The provision of managerial support and help for employees with depression is linked to lower rates of workplace absenteeism, finds an international survey study of practice in 15 countries in different regions of the world, published in the online journal BMJ Open.
The findings bolster the case for active workplace policies on mental health, say the researchers.
Many people experience depression at some point during their working lives, but mental health issues are still stigmatised. As a result, those affected often don't disclose their problem or seek help for fear of repercussions, say the researchers.
To find out if the attitude of managers to mental health issues might be associated with workplace absenteeism rates and productivity, the researchers drew on an international audit (Global IDEA) of more than 16,000 employees and their managers in 15 countries with varying levels of income (GDP) and cultural norms.
These countries were: Brazil; Canada; China; Denmark; France, Germany; Great Britain; Italy; Japan; Mexico; Spain; South Africa; South Korea; Turkey; and the USA.
Background information was obtained from the employees, including age, gender, educational attainment, and size of the employing company. Each of them was asked whether they had ever been formally diagnosed with depression, and if so, how many working days they had taken off, as a result.
The managers were asked if they actively offered help and support to employees with depression or whether they avoided talking about the issue with the employee.
Response rates varied by country, ranging from around 5 per cent in China to 39 per cent in France. Completed questionnaires were returned by around 1000 respondents from each country, of which around 10 percent were from managers.
In all, nearly 3000 respondents said they were/had been depressed. Nearly three out of four (72.6%) of all the sample worked full time and nearly half (45%) worked in small sized companies (1-50 employees).
Analysis of the responses showed that in general, managers in Asian countries tended to avoid employees with depression and were less likely to offer active support than were managers in other regions of the world.
Managers in Japan and South Korea were the least likely to offer help to their employees, while those in Mexico and South Africa were the most likely to do so.
And managers in South Korea and China were the most likely to avoid talking about depression with employees, while managers in Denmark, Canada, and Great Britain were the least likely to do so.
Living in a country with a higher proportion of managers who deployed avoidance tactics was associated with taking more days off work for depression, as was residence in a country with a higher GDP.
Similarly, living in a country with a greater proportion of managers actively offering help and support to employees with depression was associated with more days at work (presenteeism).
Analysis of the individual factors associated with absenteeism and presenteeism revealed that people who were more highly educated took more time off for depression than their less well educated peers, while those working for larger companies took fewer days off work than those working for smaller ones.
Older (45-64 year old) men with medium to low levels of educational attainment were more likely to come into work than their younger peers, as were employees living in higher income countries.
This is an observational study so cannot establish cause, added to which response rates were relatively low, and it was impossible to glean information on workplace mental health policies or the severity of symptoms.
Nevertheless, the researchers conclude that their findings "suggest that manager reactions to employees with depression can reflect broad cultural and organisational features that directly relate to employee productivity."
They continue: "This strengthens the economic case for supporting the development and implementation of effective policies and practices for managers to be able to actively support an employee with depression."
They add: "The business case for intervention through better managerial response is exemplified by the substantial costs associated with mental health problems and evidence from a number of studies that mental health can improve through workplace programmes, with economic benefits to employers."
Peer reviewed? Yes
Type of evidence: Observational