Unaddressed Mental Health and Presenteeism in the Workplace

Worth Living Ambassador & New England Lead Kim LaMontagne

I share my personal story of being a high functioning business woman balancing a career and family while fighting (and hiding) major depression, anxiety and persistent suicidal thoughts. By sharing my story, I help individuals find the courage, power and strength to accept and love who they are and rise above the fear, stigma and shame of mental illness and talk openly about it. I fought my battle alone because I was afraid of stigma. Especially in the workplace. No one should suffer alone.

Unaddressed Mental Health and Presenteeism in the Workplace: What Does Presenteeism Mean and How is it Affecting Your Bottom Line?

More than 14 million U.S. workers fall within the category and diagnostic criteria for substance dependence (Jacobson & Sacco, 2012) and millions more suffer from mental illness. Substance abuse, mental illness, and stigma in the workplace cost employers millions in “lost productivity, measured by increased absenteeism, workplace accidents and healthcare costs” (Jacobson & Sacco, 2012).

Additionally, stigma and mental illness negatively impacts other employees affecting workplace morale, productivity and outcomes.
Research reveals that mental health disorders, particularly depression, have a “staggering impact on business productivity in America, greater than physical disorders” (Harder et.al, 2014). This phenomenon has become more common in the workplace but is not well understood or supported. Untreated mental health is a public health concern.

In today’s complex and competitive business market, a company’s most important asset is human resources. “Efficient business relies on the health of the individual worker” (Ajunwa, et. al., 2016). A physically and mentally healthy worker means fewer sick days, decrease in short and long-term disability claims, more productivity and engagement, and less healthcare cost for the company. A mentally healthy workforce is better for the bottom line.

Organizational loss associated with mental health in the workplace is multipronged and includes “absenteeism, presenteeism, and turnover” (Harder, et. al., 2014). Absenteeism accounts for time off from work with no expectation of work responsibility. Among valid reasons for absenteeism, mental health conditions account for a 62.2% of days out of office and accounts for an estimated 7% of global payroll across organizations “which is more than any other disorder” (Harder, et.al., 2014). Although lost productivity and costs associated with absenteeism are staggering, an even costlier issue in the workplace is presenteeism.

Presenteeism is known as “the problem of workers being on the job but, because of illness or other medical conditions, not fully functioning” (Hemp, 2004). Presenteeism can cut individual productivity by one-third and can be even more costly than its counterpart absenteeism. Unlike absenteeism, presenteeism isn’t always apparent. It is simple to process the concept of absenteeism. When an employee is excused from work, productivity is not expected because they are not present. When presenteeism is introduced in the workplace, you often can’t tell “when—or how much—illness or a medical condition hinders someone’s performance” (Hemp, 2004). Presenteeism represents when the worker is there but is not being productive due to outside circumstances. Also known as the working wounded. In the United States alone, the costs associated with presenteeism are $180 billion per year compared to the $118 billion costs related to absenteeism” (Ammendola, et. al., 2016).

The cost and burden of mental health disorders is consistently found to supersede physical disorders when comparing direct (medical / pharmaceutical) and indirect (absenteeism / presenteeism) costs of each disorder. Mental health episodes requiring an employee to open a disability claim are typically longer than for other types of disorders (67 days vs. 33.8 days) (Harder, et. al., 2014). The average major depressive episode lasts for 26 weeks making it the “single leading cause of disability in the workplace” (Harder, et. al., 2014).

Although diagnoses such heart disease, diabetes, or cancer require a company to pay higher direct health care costs, illnesses such as depression and anxiety have lower direct costs. Unfortunately, they usually account for increased loss in productivity because “they are so prevalent, they so often go untreated and they typically occur during peak working years” (Hemp, 2014).

To build a healthier workplace, there must be a team approach to employee health and wellness. The adage of leave your problems at the door is a thing of the past. Since most employees experience major disruptive issues affecting their on the job performance, there must be a comprehensive top down organizational strategy to ensure proper management of employee health to increase retention and decrease healthcare costs. The role of the CEO and leadership within an organization is critical to supporting the success and implementation of a program to support the well-being of employees. When mental health is valued by leaders, appropriate resources become increasingly more available, employees are educated about the resources, usage increase and there is a substantial benefit to the organization and more importantly the bottom line.

Commitment to employee wellness is a topic of organizational discussion that is gaining increased interest in research. Research conducted by Health Enhancement Research Organization (HERO) shows organizational support to be an “important mediator in
presenteeism” (Garrow, 2016). Specifically, support from the top leadership that cascades throughout the culture of the organization. Business leaders have a duty to help reduce stigma in the workplace, develop a mental health strategy, and consider mental health as an ongoing educational process. This can be accomplished by investing in targeted actions that promote mental health such as workshops, employee education, frontline leader training in mental and collaboration with NAMI just to name a few. Leaders must feel empowered to make the changes required to build and sustain a mentally healthy workforce capable of increased productivity due to positive mental health. It’s good for the bottom line.

Ajunwa, I., Crawford, K. and Ford, J. (2016) Health and Big Data: An Ethical Framework for Health Information Collection by Corporate Wellness Programs, National Center for Biotechnology Information, U.S. National Library of Medicine

Ammendola, C, Côté, P, Cancelliere, C, Cassidy, J, Hartvigsen, J, Boyle, E, Soklaridis, S, Stern, P, & Amick III, B., 2016, ‘Healthy and productive workers: using intervention mapping to design a workplace health promotion and wellness program to improve presenteeism’, BMC Public Health, 16, pp. 1-18.

Garrow, V. (2016) Presenteeism A review of current thinking, Institute for Employment Studies, Feb 2016, Report 507.
Harder, H, Wagner, S, Rash, J, 2014, Mental Illness in the Workplace.

Harder, H.G., Wagner, S.L., Rash, J.A., Mental Illness in the Workplace: Psychological Disability Management

Hemp, P. (2004) Presenteeism: At Work—But out of it, Harvard Business Review, Available at: https://hbr.org/2004/10/presenteeism-at-work-but-out-of-it.

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