Tackling occupational burnout at the workplace
Finland is known for active interventions in occupational health. However, employees with burnout participate less often in improvement programmes of work practices, occupational training and measures to reduce mental stress than those with no burnout. Instead, they are more often targets of individual-focused interventions, like counselling, pharmacotherapy and non-vocational rehabilitation. About half of employees report that burnout cases occur at their workplace.
Prolonged work stress can result in occupational burnout
In 2007, the Finnish Institute of Occupational Health (Työterveyslaitos) published a study on burnout at work and occupational interventions in the Journal of Occupational and Environmental Medicine. Occupational burnout is defined as a syndrome involving exhaustion and changes in workers’ attitudes towards the value of their work and competence. Burnout is thought to result from the interplay between external and internal work demands and resources, and dysfunctional coping with such challenges. In general, the focus of interventions designed to reduce occupational stress can be categorised into two main groups:
- occupational interventions, which aim primarily to change the situational context;
- individually-focused interventions, which seek to increase a person’s psychological resources.
In the guidelines available for occupational medicine practitioners, treatment suggestions for burnout refer to both the occupational and individual approach.
In 2000–2001, the National Public Health Institute (Kansanterveyslaitos, KTL) carried out a multidisciplinary epidemiologic health study, Health 2000, in Finland. The study was conducted among 3,276 employees aged 30–64 years. Burnout was assessed according to the Maslach Burnout Inventory-General Survey and information on the participation of workers in interventions during the past 12 months was collected during structured interviews. Occupational interventions included participatory improvement of work practices, occupational training, measures taken at workplaces to reduce mental stress and vocational rehabilitation. Individually-focused interventions involved counselling or psychotherapy (treatment using verbal or non-verbal communication) for mental health problems, and pharmacotherapy (treatment using medication) for mental health problems and non-vocational rehabilitation.
Data on psychopharmacological prescriptions – psychopharmacology being the study of drug-induced changes in mood, sensation, thinking and behaviour – for 2000 and 2001 were collected from the National Prescription Register, which is managed by the Social Insurance Institution of Finland (Elämässä mukana - muutoksissa tukena, KELA). Information on health was based on clinical health examinations and fully standardised interviews to assess mental health.
Participation in interventions
According to the study carried out by the Finnish Institute of Occupational Health, the rate of participation in occupational interventions was inversely related to the severity of burnout. When compared to employees with no burnout, the probability of having participated in occupational interventions was more than 50% lower for those with severe burnout. For example, the rate of participation in improvement of work practices was 55% for those with no burnout and 39% for those with burnout, and participation in occupational training amounted to 49% and 26%, respectively. Moreover, measures to reduce mental stress were more infrequent (14%) for those with severe burnout compared to those with no burnout (26%). Significant differences also emerged between workers without burnout and those suffering from mild burnout.
Individually-focused interventions seem to be readily available to employees who seek help as a result of burnout, while rehabilitation, counselling or pharmacotherapy are necessary in cases of severe burnout. However, a strong emphasis is placed on working conditions in the etiology of burnout, and many of the work-related factors associated with psychological ill health are potentially amenable to change. Therefore, balancing the demands and resources at work would most likely be beneficial for a successful recovery from burnout. Furthermore, in order to prevent burnout, regular workplace surveys and a positive development of working conditions might prove useful. These approaches require active cooperation between occupational health services and company management.
Threat of burnout common
The latest available Quality of Work Life Survey 2003 showed that the risk of grave work exhaustion or burnout is very common in Finnish working life and is a problem which has escalated over time. For instance, in 1997, 47% of employees at least occasionally experienced a risk of burnout, while this proportion rose to 50% in 2003. The risks of burnout are particularly recognisable in female-dominated occupational groups – such as healthcare, social services and teaching. In the same survey, 49% of all wage and salary earners agreed with the statement ‘There is burnout at our workplace’. Those working in healthcare occupations had encountered the problem most often, with 66% of workers agreeing with the statement. In the teaching profession, the respective figure was 61% of workers agreeing with the statement, and in social work 55% of workers.
Both surveys show that occupational burnout is a serious problem in Finnish working life. In particular, the study carried out by the Finnish Institute of Occupational Health helps to highlight how important it is to evaluate the methods used in the prevention of burnout. In general, individually-focused interventions have not proved to be sufficient.
Ahola, K., Honkonen, T., Virtanen, M., Kivimäki, M., Isometsä, E., Aromaa, A. and Lönnqvist, J., ‘Interventions in relation to occupational burnout: the population-based Health 2000 Study’, Journal of Occupational and Environmental Medicine, Vol. 49, No. 9, September 2007, pp. 943–952.
Lehto, A.-M. and Sutela, H., Threats and opportunities. Findings of Finnish Quality of Work Life Surveys 1977–2003, Helsinki, Statistics Finland, 2005.
Anna-Maija Lehto, Statistics Finland