The 57-day problem: what attendance reports miss

Troy Winters

PsychSafe^® white paper

A 2026 report from Economist Enterprise puts a figure on the problem for US employers. It estimates that workplace stress, anxiety and depression cost American businesses about US$292 billion a year, roughly US$2,120 per employee, and that nearly 63 million US workers are affected. The split is the important part. About US$214 billion sits in healthcare, turnover and absence, costs that generate records in different systems. The remaining US$78 billion is presenteeism, which may leave no event for an employer to record. In the report’s model, presenteeism costs twice as much as absenteeism (US$78 billion against US$38 billion).

These are modelled US estimates, and they cover anxiety and depression only, and they are only estimates, but the direction is still clear: the cost that is easiest to see is only one-third of what you need to worry about.

US$214B

Generates records in different systems

US$78B

May leave no event to record — twice absenteeism’s US$38B

Days off

Days unproductive at work

Attention is finite, and distress consumes it. Employees coping with workplace-driven psychosocial hazards like overload, conflict or unclear expectations can only give the job whatever focus is left over.

Psychological safety adds a team effect. When people can speak up, ask questions and admit mistakes without fear of punishment, errors surface early and ideas move. Healthy work is also sustainable work, because the output does not have to be repaid later in burnout, absence and turnover.

Two figures are commonly cited, and both need context. A WHO-led analysis published in The Lancet Psychiatry in 2016 estimated that every US$1 invested in scaling up treatment for depression and anxiety returns US$4 in better health and ability to work over the period 2016 to 2030. That analysis looks at treatment at a global scale, not at workplace programs.

The more direct Canadian evidence comes from Deloitte, which found in 2019 that companies with workplace mental health programs in place for one year had a median annual return of $1.62 for every dollar invested, rising to $2.18 for programs in place three years or more. That finding rests on data from seven large employers, so it is encouraging rather than conclusive. The pattern is still worth noting. What is important to note is that returns grew as programs matured, which favours a sustained management system over a one-off initiative.

$1

$4

The Economist Enterprise report estimates that about US$121 billion a year, more than 40% of the US$292 billion total mentioned previously, is associated with workplace stress, the drivers of which include workplace psychosocial hazards like workload, poor management and work design. The authors are careful to say this is not a completely recoverable savings, since no employer can eliminate all stress. It does show where employers have the most influence.

But, that does matter because the common response is to add support (increasing resilience). Offering support is not the same as reducing exposure. The report found that nearly 40% of employees had not used mental health support in the previous six months, and only 22% of large employers track how much of it is used. It also notes that the evidence on individually focused interventions is mixed, while interventions that address working time, work design and psychosocial conditions show more consistent effects. That is the logic of the hierarchy of controls: change the work, and do not rely only on helping people cope with it.