Mental illnesses become top cause of sick leave in German states as respiratory cases decline
DAK health insurance data shows that for the first time since 2022, mental illnesses were the primary reason for sick leave in the first half of 2026 in Bavaria and Hesse, while respiratory illnesses fell sharply across all three states surveyed.
Mental illnesses including depression, anxiety and adjustment disorders became the most common cause of sick leave for DAK-insured employees in Bavaria and Hesse in the first half of 2026, overtaking respiratory diseases for the first time since the diagnosis reclassification in 2022. In Bavaria, mental health-related absences rose 12 per cent, while respiratory sick days fell roughly 25 per cent to 142 days per 100 employees. In Hesse, mental health absences also rose 12 per cent, and respiratory illnesses fell 21 per cent to 195 days per 100 employees. In Baden-Württemberg, respiratory illnesses remained the top cause despite a 22 per cent fall to 152 days per 100 employees; mental illness-related sick leave increased 11 per cent. Overall sickness rates dipped 0.2 percentage points in all three states, while average absence duration crept up from 9.0-9.3 days to 9.2-9.6 days.
It gives employees the opportunity, depending on their health situation, to gradually stay in working life or return to work without having to decide between full fitness for work and full incapacity.
The analysis, carried out by the Berlin-based IGES Institute for DAK-Gesundheit, covered around 312,400 insured in Bavaria, 238,200 in Hesse and 243,700 in Baden-Württemberg.
