Addressing employee
burnout: Are you solving
the right problem?
Employers have invested unprecedented resources in employee mental
health and well-being. With burnout at all-time highs, leaders wonder ifthey can make a difference. Our research suggests they can.
This article is a collaborative effort by Jacqueline Brassey, Erica Coe, Martin Dewhurst, Kana Enomoto,
Renata Giarola, Brad Herbig, and Barbara Jeffery, representing the views of the McKinsey Health Institute.

© MinoruM/Getty Images

May 2022

The COVID-19 pandemic has accelerated andexacerbated long-standing corporate challenges
to employee health and well-being, and in particular
employee mental health.1 This has resulted inreports of rapidly rising rates of burnout2 aroundthe world (see sidebar “What is burnout?”).

What is burnout?
According to the World Health Organization, burnout is an
occupational phenomenon. It is driven by a chronic imbalance
between job demands1 (for example, workload pressure
and poor working environment) and job resources (forexample, job autonomy and supportive work relationships).
It is characterized by extreme tiredness, reduced ability toregulate cognitive and emotional processes, and mental
distancing. Burnout has been demonstrated to be correlatedwith anxiety and depression, a potential predictor of broader
mental health challenges.2 When used in this article, burnout
does not imply a clinical condition.
1

Job demands are physical, social, or organizational aspects of the job that
require sustained physical or mental effort and are therefore associated withcertain physiological and psychological costs—for example, work overload
and expectations, interpersonal conflict, and job insecurity. Job resources arethose physical, social, or organizational aspects of the job that may do any of
the following: (a) be functional in achieving work goals; (b) reduce job
demands and the associated physiological and psychological costs; (c)stimulate personal growth and development such as feedback, job control,social support (Wilmar B. Schaufeli and Toon W. Taris, “A critical reviewof the job demands-resources model: Implications for improving work andhealth,” from Georg F. Bauer and Oliver Hämmig’s Bridging Occupational,
Organizational and Public Health: A Transdisciplinary Approach, first edition,
Dordrecht, Netherlands: Springer, 2014).
2
Previous meta-analytic findings demonstrate moderate positive correlationsof burnout with anxiety and depression—suggesting that anxiety and 		depression are related to burnout but represent different constructs 		
(Katerina Georganta et al., “The relationship between burnout, depression,and anxiety: A systematic review and meta-analysis,” Frontiers in Psychology,
March 2019, Volume 10, Article 284).

1

Many employers have responded by investing more
into mental health and well-being than ever before.
Across the globe, four in five HR leaders report thatmental health and well-being is a top priority for
their organization.3 Many companies offer a hostof wellness benefits such as yoga, meditation app
subscriptions, well-being days, and trainings on time
management and productivity. In fact, it is estimatedthat nine in ten organizations around the world offersome form of wellness program.4
As laudable as these efforts are, we have foundthat many employers focus on individual-levelinterventions that remediate symptoms, rather thanresolve the causes of employee burnout.5 Employing
these types of interventions may lead employers tooverestimate the impact of their wellness programsand benefits6 and to underestimate the criticalrole of the workplace in reducing burnout andsupporting employee mental health and well-being.7
Research shows that, when asked about aspectsof their jobs that undermine their mental health andwell-being,8 employees frequently cite the feeling ofalways being on call, unfair treatment, unreasonable
workload, low autonomy, and lack of social support.9
Those are not challenges likely to be reversed withwellness programs. In fact, decades of researchsuggest that interventions targeting only individuals
are far less likely to have a sustainable impact on
employee health than systemic solutions, includingorganizational-level interventions.10
Since many employers aren’t employing a systemic
approach, many have weaker improvements inburnout and employee mental health and well-being
than they would expect, given their investments.

When used in this article, “mental health” is a term inclusive of positive mental health and the full range of mental, substance use, and 		
neurological conditions.
2
When used in this article, “burnout” and “burnout symptoms” refer to work-driven burnout symptoms (per sidebar “What is burnout?”).
3
McKinsey Health Institute Employee Mental Health and Wellbeing Survey, 2022: n (employee) = 14,509; n (HR decision maker) = 1,389.
4Charlotte Lieberman, “What wellness programs don’t do for workers,” Harvard Business Review, August 14, 2019.
5
Anna-Lisa Eilerts et al., “Evidence of workplace interventions—A systematic review of systematic reviews,” International Journal of 		
Environmental Research and Public Health, 2019, Volume 16, Number 19.
6
Katherine Baicker et al., “Effect of a workplace wellness program on employee health and economic outcomes: A randomized clinical trial,”
JAMA, 2019, Volume 321, Number 15; erratum published in JAMA, April 17, 2019.
7
Pascale M. Le Blanc, et al., “Burnout interventions: An overview and illustration,” in Jonathan R. B. Halbesleben’s Handbook of Stress andBurnout in Health Care, New York, NY: Nova Science Publishers, 2008; Peyman Adibi et al., “Interventions for physician burnout: A systematic
review of systematic reviews,” International Journal of Preventive Medicine, July 2018, Volume 9, Number 1.
8Paula Davis, Beating Burnout at Work: Why Teams Hold the Secret to Well-Being and Resilience, Philadelphia, PA: Wharton School Press, 2021.
9
Jennifer Moss, The Burnout Epidemic: The Rise of Chronic Stress and How We Can Fix It, Boston, MA: Harvard Business Review Press, 2021.
10
Hanno Hoven et al., “Effects of organisational-level interventions at work on employees’ health: A systematic review,” BMC Public Health, 2014,
Volume 14, Number 135.

2

Addressing employee burnout: Are you solving the right problem?

