McKinsey Health Institute

Beyond burnout: What helps—and what doesn’t

Despite leaders’ best efforts, worldwide burnout persists. New research reveals why—and how to help employees begin to thrive again.

Yoga. Therapy. Meditation. Yes, wellness perks are helpful, but they’re not a panacea for workplace stress. In this episode of The McKinsey Podcast, Erica Coe—a McKinsey partner and coleader of the McKinsey Health Institute (MHI)—speaks with McKinsey Global Publishing’s Lucia Rahilly about why burnout has hit record levels over the past two years and what leaders can do to create a path toward lasting change.

Afterward, senior partner Tiffany Burns describes one of her rookie moments: talking a client down from sending an email when angry.

The following transcript has been edited for clarity and length.

The McKinsey Podcast is cohosted by Lucia Rahilly and Roberta Fusaro.

 

Defining burnout

Lucia Rahilly: Erica, it’s always such an inspiration to talk to you, and belated congratulations on the launch of the McKinsey Health Institute.

Erica Coe: Thank you. It has been a very exciting couple months, to be sure.

Lucia Rahilly: We’ve talked about burnout before on The McKinsey Podcast, but given that it has almost become a buzzword, I’d like to start by ensuring we’re all on the same page about what we mean when we use that term. What does it feel like to be burned out? What are the symptoms of burnout versus feeling lackluster or just, say, limping toward vacation?

Erica Coe: You’re exactly right that it has become a buzzword, so it’s helpful to ground ourselves. According to the World Health Organization, burnout is an occupational workplace phenomenon. It’s driven by a chronic imbalance between your job demands—for example, how heavy your workload pressure is—and your job resources. It might be how autonomous or supported you feel at work. It’s that disconnect and imbalance between demands and resources. It’s often correlated with anxiety and depression, and a potential predictor of broader mental-health challenges. That’s why it’s so important to get a grasp on some of the burnout challenges that many employees are facing, to ensure that employers can intervene now.

To your question of what characterizes burnout, it’s often marked by extreme tiredness, difficulty concentrating, and difficulty with cognitive and emotional processes. It’s important to understand those symptoms and tendencies fully.

From busy to burned out

Lucia Rahilly: Prepandemic, folks used to talk a lot about being busy. It was a badge of honor to be busy, a good thing. How did we go from being busy to being burned out? Did the pandemic play a role in that?

Erica Coe: I think it certainly did. If anything, of all the challenges that have come about because of the pandemic, one of the silver linings is the increased awareness and open dialogue around mental health and the importance of positive mental health and well-being and of investing in that.

Why focus on mental health?

Lucia Rahilly: Let’s turn to the research you recently undertook along with colleagues from the McKinsey Health Institute. Why did you make employee burnout a focus for MHI?

Erica Coe: We were already facing a global mental-health crisis before the pandemic. Now, after living through two and a half years of COVID-19, the crisis has only grown. With such an urgent need around a very core part of health, we knew that the only way we could improve health holistically is by first addressing mental health. Mental health impacts physical health. It impacts social health. It impacts spiritual health. You can’t have good overall health without good mental health. So we felt that to add years to life and life to years, we had to focus initially on the urgent priority of mental health.

And then there’s the question of why employers? Every day, employers are impacting the health and the mental health of their employees and workforces. So if we could find a way—through convening, collaborating, research, and innovation—to start to change the behavior of many of these employers, we felt that it could be one way to have an impact at scale. We also feel that we are very much at a tipping point for change. This is a unique moment in time. If we can find what research, what innovations can be introduced, we might be able to shift things in a new direction.

Burnout burns around the world

Lucia Rahilly: How global is this phenomenon of burnout?

Erica Coe: Interestingly, very global. We conducted a survey of 15,000 employees across 15 countries, on every continent around the world, and found consistently high burnout rates. One difference we found across these countries was the cultural context: how much stigma or discrimination exists in a workplace, how comfortable employees are sharing certain things, and the level of support they might feel from their employer.

A fascinating step in the research was translating into local languages all of the surveys we deployed across the 15 countries. At the stage of translating, we realized that there may not be a word that characterizes mental health or mental health in the workplace. And you start to see stigma in many ways, even in designing the survey instrument, but also in the findings. Understanding the stigma and the broader cultural context is critical in highlighting what interventions will work. Depending on the culture and environment that an employee is in, very different approaches need to be taken to support employees and their family members and broader communities, which these negative impacts trickle down to.

