Employee mental health and burnout in Asia: A time to act

By identifying factors affecting workplace mental health, leaders in Asia can take action to create happier, more inclusive, and increasingly productive organizations.

Employees worldwide are more stressed than ever, experiencing high levels of poor mental health and burnout. Already feeling pressure, employees were hit hard by the pandemic, having to manage not only health anxieties and COVID-19 restrictions, but also increased workloads and job uncertainty. The fallout from those stressors is now apparent—and particularly so in Asia, where burnout rates are higher than the global norm.

How do business leaders in the region respond? This article highlights Asia-focused insights that have emerged from new McKinsey research on workplace mental health. It proposes three priority actions that leaders can take to mitigate harm and create a mentally healthier workplace, thus reducing attrition and fostering greater engagement with employees.

Workplace mental health & burnout: A global challenge for employees and leaders

As we navigated through the pandemic, employees were facing growing workplace mental health challenges, despite the efforts of many employers. To better understand these challenges, and the factors that contribute to them, from February to April 2022 the McKinsey Health Institute conducted a survey of nearly 15,000 employees and 1,000 human-resource (HR) decision-makers in 15 countries. 1 India, Japan, Australia, and China represented the Asian region. 2 The study also captured demographic insights, such as respondents’ industry and level within the organization (see sidebar “What we measured”).


Global findings show widespread and persistent symptoms of distress, depression, and anxiety. Approximately one in four respondents reporting signs of burnout.

Respondents were also asked questions about contributing factors. In all 15 countries and across all dimensions, “toxic workplace behavior” was, by a large margin, the biggest predictor of burnout symptoms and “intent to leave”—accounting for more than 60 percent of the explained variation.

For positive outcomes (including “work engagement”, “job satisfaction”, and “organization advocacy”), the impact of assessed factors was more distributed, with “inclusivity and belonging”, “supportive growth environment”, “sustainable work”, and “freedom from stigma” accounting for most outcomes.

These outcomes can have a grave impact on businesses. A growing body of evidence sheds light on how poor workplace mental health is associated with costly organizational issues, including attrition, absenteeism, lower engagement, decreased productivity, and increased insurance costs. For example, the estimated cost of mental-health related absenteeism for businesses in Australia is around US $13.6 billion per annum. 3 In Japan, compensation claims for mental-health conditions reached record highs in 2021. 4 Thus the business case for addressing mental health is compelling.

Globally, many employers have taken supportive action: developing capability, encouraging workers to share their personal experiences, and increasing wellness offerings. 5   However, our survey reveals that employers tend to overlook how much the workplace affects employee mental health, engagement, and performance, and are underinvesting in systemic solutions. These issues are particularly urgent in Asia.

Asian countries have been hit hard by burnout and poor mental health outcomes

While one in four employees worldwide are experiencing symptoms of burnout, that figure is even higher for Asia—nearing one in three. Female employees and frontline workers in the region report higher levels of burnout, symptoms of depression, and distress than their global counterparts (along with higher levels of symptoms of depression and distress than male employees, a common phenomenon worldwide). 6   With more than a quarter of employees reporting symptoms of depression and anxiety, it’s clear that a real and pressing workplace challenge faces the region (Exhibit 1).

Work-related outcome variables: burnout, depression, and anxiety challenge Asian workers.
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The impacts of these conditions are often exacerbated by cultural factors, which may hinder comprehensive reporting on mental health, as well as individuals’ willingness to seek assistance. For example, in a 2020 survey in Singapore, nearly 90 percent of employees indicated that they wouldn’t seek help for a mental-health condition due to stigma. 7

There are geographical differences between the Asian countries surveyed, in both outcomes and contributing factors (Exhibit 2).

The top two factors perceived as contributing to work-related outcomes differ across Asia.
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Indian respondents expressed elevated rates of every outcome—burnout, distress, anxiety, and depression. For each outcome factor, around four in ten respondents reported symptoms.

Among associated factors, toxic workplace behavior is dominant, accounting for approximately 90 percent of explained variance for every outcome. Such behavior also accounts for 90 percent of explained variance in intent to leave, with employees reporting a desire to leave their job at a level approximately 60 percent greater than the global average.

In a different study, 41 percent of Indian employees cite a lack of separation between work and personal life, which may be stress-inducing and harmful to wellbeing. 8

Employers with businesses in India thus face a substantial problem. Understanding the contributing factors may empower employers to form a plan of action, starting with addressing toxic workplace behavior.


