We tend to think of burnout as an individual problem, solvable by “learning to say no,” more yoga, better breathing techniques, practicing resilience — the self-help list goes on. But evidence is mounting that applying personal, band-aid solutions to an epic and rapidly evolving workplace phenomenon may be harming, not helping, the battle. With “burnout” now officially recognized by the World Health Organization (WHO), the responsibility for managing it has shifted away from the individual and towards the organization. Leaders take note: It’s now on you to build a burnout strategy.
The Non-Classification Classification
The term “burnout” originated in the 1970s, and for the past 50 years, the medical community has argued about how to define it. As the debate grows increasingly contentious, the most recent WHO announcement may have caused more confusion than clarity. In May, the WHO included burnout in its International Classification of Diseases (ICD-11) and immediately the public assumed that burnout would now be considered a medical condition. The WHO then put out an urgent clarification stating, “Burn-out is included in the 11th Revision of the International Classification of Diseases (ICD-11) as an occupational phenomenon, not a medical condition… reasons for which people contact health services but that are not classed as illnesses or health conditions.”
Although the WHO is now working on guidelines to help organizations with prevention strategies, most still have no idea what to do about burnout. Since it was explicitly not classified as a medical condition, the case is less about liability for employers and more about the impact on employee well-being and the massive associated costs.
The Emotional and Financial Toll
When Stanford researchers looked into how workplace stress affects health costs and mortality in the United States (pdf), they found that it led to spending of nearly $190 billion — roughly 8% of national healthcare outlays — and nearly 120,000 deaths each year. Worldwide, 615 million suffer from depression and anxiety and, according to a recent WHO study, which costs the global workforce an estimated $1 trillion in lost productivity each year. Passion-driven and caregiving roles such as doctors and nurses are some of the most susceptible to burnout, and the consequences can mean life or death; suicide rates among caregivers are dramatically higher than that of the general public — 40% higher for men and 130% higher for women.
If those statistics aren’t scary enough, consider the fact that companies without systems to support the well-being of their employees have higher turnover, lower productivity, and higher healthcare costs, according to the American Psychological Association (APA). In high-pressure firms, healthcare costs are 50% greater than at other organizations. Workplace stress is estimated to cost the U.S. economy more than $500 billion dollars, and, each year, 550 million work days are lost due to stress on the job. Another study by the APA claims that burned-out employees are 2.6 times as likely to be actively seeking a different job, 63% more likely to take a sick day, and 23% more likely to visit the emergency room.
Obviously, this is a real problem. And it can feel like a herculean task for leaders to tackle perhaps because the concept seems too ambiguous or overwhelming. When experts still struggle to define burnout, how can we ask our managers to actually prevent it?
It’s Not Me, It’s You
According to the foremost expert on burnout, Christina Maslach, social psychologist and professor emerita of psychology at the University of California, Berkeley, we are attacking the problem from the wrong angle. She is one of three people responsible for the gold standard of measuring burnout — the eponymous Maslach Burnout Inventory (MBI) — and the coauthor of the Areas of Worklife Survey. Maslach worries about the new WHO classification in the IDC11. “Categorizing burnout as a disease was an attempt by the WHO to provide definitions for what is wrong with people, instead of what is wrong with companies,” she explains. “When we just look at the person, what that means is, ‘Hey we’ve got to treat that person.’ ‘You can’t work here because you’re the problem.’ ‘We have to get rid of that person.’ Then, it becomes that person’s problem, not the responsibility of the organization that employs them.”
To Maslach’s point, a survey of 7,500 full-time employees by Gallup found the top five reasons for burnout are:
- Unfair treatment at work
- Unmanageable workload
- Lack of role clarity
- Lack of communication and support from their manager
- Unreasonable time pressure
The list above clearly demonstrates that the root causes of burnout do not really lie with the individual and that they can be averted — if only leadership started their prevention strategies much further upstream.
In our interview, Maslach asked me to picture a canary in a coal mine. They are healthy birds, singing away as they make their way into the cave. But, when they come out full of soot and disease, no longer singing, can you imagine us asking why the canaries made themselves sick? No, because the answer would be obvious: the coal mine is making the birds sick.
This visual struck me. Although developing emotional intelligence skills — like optimism, gratitude, and hope — can give people the rocket fuel they need to be successful, if an employee is dealing with burnout, we have to stop and ask ourselves why. We should never suggest that if they’d just practiced more grit or joined another yoga class or taken a mindfulness course, their burnout would have been avoided. I have long been a proponent of empathy and optimism in leadership. I believe in practicing gratitude skills for a happier, higher performing work and life experience. I endorse the idea of building resilience to better handle stress when it arises. But these skills are not the cure for burnout, nor are they the vaccine.
