Objective The long-term prognosis for employees with work-related stress, depression or PTSD is unclear. We aim to investigate if these conditions represent a temporary setback or a decline towards long-term poor health.

Methods From the Danish Occupational Medicine Cohort we included patients referred 2000–2012 with mental disorders (N=17.900) to Departments of Occupational Medicine across Denmark. From nation-wide registries we obtained data on general health care service utilization (GP contacts) and specialized mental health care (incident private practice psychiatrist/psychologist care and psychiatric hospital care) for five years after/before the index-date of referral. Results are presented as utilization 5 years before referral (index-year -5), the year on either side of referral (index-year -1 and +1) and five years after referral (index-year +5).

Results General health care utilization increased from 7 median GP contacts in index-year -5 rising sharply to 12 in index-year -1 and 10 in index-year +1, then declining gradually to 8 in index-year +5. Incident private practice psychiatrist/psychologist care was 4.5% among patients in index-year -5 rising to 13.6% in index-year -1, 19.8% in index-year +1, declining to 7.4% in index-year +5. Incident psychiatric hospital care was 1.4% in index-year -5 rising to 5.6% in index-year -1, 8.6% in index-year +1, then declining to 4.7% in index-year +5.

Conclusions General health care utilization was elevated in the years surrounding referral, then declined to levels comparable to five years prior to referral. From a relatively low incidence, mental health care utilization increased 4–6 fold in the years around referral, then declined to levels 2–3 fold higher than five years before referral. This could indicate that work-related mental disorders represent a temporary setback for most patients, but for some becomes a decline towards long-term poor mental health. Further analyses will seek to identify at-risk groups from demographic, occupational and health-related prognostic factors.