“Sick leave is a last resort” – how occupational health services prevent absences

At Terveystalo, we succeeded in reducing sick leave by 4 percent last year in collaboration with our occupational health clients. In total, there were approximately 275,000 fewer sick leave days than in 2024.

This success stems from the core mission of occupational health: prevention and efforts aimed at maintaining work ability.

– Many people think that the role of occupational health is to grant sick leave, says Petteri Hyrynkangas, an occupational health care doctor at Terveystalo in Oulu.

– That idea is outdated. Sick leave is a last resort; all other options should be explored first.

The goal of occupational health teams is to address early signs before they escalate into problems. Signs include, for example, repeated occupational health visits by the same individuals, abnormal results in a department or company’s Nightingale analysisOpens in a new window, or issues raised in an occupational health survey.

When an indicator raises a red flag, the team takes action. In addition to the occupational health physician, the occupational health team includes an occupational health nurse, an occupational physical therapist, an occupational health psychologist, and other occupational health experts. Occupational health nurse Niko Laaksonen is on the same team as Petteri Hyrynkangas.

– My role is to act as a case manager, says Laaksonen.

– I keep track of where we’re at and ensure that the process doesn’t stall and that the employee’s needs are met.

Job modification often supports recovery more effectively than absence

Instead of sick leave, it is increasingly recommended to modify work – for example through lighter duties or alternative tasks – as this often rehabilitates and supports remaining work ability better than staying at home.

– An employee can, for instance, agree to work more remotely on a temporary basis, making it easier to take short breaks, says Laaksonen.

Working hours can also be temporarily reduced. Or if an employee feels that their current workload exceeds their capacity, some tasks can be temporarily delegated to other team members.

Timely support can be light and still sufficient

For example, during a life crisis, an employee may benefit from short-term psychotherapy. Its effectiveness is also reflected in sickness absence: mental health-related absences decreased by 45% and other sickness absences by 19% in companies that use Terveystalo’s short-term psychotherapy.

The effectiveness of short-term psychotherapy is based on rapid access to care. When support is provided in time, it can be relatively light. Hyrynkangas and Laaksonen’s team recently introduced a model in which occupational health clients with symptoms of anxiety or depression are guided to digital self-care programs with the support of an occupational health nurse.

– Self-care programs resemble therapy in that they combine information about one’s situation with various exercises. According to preliminary results, this combination was sufficient help for many, says Hyrynkangas.

Workplace phenomena are examined at group level

To ensure confidentiality, a company or team must have at least 20 employees so that survey and laboratory results can be reported at group level and reviewed with the employer to support management. However, findings can still be discussed with supervisors and the employer at a general level.

For example, survey results may reveal that alcohol consumption is high among many employees.

– If this concerns, for instance, a transport company, the issue is highly significant and must be addressed. We have examples where the matter has been raised and successfully taken forward, says Hyrynkangas.

In such cases, the approach has been as follows: individuals particularly affected by the issue were referred to the appropriate experts, and the workplace also took action.

– We worked with the company to find ways to keep the issue visible in the workplace: how to increase awareness, for example, that driving while hungover or fatigued is unacceptable?

When risks affect many, they are addressed together

Issues affecting an entire department or workplace may also emerge during consultations.

– If a person comes to us for sleep problems, we also explore whether there are underlying workplace-related issues, Hyrynkangas explains.

If there are grounds for concern, the occupational health team assesses the situation, examining how the perspectives of the employee, supervisor, and employer align.

– I ensure that data protection is maintained and that everyone feels safe and heard in the situation. Here, the occupational health nurse plays a key role, says Laaksonen.

Photo: Niko Laaksonen has received the "Occupational Health Nurse of the Future" award from the Finnish Association of Occupational Health Nurses.

When the needed support is identified, the right professionals are involved to move forward together

Once it is clear what kind of support is needed, the appropriate professionals and experts are brought in. Together, they determine the next steps.

– For example, if the situation involves a conflict that requires mediation, an occupational health psychologist is involved. If the issue is broader, an organizational psychologist will start working on developing work practices and ways of working. In addition, we provide supervisors with a wide range of support and coaching, Hyrynkangas explains.

Hyrynkangas also notes that sick leave is not beneficial in conflict situations.

– Sometimes a supervisor may even guide an employee to take sick leave if there are conflicts at work. However, absence does not solve anything—the same issues will still be there when the employee returns.

An occupational health nurse monitors the implementation of the jointly created action plan and ensures that everyone receives the support they need. The Finnish Association of Public Health Nurses awarded Niko Laaksonen the Future Occupational Health Nurse recognition in 2025. One of the criteria was a willingness to develop occupational health services together with clients and colleagues.

According to Hyrynkangas, the greatest benefit comes from active collaboration between the employer and the occupational health team, taking the workplace’s specific needs into account. This is made possible through continuous cooperation, even if close collaboration is not always visible to employees.

– Of course, we do not discuss matters concerning individual employees with the employer. From an employee’s point of view, it may even seem like we are only treating illnesses, although for us this is more of a complementary service to our core work.