Organizations pay a high price for failure to address
workplace factors11 that strongly correlate withburnout,12 such as toxic behavior.13 A growing body ofevidence, including our research in this report, sheds
light on how burnout and its correlates may leadto costly organizational issues such as attrition.14
Unprecedented levels of employee turnover—aglobal phenomenon we describe as the Great
Attrition—make these costs more visible. Hidden
costs to employers also include absenteeism, lower
engagement, and decreased productivity.15
In this article, we discuss findings of a recent
McKinsey Health Institute (MHI) (see sidebar “TheMcKinsey Health Institute: Join us!”) global surveythat sheds light on frequently overlooked workplace
factors underlying employee mental health andwell-being in organizations around the world. We
conclude by teeing up eight questions for reflection
along with recommendations on how organizations
can address employee mental-health and wellbeing challenges by taking a systemic approach
focused on changing the causes rather than thesymptoms of poor outcomes. While there is no well-established playbook, we suggest employers canand should respond through interventions focusedon prevention rather than remediation.

We are seeing persistent burnout
challenges around the world
To better understand the disconnection between
employer efforts and rising employee mental-healthand well-being challenges (something we haveobserved since the start of the pandemic), between
February and April 2022 we conducted a global
survey of nearly 15,000 employees and 1,000 HR
decision makers in 15 countries.16
The workplace dimensions assessed in our survey
included toxic workplace behavior, sustainable
work, inclusivity and belonging, supportive growthenvironment, freedom from stigma, organizational
commitment, leadership accountability, and accessto resources.17 Those dimensions were analyzed
against four work-related outcomes—intent to leave,
work engagement, job satisfaction, and organization

11

Gunnar Aronsson et al., “A systematic review including meta-analysis of work environment and burnout symptoms,” BMC Public Health, 2017,
Volume 17, Article 264.
12Sangeeta Agrawal and Ben Wigert, “Employee burnout, part 1: The 5 main causes,” Gallup, July 12, 2018.
13
The high cost of a toxic workplace culture: How culture impacts the workforce — and the bottom line, Society for Human Resource 		Management, September 2019.
14
Caio Brighenti et al., “Why every leader needs to worry about toxic culture,” MIT Sloan Management Review, March 16, 2022.
15
Eric Garton, “Employee burnout is a problem with the company, not the person,” Harvard Business Review, April 6, 2017.
16
Argentina, Australia, Brazil, China, Egypt, France, Germany, India, Japan, Mexico, South Africa, Switzerland, Turkey, the United Kingdom, andthe United States. The combined population of the selected countries correspond to approximately 70 percent of the global total.
17
The associations of all these factors with employee health and well-being have been extensively explored in the academic literature. That
literature heavily informed the development of our survey instrument. We have psychometrically validated this survey across 15 countries
including its cross-cultural factorial equivalence. For certain outcome measures we collaborated with academic experts who kindly offered us
their validated scales including the Burnout Assessment Tool (BAT), the Distress Screener, and the Adaptability Scale referenced below.

The McKinsey Health Institute: Join us!
The McKinsey Health Institute (MHI) isan enduring, non-profit-generating global
entity within McKinsey. MHI strives tocatalyze actions across continents, sectors,
and communities to achieve material improvements in health, empowering people
to lead their best possible lives. MHI isfostering a strong network of organizationscommitted to this aspiration, including
employers globally who are committed tosupporting the health of their workforce
and broader communities.
MHI has a near-term focus on the urgent
priority of mental health, with launch of aflagship initiative around employee mental
health and well-being. By convening leading employers, MHI aims to collect global
data, synthesize insights, and drive innovation at scale. Through collaboration, we

Addressing employee burnout: Are you solving the right problem?

can truly make a difference, learn together,and co-create solutions for workplaces tobecome enablers of health—in a way that isgood for business, for employees, and forthe communities in which they live.
To stay updated about MHI’s initiative on
employee mental health and well-being
sign up at McKinsey.com/mhi/contact-us.

3

advocacy—as well as four employee mental-healthoutcomes—symptoms of anxiety, burnout, depression,and distress.18 Individual adaptability was also
assessed19 (see sidebar “What we measured”).

18

Instruments used were the Burnout Assessment Tool (Steffie Desart et al., User manual - Burnout assessment tool [BAT], - Version 2.0,
July 2020) (burnout symptoms); Distress Screener (4DSQ; JR Anema et al., “Validation study of a distress screener,” Journal of Occupational
Rehabilitation, 2009, Volume 19) (distress); GAD-2 assessment (Priyanka Bhandari et al., “Using Generalized Anxiety Disorder-2 [GAD-2] andGAD-7 in a primary care setting,” Cureus, May 20, 2021, Volume 12, Number 5) (anxiety symptoms); and the PHQ-2 assessment (Patient Health
Questionnaire [PHQ-9 & PHQ-2], American Psychological Association) (depression symptoms).
19
In this article, “adaptability” refers to the “affective adaptability” which is one sub-dimension of The Adaptability Scale instrument (Michel
Meulders and Karen van Dam, “The adaptability scale: Development, internal consistency, and initial validity evidence,” European Journal of
Psychological Assessment, 2020, Volume 37, Number 2).

