By Carmen Labayen
Prevention is the most effective strategy for curbing the rising cost of absenteeism caused by factors such as anxiety or burnout.
Sick leave due to mental health issues has doubled in Spain over the past 10 years.
Work absenteeism has become a major challenge for Spain, which already tops the European rankings. Every day, nearly 1.6 million people in our country do not show up for work, resulting in an estimated economic cost of 32 billion euros by 2025. In this context, sick leave due to mental and behavioral disorders is growing the fastest, establishing itself as the second leading cause of sick leave and threatening to become chronic.
The figures speak for themselves: sick leave due to mental health issues exceded 600,000 cases per year in our country and has more than doubled over the past 10 years. Factors such as work-related stress, burnout syndrome, and anxiety have fueled this trend. Given this situation, a key question arises: How can we tackle the problem at its root before the worker ends up leaving the workforce?
This is also an interesting question when we consider that the average duration of sick leave due to mental health disorders is significantly longer than the average for all sick leave diagnoses combined—2.5 times longer by 2023, according to the study “Mental Health and Work 2025” by the General Union of Workers (UGT).
An investment, not an expense
For Belén Ureña, CEO of Eliza Project Mental Health, the answer lies in prevention. Far from being an expense, “training managers to recognize early signs of stress, burnout, or emotional distress is an essential measure,” she asserts. According to Ureña, this strategy has a “direct impact on reducing workplace absenteeism, which can reach up to 30 percent.”
The benefits go even further. Ureña points out that these programs foster “greater commitment within teams, improve the work environment, and boost productivity by 15% to 30%. ‘We can truly say that investing in mental health prevention is very costeffective,’ he emphasizes.
The roots of worplace distress
But why has the problem grown so much? Daniel Cohen, a psychiatrist and the project’s medical director, attributes it to a perfect storm of four factors. First, “increasingly demanding work environments” where digital disconnection is a pipe dream. Added to this are the “lack of work-life balance,” job insecurity, and—a key point—“late detection of distress.”
In Spain, according to a 2025 study by the European Agency for Safety and Health at Work, 49% of Spaniards report experiencing severe time pressure or work overload, 27% report poor communication or cooperation within the organization, 20% experience a lack of autonomy or influence over the pace or processes of work, and 10% of Spanish workers reveal that they suffer harassment—a figure that rises to 21% when the harassment or violence is perpetrated by clients, patients, students, etc.
Cohen explains that the problem often goes unnoticed ‘because the person lacks the tools to detect this distress.’ Stress becomes normalized until it is too late. ‘When we see that on Sunday afternoons, before Monday even begins, I’m already experiencing anticipatory anxiety, I’m already nervous, and I’m already having trouble sleeping—there really is a problem that has already taken hold,’ warns the psychiatrist.
Women and relationship-based jobs: the most affected groups
According to the UGT report, the sectors with the highest percentage of sick leave due to mental health issues are: retail; hospitality; health care and social services; administrative and support services; public administration and defense; and education.
In all these activities, they interact with clients, patients, service users, or students; some of these roles involve work that must be completed under tight deadlines or in urgent situations, and in some cases, work-life balance issues and other challenges arise, which “can lead to mental health problems,” they emphasize.
“The likelihood increases in jobs that must adapt—for example, now with the rise of AI—or in those that involve intense interaction with others, including the financial sector. Young women also suffer more from these types of disorders, which also affect men and executives,” explains Ureña.
First aid for the mind
The solution proposed by the Eliza Project is a training program designed as “first aid for mental health.” It’s not about turning employees into therapists, Cohen clarifies, but rather about “giving everyone the tools to perform early detection.” The training, aimed at the entire workforce equally, addresses the most common mental health issues in the workplace: anxiety, depression, substance abuse, and burnout.
The program, which has been running for nearly a year, has received very positive feedback. “It’s a very practical training program based on real-life cases,” emphasizes Belén Ureña. It includes role-playing scenarios with actors to help participants recognize warning signs that are often overlooked. The ultimate goal is twofold: on the one hand, to act before the problem leads to a leave of absence, and on the other, to ‘shorten the duration of the leave’ if it becomes unavoidable, always through prevention.
Ultimately, it’s about ‘humanizing the company,’ adds Cohen, and creating a ‘pleasant, sustainable, and healthy environment for everyone.’ A strategy that, according to Ureña, “only yields benefits, both for the employee and for the company.” At a time when companies have made mental health a strategic priority, training is positioned as the key to attracting and retaining talent and ensuring the sustainability of the system.
This must always be accompanied by corporate policies aimed at improving working conditions, including realistic work targets, reasonable workloads, and greater autonomy and support for employees— measures that also reduce absenteeism and the associated costs, 50 percent of which are borne by employers and the Social Security system.
