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According to the Institute of Psychiatry (April 2005), for the first time, stress, anxiety and depression have overtaken physical ailments as the most common cause of long-term absence from work. With sickness absence reportedly costing employers an average of *522 per employee per year (or an average of 10 lost working days), there are good reasons to look closely at the root causes of absenteeism and, where possible, provide early intervention to support employees in regaining their health.

Short-term absence

Short-term absence is usually defined as a period of absence of less than ten consecutive working days, and will usually be as a result of the employee suffering from a minor medical condition.

Persistent short-term sickness is one of the most common problems employers have to face. Arranging temporary cover when an employee is off sick may not always be viable, and is often both disruptive and costly. Many employers therefore adopt the approach of persuading existing employees to cover for absentees on an ad hoc basis.

While this may work in the short term, when applied over longer periods it puts pressure on existing staff, as they struggle to do their own work in addition to that of an absent colleague. The effect of this on staff morale can be damaging and counterproductive. Staff frequently feel resentful if required to do two jobs - often within the same timescale and for no extra remuneration. The situation may be further compounded when the absentee employee returns to work and is met with resentment from those who have had to cover for them during their absence.

Long-term absence

Long-term absence is defined as any period of absence in excess of ten consecutive working days. Such absence - particularly where it is stress-related - presents a different problem for employers. In the short-term they may feel able to cover an absence internally, whereas in the longer term it may be necessary to recruit temporary staff who will normally require induction training and may not necessarily fit in well with existing teams. Temporary staff will also increase the salaries and wages bill, as well as involving the payment of costly agency fees.

After a long-term absence, a phased return to work will most certainly be recommended, with possible training needed to support the employee *back into work*. Where rehabilitation is not an option, the costs of premature retirement due to ill-health will also need to be taken into account. Stress therefore has a quantifiable impact not only on health, safety and individual well being, but on the operational and financial performance of the organisation as a whole.

Attendance patterns

The link between stress and absence is so well proven that statistics on non-attendance are often used as an indicator of stress *hot spots* within an organisation. These figures may also be used to measure the effectiveness of stress management interventions.

In the analysis of attendance patterns, any extended periods of sick leave will immediately be apparent. Obviously, a stress-related illness or injury cannot be *undone*, but positive steps can still be taken by actively managing the return to work of the employee, and to minimise the risk of any identified stress reoccurring.

Of even more importance is the monitoring of short-term absences that may be the first sign of excessive pressure. Typically, absences that tend to fall into a pattern (e.g. if an employee is off sick every Monday), or are linked to particular operational requirements (such as reporting periods) are the most likely to be stress-related. It's therefore important to look initially at the pattern of absence, rather than the reasons given for it.

Stress is typically under-reported as a reason for absence - especially in the early stages - with alternatives such as colds, back pain, migraine or general fatigue being given instead. This under-reporting can occur for a number of reasons. For example, it may be that the individual has not recognised that they might be suffering from stress, or they may be reluctant to admit, either to others or themselves, that this is the real problem. There is often a stigma attached to stress, related to a perceived inadequacy or inability to cope. This exacerbates the problem by creating an artificial barrier to its identification and management.

Absence management

A successful absence management policy will ideally create a culture enabling any individual to admit to stress-related ill-health, without feeling that their future employment or career prospects may be damaged. Clearly, the earlier that specific sources of stress are identified, the sooner appropriate action can be taken to reduce the poor attendance that often ensues.

In order to establish a level of control over sickness absence, and to implement an effective policy, it's advisable to analyse employee data including the following:

* The number of days lost per year.
* The number of employees taking leave of absence.
* The average length of absence per employee.
* The employees and department(s) with the worst - and best - record of absence.
* Are there any identifiable absence patterns?
* Is absence influenced, for example, by age, gender, the number of years in the job or seasonal variations?
* How many employees take their maximum paid sickness entitlement in a year?
* Who takes the greater proportion of sick leave or other absence during the year *workers, staff or management?

The reasons for the various types and frequency of absence should then be assessed, including the following:

* Is a particular job too stressful or too boring?
* Is the work dangerous or does it require too much physical effort?
* Is the working environment unsuitable?
* Is management weak or over-aggressive?
* Is morale poor?
* Is there a culture of taking days off at particular times?
* Do working practices lack organisational support?
* Is there a general lack of incentive and motivation?

When all this information has been collated and analysed, it can then be used to devise policies and procedures in consultation with staff representatives that should, when properly implemented, substantially reduce the incidence of absence.

About The Author

Carole Spiers combines three roles of broadcaster, journalist and corporate manager in the challenging field of stress management and employee wellbeing.

With 20 years as a top industry guru on stress management and wellbeing, Carole's energy and dynamism extends to providing professional comment to media including television (BBC, ITV, Sky, NBC, CNN), print (Sunday Times, Daily Telegraph, trade and professional journals) and countless radio interviews.

A successful entrepreneur herself, Carole is the founder and MD of the Carole Spiers Group * a dynamic, niche consultancy, and the UK's No. 1 provider of Stress Management and Employee Wellbeing from the shop floor to the Boardroom

A former Chairperson of the International Stress Management AssociationUK, Carole was instrumental in establishing National Stress Awareness Day*. Carole acts as an Expert Witness on Stress Risk Assessment before the Courts, and is the author of Tolley's *Managing Stress in the Workplace*.

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