Acture, a Dutch occupational health provider, recently published research that should change how leaders think about absence.
They surveyed over a thousand employees who had taken sick leave for psychological reasons. The findings: 72 percent said they had already sensed something was wrong, often months before they actually stopped working. Only 11 percent said their manager had picked up on the signals and raised concerns about it.
That gap, between what employees already know and what managers notice, is the entire problem.
Why nobody says anything first
Almost no one walks into their manager's office after the first sleepless night and puts everything on the table. People convince themselves they are strong enough to manage it alone. They do not want to burden their colleagues. They feel vulnerable, especially if their contract is temporary or their position feels less secure than others.
So they say nothing. They keep working. They keep performing the version of themselves that the job requires, while something underneath is quietly deteriorating.
This is not a failure of communication on the employee's side. It is a rational response to an environment that has not demonstrated it is safe to say something difficult before it becomes unavoidable.
What the signals actually look like
Acture's research identifies specific, early predictors of someone heading toward burnout. People become irritated more quickly than usual. They start arriving late, a few times, in a pattern that did not exist before. They stop showing up to the things that used to be automatic, the Friday afternoon drink, the informal catch-up. They seem rushed, and they struggle to separate what matters from what does not.
These are not dramatic signals. They look like a slightly different version of someone who is otherwise still doing their job. That is exactly why they get missed.
There is a more serious signal that Acture calls frequent short-term absence. Not one long period of sick leave, but several short ones across a year. Three or four times, a few days each. This, according to the research, is the group already in trouble. Not approaching a crisis. Already in one, managing to hold the rest together.
Why managers do not catch it
It is not because managers do not care. It is because noticing requires a kind of attention that the daily pace of running a company rarely allows for.
Acture's advice is specific and almost embarrassingly simple: take ten minutes, regularly, away from the rush of the day, and actually look at your team. Not at the deliverables. At the people. What do you see? Is anyone more irritated than usual? Has anyone quietly stopped doing the things they used to do without thinking?
This sounds basic. It is also almost never done. In a fast-growing company, the founder's attention goes to whatever is making the most noise. The person who is quietly struggling, who has not yet said anything, does not make noise. They get missed by default, not by neglect.
The conversation that follows
If something looks off, the next step is a conversation. Acture is direct about what that conversation can require: uncomfortable questions, including the most uncomfortable one of all. Does this role still fit who you are.
That is a harder question than "how can we lighten your workload." It requires the leader to be willing to hear an answer they may not want, including the possibility that the honest answer changes something structural about the role or the relationship.
Most leaders avoid this conversation not because they are unwilling to help, but because the question itself feels destabilising. It is much easier to offer a practical fix, fewer hours, a different project, than to ask the deeper question about fit, sustainability, and whether the current situation is actually working.
The research notes what happens when this conversation does not take place. Everything stays implicit. The employee starts feeling the employer should be doing more. The employer starts feeling the same about the employee. Left long enough, this becomes resentment on both sides, and the relationship that could have been repaired becomes one that ends instead.
The numbers worth sitting with
Acture's data on the broader workforce is worth pausing on. Roughly 5 to 8 percent of employees are currently on sick leave. Another 20 to 25 percent are in what they call the danger zone, taking frequent short absences. Of the remainder, only about 15 percent are genuinely engaged, doing work that energises rather than depletes them.
That leaves just over half the workforce in a middle zone. Not absent, not fully engaged. This is the group, according to the research, where the most impact can be made, simply by paying attention. Can they grow within the company. How do they handle change, new technology, new demands. Are they just ticking boxes through the day. That question alone, asked honestly, tells you more than any engagement survey.
If the answer suggests disengagement, the intervention is not a programme. It is a coffee. Because, as the research puts it plainly: work is supposed to give you energy.
What this means for the leaders I work with
The pattern in this research mirrors almost exactly what I see in the teams and founders I work with. The signals are rarely dramatic. They are small shifts that get explained away because there is always something more urgent to attend to.
What changes this is not a wellness programme or a new HR policy. It is the leader's willingness to notice, and then to have the conversation that follows noticing, including the parts of that conversation that are uncomfortable.
Most leaders want to be the kind of leader who sees this early. Few have built the habit of actually stepping back regularly enough to see it. The ten minutes Acture describes is not a small ask. In a fast-growing company, ten minutes of attention that produces no immediate output can feel like the hardest thing to justify.
It is also, based on what the data shows, one of the most valuable things a leader can do.
The Acture research was reported by Het Financieele Dagblad in June 2026.
Mees Loman is the founder of Loman Leadership, a leadership coaching practice for founders and leadership teams of fast-growing companies in Amsterdam and beyond. lomanleadership.com