What we measured
Workplace factors assessed in our
survey included:— Toxic workplace behavior: Employees
experience interpersonal behavior that
leads them to feel unvalued, belittled,
or unsafe, such as unfair or demeaning
treatment, noninclusive behavior,sabotaging, cutthroat competition,
abusive management, and unethicalbehavior from leaders or coworkers.
— Inclusivity and belonging: Organization
systems, leaders, and peers foster awelcoming and fair environment for
all employees to be themselves, findconnection, and meaningfully contribute.
— Sustainable work: Organization andleaders promote work that enables ahealthy balance between work andpersonal life, including a manageable
workload and work schedule.
— Supportive growth environment:
Managers care about employee
opinions, well-being, and satisfaction
and provide support and enable
opportunities for growth.
— Freedom from stigma and discrimination:
Freedom from the level of shame,prejudice, or discrimination employees
perceive toward people with mentalhealth or substance-use conditions.
— Organizational accountability:
Organization gathers feedback, tracks
KPIs, aligns incentives, and measuresprogress against employee health goals.
— Leadership commitment: Leadersconsider employee mental health a
top priority, publicly committing to aclear strategy to improve employee
mental health.
— Access to resources: Organization offers
easy-to-use and accessible resourcesthat fit individual employee needs
related to mental health.1
Health outcomes assessed in our
survey included:— Burnout symptoms: An employee’s
experience of extreme tiredness,
reduced ability to regulate cognitiveand emotional processes, and mental
distancing (Burnout Assessment Tool).2— Distress: An employee experiencing anegative stress response, often involving
negative affect and physiologicalreactivity (4DSQ Distress Screener).3

1— Depression symptoms: An employee
having little interest or pleasure in doing
things, and feeling down, depressed, or
hopeless (PHQ-2 Screener).4— Anxiety symptoms: An employee’s
feelings of nervousness, anxiousness, orbeing on edge, and not being able to stopor control worrying (GAD-2 Screener).5
Work-related outcomes assessed in our
survey included:— Intent to leave: An employee’s desire toleave the organization in which they are
currently employed in the next three to
six months.
— Work engagement: An employee’s
positive motivational state of highenergy combined with high levels ofdedication and a strong focus on work.
— Organizational advocacy: An employee’s
willingness to recommend or endorse
their organization as a place to work tofriends and relatives.
— Work satisfaction: An employee’s levelof contentment or satisfaction with theircurrent job.

Including adaptability and resilience-related learning and development resources.
Burnout Assessment Tool, Steffie Desart et al., “User manual - Burnout assessment tool (BAT), - Version 2.0,” July 2020.
3
Distress screener, 4DSQ; JR Anema et al., “Validation study of a distress screener,” Journal of Occupational Rehabilitation, 2009, Volume 19.
4
Kurt Kroenke et al., “The patient health questionnaire-2: Validity of a two-item depression screener,” Medical Care, November 2003, Volume 41, Issue 11.
5
Kurt Kroenke et al., “Anxiety disorders in primary care: Prevalence, impairment, comorbidity, and detection,” Annals of Internal Medicine, March 6, 2007, Volume 146, Issue 5.
24Addressing employee burnout: Are you solving the right problem?

Our survey pointed to a persistent disconnection
between how employees and employers perceive
mental health and well-being in organizations. We
see an average 22 percent gap between employer
and employee perceptions—with employers
consistently rating workplace dimensions
associated with mental health and well-being morefavorably than employees.20

In this report—the first of a broader series on
employee mental health from the McKinsey HealthInstitute—we will focus on burnout, its workplacecorrelates, and implications for leaders. On average,
one in four employees surveyed report experiencing
burnout symptoms.21 These high rates were observed
around the world and among various demographics(Exhibit 1),22 and are consistent with global trends.23

Web <2022><Rethinking employee mental health>
Exhibit <1>1 of <5>
ExhibitEmployees
report highhigh rates
rates ofofburnout
burnout andand distress
distresssymptoms,
symptoms,despite
despiteEmployees reportorganizational
commitment
tomentalhealthandwell-being
asapriority.
organizational commitment to mental health and well-being as a priority.
Workplace outcomes by country
Burnout, % of employees
reporting burnout symptoms
sometimes, often, or always
Argentina

Distress, % of employees
reporting to experiencemoderate distress

Organizational commitment,% of HR decision makers reporting
mental health as top priority
70

35

21

Australia

28

Brazil

24

China

23

83

32

78

42

83

28
43

36

Egypt

52

France28

30

78Germany

24

31

73

31

73

29

19

36

South Africa

25

34

Switzerland

19

Mexico

80

38

38

India
Japan

29

74
84
56

UK

27

31

78

US

28

32

74

Note: Employees and HR decision makers surveyed were not necessarily from the same organizations.
Source: McKinsey Health Institute Employee Mental Health and Wellbeing Survey 2022; employee, n = 14,509; HR decision maker, n = 1,389

20

Our survey did not link employers and employees’ responses. Therefore, these numbers are indicative of a potential gap that could be foundwithin companies.
21
Represents global average of respondents experiencing burnout symptoms (per items from Burnout Assessment Tool) sometimes, often,or always.
22
Our survey findings demonstrate small but statistically significant differences between men and women, with women reporting higher rates ofburnout symptoms (along with symptoms of distress, depression, and anxiety). Differences between demographic variables across countries
will be discussed in our future publications.
23
Ashley Abramson, “Burnout and stress are everywhere,” Monitor on Psychology, January 1, 2022, Volume 53, Number 1.

Addressing employee burnout: Are you solving the right problem?

5

So, what is behind pervasive burnout challenges
worldwide? Our research suggests that employers
are overlooking the role of the workplace in burnout
and underinvesting in systemic solutions.

Employers tend to overlook the roleof the workplace in driving employee
mental health and well-being,engagement, and performancebiggest predictor of burnout symptoms and intent
to leave by a large margin24 —predicting morethan 60 percent of the total global variance. For
positive outcomes (including work engagement,
job satisfaction, and organization advocacy), theimpact of factors assessed was more distributed—
with inclusivity and belonging, supportive growthenvironment, sustainable work, and freedom fromstigma predicting most outcomes (Exhibit 2).

