Mental Health Training

Burn-out: high risk, high consequence, by Jane McNeice

Posted by on 2 Feb, 2021 in Mental Health |

Burn-out: high risk, high consequence, by Jane McNeice

In a global pandemic when professionals in many industries are pushed to the brink of their resources, it’s essential to recognise that no one is immune from burning-out and that the consequences of ignoring the signs of burn-out can be fatal. No matter how much a person is needed in their job, what we do not want to achieve is the saving or supporting one life at the cost of another. The well documented Japanese phenomenon of ‘Karoshi’ translates as “overwork death”.  It links heart-attacks, strokes, and starvation to otherwise fit and healthy young people, dying because they have quite simply worked themselves to death, or reached a state of such poor health that the pain and exhaustion has exceeded their resources to survive and they have suicided. The significant precursor behaviour to the death is identified as the number of hours worked and excessive workloads.

The International Classification of Diseases, Revision 11 (ICD-11) is the global standard for diagnostic information produced by the World Health Organisation. In the latest revision of ICD-11 we have seen the more than justified introduction of the diagnosis ‘Burn-out’. ICD-11 describes it as,

A syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed.

We are talking about a phenomenon caused solely within the occupational context, not from actual or perceived stress within the personal life, and ICD-11 clarifies that it should not be used to describe other areas of a person’s life. Thus there is a difference between burn-out and stress.

ICD-11 describes three dimensions of burn-out as being,

  • 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
  • a sense of ineffectiveness and lack of accomplishment.

There are likely to be many workers who are at greater statistical risk of burn-out in the current climate. These would include:

  • Health and social care workers
  • Education workers
  • Small business and new start-up owners, freelancers and sole traders
  • People experiencing additional pressure due to colleagues being absent, furloughed, or also burned-out

The signs of burn-out will present individually and to some extent uniquely but we may expect to see:

  • Fatigue
  • Poor concentration and mistakes
  • Emotional snapping
  • Poor eating patterns
  • Negative speak
  • Immune system problems
  • Unhealthy coping behaviours

When considering burn-out, it is essential that we don’t merely focus on the person and what they need to do (or not do) to reduce the likelihood and consequence. The risk of doing so is to place blame solely at the feet of those experiencing it. However, the reality is that organisations play a potentially massive role in the risk of employees burning-out. Leitner & Maslach (2000) cite several significant factors that can contribute, including workload, lack of control, values conflict, etc. Such factors are often wholly within the control of the organisation, its culture, management practices and operations, not within the individual’s control. Given what many industries are facing at the moment, it is also fair to say that organisations are not solely in control of everything. The current saturated healthcare system did not cause Covid-19; it merely responded to it and the politics and science that also surround it.

So acknowledging that unfavourable conditions can be brought together and that we cannot always control all of it, we need to focus on what we can control to prevent ‘burn-out’:

  • Employers and employees need to honestly acknowledge their starting point, and make appropriate changes that support the prevention of burn-out; this needs to be undertaken by both, not merely one or the other.
  • Employers need to ensure the business values support the prevention of burn-out, that managers and employees understand those values and operate practices that are congruent with them
  • Employers need to operate in ways that prevent and avoid burn-out of their employees, adopting policies, procedures, and practices that foster health and wellbeing and avoid the risk of burn-out
  • Individuals need to recognise self-care as their top priority, not secondary to all else or an after-thought and employers need to support that too
  • Individuals need to understand resilience, it’s importance, how resilient they currently are, and what they can do to improve their resilience levels
  • Individuals need to adopt essential and healthy practices like taking regular and sufficient breaks, and employers need to support and encourage this
  • Employers and employees need to be more mental health aware and know how to support themselves and others
  • Employers and employees need to be more suicide aware, know the warning signs, and know how to provide a suicide intervention

The above is by no means exhaustive, and a great starting point is values. If we truly value the health and lives of our employees, truly value ourselves and our own health, then appropriate practices should by nature follow, but we need to make a tangible commitment to them and to ourselves.

Mind Matters training courses are particularly helpful in raising mental health awareness, helping and equipping managers to be knowledgeable and confident in supporting employees, helping everyone to strengthen their resilience, and helping people to identify those with thoughts of suicide and know what to do next.


International Statistical Classification of Diseases and Related Health Problems (11th ed,; ICD11; World Health Organization, 2020)

Maslach, Christina, and Michael P. Leiter. 1997. The truth about burn-out: how organisations cause personal stress and what to do about it. San Francisco, Calif: Jossey-Bass.