Presenteeism: The Hidden Cost of Being Present When You’re Not Alright

Reframing support in a disconnected age 

Presenteeism has long been described as the unicorn of workplace wellbeing; elusive, hard to define, and even harder to measure. Yet when you sit with people, you see it everywhere. It shows up in hesitation, reduced clarity, missed steps, and quiet withdrawal. It is the colleague who keeps logging on, the manager who turns up, the leader who carries on, even as their reserves are running dry. 

This is not a marginal issue. According to the Institute for Public Policy Research, poor workforce health now costs the UK economy around £103 billion every year. That figure covers both productivity lost when people work while unwell and the direct impact of increased sick days. Of the £30 billion rise since 2018, around £25 billion has come from reduced productivity which is the hidden drag of presenteeism, and a further £5 billion from higher rates of sickness absence. 

These numbers matter, but they only tell part of the story. Beneath them sit the quieter costs of silence, disconnection, and unacknowledged strain, costs that do not show up in a ledger but accumulate every day across our workplaces. 

The Weight Behind the Role 

Presenteeism does not discriminate. It can affect anyone, at any level, and it often emerges where responsibility collides with private strain. 

Across the workforce, people carry burdens that rarely reach the threshold for formal intervention but nonetheless shape how they think, act, and engage. Caring for an elderly parent while managing deadlines, navigating grief while continuing to lead a team, supporting a child with additional needs while sustaining full-time responsibilities or managing the quiet shock of an empty house after a son or daughter leaves for university. 

These pressures rarely make it into HR reports, but they compound over time. People continue to perform, often admirably, but their internal reserves are depleting, unnoticed and unsupported. Presenteeism is not about laziness or disengagement; it is about the instinct to keep going, even when the cost becomes unsustainable. 

When Rest Isn’t an Option 

For many, taking time off simply isn’t feasible. Statutory Sick Pay in the UK offers £118.75 per week and begins only after the third consecutive day of absence. Many part-time or lower-paid workers do not even qualify. Research by WPI Economics shows large numbers of employees return to work prematurely because they cannot afford to stay off. 

The pressure could be compounded by fear because absence periods can trigger disciplinary procedures. For employees with hidden conditions or neurodivergent needs, the risk of stigma or misunderstanding is high. The fear of being judged or penalised pushes many towards presenteeism as a form of self-protection. 

In some organisations, the problem is reinforced by policy: rigid attendance expectations, even where remote work is possible. The unspoken message is clear; be here, whether you are well or not. 

Loneliness as a Risk Factor 

Presenteeism rarely happens in isolation. It travels with loneliness, especially for those working remotely, in hybrid roles, or in environments where they do not feel culturally safe. You can show up to every Teams call and still feel profoundly disconnected. 

The Co-op and New Economics Foundation estimate that loneliness costs UK employers £2.5 billion annually in lost productivity and staff turnover. Beyond numbers, loneliness impairs cognitive function; memory, decision-making, concentration, and increases vulnerability to long-term health decline. 

Loneliness also creates invisibility. When people feel unseen or unheard, they are less likely to seek support. This makes presenteeism both a symptom and a cycle: isolation fuels hidden strain, and hidden strain deepens isolation. 

Why Traditional Support Misses the Mark 

Most workplace wellbeing models operate around thresholds. Services are triggered at the point of visible crisis, disclosure, or breakdown. But most people do not experience difficulty this way. Many are not in crisis, but nor are they well. They are somewhere in between, coping, but only just. 

Even where EAPs and wellbeing portals exist, uptake is low. The process feels too clinical, the language too formal, or the act of reaching out still carries stigma. The result? People carry on quietly, and presenteeism becomes the norm. 

What Support Built Around Presence Looks Like 

At Sacana, we believe in reaching people before crisis. We provide structured, non-clinical one-to-one conversations, delivered by trained Matrons via secure video. Sessions are stigma-free, unlimited, and require no assessment or threshold. 

Every conversation follows the Sacana Conversation Arc - Connect → Contain → Close → Thrive - a model that creates space for people to speak openly, without judgement, and to feel genuinely heard. 

Sacana is simple by design. It is not advice, not therapy and not a transactional tool. It does not force a label or a diagnosis, rather it holds open a space where people can talk about whatever is on their mind, whether personal, professional, or unspoken. Accessible by mobile, desktop, or embedded workplace platforms, Sacana is fully GDPR-compliant, moderated for safeguarding, and ISO 27001 aligned. 

What we offer is not a fix, because many people are not broken - just bent. We offer the chance to be seen, heard, and held in a moment that might otherwise pass unnoticed, and in that connection, people find their footing again. 

Restoring Connection as a Strategic Priority 

Presenteeism is more than a wellbeing issue, it is structural, cultural, and financial. Deloitte’s analysis places the cost of poor mental health to UK employers at £51 billion annually, with nearly half attributed to presenteeism. 

Employers are investing more than ever in wellbeing, such as EAPs, training and wellness apps but engagement remains low. The issue is not lack of commitment, but lack of fit because support designed only for crisis misses the people who keep showing up, silently struggling. 

By contrast, evidence from Vitality shows that preventative, people-focused support returns 4.4 additional productive days per employee per year, equating to more than £900 in indirect value for every person supported so prevention pays back. 

Presence Alone Isn’t Wellness But It Can Be the ROI 

Sacana reframes support around connection, not crisis. We do not wait for people to prove their pain. We do not require them to reach breaking point before help is offered. Instead, we provide a space where someone can talk, without fear or performance, and in doing so, reduce the hidden costs of presenteeism before they compound. 

Because the real cost of presenteeism is not just productivity. It is people. And when people feel seen, heard, and able to share the weight they carry, they are more resilient, more present, and more able to thrive. 

Presenteeism has long been treated as the unicorn of workplace wellbeing: elusive, out of reach, impossible to pin down. At Sacana, we make it visible, measurable, and addressable. Not with more of the same, but with something profoundly simple, structured connection. 

Talk. Connect. Thrive. 

Connect with us at enquiries@sacana.com

References 

Institute for Public Policy Research (2024). Workplace sickness and economic impact, The Guardian 

Citizens Advice (2024). In Sickness and In Health: Why SSP Needs Reform 

WPI Economics (2023). Making SSP Work: Financial Risk and Presenteeism 

Office for National Statistics (2022). Sickness Absence in the UK Labour Market 

Co-op & New Economics Foundation (2017). The Cost of Loneliness to UK Employers 

Holt-Lunstad, J., et al. (2015). Loneliness and Social Isolation as Risk Factors for Mortality, Perspectives on Psychological Science 

Deloitte (2024). Mental Health and Employers: The Case for Investment 

Vitality Group (2024). Britain’s Healthiest Workplace: Key Findings