Sick leave for mental health conditions up almost 42 percent in ten years
Employees in Germany are increasingly and for longer periods absent from work due to mental health conditions. This is shown by the Fehlzeiten-Report 2026, the annual absence report of the Wissenschaftliches Institut der AOK (WIdO), the research institute of the AOK. The AOK (Allgemeine Ortskrankenkasse) is one of Germany’s largest statutory health insurers and has published this absence study since 1998, in cooperation with Bielefeld University and the Berliner Hochschule für Technik (Berlin University of Applied Sciences).
The number of sick days due to mental health conditions rose from 284 days per 100 AOK-insured members in 2016 to 403 days in 2025, an increase of almost 42 percent. In 2025, mental health conditions occurred less often than, for example, respiratory complaints — an average of 14.1 cases per 100 insured members versus 80.3 cases — but lasted much longer: an average of 28.5 days per case, compared with 5.7 days for respiratory complaints. According to the report, the steady rise in mental-health-related absence is a major driver of the overall increase in sick leave.
Burnout rising sharply, especially in care and social work
Among mental health conditions, burnout stands out the most: the number of sick days with this diagnosis rose from 11.0 to 19.5 days per 100 AOK members, an increase of 77 percent in ten years. The longest absences are seen for reactions to severe stress and adjustment disorders, followed by depressive episodes and recurrent depression.
The risk is not evenly spread across occupations. Workers in telemarketing, domestic and family care, elderly care, care for people with disabilities, and childcare score highest. According to Steffi Riedel-Heller, professor of social medicine and occupational medicine at Leipzig University and an author of the report, this results from a combination of high emotional strain, responsibility for others, high workload, little control over one’s own work, and limited social support from colleagues or supervisors.
Total sick leave among AOK-insured members came to 23.3 days per insured member in 2025, slightly below the peak of 24.5 days in 2022. Helmut Schröder, director of the WIdO and co-publisher of the report, notes that the introduction of electronic sick notes has structurally increased recorded absence. He also points out that concerns about one’s own financial situation and fear of unemployment go hand in hand with low mood, anger, and exhaustion. Given Germany’s persistently strained economic situation, he expects this psychological strain — and with it sick leave — to increase further. He advocates supportive provisions within companies that ease the situation for businesses, managers, and employees alike.
Context
Mental health problems as a growing occupational risk are not a uniquely German phenomenon. The European survey “OSH Pulse 2025” by EU-OSHA (the European Agency for Safety and Health at Work), published on 10 October 2025 around World Mental Health Day, found that 29 percent of workers in the European Union report stress, depression, or anxiety. More than 40 percent of European workers also experience severe time pressure, and about a third feel that their efforts at work go unnoticed.
The German figures therefore fit a broader European pattern: workload, high emotional demands, and limited recognition are identified in multiple countries as drivers of mental-health-related absence. For employers and policymakers worldwide, this underscores the need to take psychosocial risks as seriously as physical safety risks: early detection, sufficient control over one’s own work, and accessible support can help prevent long-term absence.
Source: AOK Fehlzeiten-Report 2026: mental illnesses cause increasingly long work absences, 13 October 2026
Additional research: EU-OSHA, “OSH Pulse 2025”
