For the first time, mental illnesses are the main cause of employee absenteeism in Germany. This emerges from the DAK health analysis for the first half of 2026, for which the Berlin IGES Institute evaluated data from around 2.2 million employed DAK insured persons.
While most employees in the Federal Republic previously reported sick because of respiratory problems, they are now doing so because of psychological suffering. At least when it comes to the number of days absent.
21 percent fewer days of absence due to respiratory illnesses
For the first half of 2026, DAK-Gesundheit recorded a decrease in days of absence due to respiratory diseases by 21 percent to 175 sick days per 100 insured people. When it comes to mental illnesses, however, the figure rose by nine percent compared to the first half of 2025 to 184 days of absence per 100 insured people. Illnesses of the musculoskeletal system remain in third place with 174 days of absence per 100 insured people.
The 2026 health report from the Barmer health insurance company paints a similar picture: although mental illnesses are not the main driver for the number of sick notes there, but rather respiratory diseases, mental illnesses lead to the longest downtime. Last year, one fifth of all days absent due to illness were due to mental illness and behavioral disorders. On average, individual sick leave due to mental illness lasted an average of 40 days per case.
Exactly which mental illnesses are driving up sick days is not immediately clear from the health insurance company reports. Figures from the German Society for Psychotherapy, Psychosomatics and Neurology from June 2025 provide further insights: According to this, 27.8 percent of adults in Germany are affected by a mental illness every year. These primarily include anxiety disorders, depression and disorders caused by alcohol and medication use.
Sick leave in Germany will fall in the first half of 2026
Apart from that, the DAK health analysis shows a positive development: sickness rates in Germany fell slightly in the first half of 2026 for the first time since the mid-2000s. Compared to the first half of 2025, it fell by 0.1 percentage points to 5.3. This means that in the first six months of this year, an average of around 53 out of 1,000 employees were on sick leave every day.
“The slight decrease in sick leave is encouraging,” says DAK CEO Andreas Storm. “Our analysis shows how quickly absenteeism can increase or decrease due to real illness.” During the corona pandemic, for example, there were fewer respiratory diseases due to the protective measures. After the pandemic, there was another increase as many people’s immune systems had to get used to the viruses that they had not been exposed to for a long time due to social distancing regulations. There was also a sharp increase in absenteeism from 2021 to 2022, but this was largely due to the introduction of the electronic certificate of incapacity for work.
However, according to the DAK analysis, the average duration of sick leave has increased minimally. It averaged 9.7 days in the first half of the year. In the first half of 2025 the value was 9.5 days.
Age groups: Younger employees get sick less often – older people get sick more often and for longer periods of time
When looking at the different age groups, there are strong differences: While sickness rates fell across the board for employees under 55, they developed in the opposite direction for older people.
The sharpest decline occurred among the youngest workers. For 15 to 19 year olds and 20 to 24 year olds, sick leave fell by 0.3 percentage points each. A December 2025 Indeed survey shows that presenteeism plays a big role among younger generations, especially Gen Z. They often prefer to go to work when they are sick because they are worried that it would otherwise affect their own career prospects or because they believe that their manager expects them to. However, among those over 60, sick leave rose by 0.3 percentage points. It is not the number of sick reports that has increased, but rather their duration.
Compulsory medical certificate from the first day of illness: Does it solve the problem?
The current developments in sick leave only fit to a limited extent with the political discussions on absenteeism in Germany. In its eyes, the federal government wants to reduce the excessive absenteeism among employees in Germany through measures. A much-discussed measure is the requirement to provide a certificate from the first day of illness.
For many experts, the question arises as to whether the new compulsory certification actually achieves the goal of reducing absenteeism. Anyone who has to go to the doctor for a single day of illness may be put on sick leave for a whole week so that neither the practice nor the patient is put under unnecessary strain. Christian Lorenz, Managing Director of the German Society for Personnel Management (DGFP), warns that this could then have the opposite effect: higher sickness rates.
The current data from DAK-Gesundheit also shows that the real problem may lie somewhere else: with long-term illnesses instead of short-term illnesses such as explanations or gastrointestinal infections. They are often accompanied by longer downtimes. It remains questionable whether requiring a certificate from the first day actually reduces absences.
Need for action for employers and HR: Company health promotion is moving into focus
However, in order to better integrate employees with long-term illnesses back into the world of work, there was also a political proposal: partial sick leave. In view of the current figures, DAK boss Andreas Storm welcomes the planned prevention offensive by Federal Health Minister Nina Warken (CDU).
She presented the initiative in Berlin last Thursday. The aim is to further develop the Prevention Act of 2015. Particularly relevant for human resources managers: In the future, small and medium-sized companies should be given greater support in corporate health promotion. However, it is not yet clear what this will look like in concrete terms.
This is how employees with mental illnesses can be supported:
- Train employees to become “First Aiders”. They can serve as the first point of contact for those affected and refer them further.
- Create a corporate culture in which mental health is discussed openly and without prejudice and which adapts as flexibly as possible to the needs of mentally impaired people.
Mara Marx is a volunteer at Human Resources.
