Category: Blog

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.

By Belén Ureña

Addressing mental health as an integrated strategy at the corporate level can significantly reduce workplace absenteeism, which threatens the competitiveness of Spanish companies. Currently, Spain leads the European ranking for workplace absenteeism due to temporary disability. Every day, 1.5 million Spaniards do not go to work, 85% of whom are on sick leave. This situation is pushing Spanish employers to the limit: the estimated economic cost to businesses by 2025 is 32 billion euros, or 3% of GDP.

In this context, sick leave due to mental and behavioral disorders is growing the fastest, as noted in the latest report on the Economic Impact of Workplace Absenteeism (2019–2025) by the Council of Economists, with growth exceeding 26%. Factors such as work-related stress, burnout syndrome, and anxiety have driven the rise in these cases, directly impacting businesses. Another notable figure is the average duration of these cases, which has increased by 7.90% nationwide in 2024. Prolonged absences pose a real challenge, both for the reintegration of employees and for the stability of the Social Security system. According to applicable regulations, temporary disability leave for general causes (ITCC) has a maximum duration of 365 days, extendable for an additional 180 days. Surprisingly, mental health is the leading cause of temporary disability among people under 30, with the highest rate observed among women aged 20 to 30. Not surprisingly, the use of antidepressants has increased by 50% over the past 10 years. Due to the psychological nature of the cause of the leave, an increasing number of workers remain in this situation beyond 545 days, forcing private insurance companies—that is, the private sector—to bear the costs of the benefits. In fact, many of these prolonged leaves of absence tend to become chronic in the absence of an effective return-to-work strategy. The lack of early intervention and the stigma associated with mental health issues exacerbate the situation, making it difficult to return to work.

What is the government doing about this? What policies is the EU implementing?

To date, it does not appear that government measures will provide much relief for businesses; rather, they seem aimed at passing the “hot potato” to private health insurance companies to reduce Social Security costs. Currently, the Ministries of Health and Labor are working to have work-related mental illnesses—depression, anxiety, and stress—recognized as occupational hazards. And far from being a solution, this could worsen the situation for the private sector since the criteria for assessing the link between a work-related stressor and a mental disorder cannot be clinically proven with 100% certainty, and the final decision rests on a judgment of reasonable probability. Doctors point out that it is difficult to distinguish between work-related stress and other concerns stemming from uncertainty surrounding employment, housing, the cost of living… which affect the vast majority of people of working age. This reality is corroborated by a study conducted by Mutua Madrileña in collaboration with the Spanish Mental Health Confederation, in which 74.7% of Spaniards believe that mental health has worsened and cite economic difficulties (91%), uncertainty about the future (89%), and the pressure, demands, and stress of daily life (88%) as the reasons behind this decline.

In this context, medical judgment prioritizes the patient’s health, and to avoid taking certain risks, sick leave ends up being extended, as the figures show.

On the other hand, within the European Union, it does not yet appear that programs such as MH4HRM—which has a budget of 400,000 euros and is designed to channel aid to companies in the field of mental health prevention—will be sufficient.

In this scenario, once again, it falls to employers to “take the bull by the horns” to tackle this problem, with preventive measures integrated into talent management. Although there is still a long way to go, beyond our borders, there are companies that are already doing so, with a very positive impact on their bottom line. To cite one example, Unilever provides mental health first aid training, promoting an open dialogue that breaks down traditional stereotypes. Since its implementation, the company has seen a 25% reduction in absenteeism due to mental health issues.  Furthermore, internal surveys show that 80% of employees are more engaged in their work and have greater confidence in their roles, contributing to a 12% increase in overall productivity in the company’s most strategic areas.

At Deloitte, employees receive training to support and help their colleagues cope with the challenges posed by mental health conditions. In addition, the company organizes mental health workshops and provides access to confidential therapy services. This approach has significantly reduced mental health-related absences by 15%, while increasing employee satisfaction by 30%. The transformative effect of these measures in numbers: teams where they have been implemented see a 10% increase in productivity compared to others.

To cite one final example, Microsoft has integrated mental health into its corporate strategy with employee assistance programs that offer confidential, free therapy for temporary needs as well as active listening services. Internal surveys reveal a 15% increase in productivity in the areas where these measures have been implemented.

These models highlight the profound impact that mental health training, prevention, and intervention programs have in the workplace. As a hub of social development, the company takes on this role of care and protection while simultaneously improving its bottom line and attracting talent.  According to a study by PwC and the Transforma España Foundation, 80% of young people prioritize working at companies with clear purposes and values, and 78% value flexibility and well-being more than salary and traditional job stability. The study delves into their motivations,  indicating that more than 50% would commit to an organization that contributes to the common good and generates a positive impact on its surroundings. In turn, younger people are drawn to a management style based on listening, empathy, and accessibility, rather than vertical, command-and-control hierarchical structures.

In Spain, there are already companies implementing these kinds of improvements, even though it remains taboo to speak openly about mental health conditions and their symptoms. More and more organizations are choosing to train their employees in prevention, which, based on accumulated experience, is the cornerstone of transformation—a process in which the company plays a fundamental role. It is time to align mental health care with the vision, mission, and results of Spanish companies.