Here, But Not Really

When someone is absent from work, it’s obvious. His or her desk is unoccupied. What about when an employee shows up but is not fully functioning in the job because of depression, migraines, back pain or stress?

This is a phenomenon that Debra Lerner, a senior scientist at the Tufts Medical Center Institute for Clinical Research and Health Policy Studies, calls “presenteeism.”

The causes may be multiple, but decreased worker productivity is the certain result. Presenteeism is less a character flaw in a worker than a temporary mental cloud that’s brought on by a particular challenge in an employee’s life, Lerner says.

The institute looked at presenteeism across a number of industries and found it caused roughly a 3 percent loss in productivity. Among the chief contributing factors were emotional turmoil and tobacco and alcohol use among those surveyed.

Depression at work brings productivity losses “in the billions of dollars” each year, says Lerner. The good news is that the problem can be managed effectively. A test program Lerner developed, the Work Health Initiative (WHI), attempts to address worker depression through an online survey, followed by four months of phone counseling.

The WHI offers “a calm way of informing people they may have depression,” explains Lerner, a professor of medicine. Initial results showed a 40 percent gain in time management skills among members of a test group.

The institute also offers a workbook component to help struggling employees gain control of their thoughts and feelings. In this approach, workers are led through exercises and given homework. In a recent trial with state employees in Maine, the workers' ability to concentrate and perform on the job increased by nearly 32 percent using WHI methods, compared to a 4 percent improvement in a control group.

This article first appeared in the summer 2012 issue of Tufts Medicine magazine.