Rates of distress, symptoms of depression, and anxiety in Japan are all lower than global levels (although these conditions still affect approximately one in five employees). However, burnout stands at 31 percent—five percentage points higher than the global average. Interestingly, intent to leave came in at 11 percent, five and six percentage points lower than the global and regional averages respectively.

Local context and culture emerge as important underlying factors. While toxic workplace behavior is still the driver for most outcomes, its contribution is 24 to 37 percentage points lower than global results, depending on outcome. Lack of sustainable work—which entails a healthy balance between work and personal life, including a manageable workload and schedule—looms large as a contributing factor in Japan. This factor accounts for 23 percent of explained variance for burnout and 35 percent for depression, compared to 13 percent of Australians, and only two and one percent of Chinese and Indian respondents respectively.

Strengthening sustainable work practices is clearly part of the solution for poor employee mental health in Japan. However, cultural factors—such as employment being viewed as “more than just a job,” or the deeply held belief that the needs of the customer take precedence over those of an employee—make addressing this a challenge. Measurement and awareness building can help, with recent Government efforts reinforcing this. For example, annual employee stress checks must be offered where an employer has 50 or more employees in a location. 9 Without individual employers making concerted and persistent efforts to improve sustainability, other actions to improve workplace mental health and wellbeing are likely to fall short.


In Australia, prevalence of symptoms of depression (26 percent of respondents), anxiety (27 percent), and distress (32 percent) broadly align with global results. Burnout stands slightly higher than global results (28 percent), though lower than the regional average (30 percent).

While toxic workplace behavior and sustainable work are issues for Australian respondents, another factor came to the fore: inclusivity and belonging, which was found to explain 14 to 23 percent of explained variance across outcomes, with a particular impact on anxiety.

To improve employee mental health, it will be important for leaders to focus not only on toxic behavior and sustainability, but also on creating a space of belonging for all employees. Focusing in on toxic workplace behaviors alone won’t meet the needs of employees. Through focusing on inclusivity and belonging, you will both increase your prospects of successfully improving employee mental health, while accessing a range of other benefits, including increased attraction, engagement, and performance.


Across each of the outcome variables, employees surveyed in China reported rates of burnout, distress, and depression and anxiety symptoms three to eight percentage points lower than global averages. Otherwise, the country reflects the overall global pattern, with toxic workplace behavior dominant for most outcomes.

For employees reporting symptoms of anxiety, access to resources accounted for nine percent of the explained variance, much higher than elsewhere in the region (three percent for Australia and Japan, and one percent for India). For symptoms of depression, the inclusivity and belonging workplace factor scored roughly double the global result, explaining 22 percent of variance.

Chinese employees express a lower intent to leave than the global average, both overall and in the face of high burnout levels. This may be due to a culture that celebrates loyalty and resilience, along with the uncertainty of the post-COVID-19 employment market. Alternatively, it may mean that employees in China have a better overall employment experience than their counterparts.

Nonetheless, one in five employees report at least one of the negative outcome variables. While Chinese respondents appear less likely to suffer poor workplace mental health, it should be noted that this survey was done prior to the current surge of COVID-19 cases and resulting lockdowns. We also know that mental health is viewed as a very personal issue, with burnout potentially being perceived as associated with a lack of resilience. This may have led to reported outcomes being somewhat lower than what is actually experienced.

Creating a workplace where employees flourish: three key actions

Despite country level variation, these results show that the time is now for leaders to address burnout and employee mental health. How do employers in Asia create environments where employees prosper and want to stay?

In our recent global article, we introduced eight targeted questions with the potential to address burnout-related challenges.

Based on our experience and survey analysis, three questions have emerged as most critical for leaders in the region to address. How do organizations address toxic workplace behavior? How do leaders provide appropriate resources to serve employee needs? And lastly, how do leaders improve measurement and organizational listening capabilities?

1. Effectively addressing toxic behaviors: Take the courageous and uncomfortable step of taking an honest look for toxic workplace behavior

Asian leaders generally acknowledge the high levels of reported toxic workplace behavior—but many understandably wish to believe that the problem is happening elsewhere, and not in their own businesses or teams. Given how severely this behavior can affect mental health, it is critical for all leaders to take a second look at their organizations, and acknowledge what their employees are experiencing.

