The 2017 Thriving at Work Report (Farmer and Stevenson) estimates the cost of poor mental health to UK businesses at somewhere between £33 billion and £42 billion. That’s £1300 per employee per year due to lost productivity, increased absence and increased turnover.

You might think that the largest cost comes from absenteeism or staff turnover. These are high. Each costs UK businesses £8 billion every year. But the greatest cost to business — up to £26 billion — comes from lost productivity. It comes from those people who are present at work but not in good mental health.

The relationship between presenteeism and health

Staff who should take time off but continue to work are presentees. Presentees desperately want to work hard. They aren’t lazy. They don’t like to be not being able to cope. So, each day, no matter their physical or mental health, they drag themselves into work. Great, right? You’ve not lost a member of staff for the day. What a fantastic employee – it’s business as usual thanks to their dedication!

But there’s a problem.

And it’s obvious when you stop and think about it.

Just how productive do you think a member of staff can be if they’re unwell? Can you really assume that a person with the flu will perform the same as when they are well? Definitely not. Maybe for a short time they will be able to keep on top of things, but it won’t be long before their work starts to slip. They might deny the issue, but as their manager, you’d be best insisting they recover and come back better in a few days. Keep them at work, and you’ll soon be dealing with a landslide of problems that they cannot help causing because they’re unable to focus.

Presenteeism and mental health is a bigger problem than physical health

Although some people will become presentees when they have a physical illness, it’s generally not too embarrassing to ask for time off. After all, everyone gets sick at some point and we can all empathise with having the flu or a stomach upset.

But let’s imagine for a moment that having the flu was far more sigmatised than it currently is. What if people believed that if you had it, you were a weak person because you let it happen to you? What if people believed that you deserved to have it because you had made bad choices in your life? And what if people believed you would never recover from it and that it defined who you were as if it was the only thing in your life that mattered? Whenever anyone spoke about you, they’d be sure to mention your illness.

Would you tell anyone?

Stigma, presenteeism and mental health

Stigma greatly impacts presenteeism due to poor mental health. Just like physical illnesses, everyone is susceptible to mental health conditions . However, talking about it is something people are scared to do. This is because up until very recently, society has seen mental health conditions as shameful and a mark of weakness. We’re living with a dark legacy that means that those dealing with mental health conditions not only have to manage the condition, but also attempt to disguise it from others as well.

As you would imagine, there’s a cost to this culture of silence. Up to £26 billion.

That’s £26 billion lost through employees unwilling to take time off for a mental health condition. Instead, as with a physical illness, they turn up, tune out and become less and less productive.

Despite a number of high-profile public figures ‘coming out’ about their mental health disorders, a stigma definitely still exists in the workplace. Research has found that only 1 in 10 employees would talk about a mental health condition with their line manager. Worryingly, only 24% of managers had received any form of mental health training (Business in the Community. Mental Health at Work Report 2017). This culture of silence drives up the cost of poor mental health because issues that could be dealt with remain hidden.

Employees worry that they will suffer discrimination or just be seen as ‘different’ if they discuss an issue they are having. As a result, many employees try to hide the fact they are stressed or are dealing with a mental health condition. And this leads directly to another cost of poor mental health.

The human cost of presenteeism and mental health

Although the financial cost of presenteeism and mental health to business is staggering, the human cost is more worrying. 1 in 4 people will deal with a mental health condition at some point in their lives (NHS, 2014), and yet 57% of people would not disclose a mental health condition to anyone at all. Not friends, not family – no-one.

As a result, we see the human cost of poor mental health reflected in such shocking statistics as the fact that somewhere in the world a suicide takes place every 40 seconds. And for every completed suicide, there are 25 attempts. In fact, suicide is the leading cause of death for both men and women under 35.

Investing in mental health pays off

At first glance, investing in mental health might not appear the best way to spend your budget. Actually, that couldn’t be further from the truth. When Deloitte (2017) analysed 23 companies that had done exactly this, the results showed a consistently positive return. For every £1.00 spent on mental health interventions on staff, companies saw a return of £4.00 on average.

But that’s just an average. Companies investing in proactive support like mental health mentoring saw a maximum return of 6:1. If they invested in cultural change and raising awareness, they saw a maximum of 8:1. It’s easy to see why there’re so many financial benefits once the cost of losing valuable employees is considered. Recruiting, on-boarding and training new staff takes time, energy and money.