When it comes to occupational health, companies have no shortage of measures in place: comprehensive insurance schemes, support services and, in some cases, even in-house resources. Employees, for their part, are supported by healthcare professionals. And yet, absenteeism, stress and burnout continue to rise.
In Switzerland, despite a decline in workplace accidents, the average number of days lost due to illness has risen from 6.3 to 8.5 days per full-time position between 2010 and 2024. The associated economic costs are estimated at nearly 12 billion francs per year, or around 1.5% of GDP. This finding highlights a paradox: the measures are in place, but their impact on the sustainable prevention of absenteeism remains limited.
Effective measures… but implemented too late
Doctors, insurers and companies now have structured frameworks for intervention. The doctor treats and protects. Insurance companies manage risk and, in some cases, offer preventive measures or case management services capable of supporting complex situations. For their part, some companies are well-equipped with internal resources – nurses, psychologists, occupational health doctors or trained managers – and, in the event of sick leave, contact is often established with the employee.
These systems work, and they fulfil their role. They help to stabilise situations, coordinate care, support a return to work and, in many cases, prevent more serious breakdowns.
Yet, despite this expansion of health services, absences continue to rise. This paradox is not due to a lack of skills or a lack of commitment on the part of those involved, but to the very nature of the intervention frameworks.
As far as insurers are concerned, even when a health service is in place, their involvement takes place within a structured medical-insurance framework. It generally begins once the sick leave has been declared, when the situation has already been identified, documented and often medicalised. This framework, which is essential for risk management, leaves little room, however, for exploring the more diffuse dimensions – relational, emotional or organisational – that precede sick leave and are often its real triggers.
From the company’s perspective, the availability of internal resources is not always sufficient to remove the obstacles. Organisational proximity can limit the expression of what is really at stake: out of fear of professional consequences, for the sake of discretion, or because the unease remains unclear, ambivalent and difficult to articulate. When support relies on a voluntary approach or on the ability to verbalise one’s needs, it quickly reaches its limits: a vulnerable person often tends to downplay, postpone or fail to seek help.
The real blind spot: the stages leading up to absence
In other words, insurers and employers know how to intervene – and they do intervene effectively – but mainly once the problem has become apparent. However, both research and practice show that it is precisely the stages leading up to absence – which are still informal and not yet medically diagnosed – that determine whether a situation will remain temporary or become long-term.
Before a period of absence, there is almost always a silent phase: emotional overload, relationship tensions, a loss of meaning, a feeling of insecurity or gradual exhaustion. These subtle signs are rarely expressed spontaneously, either because they have not yet been clearly identified or for fear of professional consequences.
During the absence, these human dimensions often remain in the background. The connection to work weakens, concerns about returning set in, and stress can become deeply ingrained.
Even seeking external support, however appropriate, can face practical obstacles: identifying the right resource, taking the initiative, acknowledging one’s need, or engaging with a setting perceived as therapeutic. The existence of a solution does not guarantee that it will actually be accessible when the person needs it most.
Sick leave is not merely a medical issue
Two employees with the same diagnosis may follow very different paths. What makes the difference is not just the treatment itself, but how the absence is experienced: the sense of being supported, the quality of the relationship with the organisation, and the way in which the sick leave is managed.
In the absence of a suitable forum for discussion, certain situations are automatically treated as medical issues, without the root cause – a relationship conflict, organisational mismatch, long-term overload or life event – being identified. The sick note then becomes the only possible response to a malaise that, at its origin, was often due to factors other than medical ones.
Rethinking the prevention of absenteeism
This observation does not suggest a lack of competence or a lack of commitment on the part of insurers or companies. It highlights a structural limitation: effective prevention of absenteeism must take place before the problem is formally identified, medicalised or officially recognised.
Sustainable prevention of absenteeism therefore requires earlier intervention, within frameworks capable of integrating the human, relational and organisational dimensions of work. This involves creating accessible, neutral and non-stigmatising spaces for listening, enabling action to be taken where traditional mechanisms do not yet intervene: at the precise moment when a situation could take a turn for the worse, but has not yet done so.
What practical steps should you take in the first few days of being off work?
- 👉 Read Episode 2 : Les appels systématiques – agir tôt pour prévenir les absences durables
- 👉 Talk to a CHS specialist about your occupational health concerns
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