The debate on presenteeism is very welcome. Research on the topic is still in its infancy but it all points in the same direction – that lost productivity due to ill health from people who are physically present in the workplace is significantly more costly to employers than losses due to sickness absence.

Having said that, however, what does it mean for employers and managers on a day to day basis? Surely we should not be encouraging people to take time off work? Is it not better to put up with some lost productivity and keep people at work while they recover?

These are tricky questions and the answers may differ between individuals and, to some extent, from one industry to another. But the most important thing is that the issue is recognised and not swept under the carpet.

Surveys about mental health show that employers tend to have very low recognition of depression and anxiety; they consistently underestimate the incidence and prevalence. The flip side of this coin, as a survey by Mind has recently shown, is that in many workplaces employees are very reluctant to disclose mental health problems for fear of damaging their workplace relationships and their careers. Hence, presenteeism due to mental ill health is common, particularly in the case of those with "white collar" jobs, and especially when fear of unemployment is so rife.

The answer to the question "should employees be encouraged to remain at work if possible?" is probably yes; it's far better to make some temporary adjustments and maintain a lower level of productivity than have the employee stewing at home getting more depressed and anxious about their job. But this should not be a reason for ignoring the problem and doing nothing to help.

If an employer's focus is only on avoiding absence rather than on dealing with the health problem, it is likely that the distressed employee will stick it out unproductively until it becomes impossible to remain in work any longer and then go off for a much longer period of sickness absence. This knock on effect of unmanaged presenteeism is starting to be recognised in the research literature.

There is now evidence from a number of studies that presenteeism can be a strong predictor of future sickness absence, particularly where this is associated with the neglect of health problems in their early stages. Centre for Mental Health, in partnership with BITC, has launched a discussion paper on Managing Presenteeism. I do hope that we can now begin a practical discussion on the best ways of dealing with this costly and often distressing issue.

Bob Grove (pictured) is Joint CEO at the Centre for Mental Health