Overwork and “burnout” — how should employers respond?

Successive surveys, medical studies and the Government’s own data (from both the Office for National Statistics (ONS) and the HSE), paint an ever-worsening picture of the nation’s mental health. Whilst the causes of depression, stress and anxiety are generally recognised to be multifactorial and are often linked with issues outside the workplace — for example, the cost of living crisis, poor physical health and family responsibilities, the issues of overwork/burnout are often cited as the main work-related causes.

With ‘Mental Health Awareness Week’ starting on 13 May, we examine what is meant by “overwork” in both a practical and legal sense, summarise the key statistics and consider how employers should best respond.

“Overwork and burnout” 

The World Health Organisation (WHO) defines stress as ‘a state of worry or mental tension caused by a natural human response that prompts us to address challenges and threats in our lives”.

It is a truism that everyone experiences stress to some degree, but it is the way in which we respond to stress which makes the difference to our overall wellbeing. Both in and outside the workplace, one person’s reaction may be entirely different from another, albeit faced with identical circumstances.

The Court of Appeal recognised in a considered judgment to four claims involving workplace stress as far back in 2002 (Hatton v Sutherland and others), that no one job should be considered to be per se intrinsically stressful, so as to automatically give rise to a foreseeable risk of psychiatric/psychological injury developing.

We believe that a similarly nuanced approach should be taken to the issue of overwork as opposed to reliance on the individual’s perception and a strict computation of the hours worked over a given period. This should include the bespoke factual matrix of the circumstances and background, to include the degree to which the employer was on notice that the employee was overworked and at risk, together with consideration of key organisational stress hazards.

Organisational stress hazards include:

• Whether the employee has control over their workload
• Has the individual low levels of influence or autonomy in their work?
• How does their workload compare to others and have complaints been raised by colleagues?
• How are workloads managed by the organisation?
• Does the role which they currently undertake differ from when it was assigned?
• Does the employee possess the requisite skill set for the role they have been asked to undertake?
• Are there any training needs which would allow them to fulfill their role more efficiently?
• If additional hours are worked, is this paid/unpaid and is this voluntary or enforced/required by the organisation?
• To what degree (if at all) was the employer “on notice” that the “overworked” employee was exhibiting signs of stress, depression and anxiety and what steps were taken to mitigate those circumstances?

The medical consequences of overwork

In its most extreme sense, the Japanese have a specific word “karoshi”, translated literally as “death due to overwork”. The phrase was coined following a number of fatalities amongst Japanese employees attributed to them consistently working excessive hours over a sustained period.

The link between long hours and depression has been mooted in a number of studies; Ogawa et al, reported those working between 80 to 99.9 hours a week and more than 99.9 hours a week had a 2.83% and 6.9% respectively, greater risk of experiencing depression compared to those working less than 60 hours. The studies are not unanimous in their findings on the link between long hours and depression, stress and anxiety. A meta-analysis conducted by Wong, Chan and Ngan in 2018 (‘The effect of long working hours on overtime and occupational health, a meta-analysis of evidence from 1998-2018’), considered three previous studies, reaching the conclusion that:

“Whilst some studies suggest long hours contribute to psychological stress and work stress, the relationship between working long hours and work stress requires more investigation”.

Other studies referred to in Chan’s meta-analysis conclude that overwork leads to increased rates of smoking, drinking and physical inactivity, though Chan again cautions that the literature did not record consistent findings on the relationship between overtime and adverse health outcomes.

Other researchers have been less cautious in attributing health outcomes to working long hours. The BBC reported in May 2021 upon a large scale study which included a contribution from the WHO with the conclusions that three quarters of a million people worldwide die each year from ischaemic heart disease and stroke attributable to working long hours and disturbed, shortened patterns of sleep.

By way of context, studies have shown unemployment to lead to a doubling of depression and suicide risk (Amiri S (’Unemployment associated with major depression disorder; a systematic review and meta=analysis 2022), whilst the most damaging stressors for mental health occur before childhood, with adverse childhood experiences to include maltreatment and domestic violence leading to a four-fold risk of a depressive disorder developing and a thirty-fold increase of suicide (Hughes, Bellis, Hardcastle-‘The effect of multiple adverse childhood experiences on health-a systematic review and meta-analysis-Lancet Public Health 2017).

Overwork: the key statistics

Ben Harris, writing for the publication HR Director (28 March 2023), reported some key findings of a survey undertaken by Censuswide:

•  Over half of employees surveyed (53%) felt overworked.
•  Young professionals (25 to 34 years) felt the most overworked followed by those aged 55 years and above.
•    30% of respondents felt that their employer had increased their work responsibilities outside their initial role.
• 32% said that their employer expected them to work outside their contracted hours.
• 40% said their workload had led to anxiety. 

With 23% of respondents saying that preparing to go back to work led to increased feelings of anxiety, Harris referred to some employees now participating in what he termed “bare minimum Mondays” – where employees undertake the least amount of work necessary to get through a Monday – as a reaction to the constant pressure to be productive. The Censuswide survey also referenced factors outside work, notably “the cost of living crisis” and family responsibilities as factors contributing to respondents feeling anxious.

The Health and Safety Executive (HSE) reported in their last, annual “Summary Statistics” report (covering the period April 2022 to March 2023), that the UK lost 17.1 million working days to stress, depression and anxiety with the average length of absence just shy of 20 days (19.6 days).

Commentary 

With depression, stress and anxiety responsible for half of all long term sick leave and with UK employees working the longest hours in Europe (42 hours on average), the findings of both the surveys and medical literature may be seen as a warning to employers that exhorting employees to “knuckle down and work harder” is likely to prove counter-intuitive in an employment market where the balance of power currently rests with the labour force and not with capital.

Whilst legal precedent recognises that no one job is considered to be so intrinsically stressful as to give rise to a foreseeable risk of an employee developing a psychiatric or psychological injury, employers keen to mitigate the risk of legal claims for overwork would be advised to consider the broader issues applicable to their organisations:

Ensuring compliance with the HSE Management Standards launched in 2005.

• Proactively risk assessing occupations which have a high number of known organisational stress hazards; employees who possess a lack of control over workloads, low levels of autonomy in their work and jobs which require a high degree of personal interaction.
• Once on notice, reacting timeously and effectively to complaints.
• Consulting and managing organisational change.

Conclusions 

The findings expressed by Kurodo and Yamamoto in their 2018 study into the relationship between long hours and mental health are worth noting:

“Empirical analysis reveals a non-linear relationship between the number of hours worked and job satisfaction. We find that job satisfaction increases when people work more than 55 hours per week but hours worked linearly erode workers’mental health. People who over value job satisfaction work excessive hours consequently damaging their mental health……educational and regulatory interventions are needed for both workers and employers to reduce the detrimental impact on mental health caused by overwork”.

Some commentators have recently expressed the view that the world has changed in over two decades since the Court of Appeal’s ruling in Hatton and that work related stress hazards may exist in any working environment. Consequently, they argue that current health and safety good practice should impose a proactive not a reactive approach to occupational stress.

For now at least, Hatton remains “good law”, but employing organisations would do well to heed the warnings expressed here.