The psychiatric assessment for employees in Romania, or “Sorry, rules are rules!”

The psychiatric assessment requirement has been included in the Labor Code since 2003 (Law No. 53, art. 27) in a general and rather imprecise formulation, stating that “no person may be hired without a medical certificate attesting that they are fit the work in question”. However, in accordance with Government Decision No. 355/2007 on the health surveillance of workers, an assessment of mental health is conducted upon the recommendation of the occupational doctor if they suspect conditions that could affect workplace safety.

In accordance with Government Decision No. 355/2007 (modified), the main fields of activity where this assessment is mandatory are the following: personnel authorized to carry firearms (police, gendarmerie, penitentiary staff and intelligence services), transport security personnel and those working at heights or in conditions of extreme isolation. There is also a requirement to obtain a psychiatric assessment for regulated liberal professions such as magistrates, lawyers, notaries and expert accountants (registered with CECCAR) – whether upon admission to certain professional bodies or for annual renewals.

A major recent change in the education sector took place starting in March 2026. Joint Order No. 55/3335/2026 introduced a mandatory requirement for an explicit psychiatric assessment for all teaching staff, auxiliary teaching staff and administrative personnel upon hiring or upon obtaining a permanent position. Regarding recent legislative changes to hiring criteria in the preuniversity education, the forms provided by regulatory authorities have both advantages and disadvantages. On the one hand, they clarify which mental and behavioral disorders disqualify individuals from employment in these fields, yet they leave certain requirements ambiguous. While the term “severe” is relatively clear in the context of depressive disorders, it is less so regarding anxiety disorders.

For university teaching staff, psychiatric assessment/certificate are required under other regulation (Order No. 4060/1502/2024), distinct from the preuniversity Joint Order (2026).

This document can also be obtained through online psychiatric consultation.

Beyond legislative ambiguities, an ethical issue also arises. As clinicians, we are obliged to assess each case individually and to promote the socio-professional rehabilitation and reintegration of our patients. The question thus arises as to whether a female patient with iatrogenic opioid dependence – developed because of treatment for pain associated with a severe rheumatological condition or fibromyalgia – can work in the education sector. We are thus left with a dilemma: we either refuse the consent of a patient like the one described above, or we distort the truth.

Solutions do exist! One example is the way the European Aviation Safety Agency has regulated medical criteria, including those regarding psychiatry (the topic is discussed in the pages of this issue of Psihiatru.ro).

It only remains for us to successfully exert enough pressure on regulatory authorities to bring the criteria for approvals in special medical cases into the era of personalized medicine.