Sick leave levels tend to rise during good times

Musculoskeletal illnesses have been the most common cause of long-term sick leave in Finland for decades. While this is still the case, psychological ill health might very possibly take over as the most common cause of long-term sick leave in the coming years. 

In 2018, 74,300 people in Finland were on long-term sick leave due to psychological ill health. That is more than the number of citizens in Lappeenranta, Finland’s 13th most populated city.

“This is absolutely a worrying development,” says Jenni Blomgren, head of the research team at the Social Insurance Institution. Blomgren has looked at Finnish sick leave numbers for many years. The good news is that Finland saw its lowest ever sick leave figures two years ago (the statistics go back to the late 1960s). Yet although the total sick leave figures have fallen dramatically in Finland since the “peak years” in the early 1970s, sick leave remains expensive both for the individual employee, for the employer and for society as a whole.

“If our society has failed to rise to the challenge before, it is high time we take psychological ill health seriously now.”

Jenni Blomgren pauses briefly to point to some graphs in her office. There is no single thing that can explain the current increase in the level of sick leave, but the strong Finnish economy is an important factor.     

To support its argument, the Social Insurance Institution uses statistics over sick leave where sick pay is paid to workers who have been off for at least ten days in a row. Around 10 % of working-age people have been on long-term sick leave in recent years in Finland.

“A lot of research from Finland and elsewhere shows that a strong economy, which allows companies to hire more people, results in people who might have been unemployed for health reasons entering the labour market. When they do, the level of sick leave among workers tends to rise, as people with bad health are now also part of the labour market.”

Jenni Blomgren adds that sick leave levels fall during a recession.

“When the economy was struggling in the wake of the crash in 2008, unemployment rose while the sick leave level sank.”

Between 2008 and 2016, many rejoiced over the downward trend in the number of people on long-term sick leave

“I think many people believed that added occupational health measures now really were starting to bear fruit – that we were succeeding in reducing job strain. But since 2016 we’ve seen that sick leave is on the rise again.”

Why does sick leave increase specifically because of psychological ill health?

“Unemployment is often linked to different kinds of mental health issues, and you are also more prone to develop psychological problems when you have become unemployed – especially if this lasts for a longer period of time.”

Blomgren also points out that working life has become more demanding in many ways, there is more pressure. Within more and more occupations, employees are very much expected to update their skills and secure fresh knowledge.

“You are expected to manage to deal with more and more complicated tasks in a shorter amount of time.”

Psychological explanation

Another explanation for why more people take sick leave while the economy is booming – well, it too is psychological.

“When employment levels are high, people dare to take sick leave. Sick leave levels rise when employees are less worried about losing their job.”

And the other way around: if the economy is struggling, people force themselves to go to work even when they are ill.

“When there is a permanent threat of cooperation negotiations in a workplace, people fear that those who have been off sick will be the first to go.”

Sick leave due to psychological problems has increased gradually since the 1990s. This is also shown in the Social Insurance Institution’s statistics.

A masked problem

“That is when psychological ill health really became recognised, and the issue became a subject for public debate. Before then, mental problems had been hidden away, and when you needed to apply for sick leave psychological ill health could be “masked” as back pain, for instance.”

Early retirement linked to psychological ill health has also been on the rise in recent years.

“Both long-term sickness benefits and early retirement money are linked the fact that the recipient has reduced work ability. If you have been off sick for a year and remain sick, you can apply for early retirement because you are unable to work. There has been a dramatic increase in the past year of people taking early retirement because of psychological ill health.”

But taking early retirement is not a finite decision, says Jenni Blomgren. In Finland, early retirees can return to work. And as Jenni Blomgren points out several times during our interview: economic swings can only partly explain the swings in sick leave figures. Many Finns still take sick leave regardless of how the economy is faring.