A large-scale study tracking over 18,700 working adults over 14 years has found that even moderate psychological distress can negatively affect job performance. The research, published in the European Journal of Health Economics, shows that workers experiencing mental strain, even without a formal diagnosis, are more likely to miss work due to illness and to show up while unwell, a pattern known as presenteeism.
Researchers analyzed data from eight rounds of an Australian survey collected between 2007 and 2021, covering nearly 71,000 observations. They measured psychological distress using the Kessler 10 scale, which asks how often people felt nervous, hopeless, exhausted, or restless over the past month. Participants were grouped into low, moderate, or high distress categories.
The study examined three workplace outcomes: how often people missed work due to illness, whether they showed up while unwell, and whether they were working fewer hours than they wanted. The results showed that workers with moderate distress were already missing more work days and were more likely to show up while sick compared to those with low distress. Workers with high distress showed even larger effects.
The financial impact is substantial. Workers with high psychological distress incurred an estimated AUD 3,656 more per year in costs related to presenteeism compared to those with low distress. This cost comes from showing up while struggling, not from taking time off.
Presenteeism often goes unnoticed
Of the three measures studied, presenteeism is the most difficult to detect. It does not appear in absence records or trigger conversations with managers. However, it can erode focus, decision-making, and work quality in ways that are easy to attribute to other causes.
Many people with moderate psychological distress do not see themselves as struggling. They are functioning and showing up. But the research highlights a gap between functioning and thriving that is hard to ignore.
Subtle signs of distress at work
Psychological distress often appears in small, easy-to-dismiss ways. These include difficulty concentrating on tasks that used to feel manageable, reduced motivation to start or finish projects, more mistakes due to mental fatigue, increased irritability that affects working with others, and more procrastination when emotional reserves are low. These are not character flaws but signals worth paying attention to.
Simple habits that can help
Small, consistent habits can make a real difference for how people feel and how they perform at work. Regular physical activity, even moderate movement like a 20-minute walk or a short strength session, can lower stress hormones and improve mood. Consistency is more important than intensity.
Protecting sleep is also key. Sleep and psychological distress have a two-way relationship: poor sleep worsens distress, and distress disrupts sleep. A consistent sleep schedule and a wind-down routine are direct ways to support mental health.
Taking short breaks throughout the workday, even five minutes away from a screen, helps the brain reset. Setting boundaries around work hours, such as clear start and end times and protecting time off from work notifications, can reduce the low-grade stress that builds over time.
Early action matters
One of the main takeaways from this research is that productivity loss begins at moderate distress, not just at the severe end. This means the time to act is before things feel urgent. Whether that involves talking to a therapist, leaning on a trusted colleague, or simply naming what you are feeling, early support matters.
The study found that workers aged 25 to 54 with high distress showed a possible connection to underemployment, or working fewer hours than desired. However, the researchers note this finding should be interpreted with caution, as the primary analysis did not find a significant link between psychological distress and underemployment.
Psychological distress does not have to reach crisis level to affect work. This 14-year study found that even moderate mental strain can increase sick days and reduce output on the days people do show up. Presenteeism, the habit of showing up while unwell, is where much of that loss happens. Tending to mental health early, through movement, sleep, boundaries, and support, is a direct investment in both performance and well-being.
