Presenteeism - The challenge

Presenteeism refers to a loss of workplace productivity resulting from employee health problems and/or personal issues, presentees are people who are ‘‘at work, but not working’’, at least not up to their full capacity.

UK presenteeism attributable to mental health problems accounts for 1.5 times as much working time lost as absenteeism, however relatively few organisations are familiar with the concept. Research has recognised that managing presenteeism effectively could be a competitive advantage for organisations (Hemp, 2004).

Both the Chartered Institute of Personnel & Development (CIPD) and the Confederation of British Industry (CBI)/AXA suggest that stress, depression and anxiety account for 40% and 37.5% of sickness absence, respectively. It is reasonable to suggest that for a period before going absent that these employees are exhibiting presenteeism compounding the losses to an organisation, this is backed up by Conti & Burton (1994).

Drawing on data from the Office of National Statistics 22.3% of all people in paid employment have some kind of mental health problem (15.4% if alcohol and drug dependency are excluded), the Sainsbury Centre make the point that employers should expect to find on average 1 in 6 of their workforce is affected by depression, anxiety or other mental health conditions or around 1 in 5 if alcohol and drug dependency are included.

Organisational policies have been cited as one of the main reasons for presenteeism along with job design features and presenteeism cultures, some of the specific issues are:

  • Job insecurity - Job insecurity stemming from downsizing and restructuring forces exaggerated levels of attendance that result in stress and illness but affects productivity.
  • Pay levels - Aronsson et al.(2000) reported that groups exhibiting the most presenteeism were among the poorest paid, backing this study up Aronsson and Gustafsson (2005) found that people having trouble handling domestic expenses were positively associated with presenteeism.
  • Sick pay - Sick pay policies and related attendance control systems can be related to the prevalence of presenteeism. Numerous studies showing that less liberal sick pay plans result in less absence, the associated result is that they could also stimulate presenteeism.
  • Attendance control - Especially concerning were fixed ‘‘trigger points’’ for a certain number of absence episodes will lead to disciplinary action. Such trigger points stimulate presenteeism, and they also convert potential presenteeism into absence as employees are concerned to return to work too soon (and thus risk going absent again) for fear of accruing two absence episodes instead of one.

In conclusion there is considerable agreement across studies that presenteeism accounts for more aggregate productivity loss than absenteeism. Basically this suggests an iceberg effect where the more visible portion of work loss, absenteeism, is dwarfed by that portion beneath the surface, presenteeism.  However by looking at work policies and practices coupled with implementing a well thought out, structured holistic health and wellbeing strategy that fosters resilience through lifestyle behaviour change and coping strategies this very costly challenge can be tackled by organisations.

Martin Noddings