So, what is?
First, ask yourself as a leader, what is making my staff so unhealthy? Why does our work environment lack the conditions for them to flourish? How can I make it safe for them to work here every day? We have to dig into the data and ask our people what would make work better for them. More generally, we need to better understand what causes people to feel motivated in our organizations, and what causes them frustration.
Frederick Herzberg is known for his dual-factor, motivation-hygiene theory — essentially, what motivates us versus what basic needs must be met in order to maintain job satisfaction. Herzberg found that satisfaction and dissatisfaction are not on a continuum with one increasing as the other diminishes but are instead independent of each other. This means that managers need to recognize and attend to both equally.
Motivators are different than hygiene factors. Motivation factors include: challenging work; recognition for one’s achievements; responsibility; the opportunity to do something meaningful; involvement in decision making; and a sense of importance to the organization. On the other hand, hygiene factors include: salary; work conditions; company policy and administration; supervision; working relationships; status and security.
Often, employees don’t recognize when an organization has good hygiene, but bad hygiene can cause a major distraction. The latter can come down to seemingly innocuous issues, like having coffee in the break room one day and no more coffee the next. People feel it. Burnout happens when these presupposed features in our day-to-day work lives are missing or taken away.
Maslach has affectionately named this feeling “pebbles.” She describes them as the tiny, incremental, irritating, and painful stuff at work that can wear you down. Through my work, I’ve seen this in action. Consider this example: The music faculty chairs at a university where I worked decided to put their entire annual improvement budget towards building a sound-proof studio. They were certain the rest of the group would be thrilled. They were wrong. In reality, staff just wanted new music stands at a cost of $300. The existing ones were imbalanced or broken, and students would often find their sheet music on the floor when practicing. The ribbon-cutting event for the studio was lackluster, and engagement was low. Some faculty didn’t even show up. The leadership expressed frustration with the lack of gratitude. Neither group shared their dissatisfaction with the other, and over the course of the following year, that seed of anger grew. The non-tenured high-performers sought out new opportunities, and the faculty lost talent. If staff had been given a say in how the budget was allocated, the team might still be intact for just $300.
Maslach shared a story with me of a CEO who decided to put a volleyball court on the roof of his office building. Employees would look up at it and see how little people were using it. It would make them cynical because that money could be going to so many other things. “They would think, If only I had some of that budget, I could fix [insert problem to be solved here].”
Leaders could save themselves a huge amount of employee stress and subsequent burnout, if they were just better at asking people what they need.
Ask Better Questions
When investing in burnout prevention strategies, it’s best to narrow the efforts down to small, micro-pilots, which mean a lower budget and less risk. I suggest starting with one or two departments or teams and asking one simple question: If we had this much budget and could spend it on X many items in our department, what would be the first priority? Have the team vote anonymously then share the data with everyone. Discuss what was prioritized and why and start working down the list. Employees may not have the perfect silver-bullet solution, but they can most certainly tell us what isn’t working — and that is often the most invaluable data.
A larger pilot can start with some critical but some simple tactics. For example, take a referendum on some of the annual events. Ask your employees if they like the holiday party or the annual picnic? What would they keep? What would they change? Or is there something else that they would rather do with that money? Digital tools and simple surveys are easy to use and deploy — particularly if you ask a simple question. The part critical to making this tactic successful is in how the data is used. Before engaging in a practice like this — or any employee survey for that matter — something has to be done with the information. If you ask questions and don’t bother with a reply, people begin to get wary and stop answering truthfully, or at all.
If sending out questions digitally doesn’t feel right, start by walking around. Some of the best data-gathering comes from the MBWA style of leadership — management by wandering around. Maslach says she’s witnessed hospital CEOs walking the floor only to realize why people keep asking for, say, a new printer. They see that because the existing one is always breaking down and never serviced, it rarely has paper. So when someone wants to print out something for a patient, they are forced to run down the hall and get somebody to help or to find a printer that works. It’s hard for leadership to then ignore needs after witnessing them first-hand.
Organizations have a chance, right now, to fix this type of thing. Burnout is preventable. It requires good organizational hygiene, better data, asking more timely and relevant questions, smarter (more micro) budgeting, and ensuring that wellness offerings are included as part of your well-being strategy. Keep the yoga, the resilience training, and the mindfulness classes — they are all terrific tools for optimizing mental health and managing stress. But, when it comes to employee burnout, remember — it’s on you leaders, not them.