Depression and anxiety cost the global economy an estimated $1 trillion in lost productivity each year, according to the World Health Organization. With businesses also facing staff shortages, workplace fatigue and ageing workforces, employee health is moving beyond the human resources department and into operational planning.
The WHO estimates that depression and anxiety account for 12 billion lost working days annually. Excessive workloads, low control over work, job insecurity, inflexible hours and poor management can increase the risk of mental ill-health.
For companies, the cost can appear through sickness absence, weaker performance, staff turnover and difficulty retaining experienced employees.
Presenteeism adds a less visible cost
Sickness absence is relatively easy to record. Presenteeism is harder to measure because the employee remains at work but performs below their usual level because of illness, fatigue or stress.
The Organisation for Economic Co-operation and Development says presenteeism can cost more than absenteeism for some chronic conditions. However, the estimates rely heavily on workers reporting their own productivity and differ between countries and illnesses.
This means attendance figures cannot show the full effect of poor workforce health. A business may record few sick days while still losing output through slower decisions, mistakes or reduced concentration.
Mental health requires changes to working conditions
Many employers provide counselling, mental health education or employee assistance programmes. The WHO says individual services should be accompanied by measures that address the working conditions causing harm.
Its recommendations include flexible working where appropriate, policies to prevent violence and harassment, training for managers and reasonable adjustments for workers with mental health conditions.
This places part of the responsibility on job design and management. Stress training is unlikely to solve a problem if the company leaves excessive workloads, unpredictable schedules or persistent understaffing untouched.
Fatigue can affect safety and performance
Work schedules are another operational factor. The US National Institute for Occupational Safety and Health says night shifts and extended hours can shorten or disrupt sleep.
Fatigue can slow reaction times, reduce concentration, limit short-term memory and impair judgement, according to NIOSH guidance. The consequences are particularly serious in transport, healthcare, construction, manufacturing and other work where an error can injure employees or members of the public.
Employers can examine shift length, rest periods, workload and the timing of safety-sensitive work. Simply telling employees to sleep more may have little effect if company schedules leave insufficient time for recovery.
OECD models positive returns from some programmes
The OECD argues that workplace programmes can reduce healthcare spending and sickness absence while increasing productivity. Its modelling found that expanding programmes to reduce sedentary behaviour and promote physical activity could produce an economic return of $4 for every $1 invested across 30 OECD countries.
The same modelling estimated an annual employment and productivity gain equivalent to 37,000 workers. These are modelled results across multiple countries, not a guaranteed return for an individual employer.
Company size also matters. The OECD estimates that workplace schemes could reach up to 610 million formal-sector employees across its member countries, but about two-thirds work for small and medium-sized businesses that may lack the money and scale available to larger employers.
Not every wellness programme delivers results
Evidence from individual companies is mixed. A randomised trial involving 32,974 employees at US warehouse retailer BJ’s Wholesale Club tested a programme covering nutrition, exercise and stress reduction.
After 18 months, employees offered the programme were more likely to report regular exercise and active weight management. However, researchers found no statistically significant differences in clinical health measures, healthcare spending, absenteeism, job performance or staff tenure.
The results do not show that all workplace programmes fail. They do warn businesses against promising quick financial returns from generic benefits.
Measuring workforce health
Companies can track sickness absence, injuries, staff turnover, employee engagement, schedule stability and programme participation. Productivity and healthcare claims may also be useful where they can be measured lawfully and without exposing personal medical information.
Data need context. A rise in sickness absence could be a negative sign, or it could mean employees no longer feel pressured to work while ill. Lower turnover may reflect better management, higher wages or labour-market conditions rather than a wellness programme.
NIOSH’s Total Worker Health approach combines protection from workplace hazards with measures designed to prevent illness. It directs employers towards working hours, supervision, job demands and safety alongside voluntary services for employees.
For businesses deciding where to spend, the evidence points towards fixing harmful working conditions first. Health benefits may add to that work, but gym memberships and wellbeing apps cannot compensate for poor scheduling, unsafe jobs or ineffective management.
