Research paper · RP51

Presenteeism Priced

Mental ill-health does not only empty chairs. It fills them with people who are physically present and economically half-there. Across verified cost-of-illness and productivity-loss studies published between 2000 and 2026, presenteeism costs attributable to mental ill-health ranged from about US$700 to US$8,000 per affected employee per year in 2024 prices (roughly ₹60,000 to ₹6.7 lakh), and from about US$90 to US$1,350 per employee when the same bill is spread across the whole workforce (roughly ₹7,500 to ₹1.1 lakh). That is a converted range, not a pooled mean. A conventional random-effects meta-analysis of Hedges g was not performed. The eligible literature is observational cost-of-illness work, not randomised trials, and the estimates are not combinable. The same person, priced with two questionnaires, two wage bases, or two costing methods, can generate a threefold swing. Presenteeism commonly costs five to ten times as much as sick leave among people with depression; published ratios run from 1.4 in Japan to 14.2 in the United States. Seventeen sources met eligibility for narrative synthesis. Zero eligible randomised trials reported a per-employee presenteeism cost as a primary outcome. Instrument type, denominator (affected staff versus the whole payroll), human-capital versus friction-cost valuation, and country wage levels explained most of the variance. India still lacks a peer-reviewed, professional-wage, per-employee presenteeism price. The widely cited Indian total — ₹51,000 crore of presenteeism inside a ₹1.1 lakh crore mental-health bill — comes from a 2022 consultancy model that imputed presenteeism as three to four times absence, rather than measuring on-the-job performance. For working adults in India the practical implication is not a single invoice. It is that programmes which only count sick days will miss the larger share of the bill. Certainty that presenteeism exceeds absenteeism is moderate. Certainty around any one global rupee figure is very low.