Many large global employers have a footprint across a number of regions around the world. It’s also important to understand how to effectively support their workforce more broadly.

What companies are doing now

Lucia Rahilly: So burnout is bad, it’s potentially at a tipping point, and employers are keenly aware of it, particularly in such a tight talent market. We have seen record quit rates and churn, as we know from our Great Attrition/Great Attraction research. What are companies doing to help employees now?

Erica Coe: If we look at investment rates—what employers are pouring into interventions—often investment is on the wellness side, and it isn’t moving the needle. Burnout rates are continuing to increase, despite many organizations committing to this, making it a C-suite agenda priority, and trying to find ways to support employees.

Burnout rates are continuing to increase, despite many organizations committing to this, making it a C-suite agenda priority, and trying to find ways to support employees.

Erica Coe

In a recent survey, four out of five HR leaders said that they consider employee mental health and well-being a top priority. There are billions of dollars around the globe going into wellness benefits. But we think the challenge is that almost all the focus is on remediating symptoms rather than getting at the root cause of employee burnout. Instead, employers should step back and reflect on the structural challenges of the environment, which may be causing the burnout in the first place. If the root causes aren’t fixed, then you’re going to continue to put your employees in environments that are increasing burnout.

When wellness feels like a work stream

Lucia Rahilly: Sometimes I’m afraid, in my own life, that these wellness initiatives—although I’m super grateful for them—risk creating another work stream. In other words, when you’re thinly stretched, adding some vinyasa 1 into the mix might feel incredibly welcome in theory. But it is daunting to actualize in practice, unless other portfolio adjustments, like reducing deliverables, are made in parallel. What’s the risk of wellness becoming another work stream for employees?

Erica Coe: The way you framed it is exactly right. Wellness is certainly critical, but in and of itself it’s not sufficient. It’s very important that individuals learn different resilience skills, different coping strategies, and that there is an individual approach to support.

Where we often get burnout wrong is assuming that it is purely an individual experience—something for a person to fix and get better on their own, and we’ll equip that person with all the tools they need to fix it. We often miss the impact that is coming from how our teams, how our leaders, how the broader organizations are influencing the way people are experiencing their lives at work. Starting to pay attention to the systemic issues and really getting into some of the root causes will be what’s needed to unlock real change here.

Toxic workplace behavior drives burnout rates

Lucia Rahilly: Let’s talk about those root causes. What are some of the drivers behind these pervasive burnout challenges?

Erica Coe: One of the things that we asked in our survey across the 15 countries was intended to find some of the strongest predictors of burnout symptoms and other negative outcomes. One of these drivers, by a large margin, was what we refer to as toxic workplace behavior. Toxic behaviors are things that leave you, or leave an employee, feeling unvalued, unsafe—something that might feel like a demeaning treatment, noninclusive behavior, really extreme competition, abuse of management, or unethical behaviors. All those become almost a cultural norm that can really feed into toxic behavior. In our survey, one in four employees reported high rates of toxic behavior at work.

Through our research, we wanted to find out if toxic behavior at work leads to higher rates of burnout. Is it predictive in any way? The subset of employees who reported experiencing these high levels of toxic behavior were eight times more likely to experience burnout symptoms—significantly higher. In terms of action, these employees were also six times more likely to report that they intended to leave their employer in the next couple of months. One interesting finding that I think came from other recent research is that often the culture of an organization is one of the biggest predictors of the rate of resignation—ten times more predictive than compensation.

The subset of employees who reported experiencing high levels of toxic behavior were eight times more likely to experience burnout symptoms.

Erica Coe

Our research revealed something about the broader environment—an interesting angle and finding for employers to consider. Are they even aware of their employees’ baseline current state? Where do you stand as an employer across some of these aspects?

Taking work behavior as seriously as skills

Lucia Rahilly: Let’s acknowledge that leaders need to do more. How can employers take on toxic behavior in the workplace?

Erica Coe: One way that employers can approach toxic behavior is to treat it as a lack of competence. If you’re looking for a skill set that has to be demonstrated at any given level, embed positive and supportive behavior as a skill. That would mean that it starts to be incorporated into performance reviews. You start to ensure you’re getting indicators in upward feedback, and you have measures and ways of picking up signs of toxic behavior.

