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Companies need to review sick leave and holidays as more people work online


Presenteeism – being physically present at work but mentally absent and unproductive due to illness, injury, stress or burnout – now comes at a greater economic cost than absenteeism, says professor Renata Schoeman, head of the MBA in Healthcare Leadership programme at Stellenbosch Business School.

During the Covid-19 pandemic this issue not only became more prevalent, but moved into the digital and virtual realm as more employees worked from home.

Now, companies will need to review their existing policies around leave and mental health to account for this, Schoeman said.

Employees who show up and attempt to work despite their poor mental health cost South Africa almost seven times as much in lost productivity as employees who are absent due to depression, she said.

The cost of mental health-related presenteeism has been estimated at R96,500 per employee annually, totalling R235 billion or 4.2% of GDP, versus R14,000 per employee and R33 billion annually for absenteeism.

Schoeman said that presenteeism came not only at an economic cost but at a cost to mental health leading to burnout and other conditions due to not being treated properly.

She noted that the problem of presenteeism had increased and also shifted to ‘e-presenteeism’ with the rapid shift in working patterns, especially remote online work and flexible schedules, during the Covid-19 pandemic.

Companies can address this issue by reconsidering their existing leave rules, including:

  • Have regular one-on-one check-ins with employees, even if it is a virtual check-in, and create a supportive conversation where employees feel comfortable speaking about their wellbeing and stress levels. An open, trusting relationship means employees are more likely to disclose any mental health challenges that they are struggling with before they develop into more serious conditions.
  • Encourage employees to sign off, close their laptops and take time for a leisure activity at the end of the remote working day.
  • Review sick leave and absence policies and procedures, and adapt them for the world of online and remote work. Consider allowing for a “mental health day” over and above formal sick leave.
  • Ensure that sick leave policies and pay are adequate, in order to help curb presenteeism caused by the financial worries of losing income. Consider the cost of adequate sick pay against the cost of an unproductive ‘presentee’ employee.
  • Reward and recognise output and results rather than hours worked.
  • Encourage employees to take their annual leave.
  • Review workplace wellness initiatives. These could include discounts on gyms and fitness programmes or online fitness and healthy living apps, employee assistance programmes, mental health “first aiders” for first-line counselling, or offering talks and workshops on work-life balance, and resources to manage their physical, mental and financial wellness.

“In ‘normal’ times, poor mental health and various personal and work stress factors are key underlying causes of presenteeism, with people often feeling pressured to show up even though they are not fit for work,” Schoeman said.

Now, in the era of Covid, with increased fears of job security and heightened scrutiny by managers of remote working employees, the pressure to be virtually if not physically present, to be ‘always on’ and prove that one is productive while working from home is even greater, she said.

“This goes along with increased financial stress, concerns for their own and loved ones’ health, and juggling home and childcare responsibilities, so that people are finding it harder to switch off and set clear boundaries between their work lives and their home and personal lives.”

Signs of e-presenteeism 

Signs that an employee is engaging in e-presenteeism include lower levels of productivity, more mistakes or a lower standard of work than usual, a lack of care about results and output, starting late or finishing early, or putting in more hours but less output, and looking tired or exhausted in virtual meetings.

Presenteeism affects employees at all levels, Schoeman said, and in the physical work environment can lead to accidents as well as spreading disease when people who are physically ill come to work.

“At lower levels, people are often working with dangerous machinery, working night shifts or working as long-distance drivers. Stress, anxiety and depression affects the ability to concentrate and so they are more prone to accidents, with potentially costly or even fatal results.”

“For those at executive level, the impact on judgement and decision-making ability of poor mental health can have serious consequences for the organisation.”


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