Mental health as a subject of interest has become increasingly popular around the globe. Individuals and organisations are realising the implications from a personal wellness perspective and ultimately the huge costs associated with related topics such as burnout.  Some research has noted the global burden of burnout due to factors such as loss of productivity and compensation costs to be around $300 billion annually^[i].  The South African media is starting to pick up on the trend and the importance of topics like workplace stress, working hours and burnout due to the negative consequences that accompany a lack of organisational focus on mental health. Our own SIOPSA president, Dr Marissa Brouwers, was interviewed on KykNET in December 2019 on the impact of long-working hours on employees and the agility required to manage these employees (noting that South African citizens ‘work the longest working hours in the world’). Carte Blanche also did a segment on burnout among doctors in South African hospitals.  The statistics were quite shocking with presenters citing that 40% of doctors suffer from burnout and are twice as likely to commit suicide.  The unfortunate thing is that burnout is not isolated to certain roles but is prevalent across industries and professions[ii].

Although awareness is growing, burnout is certainly not on the decline and seems to be functioning in a cyclical fashion within South Africa, further exacerbated by a system which requires greater output from employees, without the ‘appropriate’ comparable health rewards. Recent data coming out of Oxford University highlighted that South African workers have some of the longest working hours in the world[iii]. The research tracked working hours in over 50 countries between 1950 and 2017 showing average working hours per employee on an annual basis.  The findings are reflective of the data coming out of the International Labour Organisation (ILO) which also ranks South African employees and their average work hours similarly. These long work hours do not, however, translate into greater productivity measured by the average contribution to the economy per hour of work by an employee. The ILO data tells the story that although we work longer hours, we are not matching the productivity levels of developed nations who work less[iv]. Although the majority of workers fall within a 40-48 hr work week, 21% of the workforce work 49 hrs per week or more.  Working such long hours over a prolonged period of time without adequate rest, increases the chance of experiencing burnout and accompanying negative impact on performance.

The World Health Organisation (WHO) has described burnout as a global pandemic[v]. This has led to some interesting developments in 2019. Although mentioned in a prior revision, this year (2019) burnout was officially recognised in the 11th Revision of the International Classification of Diseases (ICD-11). The ICD-11 refers to burnout as a syndrome specifically within the work context, brought about by chronic work-related stress where employer expectations and employee workload exceed the individual’s perceived capacity and ability to cope.

Three main dimensions normally characterise this “occupational phenomenon” ^[vi], namely: feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one’s job; and reduced professional efficacy. Surely this research, coupled with the new global awareness and emphasis on mental health, would bring organisations to the table to discuss what can be done about the situation.

It was Steve Hankin of Mckinsey who coined the phrase the War for Talent and in this competitive age the need for organisations to source, select and retain talent is more important than ever to ensure their inimitable advantage[vii]. However, perhaps the term sustain should be added to the list if organisations are serious about managing their internal talent.  Large volumes of research support the links between burnout and lower engagement, decreased performance, increased turnover intention and negative thoughts about one’s job[viii]. When employees resign or take sick leave, when they are present but unproductive and disengaged (presenteeism), the impact on productivity and profits can be alarming. When considering the aforementioned, one has to wonder as talent-custodians, how do we manage these challenges and empower organisations and their employees?

Christina Maslach one of the preeminent researchers on burnout and developer of the Maslach Burnout Inventory shows some concern about the WHO and IDC-11 announcement.  She states that, “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”.  Organisations often take a view that the individual is the problem and shift the responsibility, however, research such as that done by Gallup, demonstrates that often the sources of stress are structural and systemic not primarily at the individual level[ix].  The WHO has since committed to “embark on the development of evidence-based guidelines on mental well-being in the workplace” with an emphasis on reducing workplace stress and its consequences such as burnout[x]. In light of such progress the responsibility for managing this phenomenon is seemingly shifting away from the individual to the organisation.

However, experience has taught us that: “The more we change, the more we stay the same”. Within certain organisations and industries, it seems that an ‘always-on’ culture is encouraged and even unintentionally glorified at times.  This is basically where you are available online after normal work hours or whenever your employer/clients might need you.  Burnout is no longer mainly situated with mid-late career individuals who are 40+ year olds and over 50’s. In a recent interview with clinical psychologist and mental wellness coach, Nathan Rogerson highlighted the phenomenon called Millennial Burnout. As such, burnout does not seem to discriminate based on age. Nathan speaks about how digital over-consumption which he links in part to an ‘always-on’ culture, negatively influences our ability to have down time which in turn impacts brain functioning as it cannot adequately replenish itself which ultimately impacts performance. Apart from the effects of the aforementioned, our young professionals suffer from burnout already, in contrast to the alternative ‘unemployed youth bulge’ who remain unemployed, underutilised and equally frustrated when they should be at the height of their energy and engagement (according to traditional career theories).

