What is Presenteeism at Work and Why You Should Care - woman with head on laptop

What is Presenteeism at Work and Why You Should Care

Amelia Wilcox
May 24, 2021
October 9, 2022

Do you feel the need to be constantly available and productive? So much emphasis is put on success in our culture that employees (and employers) will go to great lengths to constantly excel—or appear to be excelling. The result? Burnout, the decline in mental health, and presenteeism.  

What is presenteeism and why does it matter?

Presenteeism refers to lost productivity when employees show up to work when they aren't feeling well. When employees want to show up to work, even when they aren't able to focus due to illness, physical pain, fatigue, or mental health issues, presenteeism is the result.

The consequences of presenteeism are high. Presenteeism costs American businesses 10x more than absenteeism. Employees typically take about 4 sick days per year yet; many employees confess to being unproductive for 57.5 days each year. That's 25% of a 50-week work year!

The attempt to hide mental health challenges and continue working despite them leads to a downward spiral.

Digital presenteeism in the modern workplace

Presenteeism—one of the most costly business problems—is invisible in the modern workplace.

Digital presenteeism occurs when an employee feels obligated to be constantly available to their coworkers online. Employees may have a hard time not answering notifications, emails, or calls outside normal working hours, even if they need to rest.

Now that employees aren't expected to show up physically, they may feel the need to be constantly available digitally.

In the world of remote work, it isn't clear how many hours you are putting in. So employees stay active on their company's instant messenger or stay near their computer most hours of the day. They try to appear as present as possible to prove that they are good employees that put in hard work.

The challenge comes in when the line between work and leisure blurs—leading to drops in productivity and burnout. Employees feel expected to work even more—leading to presenteeism. Employees feel the need to be seen, to prove that they are behind their desk and not slacking.

Why presenteeism happens: common causes

The following are some common causes of presenteeism at work:

  • Management sets the example of working long hours without breaks
  • Company culture prioritizes input over output (more on that later)
  • Lack of trust in the workplace
  • Unclear sick leave policies
  • Concerns about reputation and holding a job
  • Poor task redistribution when someone takes a day off
  • Company downsizing or restructuring; recent layoffs
  • Employee concerns about making ends meet (especially for hourly workers)
  • Parents banking sick days for when their children are sick
  • Struggles with work-life boundaries due to remote work

Here are some common challenges employees face that lead to presenteeism:

Not only are employees concerned about their productivity—they are concerned about how their mental health issues will be perceived by their managers.  

Presenteeism and mental health

Presenteeism and mental health challenges are closely linked.

Depression is one of the main causes of employee presenteeism. Anxiety and depression—the most common mental health challenges—can make sitting behind a desk to work extremely difficult in itself.

As an employer, you are in a great position to support mental health. Employees need access to support—and you can help decrease the barriers to get that support.

As a result, company culture will improve, employees will be happier, and productivity will increase.

10 ways to reduce presenteeism

Here are 10 ways you can tackle presenteeism at work.

1. Add mental health support to your benefits package

Reexamine your current EAP. Are employees actually using it?

Employees often don't take advantage of EAPs due to:

  • fear that word of one's mental health challenges will come out and hurt their reputation—or even cost them their job
  • the embarrassment of contacting HR for a therapy appointment
  • difficulty getting access to mental health care through an EAP

If your company does not have an EAP or is looking for an EAP upgrade, consider a mental health support program like Nivati that connects people to therapy super easily, and also provides on-demand content for flexible care.

Half of employees never seek the mental health support they need. Workforce wellness programs will help change that.

2. Talk to employees openly about mental health and presenteeism

Homie, one of our clients, has weekly meetings with their entire company for the sole purpose of talking about mental health. They share their struggles and strategies that have helped them cope.

Simply talking about mental health can make all the difference. When you—a company leader—begin talking about mental health, employees will be more inclined to speak up as well. Create a culture where it's okay to talk about mental health and it's acceptable to take a mental health day if you need it.

Tell employees about the costs of presenteeism and let them know it's good to take breaks. Tell them that you'd rather them take a day off here and there than push through sickness, panic attacks, depression, or pain. Encourage them to seek help with a counselor.

3. Provide flexible work arrangements

The rigid 9-5 job thing just doesn't work for most remote workers. At home, there are more distractions. It is easier to get pulled away from the computer. Be understanding of this and allow employees to work at the hours that are best for them.

4. Care about results, not hours

Activity does not equal accomplishment.

Sitting at a desk for 60+ hours per week doesn't equate to results.

Express to your team that results are what matters. Don't worry about the input. Don't micromanage. Care about the output.

Employees will start to stress less about being constantly present and start to be more productive when they can work whenever is best for them.

5. Teach your managers about presenteeism

Bring presenteeism to your managers' attention. Encourage managers to talk to their direct reports about mental health. Have your managers tell your team to take a day off if they need it!

Need some more guidance on teaching your managers about mental health? Check out the downloadable Manager Training Handbook.

6. Know how to spot it

Here are some common signs employees are struggling with presenteeism:

  • Poor quality of work
  • Long working hours and/or not taking breaks
  • Difficulty getting along with coworkers
  • Tiredness
  • Complaints of mental health or physical struggles

Also read: 6 Signs Your Employees are Struggling with Mental Health

7. Have a crystal-clear sick leave policy

Does having a broken leg justify taking the day off, even if you work at a desk all day? Is a migraine grounds for a day off? What about mental health days?

Decide what your sick leave policy is, document it, and stick to it. Walk your team members through it, and make sure they understand it. Make it clear that it's okay—and even encouraged—to take the day off when you're not at your best. Employees that push through the pain and fatigue too much will run out of steam eventually. Oftentimes, it is better just to rest.

8. Encourage employees to take time off

Some companies have started incentivizing employees to take time off.

If you don't already, offer PTO—and require employees to take it. And beware of unlimited time off. Most employees take less time off when it's unlimited in an attempt to look like good, hard workers to their colleagues.

9. Be a role model

Be honest about your struggles with focusing and being productive 100% of the time. Show your employees that you're human, too! Take mental health days. Take time off. Log off early (or log in late) if you need it. Show employees that taking care of yourself pays off.

10. Reduce large workloads

Large workloads can also cause presenteeism. Do what you can to lighten the load for overworked employees.

Not sure how many hours employees are working (or attempting to work)? Send out a survey and ask employees to answer anonymously about how many hours they work per week. Let them know that the goal is to make working with your company a better experience and to achieve a better work-life balance.

Tackling presenteeism in the workplace will reap huge benefits for company culture, retention, employee satisfaction, and (of course) productivity.

We are the #un-eap. Nivati makes supporting employee mental health super easy – for employers and employees. We help companies take care of their people so they can take care of business.

Nivati’s average utilization rate falls around 65% – way more than the EAP average of about 20%.

Through our all-in-one wellbeing platform, employees' access to counseling, yoga, meditation, fitness classes, financial coaching, and so much more – live and on-demand. It only takes 3 clicks to find a therapist and schedule an appointment.

Want to learn more? Call us at 1 (800) 556-2950 or request a demo today!


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Amelia Wilcox
Amelia Wilcox
Amelia Wilcox is the Founder and CEO of Nivati, a leader in corporate massage and employee mental health support since 2010. Her high-growth B2B company provides employee stress management tools that arm businesses with actionable data and positive employee experiences to improve wellbeing, boost morale, and increase engagement. Amelia has exponentially grown her company from a solo living-room service business to an international technology brand.