Presenteeism in the workplace: the cost to employers

Absenteeism and presenteeism are significant issues for companies in today’s society, and have an impact on employers. But the blame for time off shouldn’t fall solely on employees. It’s something that employers also need to address. Here we explore what absenteeism and presenteeism are, their indirect costs to employers, and how to address the rising challenge of presenteeism in the workplace. 

📝 All articles on Wysa are reviewed by mental healthcare professionals before publication, who check that the content is thorough and accurate, and references the latest evidence-based research. Learn more. 

What is presenteeism?

Presenteeism is when people continue going to work when circumstances suggest they should do otherwise. This might be that they have an illness, and should be taking sick leave. It could be that they stay in the office after hours, rather than go home. Or it could even be answering  emails whilst on vacation. What makes something presenteeism rather than just ‘going to work’ is that the former is when people fear the repercussions of not going to work.

It’s a trend that is growing, particularly after the pandemic and during the recession, with a heightened sense of insecurity around our jobs. 

Factors that can cause presenteeism

• Many factors can contribute to presenteeism, but a lot of it is down to fear, culture, and stigma. We live in a world where the ‘hustle’ culture is praised. Long hours lead to success. Team players get promoted. You live, breathe and love your job. And in this kind of culture, presenteeism thrives, even when it’s doing neither the individual or the organization any good.
• Job insecurity is a major contributor to presenteeism, as employees may feel the need to come to work even when they are unwell or not productive because they fear losing their jobs. This fear could be due to workplace culture, but might also be a result of financial stress.  
• A culture of a heavy workload, a lack of work-life balance, and insufficient support from managers and team leaders can also cause presenteeism, as people feel they have to take challenges on themselves.  

Presenteeism and absenteeism: the difference

While absenteeism and presenteeism both have a negative impact on the workplace, there is a difference between the two. Absenteeism occurs when employees are absent from work altogether, while presenteeism occurs when employees come to work but are not fully productive. Presenteeism can be harder to identify than absenteeism because employees are physically present, but they may not be working to their full capacity.

The thing about presenteeism is that employees come to work despite being unproductive due to personal or health issues such as mental health, stress, anxiety, financial concerns, or personal problems. They may find it difficult to focus, hard to concentrate, challenging to communicate, and unable to get on with their workload - but choose not to take absence. Absenteeism is when they are away, repeatedly, without a valid excuse such as long term sick note. They’re not doing any work at all.

But both absenteeism and presenteeism can lead to reduced workplace productivity, decreased quality of work, a lack of employee engagement, and a negative work environment.

The link between mental health, presenteeism, and absenteeism

In our All Worked Up report we found that despite corporate wellness programs and employee initiatives, people arenʼt always prepared to speak to their employers about their mental health. When asked about the mental health issues they face there are a startling prevalence of symptoms that employers are unaware of.

• More than 4 in 10 workers (42%) said they suffer anxiety symptoms, yet their employer is unaware.
• 38% said they suffer from depression that their bosses donʼt know about.
• More than 1 in 4 workers (26%) said they suffer in silence at work from insomnia or lack of sleep.
• Unbeknown to their employer, more than 1 in 5 workers (23%) said that they suffer from social anxiety.
• It is not just mental health - nearly 1 in 5 workers (18%) said their employer is unaware that they suffer from chronic pain, a debilitating condition that can affect all areas of life.

American workers revealed they are more likely to either lie about taking off sick to get mental health relief or simply try to push through it and go to work, fuelling the trend of burnout happening across industries. In fact, 42% of employees, when they need a mental health day, prefer to plough on regardless, instead of being honest and taking paid sick leave.

It’s not just Wysa who have seen how stress, depression and anxiety are affecting the workforce, and through presenteeism, their companies. Deloitte found that one-third (36%) of UK employees were taking paid time off when they experienced health issues, rather than calling in sick.

And there’s a cost to this.

Which costs more to companies: absenteeism or presenteeism?

