Mental health leave hits a record in Brazil: what HR can do

Brazil's social security system granted 546,254 temporary incapacity benefits for mental and behavioral disorders in 2025, almost 16% more than the 472,328 granted in 2024, according to data released by the Ministry of Social Security at the end of January 2026. Anxiety and depression top the list, and women account for more than 63% of cases. For HR, the new record is a warning about absenteeism, turnover and how work is organized; for employees, it is a reminder that seeking help and knowing your rights makes a difference.

What the numbers show

The 2024 total had already been a record in the historical series, and 2025 went further. Mental disorders accounted for about 13% of the 4,126,112 temporary incapacity benefits granted by INSS (Brazil's social security institute) in the year, according to Agência Brasil, the public news agency. Anxiety ranked fourth among all causes of leave and depressive episodes sixth; back pain remains at the top.

Diagnosis (ICD-10)	Benefits in 2025
Other anxiety disorders (F41)	166,489
Depressive episodes (F32)	126,608
Bipolar affective disorder (F31)	60,904
Recurrent depressive disorder (F33)	60,551

The data count benefits granted, not people.

Burnout is growing fast

In ICD-11, the World Health Organization (WHO) describes burnout (code QD85) as an occupational phenomenon: a syndrome resulting from chronic workplace stress that has not been successfully managed. In Brazil, burnout is on the Ministry of Health's List of Work-Related Diseases, updated by Portaria GM/MS nº 1.999/2023, linked to factors such as organizational management, working hours and harassment. A survey by the National Association of Occupational Medicine (ANAMT) using INSS data shows that burnout leaves longer than 15 days rose from 1,760 in 2023 to 6,985 in 2025, with data through November.

What about 2026?

There is no full official report yet. A study by Cajuína using INSS open data counted 232,382 mental health leaves in the first half of the year, 13.2% fewer than a year earlier. The study warns, however, that INSS operational factors, such as medical examination drives, affect the series and that it is too early to speak of a reversal.

What this means for companies

INSS only steps in from day 16: the employer pays the first 15 days of sick leave (Lei nº 8.213/1991, art. 60, § 3). That is why official statistics only show the longer cases. Short medical notes, absences and lower performance do not appear in them, but they weigh on payroll and schedules.

In operations with sites to cover, every absence turns into overtime, a relief worker or a substitute, and puts pressure on those who stay. Without management, the cycle feeds new leaves and turnover.

When INSS recognizes a link to work, the benefit is classified as work-related, and the consequences grow: deposits to the FGTS (the employee's severance fund) continue during the leave (Lei nº 8.036/1990, art. 15, § 5), and the employee has job security for at least 12 months after the benefit ends (Lei nº 8.213/1991, art. 118). The INSS medical examination can recognize this link through the epidemiological technical nexus between the company's activity and the illness, and the company can challenge it (art. 21-A).

There is also NR-01, Brazil's general occupational health and safety standard: since May 26, 2026, it requires work-related psychosocial risk factors to be part of occupational risk management. Fines are suspended by Brazil's Supreme Court, but the obligation remains, as we explain in NR-01 and psychosocial risks.

Warning signs to watch

The WHO describes burnout in three dimensions: energy depletion or exhaustion, mental distance or cynicism about one's job, and reduced professional efficacy. Managers should not diagnose anyone, but they can notice changes and offer support. In operational data, watch for:

• more short medical notes and absences at the same site or team;
• frequent late arrivals and breaks that go untaken;
• overtime concentrated on the same people;
• conflicts and complaints of excessive pressure or harassment;
• resignations and transfer requests under the same manager.

Collective signs say more about how work is organized than about individuals, and that is where prevention works best.

