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More than one in four Belgian employees who return to work after burnout or depression are off sick again within a year. A 2026 Belgian cohort study estimated the figure at 27.9%. For anyone managing a return to work after burnout, the first day back is not the finish line. It is the start of the riskiest part of the absence.
The good news: relapse is not random. The study shows who is most at risk, and trial evidence shows what can lower that risk.
Belgian researchers affiliated with KU Leuven and Idewe followed 148 employees who went back to work between April 2022 and January 2024 after sick leave for burnout or depression. Each person was asked to fill in five questionnaires over the following 12 months. The results were published in May 2026 in the Journal of Occupational Rehabilitation.
Put simply: many people come back while still carrying symptoms, and those symptoms predict who goes off again. Being back at your desk is not the same as being recovered.
A relapse is a second absence on top of the first. The team absorbs the work again. The manager reorganises again. The reintegration effort you already made is lost.
It also lands in the one part of Belgian absence that is not improving. Securex data on 188,857 private-sector employees show the overall absence rate fell to 8.09% in 2025, down from 8.49% in 2024: the first clear drop in 25 years. But absence lasting more than a year stayed at 3.35%, a historically high level. Helan's medical director pointed out that physical conditions often have a more predictable recovery path, while psychosocial conditions such as burnout make reintegration harder.
The legal side has hardened too. For incapacities that started on or after 1 January 2026, the employer must ask the occupational physician to assess an employee who has been unfit for work for at least eight weeks. Employers with 20 or more employees must start a reintegration process within six months of the start of the incapacity when the person has work capability, or risk a fine under the Social Penal Code. We looked at the wider reform in our post on the 2025 work incapacity reform. A relapse that turns into a long absence can bring you straight back into that process.
Most organisations treat the return as the end of the file. The person is back, the part-time schedule runs its course, and attention moves elsewhere. That approach has three blind spots.
None of this is solved by the return meeting alone. The risk runs for a full year, so the follow-up has to as well.
Track how many mental health returns lead to a new absence within 3, 6 and 12 months. Do it at team or company level, never per named person. Without that number, you cannot tell whether your return process works.
Trial evidence points to this window. In a Dutch cluster-randomised trial with 158 workers, occupational physicians trained in a five-step problem-solving method used it in the first two weeks after return. Over the next 12 months, their workers had lower odds of a new mental health absence (odds ratio 0.40), and any new absence came later (hazard ratio 0.53). Ask your occupational health service whether they use a structured problem-solving approach at return. Then make sure the manager acts on what comes out of it.
Write down what changes, for how long, and who checks. Book reviews at one, three, six and twelve months. The relapse risk runs for a full year, and a review date in the calendar is the cheapest way to keep adjustments in place that long. Reviews only work if people feel safe saying an arrangement is not working, which is where psychological safety comes in.
If the conditions that contributed to the absence have not changed, the person walks back into them. Belgian employers already have to analyse psychosocial risks across five domains: work organisation, work content, employment conditions, working conditions and interpersonal relations at work. Apply that lens to the returning person's role. In the Belgian cohort, fixed shifts went with poorer work ability at return.
Remaining symptoms predict relapse, so access to confidential psychological support should not stop when someone is back at work. And since 1 January 2026, an employee who risks becoming unfit for work can ask the employer whether their workstation could be adjusted, before any absence starts. That right only helps if people know it exists, so tell them.
In a 2026 Belgian study of 148 employees who returned after burnout or depression, an estimated 27.9% had a new sickness absence within 12 months.
For incapacities starting on or after 1 January 2026, the employer must ask the occupational physician to assess an employee who has been unfit for work for at least eight weeks. Employers with 20 or more employees must start a reintegration process within six months of the start of the incapacity when the person has work capability. Failing to do so can lead to a fine.
No single measure guarantees it. The evidence points to a structured problem-solving conversation in the first weeks back, attention to remaining symptoms, written adjustments that are reviewed over the year, and changes to the job where the job was part of the problem.
Not necessarily. The authors of the Belgian study conclude that what matters is a balance between enough recovery and timely steps back to work. Since symptoms at return predict relapse, the return plan should take them into account, not ignore them.
Evoluno supports employees before, during and after a return to work, with psychologists, coaches and a self-care app. Talk to our team.
Speak with us so we can set up the best plan to take care of your team’s mental health.
