psychology research paper on workplace

ORIGINAL RESEARCH article

Work stress, mental health, and employee performance.

• 1 School of Business, Zhengzhou University, Zhengzhou, China
• 2 Henan Research Platform Service Center, Zhengzhou, China

The COVID-19 pandemic outbreak—as a typical emergency event—significantly has impacted employees' psychological status and thus has negatively affected their performance. Hence, along with focusing on the mechanisms and solutions to alleviate the impact of work stress on employee performance, we also examine the relationship between work stress, mental health, and employee performance. Furthermore, we analyzed the moderating role of servant leadership in the relationship between work stress and mental health, but the result was not significant. The results contribute to providing practical guidance for enterprises to improve employee performance in the context of major emergencies.

Introduction

Small- and medium-sized enterprises (SMEs) are the key drivers of economic development as they contribute >50, 60, 70, 80, and 90% of tax revenue, GDP, technological innovation, labor employment, and the number of enterprises, respectively. However, owing to the disadvantages of small-scale and insufficient resources ( Cai et al., 2017 ; Flynn, 2017 ), these enterprises are more vulnerable to being influenced by emergency events. The COVID-19 pandemic outbreak—as a typical emergency event—has negatively affected survival and growth of SMEs ( Eggers, 2020 ). Some SMEs have faced a relatively higher risk of salary reduction, layoffs, or corporate bankruptcy ( Adam and Alarifi, 2021 ). Consequently, it has made employees in the SMEs face the following stressors during the COVID-19 pandemic: First, employees' income, promotion, and career development opportunities have declined ( Shimazu et al., 2020 ). Second, as most employees had to work from home, family conflicts have increased and family satisfaction has decreased ( Green et al., 2020 ; Xu et al., 2020 ). Finally, as work tasks and positions have changed, the new work environment has made employees less engaged and less fulfilled at work ( Olugbade and Karatepe, 2019 ; Chen and Fellenz, 2020 ).

For SMEs, employees are their core assets and are crucial to their survival and growth ( Shan et al., 2022 ). Employee work stress may precipitate burnout ( Choi et al., 2019 ; Barello et al., 2020 ), which manifests as fatigue and frustration ( Mansour and Tremblay, 2018 ), and is associated with various negative reactions, including job dissatisfaction, low organizational commitment, and a high propensity to resign ( Lu and Gursoy, 2016 ; Uchmanowicz et al., 2020 ). Ultimately, it negatively impacts employee performance ( Prasad and Vaidya, 2020 ). The problem of employee work stress has become an important topic for researchers and practitioners alike. In this regard, it is timely to explore the impact of work stress on SME problems of survival and growth during emergency events like the COVID-19 pandemic.

Although recent studies have demonstrated the relationship between work stress and employee performance, some insufficiencies persist, which must be resolved. Research on how work stress affects employee performance has remained fragmented and limited. First, the research into how work stress affects employee performance is still insufficient. Some researchers have explored the effects of work stress on employee performance during COVID-19 ( Saleem et al., 2021 ; Tu et al., 2021 ). However, they have not explained the intermediate path, which limits our understanding of effects of work stress. As work stress causes psychological pain to employees, in response, they exhibit lower performance levels ( Song et al., 2020 ; Yu et al., 2022 ). Thus, employees' mental health becomes an important path to explain the relationship mechanism between work stress and employee performance, which is revealed in this study using a stress–psychological state–performance framework. Second, resolving the mental health problems caused by work stress has become a key issue for SMEs during the COVID-19 pandemic. As the core of the enterprise ( Ahn et al., 2018 ), the behavior of leaders significantly influences employees. Especially for SMEs, intensive interactive communication transpires between the leader and employees ( Li et al., 2019 ; Tiedtke et al., 2020 ). Servant leadership, as a typical leader's behavior, is considered an important determinant of employee mental health ( Haslam et al., 2020 ). Hence, to improve employees' mental health, we introduce servant leadership as a moderating variable and explore its contingency effect on relieving work stress and mental health.

This study predominantly tries to answer the question of how work stress influences employee performance and explores the mediating impact of mental health and the moderating impact of servant leadership in this relationship. Mainly, this study contributes to the existing literature in the following three ways: First, this research analyzes the influence of work stress on employee performance in SMEs during the COVID-19 pandemic, which complements previous studies and theories related to work stress. Second, this study regards mental health as a psychological state and examines its mediating impact on the relationship between work stress and employee performance, which complements the research path on how work stress affects employee performance. Third, we explore the moderating impact of servant leadership, which has been ignored in previous research, thus extending the understanding of the relationship between the work stress and mental health of employees in SMEs.

To accomplish the aforementioned tasks, the remainder of this article is structured as follows: First, based on the literature review, we propose our hypotheses. Thereafter, we present our research method, including the processes of data collection, sample characteristics, measurement of variables, and sample validity. Subsequently, we provide the data analysis and report the results. Finally, we discuss the results and present the study limitations.

Theoretical background and hypotheses

Work stress and employee performance.

From a psychological perspective, work stress influences employees' psychological states, which, in turn, affects their effort levels at work ( Lu, 1997 ; Richardson and Rothstein, 2008 ; Lai et al., 2022 ). Employee performance is the result of the individual's efforts at work ( Robbins, 2005 ) and thus is significantly impacted by work stress. However, previous research has provided no consistent conclusion regarding the relationship between work stress and employee performance. One view is that a significant positive relationship exists between work stress and employee performance ( Ismail et al., 2015 ; Soomro et al., 2019 ), suggesting that stress is a motivational force that encourages employees to work hard and improve work efficiency. Another view is that work stress negatively impacts employee performance ( Yunus et al., 2018 ; Nawaz Kalyar et al., 2019 ; Purnomo et al., 2021 ), suggesting that employees need to spend time and energy to cope with stress, which increases their burden and decreases their work efficiency. A third view is that the impact of work stress on employee performance is non-linear and may exhibit an inverted U-shaped relationship ( McClenahan et al., 2007 ; Hamidi and Eivazi, 2010 ); reportedly, when work stress is relatively low or high, employee performance is low. Hence, if work stress reaches a moderate level, employee performance will peak. However, this conclusion is derived from theoretical analyses and is not supported by empirical data. Finally, another view suggests that no relationship exists between them ( Tănăsescu and Ramona-Diana, 2019 ). Indubitably, it presupposes that employees are rational beings ( Lebesby and Benders, 2020 ). Per this view, work stress cannot motivate employees or influence their psychology and thus cannot impact their performance.

To further explain the aforementioned diverse views, positive psychology proposes that work stress includes two main categories: challenge stress and hindrance stress ( Cavanaugh et al., 2000 ; LePine et al., 2005 ). Based on their views, challenge stress represents stress that positively affects employees' work attitudes and behaviors, which improves employee performance by increasing work responsibility; by contrast, hindrance stress negatively affects employees' work attitudes and behaviors, which reduces employee performance by increasing role ambiguity ( Hon and Chan, 2013 ; Deng et al., 2019 ).

During the COVID-19 pandemic, SMEs have faced a relatively higher risk of salary reductions, layoffs, or corporate bankruptcy ( Adam and Alarifi, 2021 ). Hence, the competition among enterprises has intensified; managers may transfer some stress to employees, who, in turn, need to bear this to maintain and seek current and future career prospects, respectively ( Lai et al., 2015 ). In this context, employee work stress stems from increased survival problems of SMEs, and such an external shock precipitates greater stress among employees than ever before ( Gao, 2021 ). Stress more frequently manifests as hindrance stress ( LePine et al., 2004 ), which negatively affects employees' wellbeing and quality of life ( Orfei et al., 2022 ). It imposes a burden on employees, who need to spend time and energy coping with the stress. From the perspective of stressors, SMEs have faced serious survival problems during the COVID-19 pandemic, and consequently, employees have faced greater hindrance stress, thereby decreasing their performance. Hence, we propose the following hypothesis:

H1 . Work stress negatively influences employee performance in SMEs during the COVID-19 pandemic.

Work stress and mental health

According to the demand–control–support (DCS) model ( Karasek and Theorell, 1990 ), high-stress work—such as high job demands, low job control, and low social support at work—may trigger health problems in employees over time (e.g., mental health problems; Chou et al., 2015 ; Park et al., 2016 ; Lu et al., 2020 ). The DCS model considers stress as an individual's response to perceiving high-intensity work ( Houtman et al., 2007 ), which precipitates a change in the employee's cognitive, physical, mental, and emotional status. Of these, mental health problems including irritability, nervousness, aggressive behavior, inattention, sleep, and memory disturbances are a typical response to work stress ( Mayerl et al., 2016 ; Neupane and Nygard, 2017 ). If the response persists for a considerable period, mental health problems such as anxiety or depression may occur ( Bhui et al., 2012 ; Eskilsson et al., 2017 ). As coping with work stress requires an employee to exert continuous effort and apply relevant skills, it may be closely related to certain psychological problems ( Poms et al., 2016 ; Harrison and Stephens, 2019 ).

The COVID-19 pandemic has disrupted the normal operating order of enterprises as well as employees' work rhythm. Consequently, employees might have faced greater challenges during this period ( Piccarozzi et al., 2021 ). In this context, work stress includes stress related to health and safety risk, impaired performance, work adjustment, and negative emotions, for instance, such work stress can lead to unhealthy mental problems. Hence, we propose the following hypothesis:

H2 . Work stress negatively influences mental health in SMEs during the COVID-19 pandemic.

Mediating role of mental health

Previous research has found that employees' mental health status significantly affects their performance ( Bubonya et al., 2017 ; Cohen et al., 2019 ; Soeker et al., 2019 ), the main reasons of which are as follows: First, mental health problems reduce employees' focus on their work, which is potentially detrimental to their performance ( Hennekam et al., 2020 ). Second, mental health problems may render employees unable to work ( Heffernan and Pilkington, 2011 ), which indirectly reduces work efficiency owing to increased sick leaves ( Levinson et al., 2010 ). Finally, in the stress context, employees need to exert additional effort to adapt to the environment, which, consequently, make them feel emotionally exhausted. Hence, as their demands remain unfulfilled, their work satisfaction and performance decrease ( Khamisa et al., 2016 ).

Hence, we propose that work stress negatively impacts mental health, which, in turn, positively affects employee performance. In other words, we argue that mental health mediates the relationship between work stress and employee performance. During the COVID-19 pandemic, work stress—owing to changes in the external environment—might have caused nervous and anxious psychological states in employees ( Tan et al., 2020 ). Consequently, it might have rendered employees unable to devote their full attention to their work, and hence, their work performance might have decreased. Meanwhile, due to the pandemic, employees have faced the challenges of unclear job prospects and reduced income. Therefore, mental health problems manifest as moods characterized by depression and worry ( Karatepe et al., 2020 ). Negative emotions negatively impact employee performance. Per the aforementioned arguments and hypothesis 2, we propose the following hypothesis:

H3 . Mental health mediates the relationship between work stress and employee performance in SMEs during the COVID-19 pandemic.

Moderating role of servant leadership

According to the upper echelons theory, leaders significantly influence organizational activities, and their leadership behavior influences the thinking and understanding of tasks among employees in enterprises ( Hambrick and Mason, 1984 ). Servant leadership is a typical leadership behavior that refers to leaders exhibiting humility, lending power to employees, raising the moral level of subordinates, and placing the interests of employees above their own ( Sendjaya, 2015 ; Eva et al., 2019 ). This leadership behavior provides emotional support to employees and increase their personal confidence and self-esteem and thus reduce negative effects of work stress. In our study, we propose that servant leadership reduces the negative effects of work stress on mental health in SMEs.

Servant leadership can reduce negative effects of work stress on mental health in the following ways: Servant leaders exhibit empathy and compassion ( Lu et al., 2019 ), which help alleviate employees' emotional pain caused by work stress. Song et al. (2020) highlighted that work stress can cause psychological pain among employees. However, servant leaders are willing to listen to their employees and become acquainted with them, which facilitates communication between the leader and the employee ( Spears, 2010 ). Hence, servant leadership may reduce employees' psychological pain through effective communication. Finally, servant leaders lend employees power, which makes the employees feel trusted. Employees—owing to their trust in the leaders—trust the enterprises as well, which reduces the insecurity caused by work stress ( Phong et al., 2018 ). In conclusion, servant leadership serves as a coping resource that reduces the impact of losing social support and thus curbs negative employee emotions ( Ahmed et al., 2021 ). Based on the aforementioned analysis, we find that servant leaders can reduce the mental health problems caused by work stress. Hence, we propose the following hypothesis:

H4 . Servant leadership reduces the negative relationship between work stress and mental health in SMEs during the COVID-19 pandemic.

Methodology

Data collection and samples.

To assess our theoretical hypotheses, we collected data by administering a questionnaire survey. The questionnaire was administered anonymously, and the respondents were informed regarding the purpose of the study. Owing to the impact of the pandemic, we distributed and collected the questionnaires by email. Specifically, we utilized the network relationships of our research group with the corporate campus and group members to distribute the questionnaires. In addition, to ensure the quality of the questionnaires, typically senior employees who had worked for at least 2 years at their enterprises were chosen as the respondents.

Before the formal survey, we conducted a pilot test. Thereafter, we revised the questionnaire based on the results of the trial investigation. Subsequently, we randomly administered the questionnaires to the target enterprises. Hence, 450 questionnaires were administered via email, and 196 valid questionnaires were returned—an effective rate of 43.6%. Table 1 presents the profiles of the samples.

Table 1 . Profiles of the samples.

Table 1 shows the descriptive statistics of the sample. Based on the firm size, respondents who worked in a company with 1–20 employees accounted for 9.2%, those in a company with 21–50 employees accounted for 40.8%, those in a company with 51–200 employees accounted for 38.8%, and those in a company with 201–500 employees accounted for 11.2%. Regarding industry, the majority of the respondents (63.8%) worked for non-high-technology industry and 36.2% of the respondents worked for high-technology industry. Regarding work age, the participants with a work experience of 3 years or less accounted for 32.1%, those with work experience of 3–10 years accounted for 32.7%, and those with a work experience of more than 10 years accounted for 35.2%.

Core variables in this study include English-version measures that have been well tested in prior studies; some modifications were implemented during the translation process. As the objective of our study is SMEs in China, we translated the English version to Chinese; this translation was carried out by two professionals to ensure accuracy. Thereafter, we administered the questionnaires to the respondents. Hence, as the measures of our variables were revised based on the trial investigation, we asked two professionals to translate the Chinese version of the responses to English to enable publishing this work in English. We evaluated all the items pertaining to the main variables using a seven-point Likert scale (7 = very high/strongly agree, 1 = very low/strongly disagree). The variable measures are presented subsequently.

Work stress (WS)

Following the studies of Parker and DeCotiis (1983) and Shah et al. (2021) , we used 12 items to measure work stress, such as “I get irritated or nervous because of work” and “Work takes a lot of my energy, but the reward is less than the effort.”

Mental health (MH)

The GHQ-12 is a widely used tool developed to assess the mental health status ( Liu et al., 2022 ). However, we revised the questionnaire by combining the research needs and results of the pilot test. We used seven items to measure mental health, such as “I feel that I am unable (or completely unable) to overcome difficulties in my work or life.” In the final calculation, the scoring questions for mental health were converted; higher scores indicated higher levels of mental health.

Servant leadership (SL)

Following the studies by Ehrhart (2004) and Sendjaya et al. (2019) , we used nine items to measure servant leadership, including “My leader makes time to build good relationships with employees” and “My leader is willing to listen to subordinates during decision-making.”

Employee performance (EP)

We draw on the measurement method provided by Chen et al. (2002) and Khorakian and Sharifirad (2019) ; we used four items to represent employee performance. An example item is as follows: “I can make a contribution to the overall performance of our enterprise.”

Control variables

We controlled several variables that may influence employee performance, including firm size, industry, and work age. Firm size was measured by the number of employees. For industry, we coded them into two dummy variables (high-technology industry = 1, non-high-technology industry = 0). We calculated work experience by the number of years the employee has worked for the enterprise.

Common method bias

Common method bias may exist because each questionnaire was completed independently by each respondent ( Cai et al., 2017 ). We conducted a Harman one-factor test to examine whether common method bias significantly affected our data ( Podsakoff and Organ, 1986 ); the results revealed that the largest factor in our data accounted for only 36.219% of the entire variance. Hence, common method bias did not significantly affect on our study findings.

Reliability and validity

We analyzed the reliability and validity of our data for further data processing, the results of which are presented in Table 2 . Based on these results, we found that Cronbach's alpha coefficient of each variable was >0.8, thus meeting the requirements for reliability of the variables. To assess the validity of each construct, we conducted four separate confirmatory factor analyses. All the factor loadings exceeded 0.5. Overall, the reliability and validity results met the requirements for further data processing.

Table 2 . Results of confirmatory factor analysis and Cronbach's alpha coefficients.

To verify our hypotheses, we used a hierarchical linear regression method. Before conducting the regression analysis, we performed a Pearson correlation analysis, the results of which are presented in Table 3 .

Table 3 . Descriptive statistics and correlation analysis.

In the regression analysis, we calculated the variance inflation factor (VIF) of each variable and found that the VIF value of each variable was <3. Hence, the effect of multiple co-linearity is not significant. The results of regression analysis are presented in Tables 4 , 5 .

Table 4 . Results of linear regression analysis (models 1–6).

Table 5 . Results of linear regression analysis (models 7–9).

Table 4 shows that model 1 is the basic model assessing the effects of control variables on employee performance. In model 2, we added an independent variable (work stress) to examine its effect on employee performance. The results revealed that work stress negatively affects employee performance (β = −0.193, p < 0.01). Therefore, hypothesis 1 is supported. Model 5 is the basic model that examines the effects of control variables on mental health. In model 6, we added an independent variable (work stress) to assess its effect on mental health. We found that work stress negatively affects mental health (β = −0.517, p < 0.001). Therefore, hypothesis 2 is supported.

To verify the mediating effect of mental health on the relationship between work stress and employee performance, we used the method introduced by Kenny et al. (1998) , which is described as follows: (1) The independent variable is significantly related to the dependent variable. (2) The independent variable is significantly related to the mediating variable. (3) The mediating variable is significantly related to the dependent variable after controlling for the independent variable. (4) If the effect of the independent variable on the dependent variable becomes smaller, it indicates a partial mediating effect. (5) If the effect of the independent variable on the dependent variable is no longer significant, it indicates a full mediating effect. Based on this method, in model 4, mental health is significantly positively related to employee performance (β = 0.343, p < 0.001), and no significant correlation exists between work stress and employee performance (β = −0.016, p > 0.05). Hence, mental health fully mediates the relationship between work stress and employee performance. Therefore, hypothesis 3 is supported.

To verify the moderating effect of servant leadership on the relationship between work stress and mental health, we gradually added independent variables, a moderator variable, and interaction between the independent variables and moderator variable to the analysis, the results of which are presented in Table 5 . In model 9, the moderating effect of servant leadership is not supported (β = 0.030, p > 0.05). Therefore, hypothesis 4 is not supported.

