According to a new survey on mental health conducted by LifeWorks, nearly half of UK employees report doing their job when feeling unwell – physically or psychologically – at least one day per week.

Indeed, the number of sick days taken by UK workers has almost halved since 1993, according to the Office for National Statistics. Where the average employee once spent 7.2 days a year at home due to illness, this fell to just 3.6 days in 2020; the lowest recorded level since the data time series began in 1995.

And, since the pandemic and widespread pivot to working from home, many workers have become even more reluctant to use their allocated sick leave, instead preferring to continue working through illness – known as presenteeism.

“Because of Covid-19, people are now in the mindset that anything less than Covid isn’t a ‘proper’ illness,” explains Jenny Devonshire, founder of workplace wellness performance portal Pause 2 Perform. “Many people feel like working from home is a privilege, and worry that if they can’t be seen actively working, their colleagues might think they’re skiving and take it away from them, so they have to be ‘on’ all the time.”

Why don’t we take sick days when working from home?

Factors such as high work intensity, job insecurity and lack of support from supervisors and colleagues have also been found to encourage presenteeism. However, strict attendance management policies, such as limited entitlement to uncertified absence days, a lack of entitlement to sick pay, or threats of disciplinary action also play a major role in why we work through illness.

“The fear of calling in sick to my employer whilst working from home during  lockdown became so crippling I ended up quitting my job,” Jess, a social media marketing strategist, tells Stylist. “I have Crohn’s Disease, and being someone with an autoimmune disease and balancing life is hard enough – but trying to soldier through the pain is a wild ride. But in the end, calling in sick was becoming as crippling as the illness itself.”

“During the first lockdown while working from home, I was hit with a major flare-up due to the stress of the world, and ended up moving back in with my mum and grandma as a 28-year-old woman, missing my boyfriend. I had communicated that I was in no state for work and even had a doctor’s sick note, but my employer sent me a gut-wrenching message saying: “You don’t look that sick to me.

“It knocked me back into a shame spiral and I even had a short stay in hospital, but it did light a fire under my butt to get out of that employment and into a job that suited my body.”

Research by the UK Institute of Employment Studies found that business culture is a major cause of presenteeism. Employees who know that being absent would make more work for colleagues, for example teachers and nurses, are most likely to work while unwell.

“I feel so anxious about taking time off for illness and know it’s going to pile up leading to extra overtime the next week,” admits Lara*, a content manager. “I was really ill last week and still joining calls and croaking through with my camera off. I don’t know if I’m imagining it but I feel like certain coworkers are judging me for not just working through it, even though I have a fever and can hardly sit up or speak.”

But the pressure to minimise sick days and maximise productivity when ill continues even among the self-employed.

“I recently had my appendix out quite suddenly and as someone who is self-employed, it really challenged me to take time off,” Tori Porter, a PR consultant tells Stylist. “Obviously clients were very understanding, but there’s a sense of guilt for taking time off when you don’t have anyone to take over for you.

“Not having anyone to check things for me, I couldn’t help but check emails to make sure nothing was missed. I think it’s a massive learning experience for freelancers. Figuring out how to take time off. It seems so easy from the outside, getting to work on your own terms, but it does mean it’s a lot harder to take a proper holiday or sick leave.

“I do, however, think that you’re more likely to not take sick days if you are working from home as you can check your emails from the sofa and not over-exert yourself. I had Covid in March 2020 and I still didn’t take any time off as I was working from home.”

Why is working from home while ill harmful?

Devonshire suggests that there can be some benefits to sickness presenteeism while working from home. “Particularly for those suffering with long-term chronic conditions, it can allow them to partake in work from their bed or the sofa when they otherwise wouldn’t be able to, as long as they’re supported by their employer.

“When you have autonomy and control over working while you’re ill, it can be a positive,” she continues. “If you’re feeling a bit under the weather, you can still respond to the odd email, which takes away from the stress of coming back after time off.”

However, she emphasises the importance of real downtime when you’re struggling with illness. “If you are ill, your body needs rest to fight off infection and give yourself time to recover. If you don’t take that necessary break, you may find your illness lasting longer and increasing the likelihood that you’ll get sick again later on.”

But of course, continuing to work while ill does bring with it many drawbacks, particularly for a culture already experiencing unprecedented levels of burnout, a hidden overtime epidemic and a mental health crisis. 

Presenteeism can be a major threat to long-term wellbeing. There is evidence that working while sick is a risk factor for future adverse health events, including cardiovascular disease and mental health problems such as anxiety and depression. Working while sick was also found to intensify feelings of detachment from the job role, possibly in an attempt to recover from the emotional demands of the job.

Changing the culture around working from home and illness

“Managers who set a bad example by working when sick encourage similar behaviour in their teams,” explains Devonshire. “It needs to come from the top down in order to change the culture around illness. Once more people model the behaviour of truly going offline when ill, there will be a snowball effect.”

Sick in the City (SIC) is a 100% remote company run by founder, 26-year-old Rachael, who is disabled. All of SIC’s training, mentorships, and staff all work from the comfort of their own homes, working the hours most suited to them.

“When it comes to working from home, I honestly feel less pressure and would be more inclined to take a sick day if needed,” admits Rhiannon-Chelsea, an employee of SIC. “On the days I do have to be away from work, due to my chronic illness, my workplace is completely understanding, no questions asked. Some days I can get up and get on with it, and some days that is not an option.”

How to take time off of work when you’re ill

If you are taking time off for illness, Devonshire advises letting your employer know as soon as possible and over-estimating the amount of time you may need to take off. “Be sure to highlight anything urgent that you’re working on that can be delegated, but most importantly try to let go of any guilt and focus on recovering.”

Images: Getty