A long-term study tracking more than 18,700 working adults found that even moderate psychological distress can negatively affect job performance. The research, published in the European Journal of Health Economics, shows that the impact is not sudden but appears gradually as tasks take longer, focus becomes harder to maintain, and effort feels greater than the work requires.
Researchers used data from eight rounds of an Australian survey collected between 2007 and 2021, covering 70,973 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 tracked three workplace outcomes: how often people missed work due to illness, whether they showed up while unwell (presenteeism), and whether they were working fewer hours than they wanted.
Moderate distress leads to measurable productivity loss
The data shows that psychological distress does not need to reach a high level to affect work. Workers with moderate distress were already missing more days due to sickness and were more likely to show up while unwell compared to their low-distress peers. Workers with high distress showed even steeper numbers across both measures.
Workers with moderate distress took more sick days than those with low distress, and those with high distress missed even more. Presenteeism was significantly higher among workers with moderate or high distress. This pattern drains output without ever appearing on an absence record. The primary analysis did not find a strong link between psychological distress and working fewer hours than desired.
The financial toll is clear. Workers with high psychological distress incurred an estimated AUD 3,656 more per year in presenteeism-related costs compared to those with low distress. This cost comes from showing up while struggling.
Presenteeism is often overlooked
Of the three measures, presenteeism is the most subtle. It does not show up in absence records or trigger a conversation with a manager. It can erode focus, decision-making, and work quality in ways that are easy to attribute to something else. Many people with moderate psychological distress do not think of themselves as struggling. They are functioning and showing up, but functioning and thriving are not the same thing.
Psychological distress does not always look like a crisis. It often shows up in small, easy-to-dismiss ways. Difficulty concentrating makes tasks that used to feel manageable take more effort and time. Reduced motivation makes it harder to start or finish projects. More mistakes occur due to mental fatigue. Irritability and lower frustration tolerance can affect how people work with others. Procrastination tends to increase when emotional reserves are running low. These are not character flaws but signals worth paying attention to.
Small habits can support mental health at work
Small, consistent habits can make a real difference for how people feel and how they show up at work. Regular physical activity is one of the most well-supported tools for easing psychological distress. Even moderate movement, a 20-minute walk or a short strength session, can lower stress hormones and lift mood. Consistency matters more than intensity.
Protecting sleep is also important. 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. Short breaks throughout the workday, even five minutes away from a screen, help the brain reset. Stepping away is not slacking. It protects focus and reduces mental fatigue over the course of a day.
Setting boundaries around work hours is another key step. Blurred lines between work and personal time are a known driver of psychological distress. Establishing clear start and end times and protecting time off from work notifications can help reduce low-grade stress that builds up over time. Reaching out for support before hitting a wall is also important. The time to act is before things feel urgent. Talking to a therapist, leaning on a trusted colleague, or simply naming what you are feeling can help.
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 is where much of that loss happens. Tending to mental health early, through movement, sleep, boundaries, and support, is a direct investment in how people perform and how they feel.
