Sometimes the most important question isn’t, “Why is someone absent today?”

It’s what may have been happening for weeks, months or even years before the sick note was written.

Every year, organisations devote significant time and resources to managing sickness absence. Yet many conversations begin only after an employee has reached the point of needing time away from work. What if we looked beneath the absence itself and explored the psychological experiences that often precede it?

 

 

The Story Behind the Statistics.

In 2025 22.1 million working days were lost to sickness absence in the UK with mental ill health remaining the leading cause of long-term absence. Statistics tell us the scale of the challenge. But they don’t explain the human experience behind it.

In these newsletters, I will be addressing some of the issues organisations face from all around the world as mental health and wellbeing matters come to light in important and revealing ways.

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It’s always been true that every organisation experiences absenteeism. But the stats are shouting it louder than ever. Why? Because now the stats are measurable in psychological terms. And as a result, the stats are becoming ever more important as they speak to the current stresses and strains being faced in workplaces around the world.

While company reports have always measured the absences, the focus has been not on why, but how to manage the space left by the employees. Hence, managers and HR monitor and implement policies to handle the workload, the output and the productivity.  But I am drawing attention to the stats from the psychological perspective that absenteeism, due to mental health matters, can be addressed beforehand. Surely, businesses will benefit by helping and assisting their workforce before the GP hears about the stress, anxiety or depression (these being the most commonly reported) from those calling in sick.

Traditional approaches focus on managing the consequences of absence—redistributing work, maintaining productivity and implementing return-to-work procedures. These are important. But they address the outcome rather than the conditions that contributed to the absence in the first place.

 

Looking Beneath the Surface.

In situations where work is negatively impacting employees to the point of calling in sick – often on that same morning they wake up, feeling rubbish and realise they are unable to cope.

But for me, that is too late. I am suggesting the cause of that absence has been developing. Gradually, often in front of colleagues, team leads, line managers, HR and bosses. And it would have gone unnoticed because often that sick employee has resorted to silence in order to cope.

But why?

Perhaps there’s been:

• An increase in workload;
• Difficult working relationships;
• A manager who unintentionally stopped listening;
• Organisational changes creating pressure or uncertainty;
• A breakdown in team dynamics creating isolation;
• Life outside work already stretching emotional capacities.

And while these components may not directly lead to absences, what can develop is an experience of feeling overwhelmed at or by work. A sense that no matter how hard they try, their efforts will never be enough. Psychologically this can be extremely stressful and difficult to bear and particularly if the employee is having to bear it alone.

Over time, these conditions can quietly erode resilience, deplete confidence and enthusiasm and soon effect psychological wellbeing.

Psychologically, the human body often reacts symptomatically to mental stress and strain by reporting physical ailments. I see this as the mind and body working together to communicate something not always apparent. For example, a headache tells us lots, but what? Same with muscle tensions or spasms, diarrhoea or other pains. Often these symptoms are psychosomatic and as we have all grown up with physical problems receiving validated attention from parents, doctors, schools and bosses etc, we react the same way. We call in sick, reach out for help, and the GP writes the note.

In these ways, the sick note becomes less about single moments of struggle at work, but more about the accumulative impact of many unseen moments.

 

What Employees Often Don’t Say

One of the greatest challenges for organisations is to understand that many employees continue trying to perform while struggling silently inside.

Through my experiences of working with organisations, I often hear employees share common fears:

“I don’t want to let the team down.”

“I don’t want to disappoint the boss.”

“Everyone else seems to be coping.”

“There’s no point in saying something as nothing will change.”

“If they think I can’t cope, I might lose my job.”

So, they keep going. Until they can’t any more.

 

What Can Organisations Do?

Reducing absenteeism is about creating environments in the workplace where people feel able to speak safely. These spaces are likely to already exist in the form of:

• One-to-one meetings/supervision
• Team meetings
• Performance reviews
• Annual appraisals
• Team Debriefs
• Return to work conversations
• Informal conversations etc.

 

So, with these spaces already embedded into office cultures it will be important for managers and authority figures to create an atmosphere for employees to speak up, feel heard and feel understood. But this will only happen if they feel safe.

For management it is worth remembering that often employees are worried about being open and honest. And about asking the questions which may be bothering them. Often employees experience anxiety around thoughts relating to authority figures. Thoughts and feelings that lie beneath such as:

“Can I be open and honest without it affecting how my manager sees me?”

“Will I look foolish?”

“Will I get support or be criticized?”

“Will this jeopardise my job?”

All these examples come from my extensive experiences of working psychologically with adults. People often assume authority figures will react critically rather than benignly or with empathy. These are the types of cultures we can address and change.

 

A Question Worth Asking.

When someone returns from sickness absence, organisations often ask:

“Are you fit to return?”

An equally valuable question might be:

“What happened before you left?”

The answer may reveal far more than the sick note ever could.

 

An MiP Perspective

From a psychological perspective, employees are always communicating through:

• Words
• Behaviours
• Silences
• Body language

 

We just need new skills, understanding and insights into how to read and respond to these communications. If we can, then there is real evidence to suggest less time off will be needed. The organisations will have less reactive resources lost. Productivity can improve. Employee happiness and retention can improve too.

When you think about it like that, the final thought today might simply be: how do I get these changes underway?