Human Resource & Payroll Services And Solutions - Houston, Dallas, Austin - Texas www.hrp.net. "Presenteeism" is the phenomenon of employees coming to work, but with diminished productivity. It can be due to a temporary mental health disorder. The cost to employers is generally much greater than they realize -- assuming they are even tuned in to the phenomenon. How do you identify the problem -- and address it? Read on for some answers.

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Reigning in the High Cost
of 'Presenteeism'
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2. The impact of "presenteeism" on smaller employers can be
particularly challenging -- because there are fewer people to take up
the slack.
"Presenteeism" is the phenomenon of employees coming to work,
but with diminished productivity.
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3. Health vs. Performance Issue
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When an employee's productivity drops, it may be tempting to view the situation narrowly
as a performance issue. But "every performance issue is a health issue in one way or
another, and often it's a mental health issue," according to Dr. Jeff Guardalabene, a
psychologist and mental health case manager for Standard Insurance Company. Also, under
some circumstances, clinical depression, a very common cause of presenteeism, may be
treated as a disability covered by the Americans With Disabilities Act, requiring reasonable
accommodations.

4. Note: While mental health benefits are already widely included in employee benefit plans
and, when offered, must be offered on a similar basis as other health benefits,
the Affordable Care Act (ACA) will expand them further as mental health and substance
abuse treatment services are included in ACA's package of "essential health benefits."
Supervisors should not be expected to become mental health experts and diagnose illness,
and they have to come to grips one way or another with diminished output. But they can
gain important and practical insights from becoming more attentive to their employees'
health on a holistic basis, including the "whole package of their personality, their emotions
and their mental health," Dr. Guardalabene says.
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5. Effects of Depression and Anxiety
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For starters, changes in an employee's appearance and demeanor should be noted as a red
flag. Depression impacts people's motivation, planning abilities, concentration, sleep -- "all
kinds of things that would show up on the job," Dr. Guardalabene says.
Being aware of employee anxiety levels and triggers is also important and enhances your
ability to manage a potential source of trouble. Some employees, for example, may find
change (such as being shifted to a new job or team) much more stressful than others. High
anxiety can sap productivity and lead to a major depression.

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This does not mean such an employee can be forever shielded from change, but
indicates the change might need to be handled delicately.
Early intervention on the sources of presenteeism by qualified professionals is much
preferable to attacking the problem after it has reached an acute level and become obvious.
In principle, a supervisor should not suggest to an individual employee that he or she could
benefit from mental health services, but the seed can still be planted. Such a discussion may
also be guided by the strength of the relationship, and whether the employee raises the
issue.

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Dr. Guaradlabene says employees could be more open to taking advantage of employee
assistance programs and mental health benefits if employers implemented the following
practices:
De-stigmatize mental health problems. "It begins at the top. Employers can lead by
example by speaking very candidly about mental health simply as something that impacts
people.“
Publicize your employee assistance program (if applicable) and mental health
coverage. "Make it a priority for people to know that these services are available and that
they are just as important as the other benefits.“
Encourage employees to take advantage of basic screening services. Online questionnaires
provided by wellness or behavioral health services can not only identify possible issues, but
give emotionally healthy employees a higher comfort level dealing with questions about
mental health so they would be more likely to seek help if they need it at some future date.
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8. Related Research
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For a broader perspective, consider the conclusion of an academic study1 which
determined 70 percent of the full cost to employers of poor employee health is lost
productivity due to presenteeism and absenteeism, and only 30 percent involves medical
and pharmaceutical expenses.
Another study which concluded 80 percent of productivity loss is due to presenteeism, and
only 20 percent to absenteeism, for behavioral health issues.2
1 Health and Productivity as a Business Strategy: A Multi-Employer Study, Journal of
Occupational Environmental Medicine, 51940; 411-428, pp. 140-152, Loeppke R, et al
2 "EAP treatment impact on presenteeism: Implications for return on investment," Journal of
WorkplaceBehavioral Health, Hargrave G.E., et al, 2008.

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