What HR can do

• Prepare managers. They should know how to welcome, listen without judgment and refer people to the medical service or support network, without discussing diagnoses with the team.
• Review workload, targets and schedules. The Ministry of Labor's guide on psychosocial risks lists overload as a risk factor and suggests prioritizing tasks, setting realistic targets, reinforcing teams and ensuring regular breaks.
• Control overtime and rest. The CLT, Brazil's Consolidated Labor Laws, requires 11 consecutive hours of rest between two workdays (art. 66). Tracking hour banks and overtime per person keeps excess from becoming routine.
• Open listening channels. Anonymous climate surveys and the whistleblowing channel required by Lei nº 14.457/2022 for companies with a CIPA (internal committee for the prevention of accidents and harassment) help spot problems early.
• Structure the return to work. Under NR-7, the occupational health standard, after an absence of 30 days or more due to illness or accident, the return-to-work exam must take place before the employee resumes duties, and the physician assesses whether a gradual return is needed. Follow up during the first weeks.
• Protect health data. Under the LGPD, Brazil's data protection law, health information is sensitive personal data (art. 5, II). See how to organize this flow in our article on AI for medical notes.

In TIRVU+, absenteeism dashboards show absences, late arrivals, medical notes and leaves by site, contract and employee, and schedule and hour bank control helps reveal where excess hours are concentrated.

What employees need to know

• Medical notes and INSS. An illness proven by a medical note justifies the absence. From day 16 of leave, the benefit is requested from INSS through the Meu INSS app or website or by calling 135.
• Your diagnosis is yours. Physicians only record the ICD code on a medical note for just cause, a legal duty or at your request, with your consent stated on the document (Resolução CFM nº 2.381/2024, from Brazil's Federal Council of Medicine). The company must keep any health data confidential.
• CAT. If the company does not issue the work accident report (CAT), the worker, their dependents, the union, the treating physician or any public authority may file it (Lei nº 8.213/1991, art. 22, § 2).
• Where to find help. CVV, a volunteer service, offers free and confidential emotional support at 188, 24 hours a day, as well as by chat and email. In SUS, Brazil's public health system, primary care units (UBS) and psychosocial care centers (CAPS) provide free care; CAPS work on an open-door basis, with no appointment needed for the first visit. In an emergency, call 192 (SAMU).

B31 or B91: what is the difference?

	B31 (regular benefit)	B91 (work-related benefit)
When it applies	Illness with no recognized link to work	Accident or work-related illness recognized by INSS
FGTS during leave	Deposits not required	Deposits continue
Job security	No specific legal guarantee, unless a collective agreement provides one	At least 12 months after the benefit ends

What to do now

• Map absences, medical notes, leaves and overtime by site, contract and manager
• Train managers to welcome and refer, without exposing diagnoses
• Review the medical note policy: ICD code not required and restricted access
• Publicize the support network: CVV 188, UBS, CAPS and the company's medical service
• Define a return-to-work plan with the occupational physician
• Assess the link to work with the occupational health team and issue the CAT when applicable
• Bring the indicators into the NR-01 psychosocial risk inventory

FAQ

Do I have to tell the company my diagnosis?

No. The medical note must prove the consultation and the days of leave. The ICD code only appears if you authorize it.

Is burnout considered a work-related disease?

Burnout is on the Ministry of Health's List of Work-Related Diseases. However, recognition in each case depends on a medical assessment and, for social security purposes, on the INSS medical examination.

Who is entitled to 12 months of job security?

As a rule, employees who received the work-related benefit, counted from the end of the benefit. In 2025, the TST, Brazil's Superior Labor Court, set a binding thesis (Tema 125): the guarantee does not depend on a leave of more than 15 days or on the work-related benefit when the link between the occupational disease and the job is recognized after the contract ends. Each case requires analysis.

Conclusion

The record in mental health leave shows that the issue has already reached companies' payroll, schedules and workplace climate. Since official statistics only capture the longer cases, HR has room to act earlier: prepared managers, workload under control, listening channels and a well-managed return to work. And for anyone going through a difficult time, the message is simple: asking for help is a right, and there are free and confidential ways to do it.

Want to track absences, medical notes and overtime by site and act before a leave happens? Talk to the Tirvu team and see TIRVU+ working in your operation.

Sources

• Ministry of Health: psychosocial care centers (CAPS)
• WHO: burn-out an occupational phenomenon (May 28, 2019)
• Agência Brasil: illness leaves in 2025 (Jan 27, 2026)
• Agência Brasil: new mental health rules at work (May 26, 2026)
• ANAMT: survey based on INSS data (Jan 27, 2026)

This content is for informational purposes only and does not replace specialized legal advice.