Associations between workplace aggression and subsequent mental distress and sick leave among home care workers

The Norwegian home care sector faces staff shortages and high sick leave due to common mental disorders, often linked to work-related stress. This study examined associations between workplace aggression (threats/violence, bullying, and unwanted sexual attention) and subsequent mental distress and sick leave among home care workers. A total of 1426 employees (baseline n = 2591) from 130 randomly selected home care services completed surveys on workplace aggression and mental distress (HSCL-5 > 2) at baseline, 8 months, and 14 months. Registry data on medically certified sick leave (with diagnostic codes) were obtained for 1819 participants over 26 months. Mixed-effects lagged logistic regression estimated odds of mental distress, and negative binomial regression calculated incidence risk ratios (IRRs) for sick leave due to mental disorders. All types of workplace aggression were associated with increased risk of clinically relevant mental distress. Only colleague-perpetrated bullying significantly predicted sick leave for mental disorders (IRR 1.62, 95% CI 1.17–2.23). Workplace aggression was common and associated with poorer mental health and increased absenteeism. Targeted, multicomponent interventions are needed to prevent aggression and reduce its mental health impact.