Psychological Stress at Work: The Overview
Mental health conditions have for years been among the most common causes of long sick leave and of disability pensions in Germany. This article carries only figures that appear in a named primary source with a data year and a stated reference population. Where no solid source exists, no figure is given.
For employers these data matter directly: § 5 (3) no. 6 ArbSchG requires them to identify and assess psychosocial risk factors.
Sick Days Due to Mental Health Conditions
Figures on sickness absence come from different data sources with different populations. BAuA projects onto all employees in Germany, while health insurer reports cover only their own members. Two figures from different sources are therefore not directly comparable.
- BAuA, all employees in Germany, 2024: 881.5m sick days in total, of which 147.3m fell into diagnosis group F00-F99 (mental and behavioural disorders), that is 16.7% of all sick days. After musculoskeletal disorders (171.3m) and respiratory diseases (159.2m) this is the third largest of the reported diagnosis groups
- BKK, employed BKK members, data year 2023: mental disorders accounted for 16.7% of all sick days but only 5.1% of all cases. The report covers employed members, meaning compulsory and voluntary members together; for employed compulsory members alone it states 16.6%. That this matches the BAuA value is a coincidence of two populations and two data years, not a mutual confirmation
- DAK, employed DAK members, 2024: 342 sick days per 100 insured due to mental illness, based on around 2.42 million employed DAK members. This measures days per 100 insured, not a share of all sick days
- Burnout: not a stand-alone mental diagnosis. It is coded in diagnosis group Z73. Sick days in that group rose from 101.6 per 1,000 AOK members in 2015 to 186.0 in 2024 (WIdO Fehlzeiten-Report 2025, reference: employed AOK members)
Economic Costs
BAuA estimates the economic loss from sickness absence in two figures: lost production, valued at labour cost, and lost gross value added, valued at labour productivity. The second already contains the first. They must not be added together.
- All diagnoses 2024: EUR 134bn lost production, EUR 227bn lost gross value added
- Mental and behavioural disorders (F00-F99) 2024: EUR 22.5bn lost production, EUR 38.0bn lost gross value added
- Per sick day across all diagnoses: EUR 152 lost production, EUR 258 lost gross value added
Of the disability pensions newly awarded in 2024, 40.4% fell into the psychosomatics and psychotherapy indication group, that is 69,294 cases (Deutsche Rentenversicherung Bund 2025). The reference population is newly awarded disability pensions only, not all pension awards.
Risk Factors to Assess
The GDA guideline groups the factors to be assessed into six areas: work content and task, work organisation, social relations, work environment, work equipment, and working time. "New forms of work" is not an area of this guideline; the term comes from the older survey form used in the GDA Psyche programme 2013 to 2018, which is why it appears in the coverage rates below. The two frameworks must not be mixed.
The GDA closing report on the Psyche programme records which areas the inspected businesses actually covered: "working time, work organisation" 63% (a single combined field in the survey form, hence one shared value rather than two areas at 63% each), work content and task 62%, work environment 54%, social relations 50%, and new forms of work only around 13%. The reference population is roughly 13,000 businesses visited in the programme; the 12,975 entries in the report are inspection records (11,167 first inspections, 1,184 re-inspections, 124 unassignable), not unambiguously individual businesses. The report states they are not a random sample.
Compliance Gap: What the GDA Data Actually Shows
The GDA report on the business and employee survey 2023/24 (published by the NAK office at the BAuA; 3,817 businesses, business-survey fieldwork September 2023 to March 2024) reports two rates: 68% of all businesses run a risk assessment (2015: 52%), and 65% of the businesses that run one also cover mental load. By size: micro businesses with up to 9 employees 61% (2015: 42%), businesses with 10 to 49 employees 85% (2015: 71%). Older inspection data use a different reference population: 47.4% of the roughly 13,000 businesses visited in the GDA Psyche programme 2013 to 2018 had no risk assessment of mental load, and those businesses are not a random sample. No official source reports a rate for the share of all businesses holding a GB Psych. From 2026, state authorities must inspect at least 5% of the establishments in their state each year under § 21 (1a) ArbSchG. Fines of up to EUR 30,000 apply where an enforceable order by the supervisory authority under § 22 (3) ArbSchG is breached.