In all 15 countries and across all dimensions
assessed, toxic workplace behavior was the
Web <2022><Rethinking employee mental health>
Exhibit <2>
Exhibit2of <5>

Toxic
workplace outcomes,
Toxic workplace
workplace behavior
behavior isis thethe biggest
biggest driver of negative workplaceoutcomes,suchasburnout
andintenttoleave.
such as burnout and intent to leave.
Contributing factors to workplace outcomes, % of variance in outcome measure driven by factor
Negative outcomes
Intentto leave

Burnout
symptoms

Distress

4
2
7

4
2
5

5
3
5

4

8

10

11

11
9

Positive outcomes

Depression
AnxietyJob
Organizational Worksymptoms symptoms satisfaction advocacy engagement
6
3
6
10
12

6
3
5

Factors
Other128

35

28

Freedom from stigma
Supportive growthenvironment

13

Sustainable work
10

12

12
13

19

Inclusivity
Toxic workplace
behavior

19
18

73

70

69

9

12
64

10

62
27
3

23
2

31

1

Note: % values indicate the relative contribution of each predictor to the proportion of variance explained for each outcome. These metrics were forced
to sum to 100% (instead of R2 or no meaningful sum) to allow for direct comparisons of the proportion of total variance explained across outcomes. Totalr-squared for each outcome: work engagement, 0.53; organizational advocacy, 0.51; work satisfaction, 0.51; burnout symptoms, 0.36; intent to leave, 0.34;
distress, 0.22; depression symptoms, 0.21; anxiety symptoms, 0.19. Figures may not sum to 100%, because of rounding.
1
Includes organizational accountability, employee health as a strategic priority, and access to resources.
Source: McKinsey Health Institute Employee Mental Health and Wellbeing Survey 2022, n = 14,509

24

6

Measured as a function of predictive power of the dimensions assessed; predictive power was estimated based on share of outcome variability
associated with each dimension; based on regression models applied to cross-sectional data (that is, measured at one point in time), rather
than longitudinal data (that is, measured over time); causal relationships have not been established.

Addressing employee burnout: Are you solving the right problem?

In all 15 countries and across all
dimensions assessed, toxic workplace
behavior had the biggest impact
predicting burnout symptoms andintent to leave by a large margin.
The danger of toxic workplace behavior—and its
impact on burnout and attrition
Across the 15 countries in the survey, toxic
workplace behavior is the single largest predictor
of negative employee outcomes, including burnout
symptoms (see sidebar “What is toxic workplace
behavior?”). One in four employees reportexperiencing high rates of toxic behavior at work.
At a global level, high rates were observed acrosscountries, demographic groups—including gender,organizational tenure, age, virtual/in-person work,
manager and nonmanager roles—and industries.25
Toxic workplace behaviors are a major cost for
employers—they are heavily implicated in burnout,
which correlates with intent to leave and ultimately

drives attrition. In our survey, employees whoreport experiencing high levels of toxic behavior26
at work are eight times more likely to experienceburnout symptoms (Exhibit 3). In turn, respondents
experiencing burnout symptoms were six times
more likely to report they intend to leave theiremployers in the next three to six months (consistent
with recent data pointing to toxic culture as the
single largest predictor of resignation during
the Great Attrition, ten times more predictive
than compensation alone27 and associated withmeaningful organizational costs28). The opportunity
for employers is clear. Studies show that intent
to leave may correlate with two- to three-times
higher29 rates of attrition; conservative estimates

25

Differences between demographic variables across countries will be discussed in our future articles.
“High” represents individuals in the top quartile of responses and “low” represents individuals in the bottom quartile of responses.
27
Charles Sull et al., “Toxic culture is driving the Great Resignation,” MIT Sloan Management Review, January 11, 2022.
28
Rasmus Hougaard, “To stop the Great Resignation, we must fight dehumanization at work,” Potential Project, 2022.
29
Bryan Bohman et al., “Estimating institutional physician turnover attributable to self-reported burnout and associated financial burden: A casestudy,” BMC Health Services Research, November 27, 2018, Volume 18, Number 1.
26

What is toxic workplace behavior?
Toxic workplace behavior is interpersonal behavior that leads to employees feeling unvalued, belittled, or unsafe, suchas unfair or demeaning treatment, non-inclusive behavior, sabotaging, cutthroat competition, abusive management, andunethical behavior from leaders or coworkers. Selected questions from this dimension include agreement with the statements“My manager ridicules me,” “I work with people who belittle my ideas,” and “My manager puts me down in front of others.”

Addressing employee burnout: Are you solving the right problem?

7

Web <2022><Rethinking employee mental health>
Exhibit <3>
Exhibit3of <5>

Employees
reporting high levels ofof toxic behavior at
at work are more likely to
Employees reporting
experienceburnout,
leadingtoanincreased
intention
to quit.
quit.
experience burnout, leading to an increased intention to
Share of employees reporting burnout symptoms Share of employees reporting intent to leave theirby level of toxic behavior reported at work, %job in the next 3–6 months by level of burnout
experienced, %

52.5
6.9
Low levels of
toxic behavior

7.6×

52.0
8.2

High levels of
toxic behavior

6.3×

Low levels ofburnout symptoms

High levels ofburnout symptoms

Note: “Low” refers to bottom quartile of respondents; “high” refers to top quartile of respondents.
Source: McKinsey Health Institute Employee Mental Health and Wellbeing Survey 2022, n = 14,509

of the cost of replacing employees range from onehalf to two times their annual salary. Even without
accounting for costs associated with burnout—
including organizational commitment30 and higher
rates of sick leave and absenteeism31 —the businesscase for addressing it is compelling. The alternative—
not addressing it—can lead to a downward spiral inindividual and organizational performance.32
Individuals’ resilience and adaptability skills mayhelp but do not compensate for the impact of a
toxic workplace
Toxic behavior is not an easy challenge to address.
Some employers may believe the solution is simply
training people to become more resilient.

