The cost of silence: workplace bullying, mental health and short-term economic costs among non-medical healthcare workers in the Czech Republic

Workplace bullying is a critical occupational health concern in healthcare settings, yet systematic evidence from Central and Eastern Europe remains limited, particularly regarding its economic implications. This study examines the prevalence of workplace bullying among non-medical healthcare workers in the Czech Republic and its association with mental health outcomes and short-term direct costs (impacts on public budgets). A cross-sectional survey was conducted with 317 non-medical healthcare workers using the Negative Acts Questionnaire–Revised (NAQ-R) to assess bullying and the SUPOS-7 test to evaluate psychological responses. Economic data from national databases provided insight into financial implications. Results indicate substantial variation in bullying prevalence depending on measurement criteria, ranging from 17.35% (self-evaluation) to 37.85% (loose behavioural criteria). Higher exposure to work-related bullying was significantly associated with elevated symptoms of depression (β = 0.548) and anxiety (β = 0.498) as well as with reduced mental well-being (β = −0.468). Short-term direct cost modelling suggests that bullying-related sickness absence represents a non-trivial financial burden for public budgets. These findings support the need for organizational prevention strategies, leadership training and clearer institutional reporting mechanisms within Czech healthcare settings. Longitudinal research is needed to examine causal pathways and long-term and indirect costs.