Mental health at work: a measure of performance

Sickness at work is usually counted in time lost. Indeed common mental conditions – stress, anxiety and depression - account for more days of absence than any other condition, a huge tax on work and the NHS.

Now a Work Foundation report into sickness presence has provided support for the Centre for Mental Health’s findings that illness while at work is an even larger iceberg-shaped financial problem.

‘Why do employees come to work when ill? An investigation into sickness presence in the workplace’ surveyed the 1,600-odd employees of AXA, the insurance company.

By its own account, AXA prides itself on its ‘modern employment practices and for the wide range of employee benefits available to our people.’ It has a 96.5% attendance rate and low staff turnover. Overall it felt it placed a high regard on the health and wellbeing of its workforce, which in a sense makes the findings all the more troubling.

510 employees responded to the survey (about a third of employees), of which 19% self-reported depression, 25% migraines and 26% difficulty in sleeping. The other two health problems in the top five were skin problems (including hayfever and eczema - 30%) and muscular-skeletal (20%).

45% of those responding stated they had taken one or more days of sickness presence over a four week period – that is they had come in to work while ill enough to remain home.

This was the Work Foundation’s definition of sickness presence – a refinement of ‘presenteeism’, which in some definitions could include those who were perfectly well but just slacked off at work.

In the same period, 18% of the same respondents had actually taken a day off sick, indicating that sickness presence was three times the rate of absence.

It would be nice to think of the good old British worker struggling in to work for the good of the company. However what the Work Foundation found was that negative factors such as workplace stress, pressure not to take time off and money worries were the main drivers of sickness presence. Just over 40 % of employees perceived pressure from senior managers, line managers and colleagues to come to work when unwell.

This has significant repercussions for organisations. First, any data they might have on the health and wellbeing of their workforce is seriously unreflective of the actual situation. Nearly all AXA employees interviewed as a follow up to the survey stated they would go in to work with stress, anxiety or depression (although some would not if their condition was pronounced).

Second, sickness presence is directly related to performance. The Work Foundation looked at the performance data of 164 surveyed employees, and found that those reporting higher levels of sickness presence were lower performers - the 27% rated as ‘excellent’ reported half a day of sickness presence over a four-week period, whereas the 61% rated ‘successful’ had taken over a day.

Third, using pressure and stress to force employees into work just worsens the situation. Both work-related stress and pressure were significantly related to psychological wellbeing. Those reporting lower levels of psychological wellbeing (and higher levels of anxiety) were more likely to report higher levels of workplace pressure to come into work when unwell and higher levels of work-related stress.

Mental health is not just the biggest health problem at work today, it is also the measure of the corporate culture which underpins it.