30

There is merit in investing in adaptability andresiliency skill building. Research indicates that
employees who are more adaptable tend to havean edge in managing change and adversity.33 We
see that edge reflected in our survey findings:
adaptability acts as a buffer34 to the impactof damaging workplace factors (such as toxic
behaviors), while magnifying the benefit of
supportive workplace factors (such as a supportive
growth environment) (Exhibit 4). In a recent study,
employees engaging in adaptability training
experienced three times more improvement inleadership dimensions and seven times more
improvement in self-reported well-being than thosein the control group.35

Michael Leiter and Christina Maslach, “The impact of interpersonal environment on burnout and organizational commitment,” Journal of
Organizational Behavior, October 1988, Volume 9, Number 4.
31
Arnold B. Bakker et al., “Present but sick: A three-wave study on job demands, presenteeism and burnout,” Career Development International,
2009, Volume 14, Number 1.
32
Ibid.
33
Karen van Dam, “Employee adaptability to change at work: A multidimensional, resource-based framework,” from The Psychology ofOrganizational Change: Viewing Change from the Employee’s Perspective, Cambridge, England: Cambridge University Press, 2013; 		
Jacqueline Brassey et al., Advancing Authentic Confidence Through Emotional Flexibility: An Evidence-Based Playbook of Insights, Practices
and Tools to Shape Your Future, second edition, Morrisville, NC: Lulu Press, 2019; B+B Vakmedianet B.V. Zeist, Netherlands (to be publishedQ3 2022).
34
Estimated buffering effect illustrated in Exhibit 4.
35
McKinsey’s People and Organization Performance - Adaptability Learning Program; multirater surveys showed improvements in adaptability
outcomes, including performance in role, sustainment of well-being, successfully adapting to unplanned circumstances and change, optimism,
development of new knowledge and skills; well-being results were based on self-reported progress as a result of the program.

8Addressing employee burnout: Are you solving the right problem?

Web <2022><Rethinking employee mental health>
Exhibit <4>
Exhibit4of <5>

Althoughof toxic
toxic workplace
workplacebehavior,
behavior,it
Although affective
affective adaptability buffers the effecteffect ofitisnotsufficienttoovercomeabadenvironment.
is not sufficient to overcome a bad environment.
Share of employees reporting high work engagement
by level of adaptability and level of toxic behavior at work, %0

25High affective adaptability
Low affective adaptability

50

75

100

Low levels of
toxic behavior
High levels of
toxic behavior

0.2×

0.8×

Note: “Low” refers to bottom quartile of respondents; “high” refers to top quartile of respondents.
Source: McKinsey Health Institute Employee Mental Health and Wellbeing Survey 2022, n = 14,509

However, employers who see building resilience andadaptability skills in individuals as the sole solution
to toxic behavior and burnout challenges are
misguided. Here is why.

broader workplace factors puts employers at aneven higher risk of losing some of its most resilient,
adaptable employees.

Individual skills cannot compensate forunsupportive workplace factors. When it comesto the effect of individual skills, leaders should beparticularly cautious not to misinterpret “favorable”
outcomes (for example, buffered impact of toxic
behaviors across more adaptable employees) as
absence of underlying workplace issues that should
be addressed.36

What this means for employers: Whyorganizations should take a systemic
approach to improving employee
mental health and well-being

Also, while more adaptable employees are
better equipped to work in poor environments,
they are less likely to tolerate them. In our
survey, employees with high adaptability were
60 percent more likely to report intent to leave
their organization if they experienced high levelsof toxic behavior at work than those with low
adaptability (which may possibly relate to a higher
level of self-confidence37). Therefore, relying on
improving employee adaptability without addressing

36
37

We often think of employee mental health, wellbeing, and burnout as a personal problem. That’s
why most companies have responded to symptoms
by offering resources focused on individuals such aswellness programs.
However, the findings in our global survey andresearch are clear. Burnout is experienced byindividuals, but the most powerful drivers of burnout
are systemic organizational imbalances acrossjob demands and job resources. So, employers
can and should view high rates of burnout as a
powerful warning sign that the organization—not
the individuals in the workforce—needs to undergo
meaningful systematic change.

Tomas Chamorro-Premuzic, “To prevent burnout, hire better bosses,” Harvard Business Review, August 23, 2019.
Brassey et al. found that as a result of a learning program, employees who developed emotional flexibility skills, a concept related to affective
adaptability but also strongly linked to connecting with purpose, developed a higher self-confidence over time; Jacqueline Brassey et al.,“Emotional flexibility and general self-efficacy: A pilot training intervention study with knowledge workers,” PLOS ONE, October 14, 2020,
Volume 15, Number 10.

Addressing employee burnout: Are you solving the right problem?

9

Employees with high adaptability
were 60 percent more likely to reportintent to leave their organization if theyexperienced high levels of toxic behavior
at work than those with low adaptability.
Taking a systemic approach means addressing
both toxic workplace behavior and redesigningwork to be inclusive, sustainable, and supportiveof individual learning and growth, including
leader and employee adaptability skills. It means
rethinking organizational systems, processes,
and incentives to redesign work, job expectations,and team environments.
As an employer, you can’t “yoga” your way out ofthese challenges. Employers who try to improveburnout without addressing toxic behavior are
likely to fail. Our survey shows that improving
all other organization factors assessed (without
addressing toxic behavior) does not meaningfully

improve reported levels of burnout symptoms. Yet,when toxic behavior levels are low, each additional
intervention contributes to reducing negative
outcomes and increasing positive ones.
Exhibit 5 shows the estimated interplay between thedrivers and outcomes, based on our survey data.
Taking a preventative, systemic approach—focusedon addressing the roots of the problem (as opposed
to remediating symptoms)—is hard. But the upsidefor employers is a far greater ability to attract andretain valuable talent over time.

