The consequences of going into work when you’re too unwell

You awake in the morning feeling emotionally or physically unwell, but think that you can’t possibly take the day off work. You tell yourself there’s too much to get done; you can’t afford to stay at home. In the current economic climate you’re burdened with further concerns about redundancies, and how the company directors will be looking at absenteeism rates to inform their decisions of who to let go…

So you opt for presenteeism: the inevitable reduced productivity when employees come to work and are not fully engaged, or perform at lower levels as a result of ill health. Psychological interventions are an effective way to support the working populationThis is thought to be an increased problem for conditions such as anxiety and depression because of a culture that tells us the only valid reasons for failing to attend work are physical: if you’re able to sit at your desk, you’re able to work.

In a time when job security is at an all time low, there is a growing trend towards answering work e-mails from smart phones at home, working through lunch, and staying late in the office. Redundancies often leave remaining employees with the same workload divided amongst fewer people, as well as a sense of ‘survivor’s guilt’. A recent survey has found that just over half of all British workers used all of their holiday allowance last year – we are even reluctant to be absent when it is a right afforded to us by law.

The problem is not always that employers are making unreasonable demands on their employees, but that they do little to alleviate a culture of fear which encourages employees to take on an unreasonable workload. However, many businesses are gradually realising that allowing their workers to toil all hours is not the most productive option for their business: The Centre for Mental Health calculated that presenteeism costs the UK economy £15.1 billion per annum because of mental health problems alone, where absenteeism costs almost half that at £8.4 billion.

So what interventions can be put in place or encouraged in the work environment, to reduce work stress effectively for the long term? Flaxman & Bond last year looked into whether ACT Acceptance & Commitment Therapy may be of use. ACT is a form of cognitive behavioural therapy, incorporated with elements of mindfulness to counteract the avoidance, cognitive entanglement and psychological rigidity that leads us to avoid taking crucial behavioural steps in accord with our core values.

When this intervention was given in the workplace to “individuals with above average levels of distress” in two half-day training sessions, it was found to be effective in reducing psychological distress in the following 3 months via increasing psychological flexibility.

Mindfulness is also useful alone. A whole arm of this practice has developed into MBSR Mindfulness Based Stress Reduction and was recently used by a group of researchers in Canada to promote well-being among human services professionals.

They found that, when administered to a group of nurses, mindfulness therapy significantly improved relaxation and life satisfaction with particular improvements in emotional exhaustion. For teacher trainees, it was associated with greater increases than controls in ratings of life satisfaction and teaching efficacy.

Importantly, this study recognised that there are systemic factors that need to be addressed to encourage the long term reduction of stress in working populations (via management and legislation) but, in the interim, psychological interventions are an effective way to support the working population of our society.

The House Partnership, 8th January 2012