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

Objective: 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. Methods: 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. Results: 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). Conclusion: 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.