Web <2022><Rethinking employee mental health>
Exhibit <5>
Exhibit5of <5>When
When there
there are highhigh levels
levels of toxic behavior in
inaa workplace,
workplace, addressing
addressing otherorganizational
factors
doesn’tmeaningfully
improveburnout
organizational factors doesn’t meaningfully improve burnout oror intent
intent toto leave.
leave.
Employee health and business outcomes by work environment type,% of respondents with high level of outcome
Poor
environment1

Ignoring
toxic behavior2

Addressing
toxic behavior alone3

Work engagement

15

38

15

38

Work satisfaction

14

37

16

39

Burnout

38

28

19

9

Intent to leave

33

29

19

15

Note: “Low” refers to bottom quartile of respondents; “high” refers to top quartile of respondents.
High levels of toxic behavior; low levels of sustainable work, supportive growth environment, and inclusivity.
High levels of toxic behavior, sustainable work, supportive growth environment, and inclusivity.
3
Low levels of toxic behavior, sustainable work, supportive growth environment, and inclusivity.
4
Low levels of toxic behavior; high levels of sustainable work, supportive growth environment, and inclusivity.
Source: McKinsey Health Institute Employee Mental Health and Wellbeing Survey 2022, n = 14,509
1

2

10

Strongenvironment4

Addressing employee burnout: Are you solving the right problem?

Employers can and should view highrates of burnout as a powerful warning
sign that the organization—not theindividuals in the workforce—needs toundergo meaningful systematic change.
The good news: Although there are no
silver bullets, there are opportunities
for leaders to drive material change
We see a parallel between the evolution of global
supply chains and talent. Many companies optimized
supply chains for “just in time” delivery, and talent
was optimized to drive operational efficiency
and effectiveness. As supply chains come underincreasing pressure, many companies recognize
the need to redesign and optimize supply chains forresilience and sustainability, and the need to takean end-to-end approach to the solutions. The same
principles apply to talent.
We acknowledge that the factors associated withimproving employee mental health and well-being(including organizational-, team-, and individuallevel factors) are numerous and complex. And taking
a whole-systems approach is not easy.
Despite the growing momentum toward better
employee mental health and well-being (acrossbusiness and academic communities), we’re still
early on the journey. We don’t yet have sufficientevidence to conclude which interventions work mosteffectively—or a complete understanding of why
they work and how they affect return on investment.
That said, efforts to mobilize the organization torethink work—in ways that are compatible with both
employee and employer goals—are likely to pay off
in the long term. To help spark that conversation inyour organization, we offer eight targeted questions
38
39

and example strategies with the potential to addresssome of the burnout-related challenges discussed
in this article.
Do we treat employee mental health and wellbeing as a strategic priority?
This is fundamental to success. When a largeorganization achieved a 7 percent reductionin employee burnout rates (compared with an
11 percent increase in the national average within theindustry over the same period), the CEO believed thatleadership and sustained attention from the highest
level of the organization were the “key to making
progress.”38 Senior executives recognized employee
mental health and well-being as a strategic priority.
Executives publicly acknowledged the issues andlistened to employee needs through a wide rangeof formats—including town halls, workshops, andemployee interviews (our research suggests thatleaders are not listening to their people nearlyenough). They prioritized issues and defined clear,time-bound measurable goals around them—witha standardized measure of burnout being given
equal importance to other key performance metrics(financial metrics, safety/quality, employee turnover,and customer satisfaction). Although anonymous at
the level of the individual, results were aggregatedat division/department level to allow executive
leadership to focus attention and resources where
they were most needed.39 This example highlights
how CEOs have the ability to create meaningfulchange through listening to employees andprioritizing strategies to reduce burnout.

John H. Noseworthy and Tait D Shanafelt, “Executive leadership and physician well-being: Nine organizational strategies to promote
engagement and reduce burnout,” Mayo Clinic Proceedings, January 2017, Volume 92, Number 1.
Liselotte Dyrbye et al., “Physician burnout: Contributors, consequences and solutions,” Journal of Internal Medicine, 2018, Volume 283,
Number 6.

Addressing employee burnout: Are you solving the right problem?

11

Do we effectively address toxic behaviors?
Eliminating toxic workplace behavior is not aneasy task. Organizations that tackle toxic behavior
effectively deploy a set of integrated work practices
to confront the problem,40 and see treatmentof others as an integral part of assessing an
employee’s performance. Manifestations of toxic
behavior41 are flagged, repeat offenders either
change or leave, and leaders take time to becomeaware of the impact their behavior has on others.
If you lead part of an organization, looking at yourown behaviors, and what you tolerate in your own
organization, is a good place to start.42
Another component of eliminating toxic behavior
is cultivating supportive, psychologically safe
work environments, where toxic behaviors are lesslikely to spread across the organization.43 Effective
leaders know that emotional contagion44 may goboth ways: displaying vulnerability and compassion
fuels more compassionate teams; displaying toxic
behavior fuels more toxic teams.45 There are two
caveats: toxic behavior may not be intentional—
particularly if individuals are not equipped torespond with calm and compassion under pressure—and regardless of intent, toxic behavior spreads
faster and wider than good behavior.46 To prevent
unintentional dissemination of toxic behaviors,role modeling from adaptable, self-regulating,compassionate leaders may help (see sidebar“Leaders with higher self-regulation may be better,less toxic leaders”).
Do we create inclusive work environments?
Most leaders recognize the establishedassociations between performance and inclusion,
but inclusion does not happen by accident. Inclusion
is a multifaceted construct that must be addressed
comprehensively and proactively. Most companies
define inclusion too narrowly and thus address
it too narrowly as well. Over the past three years,
we’ve broadened our perspective on how to create
truly inclusive workplaces and developed a modern
inclusion model. The model includes 17 practices(based on frequency of desired behaviors) and six
outcomes (based on perceptions of effectiveness).
Each practice falls into one of three relationshipsthat shape workplace inclusion: organizational
systems, leaders, and peers/teammates.

