Abstract
BACKGROUND: The COVID-19 pandemic has affected mental health worldwide, exposing gaps in managing work-related disabilities. In Spain, Mutual Collaborators with Social Security play a pivotal role in managing temporary work disabilities associated with mental health conditions. OBJECTIVES: This study aimed to describe and analyze the prevalence, characteristics, and economic burden of mental health-related temporary work disabilities in Spain during the COVID-19 pandemic and recovery (2020-2022). METHODS: A prospective longitudinal design was used, drawing on data from CHAMAN, a secure and nationally representative database managed by Asepeyo Mutual Insurance and maintained by Mutual Collaborators with Social Security (MCSSs). The study included workers who experienced temporary work disabilities due to mental health disorders diagnosed according to the International Classification of Diseases, Tenth Revision, during the COVID-19 state of alarm (14 March-21 June 2020) and in the following two years (2021-2022). The key variables were demographics, absence duration, cost per case, and relapse rates. The analyses included descriptive statistics and the Mann-Whitney U, Chi-square, and logistic regression tests. RESULTS: In 2020, 5135 cases were recorded, with an aggregate cost of approximately EUR 44.8 million. Regional analysis showed that Catalonia, Castile-La Mancha, and Castile-León accounted for over half the expenditure, whereas costs were lower in other regions. Marked declines in incidence and costs were observed in 2021-2022, suggesting adaptation to post-pandemic conditions. However, significant gender disparities persisted, with women experiencing higher relapse rates and prolonged absences. Generalized Anxiety Disorder and Major Depressive Disorder were the most common diagnoses, particularly in sectors such as retail, elderly care, and call centers. CONCLUSIONS: Although the incidence and cost of temporary work disabilities declined, persistent gender inequalities, regional disparities, and sector-specific risks highlight the need for targeted mental health interventions. Enhancing psychosocial support, adopting gender-sensitive workplace policies, and improving regional healthcare infrastructure are essential to promote workforce well-being and ensure economic sustainability.