Absence starts at home. So why do we wait for the sick report?

Joke Boonstra, chair of the board of Arbo Unie, said something on BNR at Work this week that every HR manager should take a moment to let sink in: personal problems are the strongest predictor of long-term absence. Not the workload, not the office chair, but what people bring with them from home. A divorce, caring for a relative, money worries. And employers see it too late.

So this is not coming from a vitality app or a wellbeing provider, but from one of the largest occupational health providers in the country. At Healthguard we have been working from this idea for some time: look earlier, and look beyond work. But if Boonstra is right, and she is, then the question is not which tool you add. The question is what you do differently yourself.

The system only responds to the sick report

Ask a manager whether they can tell when someone is not doing well, and the answer is almost always yes. Less energy, a shorter fuse, work that piles up. Yet little is done with it. In a study cited in the broadcast, 72 percent of people who dropped out said they felt it coming before they reported sick, often for months. Only 11 percent said a manager had recognised or discussed those signals.

And the system does not help them. Most absence systems raise a flag after the third sick report, while the colleague who will soon be at home with burnout has often never reported sick before. They keep working. The occupational health provider only comes into view once the sick report is in. So the signal we measure is exactly the signal that comes too late.

What you can do as an organisation

1. Also measure what goes on outside work. In your (e)PMO or employee survey, ask about sleep, money worries and caring responsibilities at home as well as workload. Anonymously, at team level. And agree in advance with your company doctor at which outcome they will take action, and organise that help.
2. Look for the quiet signals. Someone who structurally works overtime, takes no leave, starts delivering lower quality or goes quiet in meetings is often in trouble sooner than someone who reports sick for a day. Agree with managers on what to look out for.
3. Create a route to help that does not go through the sick report. Does everyone know who to call when things are tight at home? And tell every employee that they may visit the company doctor’s open consultation hour without the employer’s permission, even when they are not ill. Hardly anyone knows that.
4. Train managers in the conversation. Spotting, making room and pointing the way is their role. They are not there to solve personal problems, but they are there to respond to signals in time. And give them the time for it, said Jennifer Elders in the same broadcast: a manager who is also the case manager quickly ends up looking only at what the Gatekeeper Improvement Act requires.

How to deal with a colleague who brings home to work

Boonstra rightly says that you do not need to dig into anyone’s private life. So what do you do?

• Name what you see, not what you think is going on. “You seem a bit absent these last few weeks, is that right?” is enough.
• Ask how things are going, not what is wrong. You do not need to know the cause to help. Make it less personal, Boonstra suggested: say that many people struggle with this and benefit from a conversation (for example with someone with lived experience, a coach or a company psychologist), and ask whether that might be something for your colleague too.
• Offer something practical. Temporarily different working hours, moving a deadline, taking a task off their plate. That works better than “just let me know if I can do anything”.
• Come back to it, and keep it to yourself. Asking again two weeks later does more than the first conversation. That is how you build trust and your colleague feels seen. And what someone shares does not end up in a file or at the coffee machine.

Organisations that do get their absence down work closely with their occupational health provider, Boonstra said. She mentioned a department that went from 12 percent absence to half that. And anyone who does drop out needs more than rest: “six weeks at home is not recovery”, said Elders. That is why we work with an on-site company doctor who already knows the people before there is a file, and we make sure insight and help are there before the sick report. But it does not start with a tool. It starts with the choice to look earlier.

Boonstra said two more things. A vitality week on its own is not enough, and that is true: a week like that is a way in, not an end point. And the most important protection against dropping out is engagement. People who feel valued and find meaning in their work have more of a buffer when things are difficult at home.

So the question for your organisation: how quickly do you know when a colleague is not doing well at home? And what happens then?

Curious how you organise this, so feel free to respond. The 14 October episode of BNR at Work (in Dutch) can be played back in your podcast app or via BNR; a good report of the conversation is on HRMorgen (in Dutch).