In a country where the socio-economic situation is tenuous and the prospects of finding new employment easily are low for most, the situation becomes ripe for employee exploitation as employees have little option but to acquiesce to being ‘always-on’ as well as heavy workloads and demands due to job insecurity[xi].  Organisations are undoubtedly cash strapped, retrenchments in 2019 have been frequent and high profile, for example ABSA, Tongaat Hulett and Multichoice to name a few.  Such instances inevitably lead to fewer staff doing more work and a potential case of managers ‘killing’ the goose that lays the golden egg because of the mismatch between job resources and demands[xii].  Even with a rigorous legislative framework designed to protect employees from being overworked, burnout is nevertheless on the rise. In an ironic twist StatsSA has pegged the unemployment rate at around 29% with graduate unemployment at a shocking 55%[xiii].  The question then is, are organisations really being intentional about trying to creatively bridge the gap between the need on the one hand and the problem on the other?

The Harvard Business Review rightly points out that the conversation generated by the WHO around burnout is not about reprimanding organisations or suggesting employer liability but rather the impact on employee wellbeing and the cost implications of burnout. It is, however, paramount that organisations and the employed Health-care practitioners and/or HR professionals who represent these organisations, should acknowledge and take action on the fact that burnout is not so much about employee dysfunction as it is about the workplace dynamics[xiv].  The intention of this blogpost is to enable the dialogue required amongst professionals and the organisations with whom they are employed, to equip and enable their leaders to focus on their employees’ wellbeing.  It is advisable to follow the motto noting that ‘prevention is better than the cure’ and as such, it will become crucial to build into the daily rhythms of work, ways of managing and effectively assisting employees with pressure and stress in order to avoid crisis interventions down the line.  This is not just good for business outcomes, but it is the right thing to do.  The idea in encouraging an emphasis on mental health and employee wellness is not with the notion of taking your talent out of pressurised, stressful environments or merely facilitating survival mode.  It is rather about helping them flourish within these environments as pressure and stress are no doubt here to stay. The latter of course, perfectly summarises the Industrial Psychologist’s oath and as healthcare practitioners within organisations, we remain focused in our endeavour to assist employees, organisations and the nation flourish!

References

[i] Rowe (2012) Rowe DS. The stress burden: strategies for management. Nevada RNformation. 2012;21:12–12.

[ii] Rothman, S. (2003). Burnout and engagement: A South African perspective. SA Journal of Industrial Psychology | Vol 29, No 4.

[iii] https://ourworldindata.org/working-hours#annual-working-hours-since-1950

[iv] https://www.ilo.org/ilostat/faces/oracle/webcenter/portalapp/pagehierarchy/Page27.jspx

[v]Nash (2013) Nash K. The growth of burnout syndrome. Charter. 2013;84:34.

[vi] https://www.who.int/mental_health/evidence/burn-out/en/

[vii]http://www.executivesondemand.net/managementsourcing/images/stories/artigos_pdf/gestao/The_war_for_talent.pdf

[viii] Maslach, Christina & Schaufeli, Wilmar & Leiter, Michael. (2001). Job Burnout. Annual Review of Psychology. 52. 397-422. 10.1146/annurev.psych.52.1.397.

[ix] https://www.gallup.com/workplace/237059/employee-burnout-part-main-causes.aspx

[x] http://www.euro.who.int/__data/assets/pdf_file/0018/124047/e94345.pdf

[xi] N Tilakdharee, S Ramidial & SB Parumasur. 2010. The relationship between job insecurity and burnout. South African Journal of Economic and Management Sciences, 13(3): 1015-8812.

[xii] Demerouti, E., Bakker, A.B., Nachreiner, F. & Schaufeli, W.B. 2001. The job demands resources model of burnout, Journal of Applied Psychology, 86(3): 499–512

[xiii] http://www.statssa.gov.za/?p=12121

[xiv] https://hbr.org/2019/12/burnout-is-about-your-workplace-not-your-people