For SMEs, employees are core assets and crucial to their survival and growth ( Shan et al., 2022 ). Specifically, owing to the COVID-19 pandemic, employees' work stress may precipitate burnout ( Choi et al., 2019 ; Barello et al., 2020 ), which influences their performance. Researchers and practitioners have significantly focused on resolving the challenge of work stress ( Karatepe et al., 2020 ; Tan et al., 2020 ; Gao, 2021 ). However, previous research has not clearly elucidated the relationship among work stress, mental health, servant leadership, and employee performance. Through this study, we found the following results:

Employees in SMEs face work stress owing to the COVID-19 pandemic, which reduces their performance. Facing these external shocks, survival and growth of SMEs may become increasingly uncertain ( Adam and Alarifi, 2021 ). Employees' career prospects are negatively impacted. Meanwhile, the pandemic has precipitated a change in the way employees work, their workspace, and work timings. Moreover, their work is now intertwined with family life. Hence, employees experience greater stress at work than ever before ( Gao, 2021 ), which, in turn, affects their productivity and deteriorates their performance.

Furthermore, we found that mental health plays a mediating role in the relationship between work stress and employee performance; this suggests that employees' mental status is influenced by work stress, which, in turn, lowers job performance. Per our findings, due to the COVID-19 pandemic, employees experience nervous and anxious psychological states ( Tan et al., 2020 ), which renders them unable to devote their full attention to their work; hence, their work performance is likely to decrease.

Finally, we found that leaders are the core of any enterprise ( Ahn et al., 2018 ). Hence, their leadership behavior significantly influences employees. Per previous research, servant leadership is considered a typical leadership behavior characterized by exhibiting humility, delegating power to employees, raising the morale of subordinates, and placing the interests of employees above their own ( Sendjaya, 2015 ; Eva et al., 2019 ). Through theoretical analysis, we found that servant leadership mitigates the negative effect of work stress on mental health. However, the empirical results are not significant possibly because work stress of employees in SMEs is rooted in worries regarding the future of the macroeconomic environment, and the resulting mental health problems cannot be cured merely by a leader.

Hence, due to the COVID-19 pandemic, employees experience work stress, which precipitates mental health problems and poor employee performance. To solve the problem of work stress, SMEs should pay more attention to fostering servant leadership. Meanwhile, organizational culture is also important in alleviating employees' mental health problems and thus reducing negative effects of work stress on employee performance.

Implications

This study findings have several theoretical and managerial implications.

Theoretical implications

First, per previous research, no consistent conclusion exists regarding the relationship between work stress and employee performance, including positive relationships ( Ismail et al., 2015 ; Soomro et al., 2019 ), negative relationships ( Yunus et al., 2018 ; Nawaz Kalyar et al., 2019 ; Purnomo et al., 2021 ), inverted U-shaped relationships ( McClenahan et al., 2007 ; Hamidi and Eivazi, 2010 ), and no relationship ( Tănăsescu and Ramona-Diana, 2019 ). We report that work stress negatively affects employee performance in SMEs during the COVID-19 pandemic; thus, this study contributes to the understanding of the situational nature of work stress and provides enriching insights pertaining to positive psychology.

Second, we established the research path that work stress affects employee performance. Mental health is a psychological state that may influence an individual's work efficiency. In this study, we explored its mediating role, which opens the black box of the relationship between work stress and employee performance; thus, this study contributes to a greater understanding of the role of work stress during the COVID-19 pandemic.

Finally, this study sheds light on the moderating effect of servant leadership, which is useful for understanding why some SMEs exhibit greater difficulty in achieving success than others during the COVID-19 pandemic. Previous research has explained the negative effect of work stress ( Yunus et al., 2018 ; Nawaz Kalyar et al., 2019 ; Purnomo et al., 2021 ). However, few studies have focused on how to resolve the problem. We identify servant leadership as the moderating factor providing theoretical support for solving the problem of work stress. This study expands the explanatory scope of the upper echelons theory.

Practice implications

First, this study elucidates the sources and mechanisms of work stress in SMEs during the COVID-19 pandemic. Employees should continuously acquire new skills to improve themselves and thus reduce their replaceability. Meanwhile, they should enhance their time management and emotional regulation skills to prevent the emergence of adverse psychological problems.

Second, leaders in SMEs should pay more attention to employees' mental health to prevent the emergence of hindrance stress. Employees are primarily exposed to stress from health and safety risks, impaired performance, and negative emotions. Hence, leaders should communicate with employees in a timely manner to understand their true needs, which can help avoid mental health problems due to work stress among employees.

Third, policymakers should realize that a key cause of employee work stress in SMEs is attributable to concerns regarding the macroeconomic environment. Hence, they should formulate reasonable support policies to improve the confidence of the whole society in SMEs, which helps mitigate SME employees' work stress during emergency events like the COVID-19 pandemic.

Finally, as work stress causes mental health problems, SME owners should focus on their employees' physical as well as mental health. Society should establish a psychological construction platform for SME employees to help them address their psychological problems.

Limitations and future research

This study has limitations, which should be addressed by further research. First, differences exist in the impact of the pandemic on different industries. Future research should focus on the impact of work stress on employee performance in different industries. Second, this study only explored the moderating role of servant leadership. Other leadership behaviors of leaders may also affect work stress. Future research can use case study methods to explore the role of other leadership behaviors.

This study explored the relationship between work stress and employee performance in SMEs during the COVID-19 pandemic. Using a sample of 196 SMEs from China, we found that as a typical result of emergency events, work stress negatively affects employees' performance, particularly by affecting employees' mental health. Furthermore, we found that servant leadership provides a friendly internal environment to mitigate negative effects of work stress on employees working in SMEs.

Data availability statement

The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding author/s.

Ethics statement

Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent from the patients/participants or patients/participants legal guardian/next of kin was not required to participate in this study in accordance with the national legislation and the institutional requirements.

Author contributions

BC: conceptualization, methodology, writing—original draft, and visualization. LW: formal analysis. BL: investigation, funding acquisition, and writing—review and editing. WL: resources, project administration, and supervision. All authors contributed to the article and approved the submitted version.

This research was supported by the major project of Henan Province Key R&D and Promotion Special Project (Soft Science) Current Situation, Realization Path and Guarantee Measures for Digital Transformation Development of SMEs in Henan Province under the New Development Pattern (Grant No. 222400410159).

Conflict of interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Publisher's note

All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.

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Keywords: COVID-19, work stress, mental health, employee performance, social uncertainty

Citation: Chen B, Wang L, Li B and Liu W (2022) Work stress, mental health, and employee performance. Front. Psychol. 13:1006580. doi: 10.3389/fpsyg.2022.1006580

Received: 29 July 2022; Accepted: 10 October 2022; Published: 08 November 2022.

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Copyright © 2022 Chen, Wang, Li and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Biao Li, lib0023@zzu.edu.cn

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Workplace happiness, well-being and their relationship with psychological capital: A study of Hungarian Teachers

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• Volume 41 , pages 185–199, ( 2022 )

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• Peter Gadanecz 1  

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Happiness and well-being at work has been an increasingly popular topic in the past two decades in academic and business contexts alike, along with positive psychology, through which organizations aim to find out, what makes working environments engaging and motivating. Few studies have focused on education, however, especially from a solution-focused perspective, even though it is a sector where employees are highly exposed to stress and burnout. Accordingly, the purpose of his study was to investigate the relationship between teachers’ psychological resources through the concept of psychological capital, workplace well-being and perceived workplace happiness. We used both qualitative (open-ended question) and quantitative (test battery) methods to examine the relation between the various factors. Content analysis of responses in our qualitative research suggests that the main pillars of teachers’ workplace happiness were realization of goals, feedback, finding meaning in work and social relationships. The results of our quantitative study indicated that workplace well-being and happiness correlated with inner psychological resources, hope and optimism in particular. We conclude that the future focus on employee well-being must take into account positive contributing factors and adopt a positively-oriented approach to promoting well-being. Suggestions for practical implications are also discussed.

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Introduction

The mental health and well-being of employees are crucial factors in an organization’s performance and success (Page and Vella-Brodrick 2009 ). The dynamics of employee well-being at work are pivotal for understanding the different components that affect their health, work behaviour and performance. There are resources on individual, group, managerial and organizational levels that are strongly related to employee well-being (Nielsen et al. 2017 ). Subjective well-being is connected with levels of workplace stress, absenteeism, intrinsic motivation, commitment, innovation, and satisfaction. Work-related well-being and workplace happiness have been identified as important factors in performance, job satisfaction (Crede et al. 2007 ; Fisher 2010 ), and susceptibility to burnout (Iverson et al. 1998 ). Organizational programmes designed to reduce negative workplace outcomes like burnout or stress are often risk-based, problem-focused and negatively framed approaches to mental health (Page and Vella-Brodrick  2012 ; LaMontagne et al. 2007 ). There are far fewer positively framed programs or interventions that aim to promote and to improve positive and inner aspects of employees’ well-being at the primer level (LaMontagne et al.  2014 ; Luthans 2002a ). Thus, the contributory factors of employee workplace well-being and happiness should be considered very important components of mental health and subjective well-being per se.

Well-Being and Happiness

Previous literature on subjective well-being proposed that well-being should be considered a broader phenomenon that involves affective, cognitive and behavioural aspects (Ryff 1989 ; Ryff and Keyes 1995 ; Seligman 2011 ). There are two main approaches to the concept of well-being: subjective well-being and psychological well-being. Subjective well-being is often used as an umbrella term covering various factors. Although there is a consensus that well-being is a multidimensional construct, different theoretical interpretations of the components have been proposed. Constructs of happiness and subjective well-being focus mainly on hedonic aspects of well-being – striving for maximisation of pleasure and positive emotions, but other constructs include eudaimonic aspects as well, such as autonomy and self-actualization (Fisher 2010 ).

Several theories of psychological well-being fall under the broader concept of eudaimonic well-being. One of them is the self-determination theory (SDT) formulated by Ryan and Deci ( 2000 ), who came to the conclusion that there are three basic psychological needs: autonomy, competence and relatedness. When these needs are satisfied, they foster well-being. Ryff ( 1989 ) analysed various approaches to happiness in different subfields of psychology and introduced a six-dimensional model of well-being comprising the following factors: self-acceptance, environmental mastery, autonomy, positive relations with others, personal growth, and purpose in life. Csikszentmihalyi’s concept of autotelic personality also fits into the term of eudaimonic happiness. Autotelic individuals often engage in meaningful activities for their own sake (Csikszentmihalyi 1990 ; Baumann 2012 ). Finally, in a positive psychological context, Seligman’s ( 2002 ) authentic happiness model distinguishes three types of lives that together make up an all-round happy life: a pleasant life, an engaged life and a meaningful life. Later Seligman ( 2011 ) revised his early model of happiness and in a new well-being theory proposed five pillars of human flourishing: Positive emotions, Engagement, positive Relationships, Meaning, and Accomplishment (PERMA as an acronym). According to Seligman ( 2011 ), each of these five elements contributes to well-being and is pursued for its own sake.

As can be seen above, multidimensional approaches to well-being may not only provide a more precise interpretation of well-being but may also provide a better basis for the design of interventions aimed at improving well-being and happiness. Notably, psychological well-being is a concept that can also be interpreted and measured in organizational context (Dagenais-Desmarais and Savoie 2011 ).

Well-Being and Happiness at Work

The past few decades have seen an explosion in research on workplace happiness. Many authors have attempted to identify the sources of happiness and each of them has found important but different determinants (e.g. Diener 1984 ; Freedman 1978 ; Argyle 1987 ; Csikszentmihalyi 1990 ; Emmons 1986 ). Subjective well-being is often equated with happiness. Happiness is one of the most studied facets of well-being, but is only one of the various aspects that researchers have considered (Jayawickreme et al.  2012 ).

Workplace happiness is a term that describes the experience of employees who are energized by and enthusiastic about their work, find meaning and purpose in their work, have good relationships at their workplace, and feel committed to their work. Overall or global workplace happiness refers to how employees evaluate their work life in general and most studies rely on global reports of this kind (e.g. Kahneman et al. 2004 ). Most studies have examined objective variables that influence well-being and happiness, but happiness can also be interpreted through a subjectivist approach, which considers happiness from the individual’s own perspective, and this notion has led to the self-report measurement of global happiness (Lyubomirsky and Lepper 1999 ).

Dolan and his colleagues (Dolan et al. 2008 ) studied 19 cross-national, major national datasets that included measures of subjective well-being and tried to identify all the potential influencers of well-being. Their analysis revealed seven broad categories: 1. income, 2. personal characteristics (age, personality), 3. socially developed characteristics (education, unemployment), 4. how we spend our time (e.g. caring for others, hours worked), 5. attitudes and beliefs toward self/others/life (religion, political persuasion), 6. relationships (intimate relationship, having children), and 7. the wider social, economic and political environment (degree of democracy, welfare system). Dolan et. al’s review highlighted the most frequently measured factors associated with well-being and was concerned chiefly with the impact of objective and subjective variables which in combination influence overall well-being. In our study, we adopt a subjectivist interpretation where overall subjective happiness denotes a broader and more global psychological phenomenon.

Many studies have shown that overall well-being and happiness at the workplace can be highly beneficial for organizations (Seligman 2002 ). Research has shown that happier individuals tend to have better physical and psychological health, and live longer (Roysamb et al. 2003 ; Lyubomirsky et al. 2005a , b ), perform better, can cope better with stressful events (Wood and Joseph, 2010 ), have more positive workplace relationships and are more satisfied with their jobs (Boehm and Lyubomirsky 2008 ; Connolly and Viswesvaran 2000 ). Individuals with higher levels of well-being perform better at work, are more cooperative (George 1991 ), have more satisfying relationships, stronger immune systems, fewer sleep problems, lower levels of burnout, greater self-control, better self-regulation and coping abilities, and are more prosocial (Diener and Seligman 2002 ; Chida and Steptoe 2008 ; Seligman and Schulman 1986 ; Seligman et al. 1990 ; Kubzansky et al. 2001 ; Fredrickson and Joiner 2002 ; Howell et al. 2007 ; Lyubomirsky et al. 2005a , b ; Segerstrom 2007 ; Williams and Shiaw 1999 ).

Teachers’ Well-Being and Happiness

The psychological capacities of individuals can be especially important in a professional context. Teaching is a profession which is highly associated with stress-related outcomes and teachers’ stress and burn-out are popular topics of research. Nevertheless, studies primarily focus on problems, like burn-out, stress, frustration, anxiety, attrition (e.g. Singh and Billingsley 1996 ; Kyriacou 2001 ; Brouwers and Tomic 1999 ; Trent 1997 ; Macdonald 1999 ; Ramsey 2000 ) while there are fewer solution-focused, positively framed approaches that build on teachers’ strengths or intrinsic resources linked to well-being. The workplace well-being and happiness of teachers have been investigated less often than other factors, although there are some relevant and remarkable results (Calabrese et al. 2010 ; Hoy and Tarter 2011 ; Benevene et al. 2018 ; Chan 2009 ; Chan 2010 ; Lavy and Bocker 2018 ). According to Hoy and Tarter ( 2011 ), positive psychology can be a new frame in which educational staff’s well-being can be improved.

In the context of teaching, research has shown that teachers’ happiness and well-being correlates with students’ well-being and performance. Briner and Dewberry ( 2007 ) found a relationship between staff well-being and student SATs (Statutory Assessment Tests) although a causal relationship could not be proved. Some studies show that teachers’ well-being is closely related to students’ school performance and happiness (Lyubomirsky et al. 2005a , b ; Jennings and Greenberg 2009 ). Other studies have revealed that teachers’ happiness has an impact on students’ happiness (Bakker 2005 ). Jennings and Greenberg ( 2009 ) emphasized the importance of teachers’ well-being in developing and maintaining a positive classroom climate and the teacher-student relationship. Roffey ( 2012 ) argued that focusing on teacher well-being also promotes student well-being and performance. Spilt et al. ( 2011 ) discussed empirical evidence for the influence of teacher-student relationships on teacher well-being.

Despite limited research results regarding the link between teachers’ well-being and students’ attainment, there is a reasonable expectation that such a relationship exists. It seems reasonable to assume that teachers with a high sense of well-being would presumably perform better, display better educational outcomes and that this would lead to happier and more motivated students. Bricheno et al. ( 2009 ) highlighted that more research needs to be conducted into the link between teacher well-being and student educational attainment and well-being. Teacher well-being should be actively supported in schools.

There is a substantial body of evidence relating to factors that enhance well-being. To date, many studies have mainly targeted the negative side of the teaching profession including work stress and burnout. This focus on the negative aspects of teachers’ mental health provides no guidance on how to promote and develop overall well-being. By adopting a positive psychological approach, a new perspective opens as the primary focus shifts to revealing and developing potential and inner resources rather than treating problems or negative consequences.

Positive Psychological Resources

Positive psychology offers a new perspective on improving well-being and happiness without solely focusing on deficits and disorders. This notion includes building upon existing resources and strengths that individuals possess such as optimism, hope, resilience, or gratitude, that can help to sustain good mental health (Seligman et al. 2005 ; Peterson and Seligman 2004 ; Luthans et al. 2006 ). Most of the research focused on employee well-being originates from Positive Organizational Scholarship (POS; Cameron et al. 2003 ) and Positive Organizational Behaviour (POB; Luthans 2002b ). POS and POB research have demonstrated that well-being at work is more than the result of job satisfaction and commitment, and that well-being includes “positively oriented human resource strengths and psychological capacities” (Luthans 2002a , p. 59). The concept of psychological capital (PsyCap) refers to an individual’s positive psychological state of development characterized by hope, self-efficacy, resilience and optimism (often referred as the HERO model from the acronym of the components) (Luthans et al. 2007 ). PsyCap is malleable, and therefore open to development. This notion also opens new opportunities for workplaces to enhance employee well-being (Avey et al. 2011 ). This positive approach suggests that revealing and promoting resources and strengths that individuals already have can improve their overall well-being and happiness, as well as having a positive impact on the organization’s productivity and on other (not necessarily measurable) outcomes (e.g. workplace climate, cooperation between employees, trust in leaders). The more inner resources individuals have, the more likely it is that they will experience higher levels of motivation, satisfaction and well-being (Xanthopoulou et al. 2007 ).

Some remarkable research results in recent years have demonstrated the relationship between PsyCap and well-being. For example, Culbertson et al. ( 2010 ) found that PsyCap was related to both (hedonic and eudaimonic) types of well-being. This finding suggests that PsyCap may be a core element in the application of positive psychology in organizations, and that improving employees’ PsyCap may be one of the most effective ways to enhance workplace well-being. Research has shown that micro-interventions or even Internet-based interventions (aimed at developing hope, self-efficacy, resilience and optimism) can improve PsyCap (Luthans et al. 2006 ; Luthans et al. 2008 ). These encouraging results may provide a suitable starting point when considering broader well-being interventions in organizations.

We approach teacher well-being within the positive psychology framework to give us a more comprehensive understanding of what factors may play significant roles in the formation of teachers’ well-being. For this reason, we use the multidimensional PERMA model as a basic framework. In this study, we explore teachers’ psychological capital in relation to workplace well-being and happiness. We assume that different PsyCap factors relate distinctly to different facets of well-being and overall workplace happiness. Applying the PsyCap model and the multidimensional PERMA model can help us to understand which aspects are the most relevant for overall happiness. We aim to reveal the unique contribution of each PsyCap component to each of the PERMA factors, as well as to overall workplace happiness. Our research was guided by the following research questions:

What are the sources of teachers’ workplace happiness? What are the elements that contribute to overall happiness at work?