40

Robert I. Sutton, The No Asshole Rule: Building a Civilized Workplace and Surviving One That Isn’t, first edition, New York, NY: Business Plus, 2010.
“Why every leader,” 2022.
42“Author Talks: How to handle your work jerk,” March 29, 2022.
43
Annie McKee, “Neutralize your toxic boss,” Harvard Business Review, September 24, 2008.
44
John T. Cacioppo et al., Emotional Contagion, Cambridge, England: Cambridge University Press, 1994.
45
Michael Housman and Dylan Minor, Toxic workers, Harvard Business School working paper, No. 16-057, October 2015 (revised November 2015).
46“To prevent burnout,” 2019.
41

Leaders with higher self-regulation may be better, less toxic leaders
Research shows that leaders’ development of self-regulation increases followers’ ratings of their effectiveness and isassociated with higher team financial performance as well as a higher final team grade compared with a control group.
The benefits of self-regulation also improved leaders’ development of task-relevant competencies.1 Furthermore, building
employees’ resilience and adaptability skills leads to a higher sense of agency and self-efficacy,2 which is related to reduced
burnout and improved performance.3
1

Robin Martin and JooBee Yeow, “The role of self-regulation in developing leaders: A longitudinal field experiment,” Leadership Quarterly, October 2013,
Volume 24, Number 5.
Jacqueline Brassey et al., “Emotional flexibility and general self-efficacy: A pilot training intervention study with knowledge workers,” PLOS ONE, 		
October 14, 2020, Volume 15, Number 10; and Jacqueline Brassey et al., Advancing Authentic Confidence Through Emotional Flexibility: An EvidenceBased Playbook of Insights, Practices and Tools to Shape Your Future, second edition, Morrisville, NC: Lulu Press, 2019; B+B Vakmedianet B.V. Zeist,
Netherlands (to be published Q3 2022).
3Charles Benight et al., “Associations between job burnout and self-efficacy: A meta-analysis,” Anxiety, Stress, & Coping, 2016, Volume 29, Issue 4; andAlex Stajkovic, “Self-efficacy and work-related performance: A meta-analysis,” Psychological Bulletin, 1998, Volume 124, Number 2.
212Addressing employee burnout: Are you solving the right problem?

The 17 inclusive-workplace practices, when done
consistently well, drive workplace inclusion andequity for all employees by providing clarity into
actions that matter. For example, among employees
working in hybrid models, work–life support was
the top practice employees desired improvements
on—with nearly half of employees recommending
prioritizing policies that support flexibility—including
extended parental leave, flexible hours, and workfrom-home policies.
A truly inclusive workplace implements systems
that minimize conscious and unconscious bias,
allowing employees to express themselves andconnect with each other. It also features leaders
who not only advocate for team members and treat
them impartially but also uphold and support allorganizational systems and practices. For example,
one employer defined data-driven targets for the
representation and advancement of diverse talentacross dimensions (beyond gender and ethnicity)and role types (executive, management, technical,
board)—leveraging powerful analytics to trackprogress and foster transparency along the way.
Do we enable individual growth?
Evidence suggests that individual growth, learning,and development programs are effective47 ways
to combat burnout and to retain and engage
employees, and therefore are important foraddressing growing talent and skills shortages
within organizations. Employers who “double
down” on talent redeployment, mobility, reskilling,
and upskilling tend to see improvement across a
range of financial, organizational, and employee
experience metrics. In a recent study of extensive
employee data, offering lateral career opportunities
was two-and-half times more predictive of
employee retention than compensation, and12 times more predictive than promotions48 —signaling an opportunity for leaders to support
employee desires to learn, explore, and grow way
beyond traditional career progression.

Investing in your employees’ capabilities can drive
financial returns, is often cheaper than hiring, andsignals to employees that they are valued and havean important role in the organization.
Do we promote sustainable work?
Promoting sustainable work goes beyond managing
workload. It’s about enabling employees to have asense of control and predictability, flexibility, andsufficient time for daily recovery. It’s also about
leading with compassion and empathy49—tailoring
interventions based on where, when, and how work
can be done, and how different groups are more
likely to (re)establish socio-emotional ties after along period of isolation and loss of social cohesion.
One technology company is using real-timedata on employee preferences to rapidly test anditerate solutions that work for specific groups
around return-to-office options. To find solutions
that work for your employees, consider adopting
a test-and-learn mindset. This approach canhelp the organization make progress while
adapting as context evolves (a hallmark ofmore productive organizations).
Are we holding leaders accountable?
Many organizations consider people leadershipcriteria in their performance management. Yet,
there is substantial room to grow when it comesto employers providing transparency aroundemployee mental-health and well-being objectives
and metrics.50
Organizations that are doing this well have set
clear expectations for managers to lead in a waythat is supportive of employee mental health andwell-being.51 They offer training to help managers
identify, proactively ask about, and listen to
employees’ mental-health and well-being needs.
They also introduce mental-health “pulse” checks
and incorporate relevant questions into the broader
employee satisfaction surveys, to establish a47

Arnold B. Bakker and Evangelia Demerouti, “Towards a model of work engagement,” Career Development International, 2008, Volume 13, Issue 3.
“Why every leader,” 2022.
49“It’s time to eliminate bad bosses. They are harmful and expensive,” Potential Project, The Human Leader, April 2022.
50
Workplace Mental Health Blogs, One Mind, “Fix performance management by aligning it with employee mental health,” blog entry by Daryl Tol,
March 2, 2022; Garett Slettebak, “Measuring progress on workplace mental health”, One Mind at Work, March 24, 2022.
51
Taylor Adams et al., Mind the workplace: Work health survey 2021, Mental Health America, 2021.
48

Addressing employee burnout: Are you solving the right problem?

