'We have to figure out a way to get at the source of what's driving the mental health driven presenteeism more than anything else,' says Paula Allen
Recent findings from TELUS Health found 61 per cent of employees are showing up to work while mentally or physically unwell while 35 per cent of workers also report feeling anxious, 32 per cent feel isolated and 27 per cent report feeling depressed.
TELUS Health’s Mental Health Index has tracked employee well-being since the pandemic. Scores have barely moved since 2020, hovering in a bit of a stagnant plateau despite billions poured into workplace wellness programs. While these numbers alone should make any employer pause, Paula Allen, global leader and VP of research, insights and strategic communications at TELUS Health believes the problem runs deeper than a few bad days.
"As certain things have improved, we have new challenges," she said. "We had this major drop around the pandemic with the upheaval and everything that created - isolation, risk, anxiety, uncertainty, all the things the human mind doesn't like. And then we went through that as the driver.”
While it’s “not a new phenomenon,” Allen believes presenteeism sits as a central issue to the findings, underscoring its prevalence has shifted dramatically. While occasional fatigue or underperformance is normal, 60 per cent of employees working through illness represents a genuine escalation.
While some of this is physical pain, illness or things people push through, Allen noted the real issue emerges when the problem is chronic and rooted in anxiety. For example, a single day off doesn't solve anything if the underlying stressor remains. When someone takes time away and returns to the same workplace conditions, they return to the same anxiety that drove them to come in sick in the first place.
Allen sees two primary drivers pushing workers toward disengagement and, eventually, the exit. The first, she suggests, is feeling undervalued. Not necessarily underpaid, though that plays a role, but unrecognized.
"Let’s say somebody is putting out work very, very hard. When you’re under stress, you need to have that recognition as part of the balance of it," she said, emphasizing recognition is a fundamental human need, and when organizations fail to provide it, the consequences compound. Notably, employees who don't feel valued start questioning their standing, which feeds directly into anxiety about job security and self-worth.
"When your mind is so drained by anxiety, you can't be productive," she said. "You don't feel good about work when you're not feeling valued.”
As a result, employees instinctively seek a way out, Allen emphasized. That exit takes one of two forms - resignation or disability leave. While both represent a breaking point, Allen notes that many employees currently on disability have the same health challenges as colleagues who remain at work. The difference is workplace environment.
"There are a lot of people who are at work today who have the same health compromises as people who are off, but they have an environment that motivates them to stay and that supports them with accommodation so they can keep working," she said.
Allen emphasizes that addressing mental health presenteeism requires going upstream. Either employees need counseling and coaching to develop resilience and reframe their thinking, or managers need to intervene directly - noticing changes in performance and offering support rather than criticism.
“People aren’t necessarily always at their best. We have to figure out a way to get at the source of what's driving the mental health driven presenteeism more than anything else. Physical health presenteeism is there and we have better structures for that,” said Allen, pointing to stay-at-work programs and accommodation plans. We have things to support individuals that are often not, you know, but the structures for mental health really come from leadership training and coaching and counseling from the individual side.
Contrastingly, mental health interventions, Allen suggests, rely almost entirely on manager training and individual counseling. Until workplaces address the source of anxiety itself, sending people home for a day merely postpones the problem. Allen emphasized real solutions require leadership commitment and structured support systems.
She also pushes back on the idea that throwing more money at paramedical coverage will solve the problem. While higher benefit maximums are welcome, she said, without quality governance, they create a new risk.
"You can give people this bucket of money. But what is the governance to say that the care that they are getting is quality care?" she said. "I don't want us to create another problem where it's a free for all just because the community sees that people have a nice pot of money."
Well-being, in Allen's view, is an active pursuit rather than a fixed state. The goal, she suggests, is to show employees that counseling, coaching, and self-care produce meaningful results and that “the juice is worth the squeeze.”
While the worst of the pandemic may be over, Allen suggests the stressors that replaced it are just as damaging. Inflation, geopolitical instability, and the pace of organizational change have kept anxiety levels elevated.
Meanwhile, isolation also remains a persistent problem. Being surrounded by colleagues or living in a busy city doesn't solve it either. What actually eases anxiety, Allen said, is trust - both in personal relationships and at work. The problem is that building trust has never been a priority for most organizations.
"All of this needs to be intentional because our society is moving in a way that is absolutely not healthy from a mental health point of view," she said, underscoring transparent communication, empathetic leadership, and managers who are equipped to form real relationships with their teams. Without those foundations, Allen warns, organizations are left with "a handful of people making decisions without information. And that's a big ship to pull with just a few hands," she said.