How do different PsyCap factors relate to each of the PERMA facets? Do some factors of PsyCap have a stronger link to overall workplace happiness?

Which dimensions of PERMA play a role in overall workplace happiness? Do some facets of PERMA have a stronger link to overall workplace happiness?

Participants

297 participants completed the Workplace well-being and happiness questionnaires (201 female, 93 male, three respondents did not indicate their gender). The mean age of the participants was 41.4, with a standard deviation of 7.81 and most participants were between 36 and 45 years of age. All the participants had university or college degrees. The relationship status of participants was also recorded: 207 were married, 50 single, and 36 divorced or widowed (4 participants did not respond). 65 of the participants had 1 child, 123 had two, 40 had three, 6 had four, 1 had five, and 60 had no children (2 persons did not respond).

The cohorts were participants in Educational Leadership training at the Budapest University of Technology and Economics’. This is a postgraduate course to get a qualification in the field of leadership that lasts for two years. This qualification is necessary to become a principal of any educational institute. Participants were recruited before the training session has started. The conductor of the research gave them all the information about the aim of the research personally. They received information about the opportunity to participate from the conductor of the research, therefore taking part was voluntary. Volunteers filled the questionnaires after the training session has ended.

The questionnaires were completed by teachers working at elementary (39,7%) and secondary (28%) schools, kindergartens (15,1%), art schools - music, dance, crafts - (9,4%) and special education teachers (7,8%) working for pedagogical professional services.

The participants in the study were asked to rate their workplace happiness, well-being and psychological capital on scales as a pilot study for future international research. The results of both quantitative and qualitative measures were then analysed.

Qualitative Method – Content Analysis

The aim of this research was to explore the determinants of workplace happiness via content analysis of teachers’ answers written to the open-ended question: “When do you feel/experience happiness at work?” Given that happiness is defined as a subjective phenomenon, our aim was to explore what teachers identified as the main factors that determine their workplace happiness experience in their own words, and accordingly this open-ended question was asked before the rest of the test battery. The first questionnaire, the Subjective Happiness Scale, included an instruction for participants to record responses according to their current workplace and full time job context.

Quantitative Measurements

Seligman’s PERMA model was used as a framework for measuring workplace well-being. We use a measurement that was developed on the basis of this model (Kun et al. 2017 ). Although the PERMA model focuses on positive aspects of well-being, this measurement also captures the negative side of workplace well-being. The Workplace PERMA Questionnaire comprised 6 dimensions: Positive emotions, Engagement, positive Relationships, Meaning of work, Accomplishment, and Negative aspects of work. Respondents had to record their answers on a 5-point Likert scale. The scale had a Cronbach α of .87, which indicated that the scale was reliable for the sample.

Psychological capital was measured using four different questionnaires. Resilience was measured using the Brief Resilience Scale (BRS; Smith et al. 2008 ). For the Hungarian sample, our own translation of this scale was used. The scale contained 6 items, of which 3 are positive and 3 are negative items. Respondents recorded their answers on a 5-point Likert scale. The scale’s Cronbach α of .80 showed that the scale was reliable for the sample. Self-efficacy was measured using the General Self-Efficacy Scale (GSE; Schwarzer and Jerusalem 1995 ), for which we also used our own translation. The scale consisted of 10 items, which respondents had to record their answers for on four-point Likert scales. The scale’s Cronbach α of .82 showed that the scale was reliable. The validations of the Hungarian versions of BRS and GSE scales are currently in progress. After the translation of these two scales into Hungarian we translated a completed translation back into English, compared that new translation with the original scales, and finally, reconciled any meaningful differences between the two.

Optimism was measured with the Life Orientation Test – Revised (LOT-R; Scheier et al. 1994 ), the Hungarian translation of which was developed by Bérdi and Köteles ( 2010 ). The scale consists of 10 items, including reverse items for pessimism. Respondents had to record their answers on a 7-point Likert scale. The scale’s Cronbach α was below .70, therefore the 8th item had to be omitted, after which the scale had an α-value of .70, and therefore proved to be reliable. Hope was measured on the Adult Hope Scale (AHS; Snyder et al. 1991 ). The scale contains 12 items, and two subscales: Agency (motivation to reach a goal, and the amount of energy focused on the goal), and Pathway (the personal ability to find solutions and if the goal is being seen as a stressor or challenge), measured by four items on each subscale. Four distractor items were also added to the scale. The Hungarian translation was developed by Martos et al. ( 2014 ). Respondents had to record their answers on an 8-point Likert scale. The Pathway subscale had a Cronbach α of .71, while the Agency subscale had an α of .70. The overall scale had a Cronbach α of .80 confirming its reliability. Finally, overall workplace happiness was measured by means of the Subjective Happiness Scale (SHS; Lyubomirsky and Lepper 1999 ) which consists of four items. As a Hungarian translation was not available at the time of research our own translation was used and followed the same translation process we mentioned above. Respondents had to record their answers on a 7-point Likert scale, where only the highest and lowest values were labelled within each item. In the instructions, participants were asked to answer questions specifically regarding their workplace experiences. The scale proved reliable in translation and as applied to the sample with a Cronbach α of .81.

The last section of the set contained socio-demographic questions on gender, age, relationship status, number of children, highest level of education and employment status, and also single questions about work and life satisfaction, stress at work and overall health status. The questions about life and work satisfaction and workplace stress were measured on a 3-point scale, while overall health status was measured on a 5-point scale. These questions were included to further explore if the (positive or negative) correlation between these factors and happiness can be proved. Previous Hungarian studies had examined the relation of these factors and overall well-being among healthcare professionals and educators (Deutsch et al. 2015 ; Holecz and Molnár 2014 ), but not specifically applied to the happiness experienced by teachers. However, since overall well-being and happiness are both positive constructs, we expected similar results. The surveys were conducted at the training venue.

Content Analysis – Exploring Workplace Happiness Factors

In the content analysis procedure the teachers’ answers to an open-ended question were defined as a text unit, and “that part of the text unit to which coding categories or dimensions are applicable” (Smith 2000 ., p. 320) were categorised as a coding unit.

We used linguistically defined segments (sentences, clauses, phrases, words) as coding units. The most important aspect of the text used as coding unit is the theme, that is a single idea or statement about the topic (here: about workplace happiness). A theme may be expressed in a few words, a phrase, or sentences. Each theme in a text unit was classified by its properties and then classified. We did not have a priori categories, but instead inductive, empirical ones were created for every theme that appeared to warrant classification as a new one. By using an inductive approach, categories emerge from the material without any preconceptions. Since our qualitative research tends to be exploratory, this approach seemed to be most appropriate for our research question.

Two coders analysed the written answers from 297 respondents independently to create coding categories, with the criteria of uni-dimensionality, comprehensiveness, mutual exclusivity and independence (Smith 2000 ). Frequency scores for categories were calculated by adding the number of themes that represented a given category. Categories were retained if the intercoder agreement was at least 80% and if each of the coding units had more than five recorded (or coded) units. To avoid overestimation of the agreement we also included frequency occurrences and non-occurrences. We provided the validity of the content analysis along three criteria:

Closeness of categories: two coders independently coded the study sample of 297 workplace happiness descriptions and empirical categories were retained if they arrived at an agreed upon definition of each specific categories. We excluded categories from the final analysis that was not agreed upon.

Data validity: our data accurately reflect the range of content being studied. Our measuring procedure represented the intended, and only the intended, concept.

Internal validity: a) our categories are exhaustive and mutually exclusive b) and we measured our workplace happiness concept with categories that are the highest level of measurement possible.

The answers given to the workplace happiness open-ended question varied in length from one to 48 words. We summarized a total of 762 responses (sentences, phrases, words) given to the open question, and finally, 673 coded units were classified into categories. As a result, four distinct main dimensions, and within them, 21 subcategories were defined (Table 1 ). Subcategories describe the content of the main ones in a more detailed way. The four main dimensions are as follows:

Results and success

Assessment of and feedback on the work

Meaning at work

Social relationships

Results and Success – Past, Present, Future

The first subcategory refers to success, mainly to results achieved by the teachers (“The students understood the curriculum.”). These results are the confirmation of good work and enhance teachers’ well-being, and as positive results affect not only their emotional experiences but also serve as a basis for future motivation and successes (Tadić et al. 2013 ). As a second subcategory, teachers have a sense of inner, subjective competence and self-efficacy as they feel that they are able to perform tasks that match their skills, and motivate them to perform well (“Using my skills and knowledge I did the best I could.”) . All of these ensure the sense of achievement and enjoyment of success and in turn contribute to the sense of efficacy (Friedman and Kass 2002 ). Not surprisingly, performance and success are also specifically related to children’s’ success. This is the third sub-category within the category of success. The answers to this question cover past, present and future - it is not only about the work done in the present but also covers feedback from children on past performance ( “ ...my old students come back to school and tells me how valuable the knowledge he has gained from me” ), and about the hope that can be linked to the future (e.g. that a child will be successful in an entrance exam). This time continuity is ensured by a sense of success and effective work that includes not only retrospective but also positive and future-inspired confidence. All these aspects are significant contributors to the sense of personal well-being (Zee and Koomen 2016 ). In the fourth subgroup, there is a general motive for success, and another is related to the professional side (“ I did a very good job professionally and methodologically.” ). These can be related to the concrete results achieved, joint work with their students and colleagues and success experienced at a subjective level ( “I have a sense of success.” ). A separate dimension of successes and achievements of school life can be defined, such as social events, applications for funding or projects, competitions, celebrations, and other programs (“ My students won prizes in a contest.”, “Our school won a tender.” ). The presence of this category clearly indicates that the (workplace) community is an important element of personal well-being (Gross and John 2003 ), as no one works in isolation but on a collective level, and shared goals and experiences are as positive as achieving personal goals. Individual prosperity and happiness can only be imagined in an organization that is supportive, and in addition to individual endeavours, it provides strong attachments and builds a community. Experiences shared by colleagues and teams may enhance the individual’s level of well-being (Greller et al. 1992 ; Sonnentag 1996 ). In the main category of success, the next subgroup is also related to children, which includes one of the important goals of teacher work: the development of children. This refers both to work with children in usual, everyday education situations, or to children with problematic abilities, and can also be considered when a child with ‘problematic personality traits’ changes in a positive way ( I taught to read a little kid everyone has given up about.” ). The importance of developing not only the abilities but the personality of children is also part of this category, and this development-centred work can be an indicator of teachers’ work and a sense of personal well-being. The last key element of the first major dimension is the realization and implementation of goals and plans, which may be short or long-term, and may be more general or specific (“When I can effectively implement my plans.”, “I am satisfied when each work phase works as I planned.”). These are direct, sometimes measurable indicators of success, as they demonstrate the individual’s competence, efforts and commitment to goals, which, as a source of motivation (Locke and Latham 2002 ), provide a further basis for future goals and aspirations.

Assessment of and Feedback on Work

The first major sub-category of the second dimension is feedback, and most of all, positive feedback on job performance. The number of responses about positive feedback (Mitchell et al. 1982 ) is outstanding since they account for more than half of the total number of responses in this dimension (140). Its robustness is also reflected in the fact that not only global, generally work-related feedback, but also positive, confirming, acknowledging feedback is determinative. Further analysis revealed that teachers stress the importance of feedback from students, parents, colleagues, and leaders alike content ( “I get positive feedback from children, parents, and colleagues.” ). Feedback can be direct (either verbal or nonverbal) and indirect feedback (e.g. the success of a child or a child winning a contest can be considered the result of the contribution of a teacher). The next subcategory concerns moral recognition and the appreciation of teachers’ work. As with the previous category, there is a general level of recognition from students, colleagues, parents, and leaders ( “I get appreciative words from my colleagues or from the school principal .”). The value of moral recognition and appreciation is obvious, and studies have shown that it can have a much stronger effect on performance and commitment (to the workplace) than financial benefits (e.g. Brun and Dugas 2008 ). The third category within this main dimension is the satisfaction expressed by others (superiors, colleagues, students, etc.), but this sub-category also represents personal, subjective satisfaction (“I am satisfied.”,“My colleagues are satisfied with my job.” ). Satisfaction has a striking effect on workplace happiness because of its emotional component since it directly contributes to the subjective sense of well-being of individuals (Bowling et al. 2010 ). The coding units of the next sub-category, labelled praise, appear not only in general but also on a specific level specifying who (leader, co-worker, parents) the praise is given by. Praise is also a type of the social reinforcement, which has a direct impact on motivation since it is the direct and socially awarded expression of maximum recognition (Deci and Ryan 1985 ; Sansone et al. 1989 ). It is a highly rated form of the reinforcement of good performance. In the penultimate sub-category within the second main dimension, there are coding units that confirm the respondent as a member of a particular workplace, organization, that counts on and considers a person an important part of it and takes into account his/her opinion. This sub-category was labelled organizational citizenship, referring to the fact that the employer considers his/her employee a full member of the workplace and appreciates his/her contributions to the organizational goals and values (“ They consider my job important and make me feel that what I do is required to the success of the school.” ). Organizational citizenship is an important key factor of workplace engagement (Bhatnagar and Biswas 2010 ), and without it, the worker feels as if they are only a tiny cog in the machine, which if lost, can easily be replaced by another. Finally, the last sub-category includes financial recognition and reward, which naturally includes salary (“I would be lying if I said finances do not cause happiness but is not what matters the most.” ). It is worth mentioning that there were only a few coding units in this category, this sharp difference is notable in itself: there are 29 coding units that refer to the importance of moral recognition and only 6 units to the importance of financial recognition. Apart from social incentives, it is understandable that financial incentives are also important, but it is worth pointing out that teachers do not have exclusively or primarily financial incentives, but instead moral and social motivational factors play an essential role in the formation of their well-being and happiness.

Meaningful Work – Meaningfulness and Emotion

The first and most significant among the five sub-categories of this dimension is the well-being, joy and happiness of the children. This refers to the times when children enjoy the lesson, learning, tasks, and when they give positive feedback to the teacher (“I see the joy on the children’s faces.”, “Students give feedback that they had a good time in my class.” ). Positive emotions (pleasure, enthusiasm, excitement, enjoyment) expressed by children and shared with the teacher are significant components of a teacher’s well-being (Spilt et al. 2011 ). The second sub-dimension that is also related to the children concerns rises in children’s motivation and interest (“I see genuine interest on my students’ faces.” ), and which includes changes in attitude (from passive to active), and increased desire to be praised and to learn. This is one of the main missions of pedagogical work, as one of the greatest challenges for teachers is to raise children’s interest, curiosity and motivation to learn. The next subcategory representing an important determinant of a teacher’s happiness is that his/her work had or has meaning. The most essential aspect of this category is that the teacher does not perform irrelevant, often unnecessary (e.g. administrative) tasks, but instead real and valuable pedagogical work is carried out. An important criterion for meaningful work is that the employee feels that his/her work is significant, useful, and influences others in a positive way, and is also undertaken for unselfish reasons (Pratt and Ashforth 2003 ). This subjective meaning and personal significance are very important determinants of an individual’s work-related well-being, as is evident here. The transfer and sharing of knowledge, defined as a separate sub-category, is one of the key tasks of pedagogical work, which includes the success of knowledge and information transfer processes during lessons, when children understand the material being transmitted. This sub-category also includes success in approaching, working on and completing the tasks teachers are set. The last category covers the special state and characteristics associated with teachers’ experiences while conducting everyday classroom work, which we could actually call flow at work. Flow is an optimal psychological state where attention is undivided and motivates action to fulfill the goal of expressing self (Csikszentmihalyi 1990 ). On the one hand this is when a teacher has flow in his/her work ( “I work with intrinsic motivation and experience flow.” ); on the other it is when a teacher triggers flow-like experience in children. In the happiness texts we can detect features of flow, such as work is carried out smoothly and almost unnoticed ( “The whole class becomes one unit no child is left out of attention.”) ; time passes unnoticed (“Time spent together flies.” ); they enjoy tasks (“Kids enjoy the task.” ); there is a chance for a relaxed and creative manifestation; and there are a lot of smiles and laughter. In a state of flow teachers have a sense of self-efficacy and they feel that they are at the apex of their abilities professionally and methodologically.

Social Relationships

The three sub-categories of Social relationships display the highest weighted means. The first subcategory covers the love, emotional attachment, and positive emotional feedback children express toward teachers (“I feel the love, trust, and attachment of the children” ). Positive emotional reinforcements from others are essential building blocks of subjective well-being and are important determinants of happiness (Ryff 1989 ). The more commonly an individual experiences positive emotions, the more they feel others’ acceptance and support, the better their personal well-being and the more efficiently they form and maintain their relationships (Kahn et al. 2003 ). In the case of teachers, it is no coincidence that social reinforcements from children, who are at the centre of their activities, play such an important role. The second sub-category involves teachers’ relationships with colleagues and the workplace climate. Like the previous child-centred category, relationships are still in focus. The coding units here cover positive, balanced, well-functioning relationships with colleagues (“I am happy to work with my colleagues they are like a second family to me.” ) and on an organizational level a positive, supportive climate and a positive emotional milieu (“The workplace atmosphere is good, relaxed, and cheerful.” ). The quality of relationships at work often represents an important reason for retention, as well as contributing to job satisfaction and workplace commitment (Crosby 1982 ; Venkataramani et al. 2013 ), and as a whole, provides a strong basis for individual and collective achievements and successes. The third and last sub-category of this main dimension concerns social support and co-operation (We help each other, if a colleague has a problem.”, “We work together in a good mood to achieve our goal.”). Helping and supporting colleagues, as well as sympathy and acceptance from colleagues, are an essential part of this category. Selfless help and co-operation in problem management or in finding solutions provide shared (emotional, behavioural) experiences that keep the community together and provide a safe, trusting milieu for the individual. Helping others is not only a pleasure for an individual but gives a sense of meaningful contribution to a community that is also an important building block of subjective well-being (Mitchell et al. 1982 ; Aknin et al., 2013a , b ).

Quantitative Analyses

Descriptive statistics.

Table 2 presents the descriptive information for each of the scales included in the study ( N  = 297). As can be seen, participants were above the neutral level for all measurements except the optimism scale (LOT-R).

At the time of data analysis no reference means were not available for all instruments. Some of the measurements (Acton and Glasgow 2015 ; Aknin et al. 2013 ; Avey et al. 2011 ) have not yet been validated in Hungarian, therefore we used our own translations, and the PERMA questionnaire (Baumann 2012 ) is relatively new (published in 2017 by Kun et al.) therefore it still lacks reference means. Two scales are validated in Hungarian (Argyle 1987 ; Avanzi et al. 2012 ), the reference means for these questionnaires are as follows: LOT-R: 3.25 (Bérdi and Köteles 2010 ), AHS: 5.79 (Martos et al. 2014 ). As can be seen our particular sample’s means slightly differ from these values.