It is only when we see our workplaces, teams and our own behavior exactly as it is that we have the chance at changing it. What this looks like in practice is: set a clear and unequivocal standard of what is acceptable and what is not. This goes beyond having an anti-bullying policy (although having such a policy is important). It could take the form, for example, of giving direct feedback with specific examples to leaders showing toxic behaviors and taking disciplinary action where necessary. Where behavior misses the mark (even from peers), it cannot be ignored. Otherwise, it sends a signal to employees that poor behavior will be tolerated.

Another strategy to mitigate toxic workplace behavior is cultivating supportive, psychologically safe work environments, as toxic behaviors are less likely to spread across the organization.

2. Right resources to serve employee needs: Combine foundation-level and tailored support for your people

The pandemic spotlighted several crucial workplace issues, including the fallibility of the one-size-fits-all approach to employee mental health, and the implications of a porous work-home boundary. Employees face varying challenges, which require individualized support from their employers. For example, the needs of a parent with children at home differ from those of an employee living alone. 10 These needs will also vary across the Asia region.

It is clearly important to continue to prioritize foundational levels of support, 11 offering, for example, employee-assistance programs and workplace-behavior policies, however, employers must go beyond this and support and interventions on behalf of specific cohorts. 12 This requires employers to identify those cohorts and understand their needs. A simple but effective way of doing this is to ask employees empathetically what support would help. This is a difficult but teachable skill. For employers across the region, listening requires understanding the different commitments and needs of employees, as impacted by cultural and country-level factors. This can help to drive vital workplace inclusivity.

Leaders must also examine their foundational support, working through ensuring they are providing appropriate assistance, that employees are aware of it, that employees use it, and that it is of excellent quality.

Support models are most effective when they are culturally appropriate and don’t expose employees to additional stigma. For example, workers can be provided with psychological help in a private setting, meaning they don’t need to disclose that they’re seeking such support unless comfortable doing so.

3. Improved measurement and organizational listening capabilities: Increase measurement quality and take holistic action

Research shows that many leaders are unable to cite robust metrics or data around employee mental-health initiatives. HR measurement staples are often not sufficiently specific or timely; they may even obscure what is really driving poor workplace outcomes.

Existing measurement in the region tends to be focused on engagement and may be updated only once a year (through engagement surveys), with some overlay of ad-hoc pulse surveys, attrition data and exit interviews. It’s no surprise that it’s difficult to find granular or actionable insights. Further, country-specific and cultural factors (for example, the desirability of showing vulnerability) can impact how individuals interpret and respond to survey questions.

More can be done: Asian companies have had success with measures such as regular pulse surveys, integrated input (such as performance reviews and country-specific research), and other feedback (for example Glassdoor, a website where employees anonymously review companies). By approaching measurement differently, organizations can get near real-time snapshots of employee wellbeing, across specific geographies, functions, and teams, with a granularity that shows hotspots and allows for immediate, targeted action—including leader communications.

Measurement and operating-model improvement go hand in hand. Practically, this can be solved by nominating a leader to examine the core elements of the operating model, and conduct a brief assessment of whether the organization is supporting or negatively impacting employee mental health.

Where non-supportive elements are identified, a leader can decide if these can be improved (such as by redesigning work-allocation processes), or if their impact can be reduced (such as through cultural or behavioral interventions). Ultimately, it will be important for leaders to define what to measure among employees, how to make the measurement seamless, and what actions it informs.

Driving sustainable improvement in workplace mental health will require action across all elements of the operating model: from strategy and processes, to people, structure, and culture. Only by working across all elements can the underlying ecosystem be changed. While HR plays a critical role in taking action, they alone do not have access to all the levers necessary for transformation.

Each element can have a supportive or a destructive impact on mental health. For example, the processes used to allocate work and monitor workload inform whether a person’s work is sustainable, and whether support is provided when needed.

Empowering employees also plays a critical role in driving effective action. Sadly, however, when it comes to taking action on workplace mental health, a top-down approach remains the norm—and one that is reinforced by cultural factors. Employees are not often consulted, beyond focus or reference groups.

However, with a more bottom-up approach that empowers employees to identify issues and take action, workplace mental health can be dramatically improved. With increased autonomy and control, employees become more resilient. Examples from across the region include an automotive manufacturer setting up reference groups to listen to and empower action from the shop floor, and a financial-services employer expanding existing grassroots innovation that taps into employee experience.

Leaders who face the challenges of employee mental health and burnout head-on, and who are willing to show vulnerability, set behavior standards, and hold others accountable, are well placed to create high-functioning workplaces serving fulfilled and productive employees. Now is the time to identify solutions, take holistic action, and empower workers, and so deliver a step-change in workplace mental-health outcomes across Asia.

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