Mashadi Mtoba | The real cost of depression at work

The World Health Organization estimates that 12 billion working days are lost every year to depression and anxiety, at a cost of US$1 trillion in lost productivity, with 15% of working-age adults living with a mental disorder at any given time.

South African data reveals a similar picture. A 2024 survey of 963 employees by the South African Depression and Anxiety Group (SADAG) and workplace engagement platform Heads Up found that 52% were living with a diagnosed mental health condition, 32% specifically with depression, and that 60% wished they could afford to leave their jobs.

The cost you can't see on a spreadsheet

Absenteeism is the visible cost, the one that shows up on a leave register. The bigger cost is harder to see. It's presenteeism, a term used to describe employees who are physically at work but too unwell to function at capacity.

A peer-reviewed study examining the workplace impact of depression across eight countries, including South Africa, found that presenteeism costs are consistently five to ten times higher than absenteeism costs.

A 2025 systematic review by University of Johannesburg researchers, published in the SA Journal of Industrial Psychology, examined 14 South African workplace studies and identified depression, anxiety and burnout as recurring workplace mental health challenges. The findings reinforce the need for employers to recognise mental health as part of the broader employee wellbeing and productivity conversation.

"Employers budget for absence. What they don’t budget for is the employee who is at their desk and not able to work, and that is where most of the cost sits,” says Mashadi Mtoba, Head of Disability Management at Momentum Corporate, explaining that depression is a workforce risk before it is a claim.

The workplace response matters

South African employment law also provides protections and guidance around disability, reasonable accommodation and incapacity. Where a mental health condition affects an employee's ability to work, employers may need to consider appropriate accommodation and alternatives rather than treating absence or reduced capacity as simply a performance issue.

In other words, supporting an employee's mental health isn't just good practice - for South African employers, much of it is a legal baseline.

The return-to-work evidence points to the role of workplace support

A 2025 study published in the African Journal of Disability drawn from Momentum Corporate's disability claims database, examined 514 South African disability claims for depression. It found that 48% of claimants returned to work within six months.

Arguably the most interesting finding of this study was that workplace support was the single strongest predictor of a successful return to work. Where employers provided high levels of support, 94.5% of claimants returned to work. Where support was low, that figure dropped to just 34.2%. Only 21% of claims lasting longer than 24 months resulted in a return to work.

The study is observational, so it does not establish that workplace support alone caused this difference. But it does point to the important role the workplace can play in the return-to-work journey.

“The diagnosis tells us what someone is dealing with. But this research shows that what happens around the employee matters too. Workplace support was strongly associated with whether someone returned to work,” says Mtoba.

Where group insurance fits in

Group insurance, the cover an employer arranges on behalf of its employees, sits at the intersection of this evidence.  By providing benefits such as critical illness and disability cover, it offers financial protection while helping employees navigate health-related challenges that may affect their wellbeing, ability to work, or earning capacity. It also supports recovery and facilitates a sustainable return to work wherever possible.

For employers, these services form part of a broader approach to supporting employees through periods that can have both financial and personal consequences.

The role of group insurance, therefore, extends beyond paying a claim. Depending on the cover and services available, it can form part of a broader support system that helps employees and employers navigate illness, absence and return to work.

“Leaving no one behind starts with noticing who is struggling to stay,” concludes Mtoba.

*Mashadi Mtoba, Head of Disability Management at Momentum Corporate.