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What Lost Readiness Costs Employers in the UK, US, Canada

From the team · · Updated

In short

Poor mental health costs employers tens of billions a year in each of the UK, the US and Canada. The largest share in every country comes from presenteeism, people at work while unwell, which absence records miss. Employers who act early get the best return, but most employer spending still goes to costs after harm is done.

Man resting his head on his hand at a desk, with a laptop showing a falling productivity chart

Poor mental health costs employers tens of billions a year in each of the UK, the US and Canada, and the largest share comes from people who are at work but unwell. Deloitte UK puts the UK employer cost at £51bn a year. Gallup puts the cost of mental health absence alone at $47.6 billion a year in the US. A 2026 CSA Group report estimates that Canadian employers carry about $110 billion of a $180 billion national cost. Each study measures something different, so the figures do not add up or compare directly. All of them point the same way: the cost is large, most of it is invisible in absence records, and early action returns more than late action.

How much does poor mental health cost UK employers?

Deloitte UK estimates £51bn a year. Its 2024 report, based on a YouGov survey of 3,156 UK working adults in October 2023, found:

  • The total is up from £45bn in 2019.
  • Presenteeism, people working while unwell and below their full ability, is the largest part at about £24bn.
  • 63% of respondents showed at least one sign of burnout, up from 51% in the previous survey.
  • Working parents' worry about their children's mental health costs UK employers about £8bn a year through time off, lower performance and people leaving.

Government data shows the same pressure. The Health and Safety Executive reports that 964,000 workers in Great Britain had stress, depression or anxiety caused or made worse by work in 2024/25. HSE estimates those conditions caused 22.1 million lost working days, an average of 22.9 days per affected worker.

How much does poor mental health cost US employers?

US estimates run from about $48 billion a year for absence alone to more than $80 billion a year for the workplace cost of depression. They measure different things.

Gallup's 2022 analysis surveyed 15,809 US working adults from August 23 to September 7, 2022:

  • 19% of US workers rated their mental health as fair or poor.
  • Those workers had an estimated 12 days of unplanned absence a year, compared with 2.5 days for all other workers.
  • Across the US workforce, that missed work costs an estimated $47.6 billion a year in lost productivity.

Gallup's figure counts days off only. It does not include people who come to work unwell.

A 2023 study in Advances in Therapy by Greenberg and colleagues looked at major depressive disorder alone. In 2019, 19.8 million US adults had the condition, and its total cost to society was $333.7 billion. Two of the cost lines fall directly on employers: presenteeism at $43.3 billion and absenteeism at $38.4 billion. Presenteeism was the larger of the two.

How much does poor mental health cost Canadian employers?

The most recent Canadian estimate puts the employer share at about $110 billion a year. The CSA Group Public Policy Centre's 2026 report, The Economic Cost of Mental Health in Canada, estimates the national cost at $180 billion a year. As reported by Canadian HR Reporter, the report found:

  • Employers carry about $110 billion, through disability claims, benefits, lost productivity and related costs.
  • About 14% of employer spending, roughly $15 billion, goes to prevention. The other 86% is spent after harm has occurred.
  • Presenteeism costs about $12 billion a year, nearly 90% of the indirect costs the report could measure.
  • On the current path, the authors project the annual cost could reach $600 billion by 2050.

The scale of need is clear in Statistics Canada's 2022 survey. More than 5 million people in Canada, 18.3% of those aged 15 and older, met the criteria for a mood, anxiety or substance use disorder in the previous 12 months. Generalized anxiety disorder doubled from 2.6% in 2012 to 5.2% in 2022, and major depressive episodes rose from 4.7% to 7.6%.

Why is presenteeism the largest cost?

Presenteeism is the largest cost because people with poor mental health usually keep working. They come in, but their focus, judgment and output drop. Absence shows up in HR systems, while a day of lower output at a desk leaves no record.

The three countries show the same pattern:

An employer who measures only sick days sees the smaller part of the cost. The larger part shows up later, as errors, missed targets, safety incidents and people who quit.

How big is the problem worldwide?

The World Health Organization's fact sheet on mental health at work estimates that 12 billion working days are lost every year to depression and anxiety, at a cost of US$1 trillion a year in lost productivity. WHO estimates that 16% of working-age adults had a mental disorder in 2023. The UK, US and Canadian figures above are national slices of the same global cost.

What return do employers get from acting early?

Employers get the best return from early, broad action. Deloitte UK reviewed 26 sources published since 2011 and found employers get back about £4.70 in productivity for every £1 spent on employee mental health support. Deloitte also found that early interventions, such as organization-wide culture change and education, return more than later, in-depth support.

Spending today mostly goes the other way. The CSA Group report found that 86% of Canadian employer spending on mental health goes to costs after harm has occurred.

Acting early depends on seeing a change early. Many employers rely on an annual survey and on sick-leave data, and both arrive after the change has already cost money. A more frequent, private check-in gives employees a way to notice a change in themselves, and gives leaders a view of readiness across a team without exposing any individual.

Okaya is one way to do this. It is a short, private check-in. You talk with Sanora, Okaya's AI guide, for about 3 minutes. It compares how you sound, what you say and how your expression moves today with your own earlier check-ins. It uses points from your face, not a video of you. Individual results stay private to the individual. Leadership sees anonymized, aggregated unit-level readiness only.

Key points

  • Deloitte UK estimates poor mental health costs UK employers £51bn a year, with about £24bn from presenteeism.
  • Gallup estimates mental health absence alone costs the US $47.6 billion a year. Depression's workplace cost is higher, with presenteeism at $43.3 billion.
  • CSA Group estimates Canadian employers carry about $110 billion of a $180 billion national cost, and only about 14% of their spending goes to prevention.
  • Presenteeism is the largest cost in all three countries, and sick-leave data misses it.
  • Deloitte found early, organization-wide action returns more than later support.

How should an employer compare these numbers?

Compare them by what each study counts. Gallup counts absence only. Deloitte UK counts costs to UK employers, with presenteeism as the largest part. Greenberg and colleagues count one condition, depression, across all of society. CSA Group counts employer costs that include disability claims and benefits. A figure from one study cannot be added to or subtracted from a figure from another.

For your own organization, the useful number is local: how many people are at work below their usual level this month, and how early you would know. Start with the presenteeism question, because it is the largest cost and the one your current reports are least likely to show.

To see how a short, private readiness check-in works for teams, visit Okaya.