In today’s workplace, there’s often pressure to keep showing up, even when we’re not feeling well. This behaviour, known as presenteeism, can have serious consequences for both employees and organisations. While absenteeism—taking time off—gets more attention, presenteeism is just as harmful, if not more, because it’s harder to notice.
Why Do Employees Come to Work When They’re Unwell?
Presenteeism occurs when employees come to work despite being physically or mentally unwell, leading to a drop in productivity and worsening their health over time. Research shows that presenteeism related to mental health costs the UK economy £15.1 billion annually, compared to £8.4 billion from absenteeism. Despite these high numbers, presenteeism is often ignored because it’s less visible.
There are several reasons why people choose to work when they aren’t at their best, many of which have psychological roots. Financial worries are a big factor. Some employees simply can’t afford to take time off, fearing lost wages or job insecurity. This is linked to the scarcity mindset—the belief that opportunities are limited, and missing work could mean falling behind. This mindset increases stress and often leads to burnout.
Fear of stigma, particularly around mental health, is another driver. Many employees worry that taking time off for mental health reasons will be seen as a sign of weakness. According to a survey by Mind, 45% of employees felt they were expected to manage stress on their own without asking for help. People often tie their self-worth to their job performance, so coming to work—even when struggling—feels like the only way to maintain a positive reputation.
Guilt and responsibility also come into play. Many employees feel that taking time off will burden their colleagues or disrupt projects. This sense of duty is linked to altruistic behaviour, where people prioritise the well-being of others over their own. While this can foster purpose, it can also lead to neglecting personal health.
A lack of trust in management can push employees to show up when unwell. Some fear that taking sick leave will be seen as an exaggeration or that their illness won’t be taken seriously. This breakdown in trust makes presenteeism a way for employees to avoid being judged negatively by their managers.
There’s also the fear of missing out in competitive workplaces. Employees worry that taking time off means missing key opportunities like important meetings or promotions. This fear ties back to the scarcity mindset, where employees believe their absence could hold them back in the future.
Some employees, particularly younger or healthier ones, believe they can “push through” illness. This stems from optimism bias, the belief that bad outcomes are less likely to happen to us than others. But pushing through can lead to burnout, leaving employees mentally, emotionally, and physically drained.
The Impact of Presenteeism
Presenteeism has significant consequences. For employees, it can lead to worsened health and, in severe cases, burnout. Burnout occurs when someone has been under prolonged stress and can no longer cope. It’s a long recovery process that impacts both the individual and the organisation. For businesses, presenteeism leads to lower productivity and more mistakes, and it often results in more absenteeism later. Studies show that employees working while unwell are, on average, up to 30% less productive.
Addressing Presenteeism in the Workplace
Employers play a key role in addressing presenteeism. One of the first steps is creating a work culture where health is openly discussed. Employees need to feel safe talking about their physical and mental health without fear of judgment. Managers should be trained to recognise when employees are struggling and respond in a supportive way.
It’s also important for employers to offer flexibility around taking time off. Rigid absence policies can make employees feel they have no choice but to show up. Options like working from home during minor illnesses can help employees manage their health while remaining productive. Employers should also recognise the importance of allowing employees to slow down and take downtime, especially after high-stress periods or busy times. Allowing staff to ease back into their workload, or even encouraging rest days, helps prevent presenteeism and supports long-term well-being.
Investing in mental health support is another important step. Providing services like Employee Assistance Programs (EAPs), signposting, regular check-ins, mental health first aiders, and resilience-building workshops gives employees the support they need to manage their mental health. By integrating these practices, organisations take a proactive and sustainable approach to employee well-being, addressing issues early and fostering a healthier, more resilient workforce.
What Employees Can Do
Employees can also take steps to manage presenteeism. Recognising personal limits is important. Taking time off when needed is not a sign of weakness—it’s a smart decision that prioritises long-term well-being. Rest is essential for maintaining productivity and health.
If you’re feeling pressured to work while unwell, consider talking to your manager. More employers are recognising the importance of mental health and may be open to flexible solutions that support your needs. Finally, it’s important to challenge internal beliefs that taking time off makes you look weak. Looking after your health is the best way to ensure you can contribute effectively in the long term.
Presenteeism is a complex issue, driven by a mix of internal and external pressures. By understanding the psychological factors behind it, employers can create a work culture that supports health and well-being. Ultimately, a healthier and happier workforce is more productive and engaged, benefiting everyone.