Consider a construction worker who hasn’t slept more than four hours a night for the past week, a software engineer who is battling a persistent cold but keeps working from their home office, and a schoolteacher who worries about their students so shows up each day despite feeling emotionally burned out.
What do they have in common? Presenteeism, otherwise known as the act of working while unwell – physically, emotionally, or mentally.
To be perfectly forthright, presenteeism – like burnout – is most often an individual response to a systemic problem. Few of us would prefer to be at work when we feel like garbage. Addressing presenteeism involves addressing poor management, toxic workplace cultures, and socioeconomic trends and inequities that force people to prioritise hours worked over their own health and that of their colleagues.
In writing this, we acknowledge all of this and the long way that our working cultures have to go, and we offer hope on how we get there. Holding the “and” is a psychological practice commonly used in several therapies, including dialectical behaviour therapy (DBT). At its simplest, DBT encourages a balance between opposites.
One of these opposites – at least in common discourse – is that of productivity and wellbeing. Perhaps we view our job as a machine – a mechanism where we input hours, and we receive money in return. We tell ourselves that if we manipulate the input (ie, hours worked), we can maximise the output (eg, fatter pay cheque and a fast-tracked promotion).
But, when we ramp up our working hours out of compulsion rather than passion, we are subtracting time away from our time to connect, sleep, move, rest, create, play, cook, or explore. We are using our time as a commodity to trade for more money, at the expense of our health and wellbeing.
By holding the “and”, let’s explore an alternative. What if we were supported by a workplace that encouraged us to be productive and to be healthy? What if our workplace celebrated achievement and also discouraged pulling all-nighters to reach the try-line? What if we were able to take sufficient time off to recover from physical or emotional hardship and we knew our job would be waiting for us when we came back?
It needs noting that, for some people, including those living with chronic psychological or physical illness, presenteeism is unavoidable. For these people, presenteeism might be the best option for them and their organisation.
But outside of these chronic cases, we are considerably more productive when we are working healthily and engaged, compared with working while unwell. We can achieve this state more deliberately, more of the time, by taking time off to rest and recover when it’s needed, leading to shorter illness periods and better health outcomes, and by looking after our wellbeing such that we experience lower stress and illness to begin with.
By tackling presenteeism, we can make the most of our days at work, and treat our non-work time as a chance to do more of what we love, rather than being a finish line that we cross at the end of each day or week - exhausted and gasping for air.
For organisations, this means getting three things right.
First, wellbeing is not just a nice-to-have – it’s a strategic opportunity. While supporting people’s wellbeing should always come from the heart, it’s also a virtuous cycle for a business’s bottom line with a demonstrable return on investment.
When we look after our people properly and with integrity, we reduce presenteeism and absenteeism, leading to lower people costs (the single biggest expense for many companies). We also reduce business risk from health and safety incidents, and reap the benefits of a high-performing organisation that attracts and retains good talent in a tight market.
Second, you don’t know what you can’t see. Sometimes you need to dig below the surface to understand the size of the problem. We often speak with employers who judge the health of their people based on whether they catch wind of problems or not – not realising that the responsibility to create a culture of safe disclosure falls firmly in their corner of the court. Moreover, waiting for problems to be bad enough to arrive on the CEO’s desk is a costly exercise for all involved. Proactive support is crucial.
The most effective means of accurately and proactively determining wellbeing and presenteeism is through anonymous assessments that deliver a comprehensive picture of both outcomes and the factors that contribute to them, complemented with 1:1s and team conversations.
These communication channels allow business leaders to accurately assess the size of any problems, and take evidence-based action to address them at their root.
Third, building a culture of wellbeing and productivity means supporting workers to be truly present. Once you’ve brought wellbeing to the executive boardroom, and determined the size of the problem and what’s causing it, that’s when the real work begins.
Some of the best initiatives range from actively encouraging sick and holiday leave to setting protocols for limited access to email and planned shared recovery times where meetings are not booked in – like around lunch times.
Tackling presenteeism and being truly present is the antidote to our “always on” culture – where our thinking, emotions and actions race. Being authentically present helps to calm the overwhelm, the stress spiral, and the need to work late to “show face”.
It is creating space to rest and recover, an emphasis on outcomes rather than hours worked, greater collaboration and creativity and, ultimately, greater productivity and performance.
Dr Amanda Wallis leads the research program at Umbrella Wellbeing and is passionate about making psychological research useable in our every day lives.
Gaynor Parkin is a clinical psychologist and CEO at Umbrella Wellbeing, a team of psychologists who provide workplace wellbeing support