The costs of absenteeism and presenteeism are significant - yet it’s the latter that is the most expensive, often due to the indirect cost. In fact, it has been estimated that presenteeism's impact on productivity is 12 times higher than absenteeism. Deloitte estimate that poor mental health among employees costs UK employers £42bn – £45bn each year. And it’s presenteeism that is the biggest issue, costing £27bn to £29bn, compared to absence costs of around £7bn, and turnover costs of approximately £9bn.

Organizations that recognise the link between employee well being and employee productivity are more successful than those that don’t. Presenteeism costs time, money, and even reputation if poor work is being done. It’s not just lost productivity that is the issue, but quality of output. 

And absenteeism and presenteeism are public health problem. As All Worked Up showed, 1 in 3 employees in the US and UK are experiencing moderate to severe symptoms of anxiety and/or depression, yet rather than take a mental health sick day, the vast majority are muddling on regardless, or citing another reason.

But prioritizing mental health and well being is financially savvy. Deloitte found in 2020 that for every £1 UK employers spend on mental health, they recoup £5, showing a clear return on investment, largely fuelled by better employee productivity.

7 ways to reduce presenteeism in the workplace

1. Prioritize work-life balance

Given that both absenteeism and presenteeism cost a business so much - productivity loss, lack of energy, and potentially reputation, it’s startling that we don’t prioritize work life balance more. Many workers still feel that they should stay at work even when not functioning at their best - and in the long term this can lead to more absenteeism, as employees burnout. Make it normal in your company culture to take a holiday, finish on time, and take a lunch break, by reminding your employees and demonstrating to them that there are no repercussions to doing so. 

2. Incorporate wellness programs

A number of large employers have specific wellness programs and employee assistance programs, including behavioural health solutions like Wysa which can offer both well being support and access to clinical help for mental health issues. An investment in these can reduce costs in the long term. In fact, our Employee Mental Health Report points to a 30% cost saving when using AI stepped care which takes people to the pathways and support they need, versus other employee assistance programs. 

3. Lead from the top

Managers can lead by example, by not staying long hours at work and using their breaks and paid time off, or not working through illness. In some companies the simple act of a leader standing up at the end of the working day and encouraging people to go home can reduce the urge to stay later ‘just to be seen.’ Encourage people to take paid sick leave if they seem ill or vulnerable to something, and don’t bring up sick leave, unless it becomes untenable, in feedback reports and appraisals. Make your management take their annual leave, and encourage them to have regular team lunches where all employees under them in the company take time away from their desk and switch off for an hour. 

4. Offer flexible work arrangements

Providing flexible work arrangements such as working from home, flexible schedules, or part-time work can help employees balance work and personal responsibilities, reducing the likelihood of presenteeism in the workplace. Many workers perform better when they are able to be flexible, as they can choose to work at a time when they are more energised and productive. After the pandemic more and more companies are seeing that people don’t need to be in the office to do good work.

5. Have manageable workloads

Heavy workloads can cause stress, worry and burnout. A fear of missing work or being unable to meet deadlines can cause employees to keep working, even when at the edge of what they are able to do, causing problems with their health and well being. The key to ensuring that employees are able to do their work is to make it manageable, with no unreasonable deadlines, last minute deadlines, or simply too much to do.

6. Build a community

Create a workplace where it is normal to reach out for support and share the workload. When people feel alone they are more likely to feel stressed and anxious, and unable to think clearly about what can be done to manage their well being, which can add to the likelihood of sickness and poor work and thus costs of presenteeism. In a culture where people feel supported and part of a team, they know they can get help when it all gets too much - and take a sick day if they need to. This can be achieved by company away days, team coffee mornings, employee resource groups and specific training activities designed to improve relationships.

7. Ask people what they want

Do a benefits survey to see if what the company is currently offering when it comes to corporate wellness is what people really need to help them focus on their well being. The best success from company health programs always comes when it factors in workforce values and motivations. Build your company wellness program around the things that keep your particular workforce well and reduce absence, whether that’s yoga at lunch time, flexible working, or more paid time off.

Photo by Thirdman