Depressed employees may be better off at work than at home

A new Australian study suggests rather than calling in sick and taking time off, depressed employees might find staying at work helps them better manage their illness.

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In the study, depressed employees who took sickness absence experienced no improved health or quality of life, whereas those who continued to work experienced health benefits.

Researchers from the University Of Melbourne, in collaboration with a team from the Menzies Research Institute at the University of Tasmania, report their findings in the journal PLOS ONE.

In their background information, they note previous research shows that while working through a depressive illness can improve mental health, it can raise risks and costs due to fatigue, poorer concentration and reduced job performance.

But what if, with good management, it was possible for employees with depression not only to benefit themselves, but also their employers by staying at work rather than taking sickness absence? This is where there is a big hole in the evidence base, say the authors, who set out to plug it.

Their study is the first to attempt to put into figures the estimated long-term costs and health outcomes of taking sick leave as opposed to continuing to work through depression-related illnesses.

Lead author Dr. Fiona Cocker, from Melbourne’s School of Population and Global Health, says you can’t expect to make recommendations to workers and employers without such information.

Study used ‘hypothetical cohort’ approach

For the study the researchers did not use “real” workers but an approach that is sometimes used in this type of investigation called the “hypothetical cohort.” This is a method that amasses features and characteristics typical of the target population (workers with depressive illnesses) from published studies and meta-analyses, and then uses a model to produce “results” under certain conditions.

A key component of this study was to define absenteeism (when the sick employee does not attend work for the duration of the illness episode) and “presenteeism” (when the sick employee continues to work for the duration of the illness) as mutually exclusive.

The data plugged into the model included probabilities and costs associated with seven different “health states” that members within the hypothetical 1,000-employee cohort might be expected to experience over the time horizon covered by the study (in this case, the researchers calculated figures for 1- and 5-year timescales).

These costs, included, where relevant, “lost productive time, job turnover, and health service use costs,” note the researchers.

Much of the data on probabilities and costs came from a primary Australian epidemiological data source, the National Survey of Mental Health and Wellbeing (2007). From this source, the team was also able to make some assessments about “subtle quality-of-life differences in areas including mental health.”

Depressed employees do not improve when off sick, but working ones do

What they found is that depressed employees who took sickness absence experienced no improved health or quality of life, whereas those who continued to work experienced certain health benefits.

They also found there were differences in the figures depending on whether the employees were white collar (office workers) or blue collar (manual workers), as Dr. Cocker explains:

“Cost associated with depression-related absence and attending work while depressed were also found to be higher for white collar workers who also reported poorer quality of life than blue collar workers.”

The researchers believe the findings are important not only for employers and employees, but also for GPs and other health care professionals providing support and advice on whether it would be better to continue working or stay at home during a depressive illness.

Mental health strategies should consider promoting continued working

Dr. Cocker says the findings indicate that “future workplace mental health promotions strategies should include mental health policies that focus on promoting continued work attendance via offering flexible work-time and modification of tasks or working environment.”

Having a daily routine and the support of co-workers could be one way that workplace programs and alterations can improve the long-term health and wellbeing of employees with depressive illnesses, she notes.

The researchers suggest their findings may also be useful for making recommendations concerning workers with other health conditions like diabetes and heart disease.

Medical News also recently learned how a new approach could revolutionize the care of depression in cancer patients, raising hope for the nearly three quarters of depressed cancer patients who do not receive any form of treatment for their depression.

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