Another aspect is trying to focus on the degree to which you are cultivating supportive, psychologically safe work environments. It isn’t just about removing or preventing toxicity; it’s also about amplifying compassionate leadership, for example, or cultivating a supportive environment.

Lucia Rahilly: How can the leadership send the message that they have begun to take these steps? How can they communicate to their employees that they care about mental health and that they care about their community’s well-being?

Erica Coe: Communication is a big one. Our research revealed a feeling that leaders aren’t listening to their people nearly enough. Besides communicating, it is also important to take action. That means not only celebrating successful examples of work environments and things that seem to be working but also clearly showing how you are addressing toxic-workplace behavior and making a clear change so that people feel safer and more comfortable raising issues in the future.

Leaders should also come up with time-bound, measurable goals around mental health. This can be daunting. How are you going to prioritize employee mental health and well-being as an organization? The more ways you can come up with—discrete, quick wins so you can start to demonstrate to your employees that mental health matters—the better.

More inclusive inclusion

Lucia Rahilly: Another of the issues you mentioned in the report is inclusion, which is a topic that McKinsey has published a lot on. It can still feel elusive in many workplaces. What are some of the steps leaders can take to create a more inclusive environment for their employees?

Erica Coe: There are a few different ways. Thinking about the composition of the board and leadership and creating a safe space for any colleague to feel comfortable—that’s a vital step toward inclusion. And that means thinking through leadership and diversity at the highest level—taking an expanded definition of diversity, equity, and inclusion to explicitly include neurodiversity. Often what happens is that a company defines inclusion too narrowly: “We have our diversity and inclusion strategy, there’s a specific officer who will be in charge of it, and it goes here within the organization.” Instead, take a broader approach. Think across the whole workplace about certain setups, workflows, and other ways teams might be set up that could promote inclusiveness and minimize conscious and unconscious bias. Creating a supportive workplace with widely available flexibility and customization is a significant way to help people with mental-health conditions—disclosed or undisclosed—overcome barriers.

Destigmatizing mental-health issues

Lucia Rahilly: You have done a lot of research on stigma. Say a few words about the way coming forward about burnout, and about mental-health issues in general, can create concern about being stigmatized—and about what leaders might do to mitigate that concern.

Erica Coe: The fact that, around the world, we’re having such conversations on burnout is great. The fact that McKinsey’s doing a podcast on burnout is great. These are all steps in the right direction. This shows that people are more comfortable acknowledging some of the real challenges that everybody faces.

It is becoming more accepted and normal to realize that to be at your best and be effective as a leader, it’s critical that you have moments and periods of recovery and resilience. For employers, it’s critical to acknowledge that they have accountability and responsibility for whether or not their employees are feeling burned out. That isn’t just about the number of hours an employee works. It’s the broader culture. Recognizing that takes courage. It’s a big step, because it’s a big responsibility for an employer to be willing to address burnout.

Without finding a way to even begin the dialogue in a safe way, it’s really hard to make change happen. When we think about it, looking across the world globally, everybody knows somebody who has been affected by a mental-health challenge—whether it’s something that they’re going through now or something that they experienced in the past or that they may experience in the next couple of months. Being able to openly share experiences, especially at a leadership level, starts to make a difference.

On the topic of stigma, one of the stats that always stands out to me was in a survey that we did last year of a large number of employees. Over a third of them—37 percent of the employees with a stated mental-health challenge—indicated that they would avoid treatment because they didn’t want anyone in their workplace finding out about their condition. If we think about burnout as a first step along a slippery slope toward broader mental-health challenges, by addressing stigma head on and opening a dialogue around it, we can make a very big difference.

The importance of measurement

Lucia Rahilly: Most leaders are well intentioned. They don’t want employees to burn out. They certainly don’t want most employees to leave. What’s the best way for leaders to get a baseline on burnout in their organization and then, vitally, to understand whether they’re making progress as they start to take some of these steps that you’re describing?

Erica Coe: Measurement is critical. It’s impossible to truly hold yourself accountable as a leader or as an organization if you aren’t measuring. Measurement also brings responsibility with it. If you’re going to conduct a baseline study, then there’s an expectation by your workforce that you’re going to do something with the information and that change will happen.