Correlation Analyses

Bivariate Pearson correlations (two-tailed) were deployed to test our research questions 2–3. Correlational analyses were conducted between each dependent variable, including all scales of PsyCap, and the two subscales of AHS. All correlations between variables can be found in Table 3 . Our second research question concerned the relationships between the PsyCap and PERMA subscales and SHS. Moderate positive correlations were found between the PsyCap and the overall PERMA scale (r = .52), and between the PsyCap and all the PERMA subscales (.23 < r < .55). Positive Emotions and Achievement showed the strongest relationships with PsyCap subscales, with Positive Emotions having a moderate correlation with LOT (r = .44) and weak correlations with AHS (r = .34) and the Agency subscale of AHS (r = .32). Achievement showed moderate correlations with GSE (r = .45), LOT (r = .40), AHS (r = .55), and the Agency (r = .56) and Pathway subscales of AHS (r = .41).

PsyCap in general showed connections with different subscales of PERMA, displaying moderate correlations with Achievement (r = .56) and Positive Emotions (r = .44), and weak correlations with Engagement (r = .34), Meaning (r = .32), and Positive Relationships (r = .23). The results also suggested that PsyCap was positively and significantly related to SHS (r = .50). Thus, the findings indicate that Psychological Capital factors have a positive relationship with all the workplace well-being factors and overall workplace happiness.

Upon the examination of separate scales of PsyCap, GSE showed strong correlations with AHS (r = .66) and the AHS Pathway subscale (r = .66), moderate correlation with the AHS Agency subscale (r = .49), and weak correlations with BRS (r = .35) and LOT (r = .32). LOT displayed moderate correlations with PERMA (r = .49), SHS (r = .56), and AHS (r = .41), and weak correlations with the AHS Agency (r = .39) and Pathway subscales (r = .35), and with BRS (r = .36). Furthermore, AHS yielded weak correlations with BRS (r = .34), PERMA (r = .39) and SHS (r = .36), while the Agency subscale displayed weak correlations with PERMA (r = .35) and SHS (r = .35), and the Pathway subscale showed weak correlations with BRS (r = .37) and PERMA (r = .32).

Our third research question concerned the relationship between PERMA and SHS. A positive and significant relationship was found between them (r = .47), thus supporting our third research question. SHS also showed a moderate correlation with Positive Emotions (r = .46) and a weak correlation with Achievement (r = .36) and Meaning (r = .31).

Teachers are important persons who contribute to student achievement and success (Stronge et al. 2004 ). Teachers’ workplace happiness and well-being is therefore a critical factor in positive education (Ross et al. 2012 ). The aim of this study was to reveal the most relevant workplace happiness factors and to understand teachers’ well-being in detail in the framework of the PERMA model and Psychological Capital theory.

We used both qualitative and quantitative methods. After coding nearly 300 respondents’ written workplace happiness texts it became clear that a wide range of essential factors contributed to workplace happiness. Answers were organized into four main dimensions and 21 subcategories. Most of the responses referred to results (e.g. realization of goals and plans) and experiences of success such as successful work, the success of children, and success of the school. This implies that the success of others is as important for teachers as their own individual success in producing workplace happiness. Respondents frequently mentioned the importance and significance of assessment of and feedback on their work. This second main category included moral and financial recognition, praise, and other people’s satisfaction with the teachers’ work, as well as their own feelings of satisfaction. Countless studies have revealed and confirmed the decisive role played by feedback on work, and its impact on performance, commitment to the organization, satisfaction and motivation (Kluger and DeNisi 1996 ; Eccles and Wigfield 2002 ). As regards the third main category, teachers’ answers supported the importance of meaningful work in relation to the sense of workplace happiness. Intrinsic reasons for working and finding meaning in work have a positive effect on subjective well-being (Winefield and Tiggemann 1990 ). Our results have demonstrated that perceiving work as meaningful appears to play an important role in teachers’ happiness. Meaning is derived from different aspect of teachers’ work such as knowledge sharing, interesting and motivating the children, and experiencing flow in their work. The last main dimension referred to social relationships with children, colleagues, and parents. Analysis of teachers’ responses revealed that not only good personal relationships but also a positive overall workplace climate is necessary for workplace happiness. Social relationships, then, are necessary for happiness (Diener and Seligman 2002 ). The people around teachers provide social support and teachers place a high importance in relationships as sources of happiness.

Our study used six additional questionnaires to explore the relationship between teachers’ well-being, happiness and their inner psychological resources. The data supported our research questions. Correlations showed significant relationships between the variables with the findings revealing that workplace happiness relates positively with all psychological capital factors (hope, self-efficacy, resilience, and optimism; .23 < r < .57) and all well-being dimensions (positive emotions, engagement, positive relationships, meaning, and achievement; .19 < r < .46). Optimism (of PsyCap) and positive emotions (of PERMA) were the most relevant factors in relation to workplace happiness (r = .57 and r = .46, respectively). In terms of Frederickson’s (Fredrickson 2001 ) broaden-and-build theory of positive emotions, these findings support the notion that the implementation of interventions to improve optimism and positive emotions may increase happiness. According to this theory, positive experiences and emotions create a positive spiral generating more positive thoughts, experiences and feelings that are beneficial for well-being and happiness. Experiencing positive emotions regularly can produce long-term changes in individuals’ personal resources.

We also found that two of the PERMA subscales, positive emotions and achievement, have the strongest relationship to psychological capital. More precisely, positive emotions are strongly related to optimism while achievement is related to self-efficacy and the two subscales of hope (agency and pathway). This result is consistent with the foundation of hope theory (Snyder 2002 ) which claims that a pathway involves the future potential to achieve goals, and agency involves motivation for movement along a pathway toward achieving. Not surprisingly, teachers’ achievement is essential for their subjective well-being and happiness at work as our content analysis has also confirmed above.

Our results strongly support the Acton and Glasgow ( 2015 ) approach to teacher wellbeing, which is defined as “an individual sense of personal professional fulfilment, satisfaction, purposefulness and happiness, constructed in a collaborative process with colleagues and students” (p. 101).

Practical Considerations

Our research suggests that several important factors can influence happiness and well-being in the workplace specifically. In the light of positive psychology and the potential role of ‘positivity’ as an added value, it is worth reviewing some of the potential activities that may be useful for teachers in order to improve their overall well-being. These possible activities of intervention are selected from the toolkit of positive psychological interventions (PPIs).

There are many forms of positive psychological interventions aimed at improving happiness and well-being – including in the context of work and organizational settings (Layous et al. 2014 ; Lyubomirsky et al. 2005a , 2005b ; Seligman et al. 2005 ). The aim of PPIs is to identify, develop and broaden individual trait-like characteristics such as the elements of psychological capital and to promote well-being. Interventions to increase psychological capital are assumed to lead to higher efficiency and performance (Luthans and Youssef 2004 ). The development of hope can be used to build positive well-being through identifying personally important goals, goal design, pathway generation, resources and possible obstacles in achieving goals, reframing barriers, etc. Hope interventions help individuals to set realistic goals that could boost their well-being as they achieve these goals. Optimism is another component of psychological capital development. Optimism can be enhanced through various types of interventions, resulting in increased well-being. Research findings suggest, for example, that gratitude interventions may enhance optimism and well-being (Emmons and McCullough 2003 ; Froh et al. 2008 ). Optimistic thinking includes positive expectations for the future and viewing negative life events as temporary, external, and limited to the immediate incident (Seligman et al. 1995 ). Thus, activities targeting optimistic thinking may prevent teachers from burning out and suffering stress and may have positive effects on their self-efficacy and well-being.

Further practices can be applied in the context of work in order to improve workplace happiness and well-being. Our suggestions are:

The use of strengths-based feedback (Roberts et al. 2005 ; Aguinis et al. 2012; Herman et al.  2012 ) instead of weakness-focused feedback on performance.

Matching of work tasks and employee characteristics using the ‘job crafting’ approach (Wrzesniewski and Dutton 2001 ) resulting in work becoming more meaningful for the person, which has a positive effect on well-being and productivity.

Using solution-focused brief coaching – this type of coaching focuses on solutions, individual strengths, personal resources, and the future instead of causes and problems. This technique has a positive impact on psychological well-being, strengthens hope and spurs further efforts to achieve the goal (Green et al. 2006 ; Sherlock-Storey et al. 2013 ).

Above mentioned research suggest that increasing well-being through intentional activities has multiple effects on employees. Workplace positive psychology interventions are relatively few in number and many previous studies have not focused much on what individuals can do to enhance their own well-being themselves (Sin and Lyubomirsky 2009 ; Wood et al. 2010 ; Mazzucchelli et al. 2010 ). PPIs are simple and time-saving self-guided interventions that can improve well-being in today’s work environment (Meyers et al. 2013 ).

Our findings seem to be promising in regard to determining main intervention fields for enhancing teachers’ well-being. Considering our main results linked to our research questions, we think that PsyCap can be one of the core constructs of interventions. As our results indicated, all the five well-being factors of PERMA were related to overall PsyCap, and two elements, Positive Emotions and Achievement showed the strongest relationship with it. Our findings also showed that optimism (of PsyCap) and Positive Emotions (of PERMA) were the most relevant factors in relation to overall workplace happiness. Considering these results, on one hand we recommend developing programs aiming at PsyCap components (hope, self-efficacy, resiliency, and optimism) that can have a positive effect on overall well-being (Luthans et al. 2006 ), and we also suggest putting the main focus on Achievement and Positive Emotions.

Currently little is known about which interventions impact which elements of PERMA but there are a few studies that provide the first results about techniques that increase positive emotions, enhance achievement, and raise global happiness. These studies have used different activities, for example, working on personal goals, committing acts of kindness, visualizing best possible self, or remembering one’s best achievement (Fordyce 1983 ; Sheldon and Lyubomirsky 2006 ; Pham and Taylor 1999 ; Sheldon et al. 2002 ). In order to design specific and relevant interventions for improving workplace happiness, our qualitative research may help to determine the specific areas and content of them. For example, strengthening the sense of competence and pursuing personal goals can contribute to the sense of success (Sheldon et al.2002) or job crafting technique may help teachers to find or reshape the meaning of their work (Wrzesniewski and Dutton 2001 ).

We conclude that the two models of PsyCap and PERMA and our qualitative analysis are a good starting point in developing PPIs in order to improve teachers’ workplace happiness and well-being. An additional future direction could involve developing programs for teachers specifically but more research is needed to work toward recommendations regarding this issue.

Limitations and Future Research

It is important to identify several weaker features of our study. First, our research was conducted based on a sample of Hungarian teachers and therefore the results cannot be generalized to the population. Also, teachers in our sample were affiliated with different types of education institute and we have not controlled for contingency and organizational variables. Another limitation of this research is that the constructs were measured via self-reported questionnaires, and the cross-sectional nature of the data does not allow us to infer causal relationships.

For future directions, it would be interesting to study the level of well-being and happiness among different age (Avanzi et al. 2012 ; Kinnunen et al. 1994 ) and occupational groups of teachers or in different educational institutes. We believe that research questions raised in this study deserve further research attention, along with applied PPIs practices in work environment and other relevant constructs that can serve as new resources for workplace well-being and happiness. We hope our results hold implications for the future of positive psychological research for teachers and school settings.

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Kun, A., Gadanecz, P. Workplace happiness, well-being and their relationship with psychological capital: A study of Hungarian Teachers. Curr Psychol 41 , 185–199 (2022). https://doi.org/10.1007/s12144-019-00550-0

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Annual Review of Organizational Psychology and Organizational Behavior

Volume 10, 2023, review article, open access, mental health in the workplace.

• E. Kevin Kelloway 1 , Jennifer K. Dimoff 2 , and Stephanie Gilbert 3
• View Affiliations Hide Affiliations Affiliations: 1 Department of Psychology, Saint Mary's University, Halifax, Nova Scotia, Canada; email: [email protected] 2 Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada 3 Shannon School of Business, Cape Breton University, Sydney, Nova Scotia, Canada
• Vol. 10:363-387 (Volume publication date January 2023) https://doi.org/10.1146/annurev-orgpsych-120920-050527
• First published as a Review in Advance on November 14, 2022
• Copyright © 2023 by the author(s). This work is licensed under a Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See credit lines of images or other third-party material in this article for license information

The increasing societal awareness of employee mental health issues, especially within the ongoing COVID-19 pandemic, has led to a great deal of research examining the occupational predictors and outcomes of mental ill health. The consequences of employee mental illness can be significant to organizations, whereas providing employee mental health resources may offer a competitive advantage. This article provides a review of the definitions of employee mental health, the costs of employee mental illness to organizations and to society as a whole, and the role of the workplace in promoting positive mental health, preventing mental illness, intervening to address employee mental ill health, and accommodating employees experiencing mental health challenges. We present recommendations for future research and implications for practice.

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Michael P. Leiter

2 Centre for Organizational Research & Development, Acadia University, Wolfville, NS, B4P 2R6, Canada

The experience of burnout has been the focus of much research during the past few decades. Measures have been developed, as have various theoretical models, and research studies from many countries have contributed to a better understanding of the causes and consequences of this occupationally‐specific dysphoria. The majority of this work has focused on human service occupations, and particularly health care. Research on the burnout experience for psychiatrists mirrors much of the broader literature, in terms of both sources and outcomes of burnout. But it has also identified some of the unique stressors that mental health professionals face when they are dealing with especially difficult or violent clients. Current issues of particular relevance for psychiatry include the links between burnout and mental illness, the attempts to redefine burnout as simply exhaustion, and the relative dearth of evaluative research on potential interventions to treat and/or prevent burnout. Given that the treatment goal for burnout is usually to enable people to return to their job, and to be successful in their work, psychiatry could make an important contribution by identifying the treatment strategies that would be most effective in achieving that goal.

For many years, burnout has been recognized as an occupational hazard for various people‐oriented professions, such as human services, education, and health care. The therapeutic or service relationships that such providers develop with recipients require an ongoing and intense level of personal, emotional contact. Although such relationships can be rewarding and engaging, they can also be quite stressful.

Within such occupations, the prevailing norms are to be selfless and put others' needs first; to work long hours and do whatever it takes to help a client or patient or student; to go the extra mile and to give one's all. Moreover, the organizational environments for these jobs are shaped by various social, political, and economic factors (such as funding cutbacks or policy restrictions) that result in work settings that are high in demands and low in resources. Recently, as other occupations have become more oriented to “high‐touch” customer service, the phenomenon of burnout has become relevant for these jobs as well 1 .

DEFINING BURNOUT

Burnout is a psychological syndrome emerging as a prolonged response to chronic interpersonal stressors on the job. The three key dimensions of this response are an overwhelming exhaustion, feelings of cynicism and detachment from the job, and a sense of ineffectiveness and lack of accomplishment. The significance of this three‐dimensional model is that it clearly places the individual stress experience within a social context and involves the person's conception of both self and others.

The initial research on burnout was exploratory and relied primarily on qualitative techniques. Because the earliest researchers came from social and clinical psychology, they gravitated toward relevant ideas from these fields. The social perspective utilized concepts involving interpersonal relations, i.e. how people perceive and respond to others; these included detached concern, dehumanization in self‐defense, and attribution processes. It also brought in concepts of motivation and emotion (and especially coping with emotional arousal). The clinical perspective also dealt with motivation and emotion, but framed these more in terms of psychological disorders, such as depression. Subsequent researchers came from industrial‐organizational psychology, and this perspective emphasized work attitudes and behaviors. It was also at this point that burnout was conceptualized as a form of job stress, but the primary focus was on the organizational context and less on the physical characteristics of the experienced stress.

What emerged from this descriptive work were the three dimensions of the burnout experience. The exhaustion dimension was also described as wearing out, loss of energy, depletion, debilitation, and fatigue. The cynicism dimension was originally called depersonalization (given the nature of human services occupations), but was also described as negative or inappropriate attitudes towards clients, irritability, loss of idealism, and withdrawal. The inefficacy dimension was originally called reduced personal accomplishment, and was also described as reduced productivity or capability, low morale, and an inability to cope.

Assessment of burnout

As the characteristics of burnout became more clearly identified, the next step was to develop measures that could assess them. Various measures were proposed, based on different assumptions about burnout, and many of them relied on the face validity of the measurement items or statements. The first burnout measure that was based on a comprehensive program of psychometric research was the Maslach Burnout Inventory (MBI) 2 , 3 . The MBI was specifically designed to assess the three dimensions of the burnout experience which had emerged from the earlier qualitative research. It has been considered the standard tool for research in this field, and has been translated and validated in many languages 4 . In contrast, other initial measures of burnout focused only on the dimension of exhaustion 5 , 6 .

This distinction between measures that assess several dimensions of burnout, and those that assess the sole dimension of exhaustion, continues to the present day, and reflects different conceptualizations of burnout. For example, the Bergen Burnout Inventory (BBI) 7 assesses three dimensions of burnout: exhaustion at work, cynicism toward the meaning of work, and sense of inadequacy at work. The Oldenburg Burnout Inventory (OLBI) 8 assesses the two dimensions of exhaustion and disengagement from work. Other burnout measures focus on exhaustion alone, although they differentiate between various aspects of exhaustion. For example, the Shirom‐Melamed Burnout Measure (SMBM) 9 distinguishes between physical fatigue, emotional exhaustion, and cognitive weariness; and the Copenhagen Burnout Inventory (CBI) 10 makes a distinction between physical and psychological exhaustion.

There have been other changes and modifications of burnout measures over the years. Because the initial concern about burnout emerged from caregiving occupations, such as health care and human services, the measures developed in the 1980s tended to reflect the experience of those professions. Later, however, other occupational groups became interested in the occurrence of burnout, but had some difficulties in adapting the existing measures to their work situation. For the MBI, the solution was the development of a General Survey that could be used within any occupation (MBI‐GS) 11 . Not only were various items revised to be more “occupation‐neutral”, but the dimension of depersonalization (which was more specific to human services) was broadened to refer to a negative detachment from work and was renamed cynicism , and the dimension of personal accomplishment was broadened and renamed professional efficacy . More recent burnout measures utilized more occupation‐neutral wording from the outset.

However, some measures also added some new dimensions to the concept of burnout. For example, the Spanish Burnout Inventory consists of four dimensions: enthusiasm towards the job, psychological exhaustion, indolence, and guilt 12 . Meanwhile, some researchers were concerned that the more neutral wording meant a loss of the specific interpersonal issues for human service workers, so they developed a new measure of interpersonal strain 13 . It remains an open question whether these additional elements are essential components of burnout per se , or whether they assess experiences or conditions that often accompany the experience of burnout.

An important development, at the beginning of the 21st century, has been that researchers have tried to broaden their understanding of burnout by extending their attention to its positive antithesis. This positive state has been identified as “engagement”. Although there is general agreement that engagement with work represents a productive and fulfilling state within the occupational domain, there are differences in its definition.

For some burnout researchers, engagement is considered to be the opposite of burnout and is defined in terms of the same three dimensions as burnout, but the positive end of those dimensions rather than the negative. From this perspective, engagement consists of a state of high energy, strong involvement, and a sense of efficacy 14 . By implication, engagement is assessed by the opposite pattern of scores on the three MBI dimensions.

