AOK: Fehltage wegen psychischer Erkrankungen steigen um 42 Prozent binnen zehn Jahren

Sick days from mental illness rise

Mental illness is driving a growing share of work absences among AOK-insured employees, according to the Fehlzeiten-Report 2026 of the Wissenschaftliches Institut der AOK (WIdO). In 2025, mental illness caused 403 sick days per 100 AOK members, against 284 in 2016 according to Spiegel Online, an increase of about 42 percent over ten years. ZEIT ONLINE gives the 2016 figure as 248 days, so the baseline differs between reports. The analysis covers data from 14.9 million employed AOK-insured persons. The rise comes mainly from longer absences, since employees with mental health conditions tend to be off work for a long time.

Long absences, fewer short ones

Mental health sick notes are far less common than respiratory infections but last much longer. Respiratory illnesses account for 80 percent of sick notes, according to ZEIT ONLINE, yet employees with a psychological condition were off work for 28.5 days per case on average in 2025, compared with 5.7 days for respiratory illnesses. FAZ reports that statutory health insurers must pay sick pay from the seventh week of illness, and that sick pay now makes up 6.1 percent of total statutory health insurance spending, almost one percentage point more than a decade ago. Carola Reimann, head of the AOK federal association, says that the duration per case is rising alongside the number of cases.

But the number of cases, and in particular the duration per case, are rising too.

Reimann added that mental illness is an important factor in that trend.

Occupations and regional differences

Dialogmarketing, which includes call centre staff, recorded the most mental health sick notes nationally, at 32.4 per 100 AOK-insured employees, according to DIE WELT. Elder care followed with 27.5 cases per 100, and social administration and insurance with 27.4. Regional figures show similar growth. In Saxony, dpa reports 417 sick days per 100 insured employees in 2025, up from 269 ten years earlier, a rise of 55 percent. DIE WELT reports a steeper rise in Thuringia, from 275 to 461 days, or 68 percent. In Berlin, AOK Nordost counts 381 days in 2025, against about 309 in 2016, an increase of 23 percent. The Berlin figures assign insured persons by place of residence rather than workplace, so commuters from Brandenburg who work in Berlin are not included. ZEIT ONLINE and DIE WELT also differ on burn-out: ZEIT ONLINE reports a rise from 11 to 19.5 days per 100 members, while DIE WELT reports a rise from 10.2 to 21.4 days.

Causes and economic pressure

The AOK points to several overlapping causes. Spiegel Online lists political crises, the blurring of work boundaries through constant availability, and the strain of caring for relatives or children. Reimann argues that work is not only a risk factor but also a protective one.

It gives structure, orientation and stability and can contribute to a sense of personal meaning.

Steffi Riedel-Heller, a social medicine specialist from Leipzig, points to the demands of the most affected jobs.

In these occupations several psychosocial stress factors are at work that negatively affect mental health.

Riedel-Heller names high emotional demands, responsibility for other people and heavy workloads. Helmut Schröder, managing director of the WIdO, believes that financial worries and fear of unemployment could intensify in a tense economic situation.

Total sick days fall

Overall absences eased. The AOK recorded 23.3 sick days per member in 2025, after 23.9 in both 2024 and 2023, and a peak of 24.5 in the Corona year 2022. Schröder said that the 2025 level remains above the level before the electronic sick note (eAU) was introduced.

The eAU, along with other factors such as the rise in respiratory illnesses following the Corona pandemic and the steady growth in mental illnesses, has led to a more complete recording of sick notes and to an upward level shift.

In Berlin, AOK Nordost reports that the total number of sick days per insured employee fell from 21.0 days in 2024 to 20.6 days in 2025.