become disengaged or even resentful. This feeling can easily spread to others in the organisation affecting performance.

3. Prolonged health issues - By coming to work while sick or suffering from other physical and mental health problems, employees may be prolonging their illness. This can lead to more time off work (absenteeism) and further lost productivity. Reduced energy levels and increased workloads, due to their illness-related absences from work, can lead to burnout and long term sick leave.

4. Poor employee retention – Employees who come to work when ill often feel that the organisation doesn’t understand mental health and the only way to solve their problems is to leave.

5. Financial losses – Ultimately decreased productivity, increased medical costs, and higher employee turnover rates will have an impact on the businesses’ turnover and profits.

Signs of presenteeism

When someone has a cold or a broken leg it is relatively easy to spot when they are suffering. Poor mental health is less visible and people often hide how they are feeling for fear that it might affect others’ perception of them.

Any changes to an employee’s usual behaviour can indicate that they might need help. Key signs of presenteeism include:

  • Missing deadlines or forgetting tasks
  • Becoming accident prone
  • Not engaging in meetings or turning the camera off during online sessions
  • Overworking
  • Complaining about lack of support or workload
  • Demonstrating irritability, aggression or tearfulness
  • Being withdrawn or louder than usual
  • Exhibiting an inability to concentrate, indecisiveness
  • Being tired all the time
  • Showing signs of alcohol and/or drug misuse

Tackling the causes of presenteeism

Understanding the causes of presenteeism can help to tackle the problem. Every organisation is different but common issues include:

1. High workload – there don’t appear to be many businesses which are not struggling to recruit the right people. More than two-thirds (68%) of SMEs are currently facing skills shortages (Open University Business Barometer 2023). However, piling everything onto those left simply causes more problems. Solving the problem often requires rethinking some of the business model e.g. losing those clients that are difficult or unprofitable.

2. Job insecurity – The financial crisis is hitting individuals but also businesses. It doesn’t take much for rumours of cost cutting and redundancies to start circulating. Make sure that the communications you want to employees to hear are getting through. Be honest about issues and ensure that confidential information is kept confidential.

3. Lack of sick leave pay – With the cost of living crisis deepening, (just last week water companies were talking about a 40% rise in bills) taking unpaid time off work is just not an option for some people. Companies need to weigh up the cost of allowing people to take time to recover as opposed to having well-trained staff on long-term sick.

4. Wanting or needing a promotion – Many workers feel that the only way to get a promotion and a salary increase is to put in the extra hours at work to impress their superiors. The effect of not being promoted can be devasting. Managers need to set realistic expectations when it comes to promotions, explaining that if there isn’t a business need there won’t be a promotion no matter how hard someone works.

5. Long hours culture within the organisation – Just because you work longer doesn’t mean you work smarter. If someone completes a 12-hour shift in an insurance company’s sales department, but does not sell one policy, how much value have they given to that business? On the other hand, if a part-time worker spots ways to make processes more efficient and helps increase productivity, this should be rewarded. Contribution to the running and the results of the organisation should be renumerated rather than being at your desk all hours.

6. Lack of flexibility - More employers need to recognise that allowing employees to choose hours that suit their lifestyles does not give them an excuse to slack off. Different people work differently at different stages of their lifecycle. Hybrid working allows a greater diversity in the workforce and makes employees more likely to work harder when they are at work.

7. Having access to work at home – Since the pandemic many people now work from home part of the week and take their laptops home at the end of their days in the office. Many people also access their work emails from their personal phone. Both of these make it hard to switch off at the end of the working day and leads to complete lack of a work-life balance putting pressure on your relationships with those closest to you, as your family members continually insist that they are more important than your client’s most recent email. Giving workers office phones and asking them why they are answering emails in the evening can help to stop many people being constantly on-line.

How We Can Help

Altruist have helped over 500 organisations create cultures which boost their staff’s productivity by providing them with the tools they need to identify and address mental health issues and putting in place programmes which reduces the causes of stress.

We provide mental well-being at work courses, such as Mental Health Training For Managers, and Mental Health First Aider certification.

The journey starts with auditing the current provision and writing a comprehensive strategy. Our complimentary tools help organisation assess where they are and look at where they need to be. Download our Guide to Producing an Effective Workplace Mental Well-being Strategy and complete our 2 minute audit.

This article has been updated and was originally posted in 2018.

Sarah Woods

Sarah is Operations Manager at Altruist Enterprises responsible for marketing, people and processes as well as working with Katie on strategy. She has spent most of her career as a marketing manager in professional services, supporting managing partners with structuring and growing their business areas. Sarah enjoys meeting and working with people from different backgrounds who all have unique skills. She gets pleasure from developing the individual talents of those she manages.

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