Most of us are aware that employees often need help in returning to their workplace after an illness or injury. Perhaps less well known is the idea of employees being physically present at their workplace, but needing help to return from a mental absence and from lowered levels of productivity.

The concept is known as ‘presenteeism', and studies reveal that Australian industry looses billions of dollars each year as a result.

In the United States presenteeism is seen as the result of workers enduring an illness at work, such as an allergy, perhaps because they aren't covered by sick leave and can't afford the unpaid time off.

In Australia the issue has more of a mental health – rather than physical health – focus.

In both places it involves workers who are physically present in the workplace, but due to an emotional or physical illness, aren't working to the level they could and should be.

An Australian study commissioned by Medibank Private found that one of the greatest causes of presenteeism in Australia is depression.

Dr Nick Foster of Mensline Australia said that more attention should be directed towards helping workers to strike a healthy work-life balance. The loss of a child or partner, chronic aliments of loved ones, and separation or issues surrounding separation are some of the major life issues leading to depression, he said.

Men, often less willing to acknowledge needing help with a mental problem, are particularly at risk.

“Men are nine times more like to suicide in the 12-month window around separation”, said Dr Foster. If colleagues and employers aren't aware of these statistics and the warning signs to look for, they won't know when to ask the right questions, he said.

“It's about mates helping mates. That's where men can be quite good – they can be very motivated to help their mates. Even if it doesn't seem appropriate for a manager to do that, colleagues can be caring for a mate inside the workplace and if people start to isolate themselves, they can find out why”.

Return To Work Matters asked Dr Foster to outline some of the signs an employee might be suffering from depression. “There are lots of factors you can look for”, he said.

“People's mood shifting and changing out of character, irritability and frustration that is again out of character, the inability to accept criticism, withdrawal, diminishing interest, reduced interest in exercise, general energy drop, sleeplessness, increased substance misuse and risk-taking.

“Those are all signs that you will expect to see in depression and all of those will contribute to presenteeism”, he said.

Dr Foster described an out of character or exacerbated mood shift as one lasting for quite a while. “After about two weeks is when you really need to start thinking about some kind of involvement”, he said.

So just what sort of involvement should a return to work coordinator or employer take?

One thing management should be looking at, recommends Dr Foster, is the resources that are available on a national level.

“From our perspective that would of course be the Mensline Australia support service, 1300 78 99 78, and the callback service that we can provide. We can provide free counselling over a number of sessions, as well as crisis counselling at any time of day, and it's really important for employers to be aware of that”, Dr Foster said.

People in Australia also have access to the Mensline Australia website and the info line of national depression initiative beyondblue; as well as the Suicide Callback Service (contact details below).

Outside of Australia, which is quite advanced in its provision of telephonic support services, specific support lines are lacking. In these situations resources that employers might have at their fingertips, ready to recommend to employees in need, might be a psychologist or counselling service.

It is important that employers know how to engage with an employee in a subtle and respectful way so that an employee doesn't feel dismissed; rather, that they've been referred to someone with more expert knowledge by an employer striving to do her or his caring best.

Staff can assist a worker – as well as alleviate pressure from themselves – by being equipped with information about the right organisations to refer people to.

The ability or skill to perceive and assess the emotions of others, also known as emotional intelligence, is something Dr Foster encourages we speak more about.

Management staff aren't always equipped with knowledge about how to approach an employee with depression.

“Many employers, particularly those of smaller organisations, don't necessarily have policies and procedures around what kind of mental health/personal issues you're allowed to engage in and how to do it”, Dr Foster said.

He discussed some of the management training that Crisis Support Services undertakes.

Crisis Support Services is the overarching body that manages Mensline Australia and other support services. One of its main roles is to provide workplace training, particularly around supporting managers to educate them about their professional backup, and how and where to refer workers.

Dr Foster said that even half a day's training can make a difference.

“We had countless incidences last year where managers were saying ‘I feel thoroughly threatened in this workplace', and just half a day of training managed to provide them with sufficient referrals to use, but also some cognitive frameworks, to say ‘Alright, I now know how to deal with these people. I've been threatened but now I know how to pull the boundaries down, and I can feel confident in that'”, Dr Foster said.

“[Management training] beefs up their ability to refer people in a timely manner while keeping professional boundaries secure and working with both empathy and respect within the workplace”, Dr Foster said.

Medibank Private's Sick at work outlines other employer strategies to reduce presenteeism's effects such carrying out employee health risk assessments, implementing employee assistance programs offering counselling services for employees and their families, and implementing wellness programs fostering healthy practices such as balanced diet and exercising.

“I'm all for talking about emotional intelligence in the workplace and trying to build a sense of resilience that comes out of emotionally intelligent workplaces”, Dr Foster said. “I think that is that next step to create flexible, creative and responsive workplaces in building a decent level of emotional intelligence across staff and management”.

Training and access to the right resources are two things that can equip employers or return to work coordinators with just the tools they need to keep staff happier and healthier, and reduce the impacts of presenteeism.

To hear more from Dr Nick Foster, click here

Services*:
Australia
beyondblue 
Suicide Callback Service: 1300 659 467

New Zealand
Depression Helpline
Lifeline


USA
National Suicide Prevention Lifeline: 1800 273 8255
US National Institute of Mental Health 

*If you'd like to share any information about emotional support lines or services outside of Australia, or in addition to any mentioned here, RTW Matters would love to hear from you.