However, a different approach has defined work engagement as a persistent, positive affective‐motivational state of fulfillment that is characterized by the three components of vigor, dedication, and absorption. In this view, work engagement is an independent and distinct concept, which is not the opposite of burnout (although it is negatively related to it). A new measure, the Utrecht Work Engagement Scale (UWES) 15 , was developed to assess this positive state, and extensive research has been carried out in the last decade 16 .

The relationship between burnout and engagement continues to be debated, however, and a recent approach has been to use dialectical theory to synthesize conflicting views on the two constructs, and to develop an alternate model 17 .

Conceptual models

There have been various conceptual models about the development of burnout and its subsequent impact. At first, the focus was on the relationship between the three dimensions of burnout, which was often described in sequential stages. Exhaustion was assumed to develop first, in response to high demands and overload, and then this would precipitate detachment and negative reactions to people and the job (depersonalization or cynicism). If this continued, then the next stage would be feelings of inadequacy and failure (reduced personal accomplishment or professional inefficacy).

More recently, burnout models have been based on theories about job stress, and the notion of imbalances leading to strain. The first such model was the transactional one, which served as the conceptual bridge between sequential stages and imbalances 18 . Its three stages are: a) job stressors (an imbalance between work demands and individual resources), b) individual strain (an emotional response of exhaustion and anxiety), and c) defensive coping (changes in attitudes and behavior, such as greater cynicism).

Subsequently, two developmental models of the demands‐resources imbalance have emerged: the Job Demands‐Resources (JD‐R) model and the Conservation of Resources (COR) model. The JD‐R model focuses on the notion that burnout arises when individuals experience incessant job demands and have inadequate resources available to address and to reduce those demands 19 . The COR model follows a basic motivational theory assuming that burnout arises as a result of persistent threats to available resources 20 . When individuals perceive that the resources they value are threatened, they strive to maintain those resources. The loss of resources or even the impending loss of resources may aggravate burnout. Both the JD‐R and the COR theory of burnout development have received confirmation in research studies.

A different variation of an imbalance model of burnout is the Areas of Worklife (AW) model, which frames job stressors in terms of person‐job imbalances, or mismatches, but identifies six key areas in which these imbalances take place: workload, control, reward, community, fairness, and values. Mismatches in these areas affect an individual's level of experienced burnout, which in turn determines various outcomes, such as job performance, social behaviors, and personal wellbeing. The greater is the mismatch between the person and the job, the greater the likelihood of burnout; conversely, the greater the match, the greater the likelihood of engagement. Initial empirical support for the AW model has been provided by both cross‐sectional and longitudinal studies 21 .

CAUSES AND OUTCOMES

Most models of burnout make explicit the causal theorizing that has always been implicit in burnout research: certain factors (both situational and individual) cause people to experience burnout, and once burnout occurs, it causes certain outcomes (both situational and individual). However, these causal assumptions have rarely been tested directly. Most research on burnout has involved cross‐sectional designs or studies using statistical causal models. This correlational database has provided support for many of the hypothesized links between burnout and its sources and effects, but it is unable to address the presumed causality of those linkages. The recent increase in longitudinal studies is beginning to provide a better opportunity to test sequential hypotheses, but stronger causal inferences will also require appropriate methodological designs (and these are often difficult to implement in applied settings). One other critical constraint is that many of the variables have been assessed by self‐report measures (rather than other indices of behavior or health).

Over two decades of research on burnout have identified a plethora of organizational risk factors across many occupations in various countries 22 , 23 . Six key domains have been identified, as mentioned earlier: workload, control, reward, community, fairness, and values. The first two areas are reflected in the Demand‐Control model of job stress 24 .

Work overload contributes to burnout by depleting the capacity of people to meet the demands of the job. When this kind of overload is a chronic job condition, there is little opportunity to rest, recover, and restore balance. A sustainable and manageable workload, in contrast, provides opportunities to use and refine existing skills as well as to become effective in new areas of activity.

A clear link has been found between a lack of control and burnout. On the contrary, when employees have the perceived capacity to influence decisions that affect their work, to exercise professional autonomy, and to gain access to the resources necessary to do an effective job, they are more likely to experience job engagement.

The area of reward refers to the power of reinforcements to shape behavior. Insufficient recognition and reward (whether financial, institutional, or social) increases people's vulnerability to burnout, because it devalues both the work and the workers, and is closely associated with feelings of inefficacy. In contrast, consistency in the reward dimension between the person and the job means that there are both material rewards and opportunities for intrinsic satisfaction.

The area of community has to do with the ongoing relationships that employees have with other people on the job. When these relationships are characterized by a lack of support and trust, and by unresolved conflict, then there is a greater risk of burnout. On the contrary, when these job‐related relationships are working well, there is a great deal of social support, employees have effective means of working out disagreements, and they are more likely to experience job engagement.

The area of fairness emerges from the literature on equity and social justice. Fairness is the extent to which decisions at work are perceived as being fair and equitable. People use the quality of the procedures, and their own treatment during the decision‐making process, as an index of their place in the community. Cynicism, anger and hostility are likely to arise when people feel they are not being treated with the appropriate respect.

Finally, the area of values picks up the cognitive‐emotional power of job goals and expectations. Values are the ideals and motivations that originally attracted people to their job, and thus they are the motivating connection between the worker and the workplace, which goes beyond the utilitarian exchange of time for money or advancement. When there is a values conflict on the job, and thus a gap between individual and organizational values, employees will find themselves making a trade‐off between work they want to do and work they have to do, and this can lead to greater burnout.

In terms of outcomes, burnout has been frequently associated with various forms of negative reactions and job withdrawal, including job dissatisfaction, low organizational commitment, absenteeism, intention to leave the job, and turnover 23 . For example, cynicism has been found to be the pivotal aspect of burnout to predict turnover 25 , and burnout mediates the relationship between being bullied in the workplace and the intention to quit the job 26 . On the other hand, for people who stay on the job, burnout leads to lower productivity and impaired quality of work. As burnout diminishes opportunities for positive experiences at work, it is associated with decreased job satisfaction and a reduced commitment to the job or the organization.

People who are experiencing burnout can have a negative impact on their colleagues, both by causing greater personal conflict and by disrupting job tasks. Thus, burnout can be “contagious” and perpetuate itself through social interactions on the job 27 , 28 . The critical importance of social relationships for burnout is underscored by studies that show that burnout increases in work environments characterized by interpersonal aggression 29 , 30 . Such findings suggest that burnout should be considered as a characteristic of workgroups rather than simply an individual syndrome.

Burnout has a complex pattern of relationships with health, in that poor health contributes to burnout and burnout contributes to poor health 31 . Of the three burnout dimensions, exhaustion is the closest to an orthodox stress variable, and therefore is more predictive of stress‐related health outcomes than the other two dimensions. Exhaustion is typically correlated with such stress symptoms as headaches, chronic fatigue, gastrointestinal disorders, muscle tension, hypertension, cold/flu episodes, and sleep disturbances. These physiological correlates mirror those found with other indices of prolonged stress. Parallel findings have been found for the link between burnout and substance abuse 32 .

A ten‐year longitudinal study of industrial workers found burnout to predict subsequent hospital admissions for cardiovascular problems 33 . Other research found that a one‐unit increase in burnout score was related to a 1.4 unit increase in risk for hospital admission for mental health problems, as well as a one‐unit increase in risk for hospital admissions for cardiovascular problems 31 . Other studies have provided a more detailed examination of the link between burnout and cardiovascular disease, noting the role of high‐sensitivity C‐reactive protein and fibrinogen concentrations in the link 34 .

BURNOUT IN PSYCHIATRY

To a large extent, the research literature on burnout in psychiatry echoes those previous themes. Workplace variables have been found to be more stressful for psychiatrists than other factors, and thus may be more likely to perpetuate burnout 35 . These variables include too much work, long working hours, chronic staff shortages, an aggressive administrative environment, and lack of support from management. Poor relationships with management and supervisors have also been identified as related to burnout among psychiatry residents 36 . However, research has found mixed results with regard to the role of job satisfaction in burnout, with some studies reporting no relationship 37 , 38 , and other studies reporting that job satisfaction did play a role 39 , 40 .

The rate of burnout among those employed in the health care field tends to be reported in the moderate to high levels, and it is generally believed that the burnout risk in health care is higher than in the general working population. Reported burnout rates for psychiatrists are quite similar to this overall trend 41 , 42 , 43 . Some studies have raised the possibility that psychiatrists show an even more negative risk profile for burnout than do other health care employees 36 , 43 , 44 . For example, one study found that 89% of psychiatrists had either thought about or experienced a clear threat of severe burnout 45 .

There are other critical risk factors that may be more unique to the field of psychiatry. Chief among these is the working relationship that psychiatrists, and other mental health professionals, have with clients who are experiencing psychological trauma. The challenging demands posed by these and other difficult clients can lead to greater stress and frustration among psychiatrists, which in turn can fuel the exhaustion, cynicism, and inefficacy of burnout. This process has also been described in terms such as compassion fatigue, secondary traumatic stress, and vicarious traumatization 46 , 47 , 48 . The burnout experience can become especially overwhelming when the psychiatrist becomes the target of anger, hatred, and even violence, as a result of negative transference 49 . Violent incidents with patients can be emotionally draining and difficult to manage, and can lead health providers to psychologically distance themselves from their work. The occurrence of violence can also make providers feel that they lack control over their job, and thus challenge their sense of professional efficacy.

Higher levels of burnout are correlated with more negative feelings about patients 50 and a poorer quality of patient care 51 . This link between burnout and poor care is supported by research on how burnout is manifested in psychiatrists, by changes in appearance (e.g., look of fatigue), behavior (e.g., becoming avoidant, making less eye contact), and mood (e.g., becoming more irritable and agitated, communicating poorly). In addition, perfectionist and obsessive traits may perpetuate burnout, particularly when the workload is heavy or stressful 52 .

Working with demanding patients and working with patients’ families have been found to be closely associated with psychiatrists’ levels of exhaustion and depersonalization 35 . These relationships reflect psychiatrists’ frustrations with the limits of their craft. Contact with patients’ families intensified these feelings, especially when family members expressed unrealistic expectations for treatment. Psychiatrists are emotionally drained by their inability to meet the strenuous demands they put upon themselves, and the demands inherent in their interactions with patients and patients’ families. In contrast, diminished personal accomplishment reflects problematic relationships with superiors and colleagues, rather than demands from patients. Colleagues provide the most relevant source of information regarding one's sense of efficacy in professional life. When those relationships are strained, it is difficult to find meaningful confirmation of one's job performance.

Research on burnout has always recognized a central role for social relationships in the development and resolution of the syndrome. Initially, the research focus was primarily on the therapeutic relationship between the provider and the service recipient. Over time, studies have confirmed that relationships with colleagues and supervisors are equally, if not more, relevant to the potential for providers to experience burnout. For example, recent research on attachment styles found that attachment anxiety was accompanied by more frequent incivility from colleagues, and was associated with more exhaustion and cynicism. Attachment avoidance was linked to fewer instances of positive social encounters at work, and was associated with a greater sense of inefficacy 53 . In sum, negative social interactions seem to drain energy and distance people from their job, and the absence of positive social encounters is discouraging.

CURRENT ISSUES

There are many interesting questions about burnout and engagement which are being studied in many countries around the world. A few inter‐related themes should be of particular significance for the profession of psychiatry. First is the question of the relationship between burnout and mental illness. Second is the question of the value of simplifying the multi‐dimensional construct of burnout to the single dimension of exhaustion. And third is the question of how best to ameliorate burnout in terms of treatment and prevention.

Burnout and mental illness

When the construct of burnout was first proposed in the 1970s, there were arguments that it was not a distinctly different phenomenon, but rather a new label for an already known state – i.e., “old wine in a new bottle”. However, there were a lot of differing opinions about what the “already known state” actually was. These included job dissatisfaction, anomie, job stress, anxiety, anger, depression, or some combination of them 54 , 55 , 56 . For example, one psychoanalytic perspective argued that burnout was not distinguishable from either job stress or depression, but represented a failure to achieve narcissistic satisfaction in the pursuit of ideals 57 . As a result of these critiques, subsequent research often focused on testing the discriminant validity of burnout by assessing whether it could be distinguished from these other phenomena. The results of many studies have established that burnout is indeed a distinct construct 23 .

Much of this prior discussion has focused on depression, thus raising the question of whether burnout is a precipitating factor for depression, and thus is a predictor for it, or whether burnout is the same thing as depression, and thus is itself a mental illness. Research has demonstrated that the two constructs are indeed distinct: burnout is job‐related and situation‐specific, as opposed to depression, which is more general and context‐free.

However, a recent article has renewed debate on the distinction between burnout and depression by claiming that at high levels the two states are indistinguishable 58 . This position is in contrast to the view that burnout is an occupationally‐specific dysphoria that is distinct from depression as a broadly based mental illness 22 . But close examination of the new research article reveals problems with its argument.

A necessary condition to examine the distinction between burnout and depression is a set of measures that provide a complete and accurate operationalization of each construct, and the new study fell short of this criterion. Specifically, the nine‐item depression measure (Patient Health Questionnaire, PHQ‐9 59 ) used in this study includes five items that refer explicitly to fatigue (lack of interest, trouble sleeping, trouble concentrating, moving slowly, and feeling tired). The other four items include one referring to loss of appetite and three referring to negative thoughts (suicidal thoughts, feeling depressed, negative self‐evaluation). The measure produces a single factor score; clearly that factor is heavily weighted towards fatigue (Cronbach alpha of .88). It may be argued that these nine items fail to capture the full complexity of clinical depression. In any case, the depression construct operationalized in this measure is one dominated by fatigue, accompanied by negative thoughts. To measure burnout, the study used the SMBM 9 , which is a one‐factor fatigue scale with items referring explicitly to trouble concentrating, feeling tired, and thinking in a slow, unfocused, and unclear manner. Although conceptualized as representing three distinct factors of cognitive, physical, and emotional fatigue, the measure consistently reduces to a single factor of fatigue (Cronbach alpha of .96). Given the overlap in the explicit reference of the two measures to fatigue in the majority of their items, it is not surprising that the two scales are correlated highly (r=.77) 58 .

The high correspondence of burnout and depression in this new study reflects a large level of concept redundancy between the SMBM and PHQ‐9. The two instruments primarily measure exhaustion, leading to a strong correspondence between them, especially at high levels of exhaustion. The correlation was especially high in this study; earlier research that used these identical measures reported correlations at three different times as .51, .53, and .54 60 . These results are consistent with other research that finds that burnout and depression are inter‐related conditions.

Research using the MBI departs further from depression measures in its three‐component definition of the syndrome as exhaustion, cynicism, and inefficacy. Some studies that have used the MBI and different measures of depression have found the following range of correlations. The Profile of Mood States (POMS) depression scale correlated with the MBI ‐ Human Services Survey (MBI‐HSS) exhaustion (r=.33), depersonalization (r=.30), and personal accomplishment (r=−.14) 61 . The Depression Anxiety Stress Scale (DASS‐21) depression subscale correlated with the MBI‐GS exhaustion (r=.37), cynicism (r=.47), and efficacy (r=−.21) 62 . The Beck negative emotions and attitudes subscale correlated with the MBI‐GS exhaustion (r=.46) and cynicism (r=.28), and the Beck performance difficulties and somatic complaints subscale correlated with MBI‐GS exhaustion (r=.61) and cynicism (r=.36) 63 .

The wide range of correlations between burnout and depression argues for a complex relationship between the two constructs. Clearly, they are linked to each other. For example, one study found that 90% of the respondents with severe burnout (i.e., daily occurrence of burnout symptoms) reported a physical or mental disease, with musculoskeletal pain and depression as the most common problems 64 . A longitudinal study found that increases in burnout predicted increases in subsequent prescriptions of antidepressant medication 65 .

A new understanding of this linkage comes from a recent longitudinal study in Finland, which found a reciprocal relationship between burnout and depression, with each predicting subsequent developments in the other. It was noteworthy that burnout fully mediated the relationship of workplace strains with depression: when problems at work contribute to depression, experiencing burnout is a step in the process 66 .

These studies confirm that burnout and depression are not independent. Each state has implications for the other. However, that relationship is far from saying that burnout and depression are the same mental illness.

Single or multiple dimensions

Although the original construct acknowledged exhaustion as a key aspect of burnout, it argued that exhaustion is not the whole story. Indeed, if burnout were solely exhaustion, then the word “burnout” would be unnecessary, as it would not be providing any added value. “Exhaustion” would suffice. To rename “exhaustion” as “burnout” would definitely be inviting the criticism of “putting old wine in new bottles”.

And yet, that simplification of burnout to exhaustion has been taking place not only among researchers, but also among practitioners. The driving force seems to be the goal of establishing a clinical diagnosis for burnout, so that health professionals can then receive reimbursement for treating individuals suffering from that condition.

This shift to defining and diagnosing burnout as an individual disorder or disability has been taking place in Northern Europe, primarily in Sweden and the Netherlands. There, burnout has been likened to neurasthenia or other syndromes with a quality of chronic fatigue. Sweden began using work‐related neurasthenia as a burnout diagnosis in 1997; soon, that was within the five most frequent diagnoses 67 . Researchers developed a similar diagnosis in the Netherlands, using clinically validated cut‐off scores on the MBI 68 .

To provide more precise diagnostic direction, Sweden in 2005 revised the ICD‐10 burnout diagnosis (Z73.0) as a difficulty in life management characterized by “vital exhaustion”. The signs of vital exhaustion include two weeks of daily experiences of low energy, with difficulties in concentration, irritability, emotional instability, dizziness, and sleep difficulties. Additionally, these symptoms must interfere with the patients’ capacity to perform their work responsibilities.

In the Netherlands, the term overspannenheid or “overstrain” is used to indicate burnout. This diagnostic approach estimates burnout prevalence at 3‐7% across various occupations, with psychotherapists at 4% 69 . In terms of MBI scores, Dutch researchers recommended that a burnout diagnosis should be connected with very negative scores on exhaustion accompanied by negative scores on one of the other two subscales (cynicism and inefficacy) 70 , 71 .

The use of burnout as a medical diagnosis implies one‐dimensionality, and it is clear that exhaustion has emerged as that single dimension. Moreover, since 1997, the Dutch census bureau has been assessing “burnout” among the working population by using an index of work‐related exhaustion (that is based on the MBI) in its annual national survey. As a consequence, public discourse about burnout in the Netherlands is increasingly limited to exhaustion alone. The risk is that a focus on just exhaustion (and its connection to work overload) will miss the distinct quality of burnout as reflecting a crisis of meaning or values. The exhaustion dimension captures the problem of lacking sufficient energy to make a useful and enduring contribution at work. But it is the cynicism dimension that captures the difficulty in dealing with other people and activities in the work world. Furthermore, efficacy captures the core self‐evaluation people make regarding the value of their work and the quality of their contribution. To ignore these core aspects of the burnout experience would truly be a “mis‐diagnosis” that could have important ramifications for both policy and practice.

