Successful companies show that those who know how to reduce absenteeism among their staff have competitive advantages in the market, ranging from cost savings and lower organisational costs to better employer branding. However, one important factor of successful absenteeism management is often not appreciated enough.

Psychogenic (mentally induced) absenteeism: a serious problem

Increasing flexibility and mobility demands on employees, intensification and compression of work, greater networking and cooperation between humans and machines, increased cognitive and emotional stress - all this leads to mental stress that many employees cannot easily cope with. The result can be seen in the absenteeism and health reports published in 2017 by the federal government and various health insurers (e.g. AOK, DAK, TK): days of incapacity to work, pensions for reduced earning capacity and early retirement due to psychological impairments are rising steadily. It is not for nothing that mental risk assessment has been a legal requirement since 2014. 

Absenteeism is expensive: lost added value, overtime, training time and, in some cases, overloading of colleagues compensating for absenteeism, continued payment of wages, additional organisational costs, penalties in the event of delivery problems and other opportunity costs. Psychogenic incapacity to work days (AU days) are particularly significant, accounting for approx. 17 % of all AU days and approx. 38 AU days per case of illness (the average of all cases of illness is 13 AU days). If one considers that days of sick leave due to impairments of the musculoskeletal system (approx. 22 % of all days of sick leave, 20 days of sick leave per case) and especially in their main group "back disorders" are strongly (co-)caused by psychological factors, the psychological component of absenteeism becomes even more important. Sleep disorders are also relevant in this context. For years, they have been on the increase in western industrial nations. Currently, about 35 million people in Germany suffer from them, which corresponds to 42 % of the population. Of these, 15 % - 20 % are in need of treatment. About 3/4 of all sleep problems are psychogenic insomnia (problems falling asleep, sleeping through the night and waking up). Although absenteeism due to these problems is rather low, an employee survey conducted by the DAK in 2017 shows that 3.7 % of all employees did not show up for work due to sleep disorders. Sleep disorders also cause major problems when people are present at work: Not only is performance reduced, but the risk of accidents and injuries also increases with the consequence of additional absences, which, however, are not statistically attributed to psychological factors.   

How can psychogenic absenteeism be effectively reduced in the company?

Of course, the best way to do this is to change the conditions identified for it. In the 2017 baua study on mental health in the world of work, the most relevant work condition factors for mental health are identified by means of a scoping review and employee surveys and divided into 4 topic areas :

1. Work task
2. Working hours
3. Leadership and organisation 
4. Physical environment and human-technology interaction

The focus here is on the conditions in the workplace. Changing them in such a way that pathogenic (disease-causing) influences are reduced and salutogenic (health-promoting) factors are expanded is a must without any ifs and buts, which unfortunately is often not tackled in company practice. One reason is that system-relevant components need to be changed, such as: Corporate culture, structural and process organisation, personnel structure, remuneration systems, workplace design and ergonomics, task and resource allocation, leadership and working climate, economic circumstances and job security, etc. This effort is gladly avoided. 

The solution to this problem isguided by the fact that a large part of these "operational conditions" and the "behaviour of the employees" influence each other. Therefore, psychogenic absenteeism can also be reduced through measures that start where they directly occur: with the employees who are at risk of absenteeism. These measures promote salutogenetic attitudes and behaviour, have a preventive effect against psychogenic incapacity to work and positively influence health-relevant company conditions. These in turn have a health-promoting effect on the employees.

A modular approach includes, for example:

1. Absenteeism analysis, economically adapted to the respective company. 
2. Mental risk assessment.
3. Setting S M A R T targets.
4. Estimate the cost savings from absenteeism reduction and the expected ROI.
5. Implementation and facilitation of health circles.
6. Salutogenetic attitude and behavioural training for employees (concerns prevention against mental health risks and resilience for mental demands) with methods that take effect quickly, are easy to teach and can be integrated well into everyday life.
7. Evaluation of the measures.
8. Conception of a salutogenetic sustainability strategy.

Practical example:

Situation: In a medium-sized service company, absenteeism in 2016 was just under 8.5 % of the target working time, in areas D and F even over 12 % with a rate of affected employees of over 60 %. A voluntary employee survey conducted in these two areas showed that more than 3/4 of all absences were due to psychological, psychosomatic or back problems (despite very good workplace ergonomics).

Planning and goals: All employees in areas D and F were to be recruited for salutogenetic training in the first half of 2017 with the aim of reducing total absenteeism by at least 1/3 in the second half of the year. The training participants should learn to understand and perceive psychological stress and to master preventive and salutogenetic self-help techniques.

Cross-divisional groups with an average of 15 people were formed, coordinated with the work organisation. For each group, 4 half-day trainings were scheduled at intervals of 4 weeks, individual coaching sessions in consultation and according to certain criteria, and a follow-up check after 8 weeks. A total of 60 people were to participate. The direct Lug costs for absenteeism in these areas amounted to 235 T € p.a. (If indirect costs are added, a factor of 1.2 - 2 is to be applied according to sample calculations). According to the above-mentioned 1/3 target, almost 40 T € of these 235 T € should be saved in the second half of 2017 and almost 80 T € in 2018 - a multiple of the training investment. 

Implementation, contents and methods: During a kick-off event, which informed about psychological conditions of absenteeism, their personal and company negative consequences as well as useful personal measures, the employees were successfully motivated to participate in the training. Personal goal clarification, theoretical input, exercise practice and evaluation were the elements of each training session with the contents: practical communication of how psychological maladjustment works, understanding of salutogenetic and preventive concepts, sensitisation to individual factors of psychological maladjustment, mastery of individual preventive and salutogenetic self-help techniques. Methods were used from: Embodiment-oriented concepts, hypno-imaginative methods, impact approaches, solution-oriented counselling, systemic constellation work.

Evaluation: For more than 90 % of the employees, the subjective success rating 8 weeks after the end of the training was between 7 and 9 success points on a scale of 0 to 9. The measured absenteeism was reduced by 42 % from July to October 2017. These are good prospects for 2018.