[Source: Reuters]

Germany’s plans to tighten sick-note rules may be mistaking the symptoms of rising absenteeism for the underlying illness, researchers say, pointing to mental health strains and deteriorating working conditions in sectors such ​as healthcare and education.

Workers in Germany took an average of about 22 days of sick leave in 2024, among the highest levels internationally.

That figure, from the association of ‌company health insurers BKK, jumped sharply in 2022 after the introduction of electronic sick-note reporting, which improved the recording of short-term absences.

Under plans agreed by Chancellor Friedrich Merz’s coalition, telephone sick notes would be scrapped and employers could require medical certificates from the first day of absence, part of a broader push to raise productivity in an economy grappling with an ageing population and years of weak growth.

But researchers studying sickness, mental health and labour markets increasingly point to deeper problems in professions where absenteeism ​is high, such as nursing, care work and teaching.

They cite chronic understaffing, low pay, weak career prospects and high emotional demands as risk factors for poor mental health in those professions.

In 2024, ​the latest year for which sectoral data is available, women in healthcare and social work took on average 27 sick days and teachers took 24, compared ⁠with 18 in finance and 16 in communication, BKK data shows.

“It doesn’t need to be a full-blown depression,” said Johannes Siegrist, an emeritus professor at the University of Duesseldorf. “It can also be a state of ​exhaustion or burnout as a result of problematic working conditions.”

Mental disorders account for only 4.8% of sickness cases, but when they occur they lead to 28 days of absence on average, according to data from AOK, ​Germany’s largest health insurance provider.

The number of sickness leave days taken by AOK members due to mental health issues has risen by 47% since 2014, making it the second-biggest cause of absence after respiratory diseases.