Rising Mental Health-Related Sick Leaves Strain Catalunya's Healthcare System Amid Controversial Response

In Catalunya, the number of work-related sick leaves has nearly doubled from 1.3 million in 2017 to 2.3 million in 2024, affecting a workforce of about 3.8 million. This significant increase largely stems from a rise in mental health issues and is compounded by long waiting lists and resource shortages in the public healthcare system.

The average duration of a sick leave due to mental health disorders now stands at 81 days, compared to 52 days for musculoskeletal problems. The health authorities, specifically the Conselleria de Salut, have proposed a controversial measure to financially incentivize primary care centers to reduce the length of these sick leaves by allocating an additional 5% budget for successful reductions.

However, this proposal has sparked strong criticism. Metges de Catalunya (MC), the medical union, condemns the initiative for placing economic considerations over clinical criteria in managing sick leaves. MC warns that this could lead to ‘forced returns’ to work, jeopardizing the trust between patients and doctors. They argue that only clinical assessments and medical necessity should dictate sick leave durations. Furthermore, MC stresses that any additional funding should strengthen primary care services directly toward a target of allocating 25% of healthcare resources to primary care.

Operational issues in the healthcare system contribute significantly to prolonged sick leaves. Diagnostic testing waits, such as 66 days for MRIs and 188 days for specialist consultations, delay accurate diagnosis and treatment. Additionally, there is a notable shortage of clinical psychologists resulting in waiting times up to 60 days for psychological evaluations, further hampering timely care for mental health patients.

Experts note that similar incentive schemes in other countries have increased pressure on healthcare workers and sometimes compromised patient care quality. These conditions underscore the urgent need to address structural underfunding in Catalunya's public health, where spending per inhabitant has decreased from 1,770 euros in 2010 to 1,426 euros currently.

As discussions continue, the balance between managing healthcare resources, protecting patient welfare, and ensuring sustainable sick leave practices remains a pressing challenge for Catalunya’s health system.