Objectives This study aimed to examine (i) if work-to-family conflicts (WtFC) and family-to-work conflicts (FtWC) are associated with sickness absence due to mental disorders and (ii) whether these associations are different among health and social care (HSC) employees compared to other municipal employee sectors.

Methods The Helsinki Health Study survey data collected in 2017 among 19–39-year-old female municipal employees (N=2557) were prospectively linked to administrative Social Insurance Institution of Finland register data on long-term sickness absence due to mental disorders (SA-MD) covering a follow-up of up to five years. The associations of WtFC and FtWC and SA-MD were analyzed using Cox regression models stratified by employment sector (HSC, education, other), adjusting for sociodemographic and health-related covariates.

Results Of HSC employees, 16% had SA-MD during the follow-up, which surpassed the figures for employees in education (12%) and other (11%) sectors. In the HSC sector, the youngest employees had the highest prevalence of SA-MD and, among HSC employees, prior SA-MD was the most common. In Kaplan–Meier curves, the steepest increase in SA-MD was observed for HSC employees. WtFC [hazard ratio (HR) 1.84, 95% confidence interval (CI) 1.39–2.45] and FtWC (HR 1.78, 95% CI 1.32–2.40) were associated with SA-MD among HSC employees. The associations were rather similar for employees in education and other sectors. Adjusting for work-related factors and health history somewhat attenuated the associations.

Conclusions Better possibilities to combine work and family life might aid in preventing SA-MD in all employment sectors.

Key terms healthcare worker; mental disorder; mental health; municipal employee; register-linked study; sick leave; sickness absence; social care; work–family conflict; work–family interface

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