It’s a Monday morning and all employees are at the office, present and correct. But are they really present? In some cases, the answer is no. They may be at their desks, but mentally they are miles away: distracted by feeling exhausted from working long hours, worried about a sick family member, planning an upcoming business trip or pushing through an illness of their own.

This phenomenon, known as presenteeism, was first coined in the 1990s to describe employees who are physically at work but mentally absent. According to EHSLeaders, presenteeism falls into two broad categories – personal, where people believe ‘work should always come first’, even when they are ill; and work-related, often driven by low job security or a culture where employees are reprimanded for taking time off.

In both cases, employees may just be going through the motions, doing minimal work or being so distracted that they don’t do any work at all. They may also spend their time surfing the internet or chatting to colleagues and friends instead of working. Productivity drops, and they are not fully functioning. They will probably make more errors and be less creative and unable to engage in meaningful discussions in the workplace. But besides this, if they work while ill, they risk worsening their health and also making their colleagues sick.

There is also the matter of business travel, which some may consider an exciting and inter-esting part of a job, but it also comes with  stressors and complications. Anneli Douglas, of the University of Pretoria’s (UP) Department of Marketing Management, highlighted this in her inaugural professional lecture, ‘Business travel: a double-edged sword’. She noted that, despite the value business travel adds to economies and organisations, it can also lead to increased stress for travellers before, during and after their business trips, which may translate into increased presenteeism. ‘We calculated that 2.3 days per month are lost to presenteeism induced by business travel stress,’ she said.

The economic impact of presenteeism in SA is significant – estimated at R235 billion a year (4.3% of the GDP), according to Bonitas. At the 2025 African Business Travel Association (ABTA) annual corporate travel conference, Douglas also pointed out that productivity loss owing to presenteeism can vary from 30% to more than 90%; it increases indirect and direct costs, and employees lose 12.5% of their working hours because of presenteeism, which trans-lates into an average loss of 35.6 days of productive time per employee, per year.

The impact is being felt globally too. Gallup’s State of the Global Workplace 2025 report reveals that employee disengagement cost the world economy $438 billion in 2024 after the level of engagement fell two points to 21%. Management engagement also fell from 30% to 27% in 2024, with young managers and female managers experiencing the largest decline.

Locally, the South African Depression and Anxiety Group’s (Sadag) Working Life survey shows that 75% of employees struggle to switch off from work, even outside office hours. Only 47% of respondents said their employers offer Employee Assistance Programmes (EAPs). For some workers, EAPs only exist on posters and don’t provide true psychosocial support services. This is a matter of concern for Themba Hadebe, clinical executive at Bonitas Medical Fund, who says that 19.1% of South Africans form part of the active job market but only 16.1% are able to afford private medical aid, which should make access to healthcare a key priority as it has an impact on employer investment. ‘Any corporate wellness programme should have a primary healthcare clinic for basic screening and dispensing of chronic medication and treating employees who are ill at work,’ he says.

Tyran Naidoo, who heads Discovery Healthy Company, echoes this. ‘Employers must go beyond the facade of well-being to create a genuinely supportive and psychologically safe working environment. While individual resilience is important, employers must support their people through structured  mental health programmes and create a culture prioritising mental health.’

Additional research indicates that workers with depression reported the equivalent of 27 lost work days per year, with nine of these actual sick days. ‘If an employee goes to work despite feeling really ill, not only is there a chance they will infect their colleagues, but they are not going to get much work done,’ says Hadebe. ‘Their decision-making abilities may be impaired and there is no telling what the longer-term effects might be. And it’s not just about physical health. It may be a mental health issue, which has become more prevalent over the last few years.’

But while the numbers may be daunting, there are constructive steps companies can take to prevent and combat presenteeism, and it starts at the top. The Gallup poll found that manager engagement fell from 30% to 27%. As the conduit between executives and employees, managers have the biggest impact on staff ‘on the floor’, and if they’re disengaged, there is a strong likelihood the staff will be, too. The report goes on to say that ‘countries with less engaged managers are more likely to have less engaged individual contributors’. The recommended actions for leaders is: ensure all managers receive training to cut extreme disengagement in half; teach managers effective coaching techniques to boost performance to 20–28% and increase manager well-being by 32% through ongoing development. Gallup’s data also presents ‘a potential productivity boom opportunity if executive leaders take decisive action’. It estimates that if the world’s workforce were fully engaged, $9.6 trillion in productivity could be added to the global economy – the equivalent of 9% in global GDP.

Executives also need to take an intensive look at the company culture. Do employees feel like they are under constant stress? Are they able to take time off when they’re ill, or are they afraid they’ll be reprimanded or their work will pile up in their absence because of short staffing? Are they expected to be online after hours to reply to messages and emails?

In a recent IOL article, Sadag’s founder, Zane Wilson, says that companies need to do much more when it comes to mental health. ‘The integration of innovative programmes to ensure employees are working in a mentally healthy environment and more mental health education will assist employers with an atmosphere of a more productive workforce.’ At the ABTA conference, Douglas also suggested that ‘organisational support and co-ordination will assist travellers in managing travel stressors. Policies are typically developed within functions other than HR. Co-operation between the different functions should be strengthened, and conditions should support work-life balance’.

Company Wellness Solutions, a corporate health specialist, says the key to managing presenteeism is ‘shifting the focus from hours worked to results delivered’. If companies want to build a balanced environment, it suggests they should ‘promote work-life balance; foster trust and transparency; implement flexible work policies and recognise and reward results’.

So, the message is clear: employees who feel secure and valued are far more productive – and that can only be good for business.

By Philippa Byron
Image: iStock