Mel Riley explains the problem with presenteeism

The Scenario

Sitting across from the doctor, Jane felt pangs of guilt rise. Close to tears, Jane explained to her GP why she had been reluctant to seek help. “I don’t want to let them down. Someone else will have to pick up my workload now.” Jane was signed off work with stress; what led Jane to her predicament was a prolonged period of what is coming to be known as “presenteeism”.

What is Presenteeism?

Presenteeism is, in its simplest form, the act of a person being present at work when they really should not be. It can manifest as working when sick, working longer hours than contracted for, not taking breaks or holidays, and limping on when unengaged, demotivated or overwhelmed. The impact on both the organisation and the employee can be significant, and in Jane’s case, culminated in six weeks of stress leave.

The reasons why presenteeism occurs can vary, but one of the key reasons – and one particularly pertinent under the spectre of COVID-19 – is insecurity about one’s job. Concerns about redundancy or worry about losing a role or being side-lined for promotion may cause an employee to be afraid to say no and to take on too much.

With Jane, it was her desire to not let anyone down, and a sense that she should be able to manage all the demands being made of her, that left Jane failing to acknowledge how serious things had become.

Other Factors Contributing to Presenteeism

  1. Managers not recognising what constitutes an unmanageable workload for an individual (and not appreciating that this can vary by employee).
  2. Individuals choosing to overwork in order to avoid other life stressors.
  3. Organisational culture not valuing mental health as much as physical health, resulting in employees unwilling to take sick leave due to stigma or fear of not being believed.
  4. Individuals in denial that things are as bad as they are.
  5. Employees not knowing who to talk to or what to do about the situation they find themselves in.

The increase in home working in response to the current pandemic adds a new challenge to maintaining boundaries between work and home life; some employees might be even more inclined to work when ill if that work can be done at home.

The COVID-19 restrictions and lockdowns also mean that our usual coping strategies may not be accessible to us: that fast-paced squash game to blow off steam, sharing our problems over dinner with friends, or escaping to the movies for an afternoon – all gone!

It’s strange to think we should have the same capacity to handle work pressure when we have the additional stress of a pandemic in our lives!


“To manage the additional workload, I cancelled training courses I had been encouraged to attend, and I even stopped my morning exercise sessions to work even more. All this just meant I became more isolated; I was unknowingly further exhausting myself in an effort to keep up. I missed out on self-development opportunities and saw a decline in my physical health. I was beginning to spiral.”

Jane’s desire to put her work before herself meant she was suffering, and the consequences began to impact those she was hoping to support as well as those she hadn’t prioritised – her family.

“I was getting short-tempered, and while I tried to maintain a professional façade, people were starting to notice, including my family. On more than one occasion family members expressed concern over how irritable and snappy I had become.”

The issue with presenteeism is that while an individual may be working, the time they spend working may be doing more harm than good. When employees become demotivated their productivity often drops and, even if they work additional time, the quality of their work is likely to be lower. So, from a company point of view these “free” extra hours from employees aren’t necessarily a benefit.

Addressing Presenteeism

Without knowing what is going on, a company may mishandle productivity issues with inappropriate disciplinary actions or unnecessary performance improvement plans being implemented. As well as wasted effort, this could lead to claims of bullying or a failure in a duty of care. There is even the potential that things could descend into legal battles.

Leaving presenteeism unaddressed is also not an option for an organisation. Problematic behaviours may develop, and wider morale issues may propagate as the individual’s dissatisfaction leaks out. Ultimately, if presenteeism goes unresolved it may result, as it did with Jane, in long-term absenteeism with a greater associated fiscal and organisational cost than would have been the case if managed earlier.

For the individual themselves, unaddressed presenteeism can lead to a further decline in physical and mental wellbeing. Family life, which may have once been a means to rejuvenate, may become another source of tension leading to a vicious circle of stress.

Breaking Point

“It all came to a head during a call where, despite my efforts, someone expressed dissatisfaction with my work, and I stormed around the house. Afterwards I called my Executive and said quite bluntly that I wouldn’t be working on that project anymore. Having witnessed my meltdown, my family urged me to see a doctor and said I needed some time out. My family explained that that I had become quite hard to live with and convinced me that, as with aircraft oxygen masks, I needed to help myself before I could help anyone else.”


Being signed off was Jane’s first step on the road to recovery. As well as the time away from work she engaged with her company’s Employee Assistance Programme (EAP) to undertake some counselling and evaluate her behaviour, thought processes and what she wanted from her career. Jane was fortunate enough to be in a position where she was able to have a phased return to work and took the decision to move to a four-day week; something she appreciates not everyone can do.

What can companies do to combat presenteeism?

A first step is to increase awareness amongst staff of what presenteeism is and the impact it can have, and to urge staff to look for the signs of it both in themselves and in their teams.

Foster healthy working environments and practices. Encourage colleagues to take lunch breaks (and discourage meetings being scheduled at lunchtime). Nurture a culture where logging off on time is the norm and late working the exception and promote mental well-being in all. Managers must be empowered to make accommodations to better support employees and to do so early, whether that be additional time working from home, flexible working hours, approving short notice leave, or even agreement to move to a part-time role if needed.

Companies must assess what support, information and signposting they can give to employees and how accessible it is, be that their website for the EAP, a phone number for counselling support, or policies on sickness and bereavement leave. It is imperative that these are easily understood and that a means to ask for clarity in a confidential manner is possible.

Some UK companies are also investing in the training of employees as Mental Health First Aiders, giving them the skills and knowledge to be a first point of support for anyone facing difficulties whether in the workplace or at home.

What can Individuals do to combat presenteeism?

From an employee perspective we need to recognise when we are not okay and seek support early, not letting shame or guilt stop us seeking that help. Simply speaking to a partner, a friend, or your doctor can be a good first step in obtaining that support – it doesn’t all have to come from the company. A counsellor will listen without judging, help you manage your feelings, offer ideas and suggestions for the next step and give you tools to support your recovery.

Think about what assistance is needed and evaluate your contract and financial situation to know what is possible so you can make informed decisions. Strive not to allow work to become a way to avoid issues in your personal life and recognise that we are all human, we will all struggle, and that it is not weak to take time for self-care.

“Following my problems coming to light, my company have thankfully been supportive. As well as counselling and reduced working days, my manager has helped redistribute some of my workload, and perhaps most importantly has continued to check in on me – to simply ask how I am and be attentive to my answer.”

Jane’s experience has taught her that dedication to her work, at the expense of all else, is counterproductive. To be her best at work she needs to take care of herself first.


Organisations can benefit from recognising the need for balance. By recognising presenteeism, fostering the right culture, and providing mechanisms of support, employee morale can be improved, productivity and the quality of work can increase, and benefits may also be seen in recruitment and employee retention.

Businesses which think proactively about enabling the wellbeing of their staff, for example offering an employee who is struggling the opportunity to talk to a counsellor – before that person reaches their breaking point – may reap the rewards of a more motivated and productive workforce.

Organisations who embrace the care of their employees, who recognise that employees working long hours or while ill is not a good thing, and who genuinely promote a healthy work-life balance, can potentially find their approach may even become a recruitment and marketing USP (unique selling point).

Finally, as the saying goes, if you do not make time for your wellness you may find you are forced to make time for your recovery.

Mel Riley is a counselling coach and senior accredited psychotherapist. Mel provides personalised therapy to a wide range of adults and children, and also delivers clinical supervision, training and business mentoring. She has a special interest in ... (Read More)

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