By Carolyn Crist

(Reuters Health) – In a working environment where managers feel comfortable offering help and support rather than avoiding employees with depression, absenteeism is lower and presenteeism is higher, according to a study covering 15 countries.

On average, this association between supportive managers and less depression-related absenteeism applied on a national level too, the researchers found. Employees who live in a country with a larger number of managers who avoid talking about depression tend to take more days off work, the study team reports in BMJ Open.

“Depression is common in the workplace, but even in the most open workplaces, it can be a taboo,” said lead study author Sara Evans-Lacko of the London School of Economics and Political Science in the UK.

Previous studies indicate that about 70 percent of workers feel effects from at least one mental health issue, she said.

“It’s so common that we even recognize it as common, but there’s still a barrier to acknowledging it and talking about it,” Evans-Lacko said in a phone interview.

Evans-Lacko and colleague Martin Knapp analyzed a database of surveys done across an economically diverse range of countries: Brazil, Canada, China, Denmark, France, Germany, Italy, Japan, Mexico, South Africa, South Korea, Spain, Turkey, the UK and the U.S. They looked at workers who had been previously diagnosed with depression, manager attitudes about discussing depression, work performance measures such as absenteeism and country-level effects such as gross domestic product (GDP) as a sign of economic prosperity.

Managers who said they had one or more employees with depression in the past were asked how they responded to that person, and researchers found wide variation across the countries, but in general, managers in Asian countries tended to avoid employees with depression.

Just 16 percent of mangers in Japan had offered to help an employee with depression. Managers in China and South Korea in particular also reported low levels of support and training in dealing with depression in the workplace and were less likely to offer active support.

The most supportive managers were in Mexico, where 67 percent said they had offered help, and in South Africa and Spain, where 56 percent had offered help.

Among individual employees, those working in smaller companies or with high educational attainment tended to take more time off because of depression, the study found. Individuals living in high-GDP countries also took slightly more time off, though at the country level, higher GDP was linked to higher rates of presenteeism – showing up to work even with depression.

On the individual level, men aged 45-64 with medium to low education levels also tended to have higher levels of presenteeism, while 25-to-44-year-olds overall tended to have lower levels of presenteeism.

Manager reactions to employees with depression were at least as important as national GDP in predicting employee absenteeism or presenteeism, the study team notes.

“Managers at the top set the tone, which cascades into workplace policies and training programs that other managers can use to support their employees,” Evans-Lacko said. “Managers often don’t know what to say or don’t want to make it worse, but talking about it helps.”

To help countries move forward with these workplace initiatives, the Organization for Economic Co-operation and Development (OECD) is reviewing its mental health policies, according to David McDaid of the London School of Economics and Political Science, who was not involved in the study.

In Norway, for instance, researchers are studying how helping people with depression in the workplace to talk to their family doctor can be supportive, he said.

“We’re trying to understand the different variables, including how workplace programs are organized, how managers are trained, and how culture impacts these stigmas,” said McDaid, who studies preventive strategies for maintaining mental health, particularly in workplaces.

McDaid and colleagues are focused on how small- and medium-sized businesses that don’t often have the size and revenue to invest in mental health programs can support their employees.

“Businesses shouldn’t be worried that if someone has depression that it was caused by the workplace, which could be why many companies are reluctant to talk about it,” he said in a phone interview. “People bring their problems from life into the workplace, and not only are businesses not to blame, it’s a great place to intervene and help.”

SOURCE: BMJ Open, online July 23, 2018.