The research team, led by Lisa Björk of the University of Gothenburg and the Institute of Stress Medicine in Region Västra Götaland, together with Jenny Hultquist, Gunnel Hensing and Monica Bertilsson, set out to test a deceptively simple assumption. Because sickness absence due to common mental disorders is known to be unevenly distributed across the Swedish labour market, with higher levels in the public sector, in service industries where people are the main object of work, and in female-dominated occupations, the researchers reasoned that managers in different industries might encounter and interpret reduced work capacity in fundamentally different ways. A hospital ward manager, constantly observing the social and emotional demands of patient care, might notice different impairments than a manager of software engineers whose work revolves around data and cognitive output.

To investigate this, the team analysed survey responses from 1,819 Swedish managers who reported having had at least one employee with depression or an anxiety disorder during the previous two years. The data were collected between September and December 2017 as part of the New Ways – Mental Health at Work research programme, within the project Managers’ Perspective – A Missing Piece, and approved by the Regional Ethics Review Board in Gothenburg. Participants were recruited through the Swedish Citizen Panel at the SOM Institute at the University of Gothenburg and through the HELIX Competence Centre at Linköping University, achieving a total response rate of 71 percent. Of the managers included in the final analysis, 927, or 51 percent, had experienced one staff member with depression or anxiety, while 892, or 49 percent, had experienced several.

The methodological design is one of the study’s notable strengths. Rather than relying on a single definition of industry, the researchers applied three separate classification schemes, each grounded in a different logic. The first categorised organisations by ownership, distinguishing governmental, county council and municipal employers from private companies and not-for-profit organisations. The second classified industries by their main work object, following a long tradition in occupational sociology that divides work into tasks centred on data, things or people. The third, most fine-grained scheme combined work object with the gender composition of the industry, yielding categories such as male-dominated industries handling things, gender-mixed industries spanning all three objects, and female-dominated industries handling people, namely education and health and social care.

The exposure findings were clear and consistent across all three classifications. Managers in municipalities and counties, in industries where people are the main work object, and specifically in health and social care and education, were significantly more likely to have experienced several employees with depression and anxiety. In health and social care and education, 57 percent of managers reported multiple affected staff members, followed by public administration at 52 percent, labour-intensive services at 48 percent, knowledge-intensive services at 45 percent, machinery operations at 42 percent, and goods and energy production at just 38 percent. When classified by ownership, private companies stood out with only 42 percent of managers reporting several affected employees, compared with 56 to 57 percent elsewhere. By work object, industries centred on data showed the lowest multiple-exposure rate at 40 percent.

These patterns align closely with earlier register-based research showing that psychotropic drug prescriptions, psychiatric care, sickness absence and disability pensions due to depression and anxiety are all more prominent in female-dominated industries. Two systematic reviews cited by the authors suggest a causal link between detrimental psychosocial work environments and depression and burnout, with negative consequences affecting women and men working in such environments in similar ways. The implication is sobering: more women may be affected not because of inherent vulnerability, but because they disproportionately work in settings where job insecurity, high demands, high workload, low job control and low reward are common.

Yet the study’s second, and arguably more surprising, finding concerns how managers rated the effects of those disorders on work capacity. Using a nine-item instrument derived from a validated measure of work capacity in workers with common mental disorders, the researchers aggregated responses into two indices: task-oriented work capacity, capturing abilities such as prioritising among work tasks, and relational work capacity, capturing abilities such as interacting with other people. The indices showed good internal consistency, with Cronbach’s alpha values of 0.81 and 0.70 respectively. Three separate multivariate analyses of covariance, one for each industry classification and each controlling for organisational size and the manager’s span of control, found no statistically significant effect of industry on these ratings. The effect sizes were vanishingly small, with partial eta-squared values ranging from 0.002 to 0.006.

The authors propose three possible explanations for this null result, each carrying important implications. The first, which they ultimately consider unlikely, is that depression and anxiety may genuinely affect work capacity in similar ways across industries, perhaps because automation and digitalisation have aligned work tasks across sectors. The second concerns the measurement instrument itself: the division into task-oriented and relational components may be too fine-tuned for managers, who may hold a more general conception of reduced work capacity without being able to pinpoint specific problematic aspects. The third explanation centres on the inherent complexity of work capacity as a phenomenon. Physicians in clinical studies have long reported that assessing work capacity is difficult because of individual variation in symptoms and symptom management, and patients themselves often struggle to articulate their limitations, which is why communication tools such as the Capacity Note in Swedish primary health care have been developed to help patients find a more precise language for their experiences.

The study also raises the possibility of underreporting in male-dominated sectors. Managers depend heavily on employee disclosure, and workers frequently avoid disclosing mental health problems for fear of stigmatisation. Previous qualitative work has found that masculine workplace cultures built on ideals of strength and endurance can hamper disclosure, and a separate Swedish study showed that male managers hold significantly more negative attitudes toward depression than their female counterparts. Together, these findings suggest that common mental disorders may be underestimated in industries dominated by men, though the authors caution that this assumption requires confirmation in future studies. Notably, even in the full study population of 3,358 managers, 73 percent reported none or only one affected employee in the previous two years, underscoring that encountering these conditions remains a relatively rare experience for most managers.

The practical takeaway is unexpectedly liberating for organisations designing support programmes. Had the findings confirmed industry differences, tailored training for managers in different sectors would have been warranted. Instead, the uniformity of ratings across the labour market suggests that support for managers dealing with employees’ depression and anxiety does not need to be customised by industry. What matters is that managers everywhere receive the support they need to reduce work-related risk factors, assist affected employees and help those on sick leave return to work. The authors also point to a specific professional role: occupational therapists, with their expertise in assessing individual functionality, teaching coping strategies and adapting work environments and tasks, are well positioned to provide that support to both employees and managers. As common mental disorders continue to shape working life, this study suggests the challenge is shared across every sector, and so is the solution.

Subject of Research: Industry differences in managers' experiences and ratings of work capacity in employees with depression and anxiety

Article Title: Managers’ experiences of work capacity in employees with depression and anxiety

Article References: Björk, L., Hultquist, J., Hensing, G., & Bertilsson, M. (2025). Managers’ experiences of work capacity in employees with depression and anxiety. Scandinavian Journal of Occupational Therapy, 32(1), Article 2570900. https://doi.org/10.1080/11038128.2025.2570900

Image Credits: AI Generated

DOI: 10.1080/11038128.2025.2570900

Keywords: common mental disorders, depression, anxiety, work capacity, managers, occupational health, sickness absence, gender composition, Swedish labour market, psychosocial work environment, occupational therapy, workplace mental health