If you don’t do a baseline at all or don’t ask these questions to really understand the current state of your workforce, we know that burnout is getting worse. The more you find out now, the more you show commitment early because you care and you’re asking. Then this equips you with information and insights so you can make the type of targeted interventions that have to happen.

The McKinsey Health Institute has launched a free open-access survey for any employer around the world. It gets a baseline of the current state of employee mental health and well-being, and gets some insights so you can start to target what interventions might make a difference. The mandate of the McKinsey Health Institute is to ensure we’re sharing everything back for the benefit and learning of others. Employers who take the survey are committing to share their data for broader learning and research in a sanitized database where we’re starting to aggregate findings from employers around the world.

There are also a number of ways to get a standardized measurement of burnout and then to measure that alongside other key performance metrics, such as financial metrics, safety, equality, and employee turnover. You could imagine a world in which burnout becomes a standard metric on an operational dashboard that any employer maintains, regardless of industry or sector or geography.

Prioritizing mental health

Lucia Rahilly: Last question. In recent months we’ve entered a new period of economic volatility. Inflation is high, recession is arguably imminent. Leaders are facing one of the most difficult operating environments they have encountered in years. How optimistic are you that we’ll be able to prioritize and resolve burnout in this changing and destabilizing climate?

Erica Coe: If the war for talent is less critical and there are budget constraints, one thing that certainly could happen is that there’s less of a need to be investing in employee mental health and well-being. I’d emphasize some of the well-documented evidence on the impact of employee mental health and well-being on the long-term sustainability of an organization. Don’t lose sight of that long-term goal. If there is any moment to double down on the mental health of your workforce, it’s now. This will pay off in the long run. There is a clear benefit to employers. But focusing only on the short term, which may lead employers to turn away from this, would certainly have a negative impact in the long term.

The McKinsey Health Institute recently became a founding member of the World Wellbeing Movement. A lot of the dialogue there is around how to redefine ESG, 2 with health in the center. We are also thinking about sustainability as the overall health and mental health and well-being of an organization. I hope that we can continue to strengthen the evidence base and the incentives there. Regardless of the broader economic environment, we want to show that it does pay for employers to be investing in the mental health of the workforce. Hopefully, that will keep us on the right path.

Lucia Rahilly: Thanks so much for joining us, Erica.

Erica Coe: Thank you. I really appreciate the opportunity.


Roberta Fusaro: Though it might not cause burnout, giving tough feedback to a colleague can cause discomfort. Senior partner Tiffany Burns can relate and shares how she persuaded her client not to send an email to a coworker during a fit of frustration. This comes from our My Rookie Moment series.

Tiffany Burns: I was on a project, and it was the first time that I was stepping into the role of project manager. A very new experience, in a big role—you’re the quarterback of the team and you need to be the one guiding the team and integrating all of the work that we’re doing. I was working with a new client and in a new role. I knew that a lot was going to be different and that it was going to be challenging.

My new client was a great executive, in an organization in the retail and consumer space, which I often did work for as an associate. She was having a bit of a challenge with one of the other executives who was part of the project that she was working on. In that context, she was super frustrated and felt that this colleague wasn’t being collaborative and that they were not on the same page. I remember her having a pretty explosive conversation in person with that colleague and her writing an email to that colleague in response to that interaction.

We all know that when you’re upset or frustrated that is probably not the right time to write a message. She had drafted the email very ferociously: “here’s how I feel and what I perceived in this interaction and what I don’t think is right.” She called me into her office and said, “I trust your judgment. Can you take a look at this email and give me your thoughts?” I read the email, and there was no way I could provide any constructive criticism—criticism that would get it to something that made sense for her to send to the colleague. I felt that sending this email wasn’t a good idea.

In a bold movement, I crossed out the email and said, “I don’t think you should send this email. I don’t think this is the tone and the perspective you want to take, given the issue. I really think that you need to go and have a conversation and talk about why you found the interaction challenging and how you could do better moving forward.”

Coming out of this interaction, my relationship with this client went to the next level. She really appreciated the amount of care and concern I had, and how important it was for me that she responded the appropriate way.

Tiffany Burns

This was a big moment for me—to tell my senior client something that was somewhat personal and, basically, to say, “The thing you’re going to do is a totally bad idea.” The good news is that coming out of this interaction, my relationship with this client went to the next level. She really appreciated the amount of care and concern I had, and how important it was for me that she responded the appropriate way and that I was willing to take a risk and communicate that to her.

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