Is manager support related to workplace productivity for people with depression: a secondary analysis of a cross-sectional survey from 15 countries

OBJECTIVES: To examine variations in manager reactions and support for people with depression and to investigate how these reactions are related to (1) absenteeism and (2) presenteeism due to depression among employees with self-reported depression across 15 diverse countries. DESIGN: Secondary data analysis of cross-sectional survey data. SETTING: 15 countries, diverse in geographical region and gross domestic product (GDP): Brazil, Canada, China, Denmark, France, Germany, Great Britain, Italy, Japan, Mexico, Spain, South Africa, South Korea, Turkey and the USA. PARTICIPANTS: 16 018 employees and managers (approximately 1000 per country). PRIMARY AND SECONDARY OUTCOME MEASURES: We assessed level of absenteeism as measured by number of days taken off work because of depression and presenteeism score. RESULTS: On average, living in a country with a greater prevalence of managers saying that they avoided talking to the employee about depression was associated with employees with depression taking more days off work (B 4.13, 95% CI 1.68 to 6.57). On average, living in a country with a higher GDP was marginally associated with employees with depression taking more days off of work (p=0.09). On average, living in a country with a greater prevalence of managers actively offering help to employees with depression was associated with higher levels of presenteeism (B 7.08, 95% CI 6.59 to 7.58). Higher country GDP was associated with greater presenteeism among employees with depression (B 3.09, 95% CI 2.31 to 3.88). CONCLUSIONS: Manager reactions were at least as important as country financial resources. When controlling for country GDP, working in an environment where managers felt comfortable to offer help and support to the employee rather than avoid them was independently associated with less absenteeism and more presenteeism.