It is interesting that North American jurisdictions have been reluctant to recognize burnout as a clinical diagnosis, partially due to concerns about a flood of requests for disability coverage. The lack of an official diagnosis of burnout limits access to treatment, disability coverage, and workplace accommodations. Alternatively, disability applications have referred to depression, neurasthenia, or chronic fatigue. An unfortunate consequence is that inaccurate diagnoses may reduce possibilities for successful recovery and return to work.

New research has begun to focus on an innovative use of the three burnout dimensions, which allows for multiple distinct patterns along the burnout‐engagement continuum. In addition to the two standard endpoint patterns of Burnout (high on all three dimensions) and Engagement (low on all three dimensions), this approach can identify people who are only experiencing one of the dimensions, rather than all of them 72 . A particularly relevant comparison is between people with the complete Burnout profile and those with only high exhaustion (the Overextended profile). The research findings show that these two patterns are decidedly different in terms of their workplace experience, so it is clear that exhaustion alone is not a proxy for burnout. Instead, the profile that comes closer to the negative endpoint of Burnout is the cynicism‐only one (Disengaged profile), which suggests that the experience of cynicism may be more of a core part of burnout than exhaustion. Cynicism is more clearly linked to the job environment, in terms of the poor quality of social relationships at work and the lack of critical resources, and that will lead to reduced job satisfaction and poor job performance 73 .

Treatment and prevention

The personal and organizational costs of burnout have led to proposals for various intervention strategies. Some try to treat burnout after it has occurred, while others focus on how to prevent burnout by promoting engagement. Intervention may occur on the level of the individual, workgroup, or an entire organization. In general, the primary emphasis has been on individual strategies, rather than social or organizational ones, despite the research evidence for the primary role of situational factors.

Many of these individual strategies have been adapted from other work done on stress, coping, and health. The most common recommendations have included: a) changing work patterns (e.g., working less, taking more breaks, avoiding overtime work, balancing work with the rest of one's life); b) developing coping skills (e.g., cognitive restructuring, conflict resolution, time management); c) obtaining social support (both from colleagues and family); d) utilizing relaxation strategies; e) promoting good health and fitness; and f) developing a better self‐understanding (via various self‐analytic techniques, counseling, or therapy) 74 .

Initiatives to moderate workload demands complemented by improvements in recovery strategies through better sleep, exercise, and nutrition have direct relevance to the exhaustion component of burnout. Cynicism, in contrast, pertains more directly to a sense of community or to the congruence of personal and workplace values. For example, an intervention that improved workplace civility among health care providers showed that cynicism declined as a function of improved civility 75 , and that this change was sustained at a one‐year follow‐up assessment 76 . A sense of efficacy, in contrast, could be more responsive to improvements in the forms of recognition from colleagues and leaders within an organization or the profession. An alternative proposal has been that people can make various changes in how they do their job (a process known as “job crafting”), and that such job alterations could lead to less burnout 77 .

Unfortunately, there is very little research that has evaluated the efficacy of any of these approaches in reducing the risk of burnout. Especially rare are studies modeled even loosely on randomized control trials. More common are studies with a single intervention group of volunteer participants for whom there are rarely follow‐up assessments after treatment has ended 78 . It is not yet clear whether burnout is generally susceptible to a range of strategies or whether it is crucial to fit the strategy to the specific context of a workplace to be effective.

The same basic points can be made about studies examining interventions specific to psychiatrists. There have been several recommendations about possible interventions, but no thorough research on whether these ideas are viable solutions. One fairly common recommendation emphasizes the importance of various forms of support, such as peer support groups, formal support via regular feedback and performance evaluation, or the use of a community‐based approach in the work environment. Interestingly, medical students and residents have also identified support as a critical factor, including support from faculty, peers, outside personal relationships, and counseling services 79 .

Another suggestion involves having psychiatrists evaluate their workload frequently, to ensure they are not putting themselves at additional risk for burnout. A related recommendation is that psychiatrists should develop a more versatile lifestyle, in which they diversify their work (e.g., take on a part‐time teaching job, do some writing, or extend one's practice to other types of clients) and/or engage in activities outside of work (such as hobbies and other personal interests).

Mental health professionals who have worked in the areas of trauma and palliative care have made additional recommendations on how to deal with burnout 80 , 81 . Notably, one approach emphasizes the need to take care of oneself – and not only in terms of personal health and physical fitness, but also in terms of psychological wellbeing. Professionals who deal with trauma survivors are encouraged to work through their own personal traumatic experiences in order to prevent becoming “wounded healers” or secondarily traumatized therapists. Professionals working in hospice and palliative medicine are encouraged to focus on spirituality and human nature, via prayer, meditation, or religious services. Other methods for self‐care include taking regular breaks from work, advocating for better social recognition of the difficult work that is being accomplished, and focusing on the positive aspects of life, both at work and home, so that one is not overwhelmed by adversity and misery.

Although various studies have provided excellent ideas to explore as interventions, the logistics of funding, designing, implementing, and evaluating these ideas remain the primary obstacles to better knowledge about the best solutions for burnout. For example, a Swedish group contrasted two therapeutic modalities for people who had been on long‐term leave from work with a diagnosis of “work‐related depression”. They found that both cognitive group therapy and focused psychodynamic group therapy were effective in facilitating their return to work, but found no difference in effectiveness between the two approaches 82 . This study raises two important issues for further research. First, to what extent does “work‐related depression” map upon clinical depression, in contrast to mapping upon burnout? Second, what are the common qualities of the two therapeutic modalities that could serve as mechanisms in treatment efficacy?

CONCLUSIONS

Research to date indicates that the three aspects of burnout do present challenges for psychiatrists. Many of the issues for psychiatrists are similar to those facing other professionals providing human services to people in need of help. But additionally, psychiatric work entails close contact with people in emotional distress, and in some cases the potential for threats from some of these patients. Both of these stressors make demands on psychiatrists’ energy, their capacity for involvement with others, and their sense of professional efficacy.

An issue of special significance to psychiatry is the alignment and differentiation of burnout and depression. The concept of workplace depression as a basis for workers’ disability coverage in some European countries raises important issues for practitioners, which have extensive implications for employees, employers, and insurance providers. Research and conceptual development that includes multidisciplinary participation is needed for definitive progress.

Psychiatry is in a strong position to contribute to the growth of knowledge regarding burnout. The question of burnout's status as a basis for disability claims requires precise and objective assessment. Further, psychiatric‐based treatments may be relevant to burnout, especially regarding return to work for people experiencing severe burnout. Finally, effective research on preventing and alleviating aspects of burnout among psychiatrists requires giving the issue a high priority within the profession.

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Article contents

Human resource management and organizational psychology.

• David E. Guest David E. Guest School of Management and Business, King's College London
• https://doi.org/10.1093/acrefore/9780190236557.013.14
• Published online: 29 March 2017

Human resources (HR) management addresses those policies, practices, and activities concerned with the management of people in organizations. Although it is typically considered at multiple levels of analysis, it provides an important context for the application of work and organizational psychology. Core research questions address the determinants of HR strategy and practices adopted by organizations and how these are linked to outcomes including in particular organizational performance and employee wellbeing. Much research explores this linkage process including how far HR practices are able to ensure employee abilities, motivation, and opportunities to contribute; the distinctive role of human capital; how employees react to these practices; and the steps management can take to ensure their effective implementation. Most research confirms an association between the adoption of a greater number of what are typically termed “high performance” or “high involvement” HR practices and higher organizational performance and employee wellbeing. However, doubts remain about the causal direction of the association. Continuing research challenges include how best to measure HR practices, understanding more about contextual influences, and incorporating more fully the role of employee attitudes and behavior including employee attributions about the motives of management in their use of HR practices.

• human resources management
• organizational performance
• employee wellbeing
• human capital

Introduction

Human resources management (HRM) can be broadly defined as “all those activities associated with the management of work and people in organizations” (Boxall & Purcell, 2011 ). It serves as a focus of study but also as an occupation for specialists and a day-to-day component of the work of line managers. HRM is a relatively new area of study, but research has burgeoned in recent years, and this article will examine some of the central research debates and research findings.

HRM may not at first sight appear to be an obvious candidate for inclusion under the banner of work and organizational psychology. It is, after all, a multidisciplinary area of research, often conducted at the organizational rather than the individual level of analysis. But it also incorporates many of the core activities typically associated with work and organizational (W/O) psychology ranging from topics such as selection and training to outcomes such as wellbeing, absenteeism, and labor turnover. It therefore serves as an integrative context within which to consider the work of W/O psychologists. At the same time, HRM has emerged as a major field of theorizing and research in its own right, with several specialist academic journals and large numbers of practitioners who label themselves as HR professionals, and it offers the promise of some integration across disciplines and across levels of analysis.

The article starts with a brief overview of influences on the emergence of HRM, emphasizing those disciplinary perspectives that lie beyond the usual territory of W/O psychology. Subsequent sections examine the nature of HRM, the kind of outcomes it is expected to influence, and the processes whereby HRM and outcomes might be related. Each of these is a continuing focus of theorizing and research. In each section, conceptual and empirical issues and evidence will be reviewed.

Disciplinary Influences

Three broad disciplinary perspectives have been particularly influential in informing the development of HRM theory and research. The first, reflecting the historical traditions of the application of HRM, is the sub-discipline of industrial relations. The second is the influence of business strategy, reflecting the location of some researchers in business schools and the potentially important role of effective HRM for business performance. The third influence is W/O psychology and the overlapping field of organizational behavior.

The practice of what we now describe as HRM emerged in the early decades of the 20th century . Those working in the field were initially described as welfare officers and then personnel managers. When there was a need to address industrial conflict, the role of the industrial relations manager increasingly came to the fore. In the 1930s, the study of industrial relations and, more broadly, relations at work began to emerge within universities. Well-known examples over the decades include the Hawthorne studies (Roethlisberger & Dickson, 1939 ), the work of Whyte ( 1955 ) and others on the role of pay and restriction of output, and Walton and McKersie’s ( 1965 ) behavioral theory of labor negotiation. Those engaged in this type of research typically had backgrounds in sociology, economics, or psychology, providing an early multidisciplinary perspective. Topics for research included forms of industrial conflict ranging from strikes to absenteeism, systems for alleviating or preventing conflict such as collective bargaining, systems for workers’ participation and the influence of pay on behavior. By the 1970s, there were flourishing departments of industrial relations in universities in many countries, undertaking research and providing education to those seeking to pursue a career in industrial relations or personnel management. By the 1980s, patterns of industrial conflict began to change and eventually diminish, and academic industrial relations departments entered a slow decline, though several prominent journals remained. A number of researchers who once worked in these departments switched their research focus to HRM, often providing some of the most trenchant critical analysis of the field (see, e.g., Godard, 2004 ).

The influence of business strategy on HRM began to emerge in the 1980s. A major factor in this was the growth of teaching and research in the business schools, particularly in the U.S. The initial argument, proposed in general normative terms, most notably by Porter ( 1985 ), but applied to HRM by, for example, Miles and Snow ( 1984 ) was that organizations had strategic choices about how to compete, and this should influence the approach organizations adopt to HRM. The most obvious distinction was whether to compete on the basis of cost minimization or some combination of quality and innovation. Each required rather different ways of managing people at work. A clear exposition of this was outlined by Schuler and Jackson ( 1987 ) who set out five steps. First, an organization has to clarify its mission and values. Second, and building on this, it has to determine its competitive strategy. Third, it needs to determine the kinds of employees and the sorts of behavior that will enable the strategy to be achieved. Fourth, the organization needs to determine the HR policies and practices that will help to ensure that the right employees are performing appropriately. Finally, organizations should check that employee behavior is actually aligned with the strategic goals.

Further interest in HRM from a strategic perspective was provided by advocacy of the resource-based view of the firm (Barney, 1991 ). This argued that to compete effectively, organizations needed to acquire and utilize resources that are rare, expensive, hard to replace, and not easily replicable. Part of the analysis, developed further by Barney and Wright ( 1998 ), was that human resources fitted these criteria better than other resources such as finance or machinery, which could more easily be copied. This boosted the idea of employees as “human resources,” a term that causes distaste in some quarters.

The resource-based view of HRM placed considerable emphasis on the economic concept of human capital (Nyberg & Wright, 2015 ). For example, Lepak and Snell ( 1999 ), argued that organizations need to invest heavily in attracting, retaining, and utilizing “human capital” that is highly unique to the firm and highly valuable. In contrast, human capital that is valuable but plentiful is best acquired, perhaps by being brought in. Where human capital is unique but of low strategic value, it might be best to form an alliance. Finally, human capital that is low in value and uniqueness is perhaps best contracted in. This might appear to be a cost-effective strategy, and research has shown the benefits of a selective approach (Lepak & Snell, 2002 ). However, Peel and Boxall ( 2005 ) found that seeking to classify human capital is far from straightforward and likely to vary from firm to firm. We return to the topic of human capital later in the article.

The third major source of influence on HRM comes from work and organizational psychology and (OB) organizational behavior (hereafter just W/O psychology). The reason for this is straightforward; HR practices such as selection, training, appraisal, and reward are the bread and butter of the research and practice of W/O psychologists. HR practitioners are constantly on the lookout for the best practices to apply, and it is the W/O psychologists who undertake the research that provides them. Although the picture is mixed, many W/O psychologists and most of those who use the OB label now work in business schools and, with an interest in effective management, this makes the field of HRM a natural context for their research and consultancy. At the same time, W/O psychology has a particular focus on individual and group behavior and associated outcomes. This has helped to promote a more employee-centered, micro-level focus to HRM.

A distinctive feature of HRM is its ability to integrate features of the macro strategic perspective with the more micro-level perspective typically adopted by psychologists. Indeed, writers such as Wright and Boswell ( 2002 ) have argued that some integration of macro and micro areas is essential for the field to develop. A feature of an integrated perspective, and a key argument of advocates of HRM (see, e.g., Becker & Huselid, 1998 ; Jackson, Schuler, & Jiang, 2014 ), is that HRM should be viewed as a system. What this implies is that it is not enough to focus on selection, training, rewards, or job design; it is necessary to view the whole range of HR practices as an integrated whole and to ensure that they are aligned to provide “internal fit.” If this approach succeeds, there should be a kind of gestalt whereby the sum is more than the parts.

The dominant research topic has been the relationship between HRM and outcomes, and in particular, organizational performance. However, researchers are increasingly exploring the relationship with employee wellbeing and the feasibility of mutual gains (Van de Voorde, Paauwe, & van Veldhoven, 2012 ). Some years ago, Guest ( 1997 ) noted that if research on HRM is to progress, there needs to be clearer theory and research concerning the nature and measurement of HRM, of outcomes and the nature of the relationships among them. Since then, either directly or indirectly, much of the research has addressed these three core issues. In the following sections, we consider each of these in turn.

The Nature of HRM

A major and continuing challenge for research has been how to conceptualize and operationalize HRM. There are several interrelated issues that need to be addressed. What HR practices should be included in the general field of HRM? What is the underlying rationale for including specific practices? How much detail is required about each practice? Can and should practices be combined in any kind of bundles? Who should provide information about them? And what kinds of response categories are appropriate? All these questions have provided the focus for extensive conceptual and empirical work.

Diversity in Conceptualizations of HRM

In several earlier articles on HRM, it was conventional to identify four broad topics that reflected the field. These were recruitment and selection, training and development, performance appraisal, and rewards (see, e.g., Fombrun, Tichy, & Devanna, 1984 ). However, this list omitted a range of issues concerning the employment relationship, such as job security, communication, and flexible work arrangements. Writing for general managers at Harvard, Beer, Spector, Lawrence, Quinn Mills, and Walton ( 1985 ) suggested that broad core topics that needed to be addressed included employee influence, human resource flows, reward systems, and work systems. These two differing approaches highlight the scope for diversity when studying HRM. It is therefore perhaps not surprising that when Becker and Gerhart ( 1996 ) reviewed the existing studies, they found a wide variety of practices being measured. Indeed, no one practice appeared in every study they reviewed. Several years and many studies later, two extensive reviews (Boselie, Dietz, & Boon, 2005 ; Combs, Liu, Hall, & Ketchen, 2006 ) found that little had changed with respect to the variety of practices used in studies. There was also considerable difference in the number of practices used; indeed, Combs et al. found that the number ranged between 2 and 13 with an average of 6.2. The variety of practices used to measure HRM makes comparison across studies highly problematic. This has not stopped such comparisons being made, notably in meta-analyses.

Alternative Rationales for Determining the Content of HRM

There has clearly been a need to find some underlying rationale to determine which practices should be included in any study. One approach has been to focus on external and internal fit. In the case of external fit, as Porter ( 1985 ) and Schuler and Jackson ( 1987 ) have argued, the starting point is to determine the mission, values, and core goals of the organization and then determine its competitive strategy. Since the main goal of most private-sector organizations is to maximize financial performance, it is those HR practices that help to achieve this that should be included. As researchers have accepted this logic, one consequence has been a change in language, so that many studies now don’t refer to HR practices, but rather to high-performance work practices (HPWPs).

In public sector organizations, the mission and values may be rather different, and the concept of competitive strategy may be inappropriate. Furthermore, as Paauwe ( 2004 ) and others have pointed out, in Europe, with its focus on social partnership, legislation at European and national levels requires the application of a range of HR practices to promote issues such as health and safety at work, equal opportunities, and flexible working. Partly reflecting this perspective, and acknowledging the roots of HRM in the industrial relations tradition, scholars have outlined alternative bases for determining appropriate HR practices. In the U.S., Walton ( 1985 ) argued that effective management of the contemporary workforce requires a shift from policies and practices seeking control to those that promote employee commitment. This has led to advocacy of what is termed high commitment (Wood & Albanese, 1995 ) or high-involvement HRM (Boxall & Macky, 2009 ). These terms suggest a rather different approach, reflected in the writing of Beer et al. ( 1985 ) that recognized the legitimacy of outcomes of concern to employees and other stakeholders.

One problem with an approach to HRM that starts from mission, values, and stakeholder interests is that it still leaves open the choice of practices and it does not clearly specify how those practices should be deployed. Therefore, though there can be agreement about the need to include practices such as selection and training, the specific features of such practices can remain unclear. For example, selection can be measured through the use of certain types of psychometric tests or the use of assessment centers. Alternatively, it can be measured in relation to its aims, such as by hiring those who demonstrate immediate competence in a specified job or those with a positive attitude toward learning. The complexities and choices in measuring these variables are familiar to W/O psychologists. The problem in measuring them in the context of HRM is that each practice is just one among several. As a result, it is not surprising that researchers have measured a wide and varied range of practices, and have done so in often rather different ways.

Internal Fit and the Role of HR Bundles

The aim of internal fit is to identify sets of HR practices (sometimes described as bundles) that will complement each other. The most frequently cited approach to achieve this is the so-called AMO model. This draws on Lawler’s ( 1971 ) expanded version of expectancy theory. While expectancy theory proposes that motivation is a function of the perceived links among effort, performance, and rewards, Lawler extended this to propose that effective performance also depends on individuals having the appropriate ability and role. Applying this to HRM (Becker, Huselid, Pickus, & Spratt, 1997 ; Guest, 1997 ) it is suggested that the immediate goals of an HR system designed explicitly to ensure high performance are to ensure that employees have the ability (A), motivation (M), and opportunity (O) to contribute effectively. HR practices required to achieve these goals can then be clustered together in three broad bundles. For example, ability or competence may be generated through appropriate selection, training, and development practices. The quality of these practices can be greatly enhanced by building on the evidence base developed by W/O psychologists. However, this approach is not without its challenges. For example, there are potential substitution effects—should the focus be on selection of competence or the training of competence? Furthermore, some practices, including those linked to job design, can have an impact on both motivation and opportunity to contribute, thereby blurring the bundles.

