When employees struggle with mental health issues, the cost isn’t only personal, it’s economic. Globally, poor mental health is estimated to eat into productivity and cost economies hundreds of billions of dollars annually through lost work, reduced output, absenteeism, and disengagement. (World Health Organization) 

For business leaders, CEOs, and HR professionals, these aren’t abstract figures, they are real business risks affecting performance, retention, and the bottom line.

Hidden Costs: Absenteeism and Presenteeism

Two of the biggest drivers of economic impact are:

• Absenteeism:  Employees unable to come to work due to illness, stress, or burnout 

• Presenteeism:  Employees physically at work but not fully functioning because they are unwell 

These effects don’t just reduce output; they erode decision-making quality, slow innovation, and fuel turnover. (World Health Organization)

South Africa: A Substantial Economic Drag

In South Africa, mental health challenges present a significant drag on economic performance. Research shows:

• The cost of mental health-related presenteeism alone has been estimated at tens of billions of rand per year, with figures equivalent to around 4.2% of GDP from lost productivity due to employees working while unwell. (Skills Portal) 

• Other studies estimate that unaddressed mental health conditions can cost the economy well over R160 billion annually through lost days of work and lower performance. (Stellenbosch Business School) 

In practical terms, this means organisations in South Africa — across industries — are potentially forfeiting significant value every year because invisible mental health burdens go unaddressed. 

The Netherlands: Productivity Isn’t Immune 

The Netherlands often ranks highly for work-life balance and wellbeing, but even here mental health has economic consequences. Research suggests:

• Mental ill-health costs Dutch society a notable share of GDP, largely from reduced participation and productivity rather than direct healthcare costs. (OECD) 

• Stress and work-related mental health complaints contribute to sickness absence and lower output, with national surveys historically showing billions of euros in productivity losses tied to stress-related absence. (PMC) 

This isn’t unique to the Netherlands along with other high-income countries, it highlights how modern work environments can mask rising mental health pressures even where formal protections and benefits are strong. 

Common challenges include:

• Mental health issues are prevalent. Anxiety, depression, burnout, and stress are common drivers of reduced performance.(World Health Organization) 

• The economic impact is largely indirect. Businesses feel the brunt mainly through productivity loss, not just healthcare costs.(OECD) 

• Invisible losses matter. Employees who stay at work while unwell can cost more in lost productivity than employees who are absent. (Skills Portal) 

For leaders, this mean that ignoring mental health isn’t just a wellbeing issue it’s a commercial risk. 

A Strategic Imperative for Today’s Workplace 

The business case for prioritising mental health is clear: 

• Organisations that proactively support mental wellbeing can improve productivity, reduce turnover, and strengthen employer brand.(World Health Organization) 

• Early support, easy access to care, and a culture that normalises mental health conversations help reduce hidden costs and support sustainable performance. (World Health Organization) 

  
  

In an era where talent is a key competitive advantage, supporting mental health is not simply compassionate, it’s strategic. The future of work depends on organisations recognising mental wellbeing not as a fringe benefit, but as a core driver of performance.