Successful companies demonstrate that those who know how to reduce staff absenteeism have competitive advantages in the market, ranging from cost savings and reduced organizational effort to better employer branding. However, one important factor in successful absenteeism management is often underestimated.

Psychogenic (psychologically induced) absenteeism: a serious problem

Increasing demands on employees for flexibility and mobility, intensification and condensation of work, greater networking and cooperation between humans and machines, and increased cognitive and emotional stress—all of this leads to psychological strain that many employees are not easily able to cope with. The results are evident in the absenteeism andhealth reportspublished in 2017by theGerman federal government and various health insurance companies (e.g., AOK, DAK, TK): days of incapacity to work, disability pensions, and early retirement due to mental health issues are steadily increasing. It is not without reason that psychological risk assessment has been required by law since 2014. 

Absenteeism is costly: lostvalue creation, overtime, training time, and in some cases excessive workloads for colleagues compensating for absences, continued payment of wages, additional organizational expenses, contractual penalties for delivery difficulties, and other opportunity costs.Psychogenic sick days (AU days) have a particularly significant impact, accounting for approximately 17% of all sick days and approximately 38 sick days per case of illness (the average for all cases of illness is 13 sick days). Considering that AU days due to musculoskeletal disorders (approx. 22% of all AU days, 20 AU days per case) and especially in their main group "back disorders" are strongly psychologically (co-)determined, the psychological component of absenteeism becomes even more significant. Sleep disorders are also relevant in this context. They have been on the rise in Western industrialized nations for years. Currently, approximately 35 million people in Germany suffer from sleep disorders, which corresponds to 42% of the population. Of these, 15%–20% require treatment. Approximately three-quarters of all sleep problems arepsychogenic insomnia (difficulty falling asleep, staying asleep, and waking up). Although absenteeism due to this condition is relatively low, a 2017 employee survey by the DAK shows that 3.7% of all working people did not show up for work due to sleep disorders. Even when employees are present at work, sleep disorders cause major problems: not only is performance reduced, but the risk of accidents and injuries also increases, resulting in additional absenteeism, which, however, is not statistically attributed to psychological factors.   

How can psychogenic absenteeism be effectively reduced in companies?

Of course, the best way to do this is by changing the conditions that have been identified as contributing factors. In the 2017 baua study on mental health in the workplace, a scoping review and employee surveys were used to identify the working conditions that are most relevant to mental health anddivide themintofour thematic areas:

1. work assignment
2. working hours
3. Leadership and organization 
4. Physical environment and human-technology interaction

Thefocushereison working conditions. Changing these conditions in such a way that pathogenic (disease-causing) influences are reduced and salutogenic (health-promoting) factors are expanded is an absolute must, but unfortunately this is often not addressed in everyday working life. One reason for this is that systemically relevant components need to be changed, such as corporate culture, structural and procedural organization, personnel structure, remuneration systems, workplace design and ergonomics, task and resource allocation, leadership and working atmosphere, economic circumstances and job security, etc. This effort is often avoided. 

The key tosolving this problem is the fact that most of these "working conditions" and "employee behavior" influence each other. Psychogenic absenteeism can therefore also be reduced by measures that address the root cause: employees at risk of absenteeism. These measures promote salutogenic attitudes and behaviors, have a preventive effect against psychogenic incapacity to work, and positively influence health-related working conditions. These, in turn, have a health-promoting effect on employees.

Amodular approach includes, for example:

1. Absenteeism analysis, tailored to the specific company's economic situation. 
2. Psychological risk assessment.
3. Setting S M A R T goals.
4. Estimation of cost savings through reduced absenteeism and expected ROI.
5. Implementation and facilitation of health circles.
6. Salutogenic attitude and behavior training for employees (focusing on prevention of mental health risks and resilience for mental demands) using methods that are quick to grasp, easy to teach, and easy to integrate into everyday life.
7. Evaluation of the measures.
8. Designing a salutogenic sustainability strategy.

Practical example:

Situation: In a medium-sized service company, absenteeism in 2016 amounted to just under 8.5% of scheduled working hours, and in departments D and F it was even over 12%, with a rate of over 60% of employees affected. A voluntary employee survey conducted in these two areas revealed that more than three-quarters of all absences were due to psychological or psychosomatic issues or back problems (despite very good workplace ergonomics).

Planning and goals: All employees in departments D and F should be recruited for salutogenic training in the first half of 2017 with the aim of reducing total absenteeism by at least one-third in the second half of the year. Training participants should learn to understand and recognize psychological stress and master preventive and salutogenic self-help techniques.

Cross-departmental groups with an average of 15 people were formed, tailored to the work organization. Four half-day training sessions were scheduled for each group at four-week intervals, with individual coaching sessions arranged in consultation and according to specific criteria, and a follow-up check after eight weeks. A total of 60 people were to participate. The direct costs of absenteeism in these areas amounted to €235,000 per annum (when indirect costs are added, a factor of 1.2–2 is to be applied according to sample calculations). In accordance with the above-mentioned 1/3 target, just under €40,000 of this €235,000 was to be saved in the second half of 2017 and just under €80,000 in 2018 – a multiple of the training investment. 

Implementation, content, and methods: Ata kick-off event that provided information about the psychological causes of absenteeism, its negative consequences for individuals and companies, and useful personal measures, employees were successfully motivated to participate in the training. Personal goal clarification, theoretical input, practical exercises, and evaluation were the elements of each training unit, with the following content: practical teaching of how psychological stress works, understanding of salutogenic and preventive concepts, raising awareness of individual factors of psychological stress, mastering individual preventive and salutogenic self-help techniques. Methods used included embodiment-oriented concepts, hypno-imaginative techniques, impact approaches, solution-oriented counseling, and systemic constellation work.

Evaluation: Eight weeks after the end of the training, over 90% of employees gave a subjective success rating of between 7 and 9 points on a scale of 0 to 9. Measured absenteeism fell by 42% between July and October 2017. This bodes well for 2018.