The concept of bundles can also present a challenge for psychologists who have typically developed expertise in specific practices, since the argument concerning internal fit suggests that it is not enough to focus on practices that develop one of these outcomes because they are all important. For example, it is not helpful to have highly motivated but incompetent employees or to have highly competent employees who have no opportunity to use their knowledge and skills. So the notion of internal fit within an HR system implies that there need to be HR practices present that can contribute to each element of the AMO model.

Meta-analyses by Jiang, Lepak, Hu, and Baer ( 2012 ) and Subramony ( 2009 ) tested models based on the three AMO bundles of practices and also tested a single integrated measure of HRM. They found a better fit with the three bundles. Furthermore, each was associated with somewhat different outcomes. This is further support for the view that all three bundles need to be present to have a full impact. Subramony found that opportunity to contribute and motivation had a stronger impact than human capital, which on its own was non-significant. On the other hand, Jiang et al. found that each bundle on its own had a modest but significant impact on financial outcomes. Reflecting this, subsequent research has shown that human capital on its own can improve employee behavior and organizational performance (Crook, Todd, Combs, Woehr, & Ketchen, 2011 ). But the impact is not as great as the application of the three bundles. This is somewhat akin to research on the impact of selection and training effects that has consistently shown that high-quality application of both practices can enhance and benefit individual performance. When this is aggregated to the unit or organizational level, we might expect an impact on organizational performance (see, e.g., Aguinis & Kraiger, 2009 ; Schmidt & Hunter, 1998 ). Nevertheless, Subramony ( 2009 ) also showed that each bundle made a stronger contribution than any individual practice. Given these competing results, further research needs to establish the relative importance of individual HR practices, bundles of practices, and an aggregated measure.

Human Capital

Recent theorizing and research have given considerable prominence to the concept of human capital and the specific bundle of HR practices associated with it. As originally conceived by Becker ( 1964 ), the concept was quite wide-ranging and covered the knowledge and skills of individuals and also their information, ideas, and health. Ployhart and Moliterno ( 2011 ) have distinguished between cognitive abilities and other individual characteristics like personality, interests, and values, all of which, as they acknowledge, are typically considered at the individual level. However, they outline enabling factors such as task complexity and interdependencies that create conditions where these types of capital can be aggregated to the unit level and analyzed with respect to their impact on unit performance. Researchers have begun to consider human capital at the unit level as a collective set of capacities for management to utilize (see, e.g., Ployhart, Nyberg, Reilly, & Maltarich, 2014 ) and Nyberg and Wright ( 2015 ) argue that it offers an opportunity for multidisciplinary as well as multilevel research. Although interest in human capital is generating a large body of research, it is potentially limited by its focus on one element, the A within the AMO model.

Levels of Detail about HR Practices

After a decision about which HR practices to include in any study, there remains the issue of how much detail to seek. For example, it is possible with respect to training to ask about the presence of a training policy, hours of training provided, off-the-job versus on-the-job training, and so on. Indeed, the amount of formal training provision is one of the most frequently included items in studies of HRM. However, this is not without problems since it might refer to a goal to provide specified hours, it might refer to off-the-job formal training but ignore informal and incidental learning, and it may apply to only some of the employees. In short, even if the relevant HR practices can be identified, there are unresolved research questions about the level of detail and how far this should be standardized across practices.

Sources of Information about HR Practices

A further and increasingly widely researched question is who should provide information about HR practices. Researchers have noted a gap between intended and implemented practices (Khilji & Wang, 2006 ), and among those concerned with the impact of HRM on outcomes, it is argued that effective implementation is more important than the presence of a policy or practice (Bowen & Ostroff, 2004 ). Senior managers in HR departments may report that a practice such as universal annual appraisal is a firm company policy. However, employees will be in a better position to report whether they have actually received an appraisal in the past year or whether they have perceived and are actually aware of specific policies and practices even if they have not directly experienced them. An example might be policies and practices related to bullying and harassment. Therefore, while much of the research on HR practices has obtained information from senior managers, there is a strong case for collecting information from employees. This may not only increase accuracy, but also enhance reliability. However, the attractions of collecting data from senior managers include the ability to compare across many organizations and to collect data swiftly at an organizational level to permit assessment against organizational-level outcomes. While it is possible to aggregate employee data, collecting such data across many organizations is a complex and time-consuming activity. An alternative is to focus on an important category of employees and ask about the HR practices that apply to this group. This can offer some advantages in accuracy over asking about the workforce as a whole, but it risks ignoring the HR practices applied to the remainder of the workforce.

Response Categories for HR Practices

Researchers need to give consideration to the choice of response categories when collecting information about HR practices. Once again, the published research displays a wide range of approaches. In many cases, the logical response categories will be a straightforward “Yes/No” as in responses to questions such as “Have you received an appraisal in the past 12 months?” An alternative is to turn these questions into statements and use a Likert scale, typically from “strongly agree to strongly disagree,” which permits a factor analysis of the responses, but also invites potentially inaccurate responses to categorical items. When the questions are directed to managers, an alternative to asking for categorical answers is to ask about the percentage of workers who are likely to have experienced a particular practice. This permits a more flexible response, although the accuracy of such responses is open to question and they present potential problems of aggregation, particularly if different practices apply to different categories of employees. There are therefore choices concerning the approach to adopt for response categories, with no consensus in sight.

Aggregating HR Practices

A final issue concerns how to aggregate practices. This issue was first addressed some years ago by Delery and Doty ( 1996 ) who tested competing theories and different ways of combining data to address both external fit, through a contingency approach linking practices to strategy, and internal fit, based on a simple count of practices in place and a configurational model that examined interactions between bundles of practices. It was found that there was no clear advantage to a configurational model. Subramony ( 2009 ) and Jiang et al. ( 2012 ) also found no consistent evidence that one bundle in the AMO model or that any combination of A, M, and O is superior in terms of its impact. Interestingly, this is similar to the findings in a meta-analysis of expectancy theory (van Eerde & Thierry, 1996 ). The most widely used approach over the years has been to provide a count of the practices that are reported to be present on the grounds that a greater number of practices indicates the strength of the HR system and therefore increases the likelihood that they will have an impact. Although this is a plausible argument, it ignores the likelihood that certain practices will be more important than others. It also supports a universalist model that holds that the same broad set of practices applies, irrespective of the context and strategy, a view that is not well supported by the research and that supporters of contingency theory find inherently implausible.

Identifying and Measuring HR Practices: A Summary

This brief overview has shown that there are major problems in conceptualizing and operationalizing the presence and application of the HR practices that constitute the HRM system. Much of the difficulty can be attributed to the complexities that arise from the lack of clear definitions of the content and boundaries of any HRM system, from the variety of perceived goals of the system and therefore the practices that deserve priority, and from the various levels of analysis at which the research is undertaken. These challenges are of a different order than those faced by W/O psychologists who have typically focused more narrowly on a specific practice at the individual or group level. However, the lesson of HRM for W/O psychology is that this type of detailed focus needs to be understood in its wider context, recognizing the risk that a specific practice can act as a proxy for a wider set of practices unless some way can be found of controlling for their influence. Researchers need to be clear about the underlying rationale for the kind of HRM they are exploring and be explicit about the reasons certain HR practices are included and what assumptions are being made about aggregation. Too many studies have lacked a theory or even an explanation for their choices of practices. It is also worth noting that the research, with its focus on HR practices likely to enhance performance, omits a number of important topics that are likely to be of interest to employees and have been the focus of extensive research by W/O psychologists, such as the role of careers and career management, equal opportunities, and work-life balance. Despite all the problems of identifying and measuring HR practices, and the unreliability that the diversity of practice indicates, the large body of research, reflected in the various meta-analyses (see, e.g., Combs et al., 2006 ; Jiang et al., 2012 ) consistently reveals a positive association at the organizational level between the use of more HR practices and financial outcomes.

The Outcomes of HRM

Most of the early research was concerned with the relationship between HRM and organizational performance and was conducted at the level of the organization. For example, in the early seminal study by Huselid ( 1995 ) who surveyed leading U.S. companies, outcomes included aggregated labor turnover and productivity, but the main focus was on various financial indicators, including market value of shareholder equity. In Jiang et al.’s ( 2012 ) meta-analysis, the main dependent variable was financial performance reflected in a variety of measures, including return on assets, return on equity, and a general measure of overall financial performance. The problem with the use of financial indicators is that they are subject to a wide variety of influences, including the vagaries of the economic system. Therefore, as a distal outcome, the size of the association with HRM is always likely to be quite weak. An alternative is to utilize more proximal measures that are organizationally relevant in the sense that they could have a financial impact but are more likely to be influenced by HRM. In other words, they can provide a test of mediation. This has led to the use of outcomes like labor turnover, productivity, and service quality. Two early studies in strip steel mills (Arthur, 1994 ; Ichniowski, Shaw, & Prennushi, 1997 ) explored the link between HRM and productivity. However, productivity has proved particularly challenging to measure, especially in the service sector, and in their meta-analysis, Combs et al. ( 2006 ) found that there was a stronger association between HRM and financial performance than between HRM and productivity. What this perhaps illustrates is that there are questions concerning both the reliability and validity of these outcome measures.

Identifying outcome measures can become greater at the unit level rather than the organizational level. One way of addressing this has been to obtain subjective assessments of outcomes from managers. This is the approach that has been adopted over the years by the British Workplace Employment Relations surveys that collect data from about 2000 workplaces (see van Wanrooy et al., 2013 ). They ask managers to rate their performance on a variety of criteria against competitors they know about in the same sector. Analyses of the results where it is possible to compare against independent financial reports (e.g., in single unit organizations) show that there is a modest positive association between the subjective and more objective indicators (Forth & McNabb, 2008 ; see also Wall et al., 2004 ). However, in their meta-analysis, Combs et al. ( 2006 ) reported higher associations between HRM and performance where subjective rather than objective indicators of performance are used. There are some sectors where unit-level comparisons are feasible, including retail and banking, because organizations have a large number of more-or-less identical branches. Similar arguments are increasingly made about public-sector organizations such as hospitals and local authorities, and benchmarking has become popular based on assumptions about the validity of such comparisons. For relevant research on hospitals, see Givan, Avgar, and Liu, ( 2010 ) and West, Guthrie, Dawson, Borrill, and Carter ( 2006 ), and for local authorities, see Messersmith, Patel, Lepak, and Gould-Williams ( 2011 ).

Psychologists have been more interested in employee outcomes, and a growing number of studies explore the relationship between HRM and employee attitudes, behavior, and wellbeing. The choice of measure depends on whether the primary interest lies in organizational performance or employee wellbeing. In the case of the former, it can include individual-level performance, organizational citizenship behavior, absence, and labor turnover. When the main interest is in wellbeing, outcome measures include psychological contract fulfillment, perceptions of employment security, and perceived organizational support, as well as measures of stress, burnout, and engagement, and standard measures of job satisfaction and wellbeing (for a review, see Clinton & van Veldhoven, 2013 ). Almost all the research shows a positive association between the presence of more HR practices and more positive employee responses (see Clinton & van Veldhoven, 2013 ). However, a small minority of studies have revealed increases in levels of stress (see, e.g., Ramsay, Scholarios, & Harley, 2000 ). This has led critics such as Godard ( 2004 ) to argue that HRM is bad for workers because it is likely to result in work intensification and the consequent stress.

Although the evidence of negative consequences for employees is weak, the topic has generated interest in the extent to which HRM is associated with both higher organizational performance and improved employee wellbeing. The relatively few reported studies in which both have been measured have been reviewed by van de Voorde, Paauwe, and van Veldhoven ( 2012 ) and Peccei, van de Voorde, and van Veldhoven ( 2013 ). They find that the presence of more HR practices is associated with both higher performance and higher job satisfaction and organizational commitment. However, the evidence from the very few studies that have included health-related wellbeing measures, mainly indications of stress, is somewhat more equivocal, revealing a mix of positive, neutral, and negative outcomes for employees. It is unclear whether the studies with more negative results were utilizing high-performance work systems to enhance performance or high-commitment/high-involvement approaches that give higher priority to employee roles and outcomes. Future research exploring this issue will need to be clearer about the HRM strategy that underpins the type of practices adopted.

In summary, the research on HRM has predominantly explored outcomes that reflect organizational and managerial interests associated with performance. These have often been quite distal measures, such as financial performance, and have usually been collected at the organizational level. A smaller stream of research has explored employee outcomes like job satisfaction and wellbeing. As more proximal measures, these might be expected to reveal a stronger association with HRM. Relatively few studies have explored both organizational and employee outcomes. Those that have done so tend to show mutual benefits, but the results are somewhat inconsistent and seem to depend in part on the type of employee outcome under investigation. This is an area that would benefit from further research.

Understanding the Relationship between HRM and Outcomes

The early research was primarily concerned with establishing a relationship between HRM and organizational performance, but much of the focus shifted to seek explanations for how or why there appears to be an association. The relatively limited body of research exploring the role of external fit of HR practices with the business strategy has failed to show any consistent impact on outcomes (Jackson, Schuler, & Jiang, 2014 ). Instead, most subsequent research has been based on internal fit and development and testing of linkage models. These typically propose that HR practices influence employee perceptions that in turn affect employee attitudes and behavior and subsequently employee performance. This can then be aggregated to proximal (e.g., productivity, service quality) and distal (e.g., financial) organizational performance. Elements and sometimes a complete linkage model have been tested, and research has typically reported support for the expected associations indicating full or partial mediation. The AMO model has been the most extensively tested, and the meta-analysis by Jiang et al. ( 2012 ) provides a good example of this. They linked measures of the HR bundles to indicators of human capital and motivation, and linked those in turn to labor turnover and internal measures of performance, and finally linked both of those to financial performance. They reported good evidence for these linkages and for partial mediation.

The AMO model suggests that HR practices succeed by leveraging employee behavior. Alternative models based on high-commitment or high-involvement rather than high-performance HRM utilize social exchange theory (Gong, Chang, & Cheun, 2010 ; Piening, Baluch, & Salge, 2013 ). The core argument is that if HR practices are used to enhance the commitment and involvement of employees and to ensure a positive employment relationship, this will in turn be positively perceived by employees at both an individual and collective level. It might, for example, be perceived in terms of fulfillment of the psychological contract (Rousseau & Greller, 1994 ) or in the form of perceived organizational support (Eisenberger, Cummings, Armeli, & Lynch, 1997 ). Based on the norm of reciprocity (Gouldner, 1960 ), employees can be expected to respond with positive attitudes and behavior. Research supports these linkages and shows an association with organizational commitment, organizational citizenship behavior, higher individual performance, and a lower propensity to quit the organization or be voluntarily absent (e.g., Kehoe & Wright, 2013 ; Takeuchi, Chen, & Lepak, 2009 ). Overall, therefore, there is consistent support for a linkage model. More research is needed to test competing explanations for these linkages and to understand why the strength of the association varies. Some issues, to which we now turn, offer possible explanations.

The Role of Employee Attributions

As the role of employees takes center stage in the analysis of the impact of HRM, it is recognized that to understand the effect of HRM on attitudes and behavior, it is first necessary to consider how employees perceive HR practices. Researchers have begun to use a form of attribution theory to explore how employees interpret management motives for adopting certain HR practices and to examine how their interpretation affects their attitudes and behavior. Nishii, Lepak, and Schneider ( 2008 ) researched attributions among employees in a large Japanese retail chain. They hypothesized that if employees attributed management’s use of HR practices to a desire to enhance quality of service or employee wellbeing, then the response would be positive and would, in turn, have a positive effect on customer service. In contrast, if they were attributed to management’s desire to enhance control over employees or to intensify work, then these negative attributions would feed through into less enthusiastic employee behaviors that would be reflected in customer evaluation of service quality in the branches. Their findings supported these hypotheses. Subsequent research by van de Voorde & Beijer ( 2015 ) tested the impact of wellbeing and performance attributions on individual employee outcomes and found that, as predicted, wellbeing attributions had a positive impact on commitment to the organization and on employee wellbeing, reflected in lower levels of job strain, whereas performance attributions resulted in higher levels of job strain. Both studies confirm the importance of understanding employee attributions in any model seeking to explain the links between HRM and outcomes.

Research on employee attributions highlights the potential role of signaling theory (Connelly, Certo, Ireland, & Reutzel, 2011 ), a variation on communication theory. To put it at its simplest, what do HR practices, singly or in combination, signal to employees? Rousseau and Greller ( 1994 ) used signaling theory to explain how HR practices communicated to workers the content of the psychological contract. Signaling theory formed the basis for an influential conceptual article by Bowen and Ostroff ( 2004 ) concerning the implementation of HRM. They support the view that it is not sufficient to have good HR practices in place; implementation is only likely to be effective if management can clearly signal the intentions behind the HR practices. They argue that this is more likely to be achieved when there is what they call a “strong” HR system. They hypothesize that this will entail three features that need to be clearly signaled: high consensus, implying agreement among the relevant stakeholders about the viability and fairness of the HR practices; high distinctiveness, implying that HR practices should be visible, understandable, and relevant; and high consistency, implying that HR practices complement each other and are seen as aiding goal achievement. Bowen and Ostroff’s approach suggests that strong leadership signaling support from the top of the organization is required to ensure a strong HR system and therefore an increased likelihood of effective implementation of HR practices.

Researchers have begun to test Bowen and Ostroff’s propositions. A first step has been to develop measures of the three core components and the sub-elements that Bowen and Ostroff outline (see, e.g., Delmotte, De Winne, & Sels, 2012 ; Coelho, Cunha, Gomes, & Correia, 2015 ). A second step has been to test the validity of the model by studying the association of the dimensions with performance outcomes (see, e.g., Sanders, Dorenbosch, & De Reuver, 2008 ; Li, Frenkel, & Sanders, 2011 ; Pereira & Gomes, 2012 ). The results of these studies highlight the complexity of the model, suggesting that it would benefit from some simplification. Secondly, they indicate that the distinctiveness dimension appears to be more important than the other dimensions, and that the relative importance of the three dimensions of HRM system strength seems to vary across studies and perhaps across national cultures. Despite the enthusiasm with which some researchers have been exploring the Bowen and Ostroff model, there may be a case for revisiting some of the underlying dimensions.