13

baseline and track trends in how employees are
feeling. Discussion on employee mental healthand well-being can be incorporated into regularleadership meetings, including concerns, risks,and potential actions.
To encourage leaders to lead by example andincrease their accountability, some employers
embed employee mental-health support into
leaders’ reviews based on anonymous upward
feedback from their teams. Finally, some companies
are exploring if they can go even further and tie
incentives to short- and long-term employee
mental-health and well-being objectives.
Are we effectively tackling stigma?
As noted in a previous McKinsey article, the majorityof employers and employees acknowledge thepresence of stigma52 in their workplaces. Stigma
has been shown to have real costs to workforce
productivity, often exacerbating underlying
conditions because of people being afraid to seek
help for mental-health needs and driving down an
employee’s self-worth and engagement.
We see several actions that organizations are taking
to eliminate stigma.53 Leading by example can makea difference, with senior leaders stepping forward
to describe personal struggles with mental health,using nonstigmatizing language.54 Leaders showing
vulnerability helps to remove shame and promote a
psychologically safe culture.55
Stigma can also be reduced by companies
prioritizing mental wellness as critical for peak
performance instead of rewarding overwork at theexpense of rest and renewal—rewarding an “athlete”
mindset instead of overemphasizing a “hero.” Thiscan begin to shift perception of signs of burnout orother mental-health needs as being indicative ofa moral failing. Finally, creating a dedicated role to52

support employee mental health and well-being
and appointing a senior leader, such as chief
wellness officer, will increase awareness andshow commitment.
Do our resources serve employee needs?
Leaders should evaluate whether mental-healthand well-being resources are at parity with physicalhealth benefits and how frequently they are being
used by employees. An increasing number of
employers have expanded access to mental-healthservices56; however, research shows that almost
70 percent of employees find it challenging toaccess those services.
In a previous survey, 45 percent of respondents
who had left their jobs cited the need to take careof family as an influential factor in their decision(with a similar proportion of respondents who are
considering quitting also citing the demands offamily care). Expanding childcare, nursing services,or other home- and family-focused benefits could
help keep such employees from leaving and showthat you value them. Patagonia, long the standardbearer for progressive workplace policies, retains
nearly 100 percent of its new mothers with on-site
childcare and other benefits for parents.
Never in history have organizations around theworld devoted so much attention and capital
to improving employee mental health and wellbeing. It is lamentable that these investments
are not always providing a good return regarding
improved outcomes. Employers that take thetime to understand the problem at hand—andpursue a preventative, systemic approach focusedon causes instead of symptoms—should seematerial improvements in outcomes and succeed
in attracting and retaining valuable talent. More
broadly, employers globally have an opportunity
to play a pivotal role in helping people achieve

In the context of employee mental health, stigma is defined as a level of shame, prejudice, or discrimination toward people with mental-healthor substance-use conditions.
Erica Coe, Jenny Cordina, Kana Enomoto, and Nikhil Seshan, “Overcoming stigma: Three strategies toward better mental health in theworkplace,” July 23, 2021.
54
Evelien Brouwers et al., “To disclose or not to disclose: A multi-stakeholder focus group study on mental health issues in the work environment.
Journal of Occupational Rehabilitation, 2020, Volume 30, Number 1.
55
Global thriving at work framework, MindForward Alliance, 2020.
56
Charles Ingoglia, “Now more than ever, employers must provide mental health support for employees,” National Council for Mental Wellbeing,
May 4, 2022.
53

14

Addressing employee burnout: Are you solving the right problem?

material improvements in health. With collaborationand shared commitment, employers can make ameaningful difference in the lives of their employees
and the communities they live in.

The McKinsey Health Institute (MHI) is collaboratingwith leading organizations around the world toachieve material improvements in health—adding

years to life and life to years. As part of that, MHI
is focused on improving employee mental healthand well-being at scale—in a way that is good forbusiness, for employees, and for the communities
they live in.
To stay updated about MHI’s initiative on
employee mental health and well-being, sign up
at Mckinsey.com/mhi/contact-us.

Find more content like this on the

McKinsey Insights App

Jacqueline Brassey is a director of research science in McKinsey’s Luxemburg office, Erica Coe is a partner in the Atlanta
office, Martin Dewhurst is a senior partner in the London office, Kana Enomoto is a senior expert in the Washington, DC,
office, and Barbara Jeffery is a partner in the London office; they are all leaders with McKinsey Health Institute (MHI).
Renata Giarola, in the Southern California office, and Brad Herbig, in the Philadelphia office, are consultants with MHI.
The authors wish to thank Yueyang Chen, Elena Chit, Aaron de Smet, Soheil Eshghi, Lars Hartenstein, Tom Latkovic, David
Mendelsohn, Roxy Merkand, Isidora Mitic, Bill Schaninger, Wilmar Schaufeli, Jeris Stueland, Berend Terluin, Karen van Dam,and Marieke van Hoffen for their contributions to this article.

Scan • Download • Personalize

Designed by McKinsey Global Publishing
Copyright © 2022 McKinsey & Company. All rights reserved.

Addressing employee burnout: Are you solving the right problem?

15