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Presenteeism: the hidden cost of ignoring employee mental wellbeing

October 2018

In recent years, the UK has made significant progress in reducing the stigma surrounding mental health, yet stigma in the workplace is lagging behind. In fact, recent research by Shaw Trust found that although awareness of mental health issues in employers has more than doubled since 2009, half of employers view staff with mental health conditions as a ‘significant risk’ to their business, this is a 10% increase since 20091.

This may not be all that surprising, given that 72% of workplaces have no mental health or wellbeing policy1 and less than a quarter (24%) of line managers have received any mental health training2. Even those workplaces which have put in place reactive processes to help those with diagnosed mental health disorders are still failing the majority of their employees, by not addressing their mental wellbeing more widely.

Definition of mental wellbeing:

Mental wellbeing, as defined by mental health charity Mind, describes your mental state and is dynamic. If you have good mental wellbeing you are able to:

  • Feel relatively confident in yourself and have positive self-esteem 
  • Feel and express a range of emotions 
  • Build and maintain good relationships with others 
  • Feel engaged with the world around you 
  • Live and work productively 
  • Cope with the stresses of daily life, including work-related stress 
  • Adapt and manage in times of change and uncertainty3

A person’s mental wellbeing is related to their mental health. For example, experiencing poor mental wellbeing for an extended period of time increases the risk of developing a mental health problem.

Mental wellbeing and presenteeism

Improving workplace mental wellbeing is not just a ‘nice to have’ - a recent report estimated the cost to UK employers of poor mental wellbeing in the workplace to be around £30 billion per year4. These costs were estimated to be made up from: staff turnover (10%), work absences (30%) and presenteeism (60%). The same report estimates 30% of these costs could be saved through improved organisational practices.

Definition of presenteeism:

Presenteeism is the loss in productivity caused by employees being present at work, but working at less than full capacity due to poor wellbeing, in this case poor mental wellbeing.

It is easy to see how presenteeism could be caused by poor mental wellbeing, a survey by CIPD showed that 85% of people found it more difficult to concentrate when suffering with their mental wellbeing5. A further 64% said it would cause them to take longer to complete tasks.

The extent of the problem

Presenteeism due to poor mental wellbeing often goes ignored, partly due to the difficulty in quantifying the issue.

In a YouGov/Barclays survey of employees in large businesses, stigma was widely cited as being a part of the problem. 58% of those surveyed said they would not feel comfortable talking to their manager about their mental wellbeing, making it very difficult to measure the extent that presenteeism could be an issue for an organisation.

The survey aimed to gain some measure of the impact on UK businesses. Graph 1 shows the percentage of respondents who suffer from various symptoms of poor mental wellbeing (at least once per month). The symptoms most commonly suffered at work included feeling disengaged, poor self-esteem and difficulty in expressing emotions.

Graph 1: % of respondents who suffered from these symptoms at least once per month at work

Of those people who indicated that they did suffer from poor mental wellbeing, 61% of them went on to report that this had affected their productivity at work. This proportion increased for high earners, suggesting presenteeism could be more problematic for those in senior roles.

Overall, around one in two of those we surveyed indicated they had problems with presenteeism, with roughly the same amount being aware of it being an issue in their workplaces (see graph 2). This indicates a potential lack of awareness of mental wellbeing and how this can affect people, particularly amongst those who haven’t suffered themselves.

Graph 2: Proportion of respondents who think presenteeism due to poor mental wellbeing is a problem in their workplace

Why employers need to act

The productivity of UK workers has long been lagging behind other industrialised nations. In 2016, output per worker in the UK was 15.4% below the G7 average6 and productivity growth has been stubbornly flat since the financial crisis of 2008.

Graph 3: Productivity – output per worker

(Source: International comparisons of UK productivity, first estimates: 2016, ONS)

Investment in mental wellbeing could be one way to address stalled productivity growth, as the long-held notion that a contented workforce is a productive one is backed up by research that suggests happiness can improve productivity by as much as 12%7.

As well as productivity, recruitment of talent is an area that will benefit from this investment. 61% of respondents said that the presence of mental wellbeing initiatives within an organisation would have a medium to large positive influence on their decision to accept a job offer**. This proportion rose to 67% for 18-34 year olds, and given that by 2025, it has been estimated that three quarters of the workforce will be millennials8, it is clear that organisations wishing to successfully hire the best new talent cannot afford to ignore mental wellbeing.

What can be done?

Many of the people we surveyed called for a designated (and possibly external) person to speak to about their mental wellbeing. Other responses included having a more open and honest environment; mental wellbeing training for line managers and minimising the causes of stress which contribute to poor wellbeing, for example by increasing staffing levels or offering resilience training.

Researchers have called for increased awareness of mental wellbeing as a concept – building on the positive steps many businesses have made in relation to diagnosed mental health disorders.

Increased awareness could help people to better monitor their own mental wellbeing, as well as reducing the stigma for others that are suffering.

Once mental health and wellbeing are on an organisation’s agenda, the Deloitte Centre for Health Solutions recommends the following implementation cycle for workplace wellbeing initiatives:

Adapted from: “At a tipping point? Workplace mental health and wellbeing”, Deloitte Centre for Health Solutions, March 2017

For practical information on what steps to take to improve employee mental wellbeing, see Mind’s resources on ‘Taking care of your staff’^. Or see their advice on understanding and improving your own mental wellbeing^. Alternatively, visit ‘Mental health at work’^ for resources and information for employers, line managers and colleagues.

Related content: ‘This is me’ campaign

Our campaign, ‘This is Me’, challenges the stigma around mental health at work and aims to break the culture of silence by supporting people to tell their own stories.

The campaign has also resonated with other organisations, and in 2016, Barclays partnered with the City of London’s Lord Mayor’s Appeal, Mind, Business Healthy, and the City Mental Health Alliance to launch ‘This is Me in the City’. Find out more about getting involved in this campaign here^.

Watch our video showcasing four participants in the ‘This is Me’ campaign from four different large corporates:


1Mental Health: Still The Last Workplace Taboo?, Shaw-trust, 2018

2Mental Health at Work Report 2017, Business in the Community, 2017.

3How to improve your mental wellbeing, Mind Org, 2013^

4Mental ill-health in the workplace is costing UK employers billions, Acas, 2012^

5Employee Outlook: mental health and well-being, CIPD, 2016

6International comparisons of UK productivity (ICP), first estimates: 2016. The Office of National Statistics

7Oswald, Andrew J. , Proto, Eugenio and Sgroi, Daniel. (2015) Happiness and productivity, Journal of Labor Economics, 33 (4). pp. 789-822.

8The Millennial Survey, Deloitte, 2015 

** Defined on a scale, with 0 being no positive influence and 10 – A large positive influence, the 61% belonging to those that selected 6 – 10.

All figures, unless otherwise stated, are from YouGov Plc. Total sample size was 1007 employees from large businesses. Fieldwork was undertaken between 31st July - 7th August 2018. The survey was carried out online.