Last reviewed 29 January 2014

According to a recent PricewaterhouseCoopers (PwC) report, British workers take on average nine days off sick a year, compared with an average of 4.9 days in the US, and 2.2 days in Asia-Pacific countries. Overall, the cost of sick leave to UK employers is £29 billion a year1. Judith Tavanyar looks at physical and mental health at work.

PwC HR consulting leader Jon Andrews commented that companies striving for growth need to invest in health and well-being services in order to improve employees’ health, morale and motivation, and that “the stark variation in absence levels… across western Europe suggests… workplace environment and culture can have a huge influence on the number of sick days employees take”.

A key message here is that having healthy staff leads not only to lower absenteeism and improved productivity (and, thus, to savings on sickness pay and cover), but also to improved morale, increased staff retention and ultimately a more competitive, successful business overall.

This seems obvious, perhaps, but the report raises some important questions. Namely, in what way does a “healthy” workplace improve employees’ morale and motivation as well as how can the environment and culture of a workplace exert a “huge influence” on sickness leave?

In the current economic climate of redundancies, merged jobs and tightened budgets, it is hardly surprising that stress levels in many organisations are sky-high. If we understand stress as “a reaction to a stimulus that disturbs our physical or mental equilibrium”2, we can see how it might generate both excitement and engagement in the short term, or, if left unchecked and unmanaged in the longer term, have a highly detrimental impact upon physical and mental health.

To some extent, “stress” — an acute or ongoing sense of pressure, strain or challenge — is part of daily life. What is important is how individuals react to it, their outlook, and the support they receive to cope. In her book, In the Grip3, Naomi Quenk describes how extreme stress may present to others as individuals “acting out of character” over an extended period. Normally extravert people may seem withdrawn and “cut off”, while those who usually seem confident and upbeat may show, for example, a sharp decline in confidence or increased, apparently irrational, anxiety.

At its most debilitating and extreme, unrecognised stress can cause panic attacks, depression and what psychologists call “flattened effect” — an apparent lack of interest in engaging with others, sometimes leading, in a tragic minority of cases, to suicidal tendencies. The links between physical and mental health are well documented: the brain’s “neurotransmitters”, or small protein molecules, communicate with the rest of the body affecting hormonal balance, the digestive system, liver function and capacity.

The functioning of these “brain messengers” makes all the difference between whether we feel full of energy and joy at being alive, or totally drained and depressed. Serotonin, possibly the best-known of these neurotransmitters, boosts mood, sleep, appetite, learning and memory; it decreases when the hormone cortisol increases, one of the primary results of extreme stress, whether acute or chronic in nature.

It is easy to see the circular impact of physical and mental well-being: people with a positive outlook and optimism are usually more physically resilient and often live longer than those who are depressed or pessimistic. Conversely, people experiencing chronic pain are likely to struggle to maintain their motivation and energy in comparison with physically healthy colleagues.

Caitlin Limmer, a serious marathon runner who left a promising career as an opera singer following life-threatening illness to start a club for runners of all abilities, speaks of the astonishing difference physical exercise can make to mood, sense of confidence and individual happiness. “As a mother of two young kids and then recovering from serious illness, it was time for myself. If I can get out of the front door for 20 minutes a day, it changes me for the rest of the time — I can do anything.”

She describes her mission as helping people to “understand how exercise makes you happy”. She adds: “Some people in my club have mental health issues, of varying levels of severity. For them, it’s focused time where they can put themselves first, release adrenalin and endorphins, feel better about their bodies, feel less anxious and generally feel more in control and happy to have achieved something for themselves. And of course, they increase their fitness at the same time.”4

One of the most obvious reasons why many organisations ignore the importance of creating a culture where physical and mental well-being are respected is that it is viewed as too expensive. While subsidising gym fees and healthy canteen meals, on-site counselling or massage, ergonomic furniture and gentle lighting will doubtless come at a cost, there are plenty of measures that organisations seeking to be “fit for purpose” might adopt at little or no impact on their budgets.

Flexibility of working hours is one, offering the opportunity for greater work-life balance, more manageable childcare arrangements, the possibility to exercise before or after work. This is often overlooked or viewed as a passport to employee laziness, in favour of the erroneous idea that increased hours at work necessarily equals greater productivity. However, the global trend to “virtual working” suggests productivity and engagement can be just as great, if not greater, among employees offered the opportunity for flexibility and choice in working arrangements.

A culture of open communication is surprisingly important in reducing stress and increasing motivation. Managers who are likely to be effective in keeping workplace stress at a manageable level are those who:

  • take the time to give and ask for feedback openly — both positive and constructively critical — from their staff

  • understand the powerful impact of addressing conflicting relationships, and responding to the indications of chronic stress early and respectfully

  • can show appreciation as well as listen with sensitivity to their colleagues’ problems

  • give clear and consistent direction and understand the need to vary their leadership style according to their team’s needs.

None of this makes extraordinary reading; what is perhaps extraordinary is that so many organisations, operating in a highly pressurised economic environment, continue to disregard the fact that increased and unremitting pressure may yield short-term results at a very high long-term cost: employee burnout, spiralling sick leave costs, and at its most extreme, loss of personnel, recruitment costs, demotivated and increasingly stressed colleagues who struggle to fill the skills and talent gap.

In a recent TED (Ideas worth spreading) talk, Benedictine monk Brother David Steindl-Rast spoke of the importance of “slowing down” — of not driving ourselves at such speed that we give up our chance to be aware of ourselves, our relationships and the possibilities each second offers to make life better, if we take time to notice it.5

Whether you see this as fanciful nonsense or solid good sense probably depends on the extent to which you view employees as machines to be driven at top speed for extended periods, or as complicated, creative beings who are inspired to excel when they feel valued and cared for; or, in other words, as the very lifeblood of the organisation employing them.


  1. Throwing a Sickie? UK Employees are Experts, Barnato, K, HITC Business, 16 July 2013

  2. From Psychologies Today:

  3. In the Grip: Understanding Type, Stress and the Inferior Function, Quenk N, Oxford Psychologists Press, 2000

  4. Caitlin Limmer, Running Coach, email

  5. TED (Ideas worth spreading) talk by Brother David Steindl-Rast, posted November 2013