The HR Implementation Process and Actors

Research on attribution theory, signaling theory, and the strength of the HR system is concerned with HR implementation. It is based on recognition that the presence of HR practices is not enough to ensure that they have an impact. A related stream of research has explored the process of HR implementation by focusing more directly on the roles of the main actors. Guest and Bos-Nehles ( 2013 ) have outlined a descriptive framework that implicated several parties in the implementation process. Top management and senior HR managers have responsibility for deciding whether certain practices should be present. HR managers, perhaps with outside help from consultants and W/O psychologists, shape the quality of the practices. Line managers, with support from local HR managers, have to implement practices on a day-to-day basis, and in addition they need to be motivated to ensure that they are implemented in a high-quality rather than a ritualistic way. Finally, their impact depends on employees’ perceptions of and attributions about the practices. There has been some concern that line managers may be a weak link in this process. Case studies led Hope Hailey, Farndale, and Truss ( 2005 ) to conclude that in the U.K., line managers were neither willing nor able to accept their HR implementation role. In contrast, Bos-Nehles ( 2010 ) found that Dutch managers were motivated to ensure effective implementation of HR but often lacked the time to do so (Bos-Nehles, 2010 ). A study of the implementation of policy and practice to address bullying and harassment in healthcare (Woodrow & Guest, 2014 ) found that although best HR practices were in place, they were invariably poorly implemented due mainly to lack of senior management support, but also to employees’ perceptions that the HR systems were ineffective in helping to resolve incidents of bullying and harassment. This would appear to support Bowen and Ostroff’s argument about the need for a strong HR system with top-level support.

The interest in HRM implementation has increased the focus on the role of HR specialists. There has been a longstanding stream of research on the role of HR managers reflecting concerns about their lack of power and influence (see, e.g., Legge, 1978 ; Ritzer & Trice, 1969 ; Guest & King, 2004 ). In a highly influential attempt to boost the role, Ulrich has presented a stream of writing and research outlining evolving ideas about the HR department structure, the various HR roles, and HR competencies required for effective performance by HR professionals (see Ulrich, 1997 ; Ulrich & Brockbank, 2005 : Ulrich, Younger, Brockbank, & Ulrich, 2013 ). Underpinning his research was a desire to see the HR function contributing to effective HR implementation or, as he expressed it, moving from “doing” to “delivering.”

Ulrich’s ideas generated considerable excitement among HR professionals in several countries, resulting in a rush to implement them. However, they have also been the subject of extensive conceptual critiques (see, e.g., Caldwell, 2008 ) and empirical research (see, e.g., Buyens & De Vos, 2001 ; Wright, 2008 ), raising serious questions about the feasibility of implementing them beyond the context of large, predominantly U.S. private-sector organizations, something Ulrich himself recognized. Nevertheless, his work is important in highlighting the role of HR professionals who often serve as gatekeepers for the application of the research of W/O psychologists in organizations.

The Role of Individual Differences

As psychologists have become more interested in HRM, attention has begun to focus on individual differences. One illustration of this has been a broadening of the conceptualization of the characteristics that constitute human capital, reflected in the work of Ployhart and Moliterno ( 2011 ), including the role of personality and values as human capital. Another stream of research has been considering age and the question of whether specific HR practices or bundles of practices have a greater impact at different ages. The rationale for expecting that this might be the case draws on selection, optimization, and compensation (SOC) theory (Baltes, Staudinger, & Lindenberger, 1999 ). For example, Bal, Kooij, and De Jong ( 2013 ) and Kooij et al. ( 2013 ) have shown how developmental HR practices among younger workers and accommodative HR practices among older workers can enhance commitment and wellbeing. There would appear to be room to extend this approach to consider other individual differences such as gender and education, but also variations in employment circumstances like temporary employment and other forms of employment flexibility. For example, what sort of HR practices are most suitable for long-distance workers including those working from home?

The Use of Multilevel Analysis

Bowen and Ostroff’s ( 2004 ) model builds on previous work by Ostroff and Bowen ( 2000 ) in arguing for a multilevel approach for understanding HRM processes and their impact. Ployhart and Moliterno ( 2011 ) make a similar point with respect to the aggregation of human capital. There is a strong case for multilevel analysis when employee attitudes and behavior form part of the study but the primary concern is with organizational performance, something that has become relatively common in recent research (see, e.g., Liao et al., 2009 ; Messersmith et al., 2011 ; Piening, Baluch, & Salge, 2013 ). Another context is when moderating variables are hypothesized to affect outcomes, requiring the use of moderated mediation. The kinds of moderating variables that have attracted most research attention are organizational climate and leadership, but there is room to extend this type of research to consider a potentially wide range of moderating variables, including exogenous factors like business sector and market conditions.

Comparative HRM

HRM is potentially a very broad field, and its extensive scope can be illustrated through the large body of research and writing on comparative HR systems. While most multilevel analysis uses the organization as the highest level of analysis, a distinct body of research has explored HRM at the country level. This research studies comparative HR systems and the impact of national institutions and cultural factors in shaping the kind of HR practices that are likely to be acceptable and have impact. European countries typically have a stronger institutional framework, including legislation that requires certain practices to be in place. In a country such as the U.S., organizations have fewer constraints on the HR practices they can choose whether or not to apply. Along with the major comparative studies of national cultures and leadership, the Cranet project (see, e.g., Mayehofer & Brewster, 2005 ) has for years been conducting standard surveys in many countries collecting data on HR practices, the structure of the HR function, and perceptions of impact. Rabl, Jayasinghe, Gerhart, and Kuhlmann ( 2014 ) have analyzed country differences in the strength of the HRM-performance relationship across studies reported in 29 countries. Although in all cases, the associations were positive, there were wide country differences in the average strength of the association, and their hypotheses about the influence of two dimensions of national culture, namely tight-loose properties and degree of flexibility, were not supported.

In policy terms, research on comparative HRM is particularly relevant for international organizations sending managers on overseas assignments. Schuler, Dowling, and De Cieri ( 1993 ) have provided an integrative framework within which to consider international HRM, including overseas assignments. Black and Mendenhall ( 1990 ) have explored issues in selection and more particularly cross-cultural training methods, while Black, Mendenhall, and Oddou ( 1991 ) have outlined the steps necessary for effective adjustment to an overseas assignment. Doherty, Dickmann, and Mills ( 2011 ) have explored motives among company-initiated and self-initiated overseas assignments, while Bolino ( 2007 ) has analyzed the implications of such assignments for career success. Comparative HRM therefore provides a good example of how HRM research can be considered at different levels of analysis, from different disciplinary perspectives, and from both conceptual and applied perspectives.

The Importance of Longitudinal Research

Much of the reported research linking HRM and outcomes has been cross-sectional, raising questions about causality and leading to calls for longitudinal studies. Researchers have begun to answer this call. Birdi et al. ( 2008 ) examined the impact of three HR practices (training, teamwork, and empowerment) and four operational practices (total quality management, just-in-time, supply chain management, and advanced manufacturing techniques) on productivity in a large sample of manufacturing firms over a 22-year period. They found a positive impact of HR practices but not operational practices, and they also found no interaction between them. They reported a lengthy time lag of several years before any impact was significant. In contrast, Piening, Baluch, and Salge ( 2013 ), in a longitudinal study in healthcare, found support for a causal chain from employee perceptions to changes in job satisfaction to changes in patient satisfaction. However, they found that the impact was greatest in the first year and diminished thereafter. The longitudinal study in healthcare by West et al. ( 2006 ) reported a more direct association between the presence of more HR practices and mortality rates after controlling for a range of other potential influences.

Longitudinal studies have generally supported a causal ordering whereby HR practices affect outcomes. However, they have rarely considered the possibility of reverse causality. The potential for reverse causality is based on the assumption that high performance and, in particular, high financial performance create room for investment, including investment in human resources. There is also the possibility that working for a successful organization is a source of satisfaction that in turn further enhances performance, a conclusion that might be drawn from the longitudinal study of company-level performance and job satisfaction over a number of years reported by Schneider, Hanges, Smith, and Salvaggio ( 2003 ). In the context of HRM, Guest, Michie, Conway, and Sheehan ( 2003 ) reported an association between HRM and subsequent financial performance. However, when they controlled for prior performance, this association disappeared, raising questions about the causal ordering. It also raises wider questions about the size of impact of HRM, since few studies have taken into account prior financial performance. This point is strongly reinforced in a study by Shin and Konrad ( 2016 ) that used a longitudinal Canadian company-level dataset to explore the relation over time between HRM and productivity. After controlling for past performance and past HRM, they found a modest positive two-way causal link between the variables, with each having an influence on the other over three two-year time lags. The study by Piening, Baluch, and Salge ( 2013 ) found support for a cyclical process whereby HRM affected outcomes and these in turn affected HR practices. But Van de Voorde, Paauwe, and van Veldhoven ( 2010 ), in a cross-lagged study, found that an “HR-indexed” measure of organizational climate had an impact on organizational performance, though there was no evidence of performance influencing climate.

These studies help to highlight the challenges of establishing the causal direction in the HRM-outcomes relationship and challenge the size of the associations reported in cross-sectional studies. When the outcome is financial performance, one of the problems is that it tends to be very stable from year to year, leaving only a small amount of variance to explain. The same may be the case for HR practices. There are also major challenges in controlling for other endogenous and exogenous variables. What may be needed are naturally occurring quasi-experimental studies, possibly at branch levels. At a micro level, W/O psychologists have been more successful in demonstrating causality with respect, for example, to interventions for improving selection, training, or job design. Since the distinctive feature of HRM is that it needs to be considered as a system of practices and is more typically explored at the unit or organizational level, this presents distinctive challenges of access over time and interpretation of results when other factors are hard to control for. Understanding the dynamics of changes in the use of HR practices may require in-depth longitudinal, qualitative studies along with the dominant quantitative research.

HRM provides an important context for research in W/O psychology. It incorporates the core practices and activities that constitute W/O psychologists’ areas of expertise. HR departments often act as gatekeepers for W/O psychologists from outside the organization or as hosts for those working within it. HRM extends the traditional domain of W/O psychologists by incorporating strategic issues, and it raises ethical issues in terms of the “utilization” of employees that can sometimes spill over into “exploitation.” It is therefore important that research on outcomes addresses the impact of employee wellbeing while at the same time recognizing the pragmatic political requirement to explore those contexts, conditions, policies, and practices that offer the potential for both high performance and high wellbeing. HRM is a broad topic that has attracted an extensive and growing body of research. It also raises a lot of challenging research questions. Its multilevel, multidisciplinary characteristics pose additional challenges for W/O psychologists. But it is an important applied subject with room to link theory, research, and application, and it is one to which W/O psychology is making an increasingly significant contribution.

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• Article Information

FPS indicates Finnish Public Sector Study; SLOSH, Swedish Longitudinal Occupational Survey of Health; and WEHD, Work Environment and Health in Denmark.

FPS indicates Finnish Public Sector Study; NA, not applicable; OR, odds ratio; SLOSH, Swedish Longitudinal Occupational Survey of Health; and WEHD, Work Environment and Health in Denmark.

FPS indicates Finnish Public Sector Study; OR, odds ratio; SLOSH, Swedish Longitudinal Occupational Survey of Health; and WEHD, Work Environment and Health in Denmark.

eAppendix 1. The Choice of Measurements, Dimensions, and Cutoffs of Workplace Psychosocial Resources

eAppendix 2. Comparisons with Other Possible Categorizations

eAppendix 3. Measurement of Covariates

eTable 1. Items Measuring Workplace Resources

eTable 2. Changes of Resources and Restrictions

eTable 3. Measurement Invariances for Sleep Measurement Across Waves, Using the Confirmatory Factor Analysis

eFigure 1. Study Design

eFigure 2. Trajectory of Sleep Disturbances

eFigure 3. Results From Analyses of Changes, Before and After the Adjustment of Night Shifts

eFigure 4. Additional Adjustment for Night Shifts for Analyses on Concurrent and Longitudinal Associations

eFigure 5. Results From Alternative Definition of Sleep Disturbances

Data Sharing Statement

• Error in Author Affiliation JAMA Network Open Correction June 21, 2023

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Xu T , Rugulies R , Vahtera J, et al. Workplace Psychosocial Resources and Risk of Sleep Disturbances Among Employees. JAMA Netw Open. 2023;6(5):e2312514. doi:10.1001/jamanetworkopen.2023.12514

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Workplace Psychosocial Resources and Risk of Sleep Disturbances Among Employees

• 1 Stress Research Institute, Stockholm University, Stockholm, Sweden
• 2 Department of Public Health, University of Copenhagen, Copenhagen, Denmark
• 3 National Research Centre for the Working Environment, Copenhagen, Denmark
• 4 Department of Psychology, University of Copenhagen, Copenhagen, Denmark
• 5 Department of Public Health, University of Turku, Turku, Finland
• 6 The Centre for Population Health Research, University of Turku, Turku, Finland
• 7 Turku University Hospital, Turku, Finland
• 8 Clinicum, Faculty of Medicine, University of Helsinki, Helsinki, Finland
• 9 Finnish Institute of Occupational Health, Helsinki, Finland
• 10 UCL Brain Sciences, University College London, London, United Kingdom
• Correction Error in Author Affiliation JAMA Network Open

Question   What are the associations of clustering of and changes in workplace psychosocial resources (ie, leadership quality, procedural justice, culture of collaboration, and coworker social support) with sleep disturbances?

Findings   In this cohort study, including 219 982 participant-observations nested within 114 971 participants, clustering of favorable workplace psychosocial resources was associated with a statistically significant lower risk of sleep disturbances. Improvements in leadership quality and procedural justice (ie, vertical resources) and in culture of collaboration and coworker social support (ie, horizontal resources) were associated with a lower risk of persistent sleep disturbances in a dose-response fashion.

Meaning   These findings suggest that multilevel workplace interventions are essential to promote short- and long-term sleep quality among workers.

Importance   Workplace psychosocial resources naturally tend to cluster in some work teams. To inform work-related sleep health promotion interventions, it is important to determine the associations between clustering of workplace resources and sleep disturbances when some resources are high while others are low and to mimic an actual intervention using observational data.

Objective   To examine whether clustering of and changes in workplace psychosocial resources are associated with sleep disturbances among workers.

Design, Setting, and Participants   This population-based cohort study used data from the Swedish Longitudinal Occupational Survey of Health (2012-2018), the Work Environment and Health in Denmark study (2012-2018), and the Finnish Public Sector Study (2008-2014), collected biennially. Statistical analysis was conducted from November 2020 to June 2022.

Exposure   Questionnaires were distributed measuring leadership quality and procedural justice (ie, vertical resources) as well as collaboration culture and coworker support (ie, horizontal resources). Resources were divided into clusters of general low, intermediate vertical and low horizontal, low vertical and high horizontal, intermediate vertical and high horizontal, and general high.

Main Outcomes and Measures   Odds ratios (ORs) and 95% CIs were reported from logistic regression models for the associations between the clustering of resources and concurrent and long-term sleep disturbances. Sleep disturbances were measured by self-administered questionnaires.

Results   The study identified 114 971 participants with 219 982 participant-observations (151 021 [69%] women; mean [SD] age, 48 [10] years). Compared with participants with general low resources, other groups showed a lower prevalence of sleep disturbances, with the lowest observed in the general high group concurrently (OR, 0.38; 95% CI, 0.37-0.40) and longitudinally after 6 years (OR, 0.52; 95% CI, 0.48-0.57). Approximately half of the participants (27 167 participants [53%]) experienced changes in resource clusters within 2 years. Improvements in vertical or horizontal dimensions were associated with reduced odds of persistent sleep disturbances, and the lowest odds of sleep disturbances was found in the group with improvements in both vertical and horizontal dimensions (OR, 0.53; 95% CI, 0.46-0.62). A corresponding dose-response association with sleep disturbances was observed for decline in resources (eg, decline in both dimensions: OR, 1.74; 95% CI, 1.54-1.97).

Conclusions and Relevance   In this cohort study of workplace psychosocial resources and sleep disturbances, clustering of favorable resources was associated with a lower risk of sleep disturbances.

Sleep is essential to physiological restitution and recovery. 1 , 2 Impaired sleep and prolonged activations of the physiological stress response may have far-reaching effects on the hormonal and immune system and metabolism, eventually contributing to a higher risk of cardiometabolic diseases. 3 As the workplace is an important foundation for social and professional networks, investigating the preventive potential of favorable psychosocial work environment on reducing sleep disturbances is essential. 4

Large-scale studies on workplace psychosocial resources, such as leadership quality, organizational justice, culture of collaboration, and coworker support, have only recently started to emerge. While higher workplace psychosocial resources have been associated with reduced risks of stress-related cardiometabolic diseases, 5 , 6 previous findings on sleep disturbances are mixed. Some studies have reported a direct association between higher workplace psychosocial resources and lower risk of sleep disturbances among workers, 1 , 2 , 7 - 11 while others could not identify such an association. 12 - 14 In these studies, each workplace resources was addressed individually, while it is more likely that workplace psychosocial resources interact and thereby affect sleep and health through multiple mechanisms. 4 Thus, it is important to investigate how different combinations of workplace psychosocial resources may be associated with sleep disturbances.

A further drawback in current evidence involves reliance on smaller-scale, cross-sectional findings. 1 , 2 , 7 - 14 In samples of up to 3000 individuals, relational justice, leader support, and general workplace social support were associated with reduced risk of sleep disturbance within the first year of follow-up, 7 , 8 but these associations disappeared with longer follow-up. 12 - 14 Other studies with larger sample sizes supported a prospective association of relational justice and empowering leadership with sleep disturbances, but these studies did not consider the transition from short- to long-term. 9 - 11 Importantly, such longitudinal associations may result from long-term effects of workplace psychosocial resources, but we cannot exclude the possibility of individual differences in perceptions of workplace characteristics and reporting sleep disturbances as an explanation for our results. Future studies emulating a target trial and investigating the extent to which changes in clustering of workplace resources are associated with changes in the risk of sleep disturbances are warranted to reduce the likelihood of this limitation and to evaluate the benefits of interventions with an aim to improve workplace resources. 15 We are not aware of such studies having been conducted.

To address these limitations, we assessed the clustering of and changes in 4 major workplace psychosocial resources (ie, leadership quality, procedural justice, culture of collaboration, and coworker social support) to examine their concurrent and longitudinal associations with sleep disturbances. We studied 114 971 men and women from Denmark, Finland, and Sweden, with a up to 6 years of follow-up.

This cohort study used data from the Work Environment and Health in Denmark (WEHD) study, Finnish Public Sector Study (FPS), and Swedish Longitudinal Occupational Survey of Health (SLOSH). Ethical approvals were obtained from the Regional Ethical Review Board in Stockholm (for use of SLOSH data) 16 and the Ethics Committee of the Hospital District of Helsinki and Uusimaa (for use of FPS data). 17 Use of WEHD data was approved by and registered with the Danish Data Protection Agency. Participants were informed about the purpose of the SLOSH, WEHD, and FPS, and by returning the questionnaire, the participants consented to participate. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology ( STROBE ) reporting guideline.

The WEHD is a nationwide population-based biennial occupational survey, with baseline in 2012. It consists of individuals from the general working population and supplementary surveys on selected workplaces in Denmark. 18 Data for this study were obtained from the 2012, 2014, and 2018 waves (wave 2016 was dropped due to sleep measurement inconsistencies).

The FPS is based on a dynamic public sector cohort in Finland followed up with repeated questionnaire surveys at 2- or 4-year intervals since 2000. 17 Data for this study were obtained from the 2008, 2010, 2012, and 2014 surveys.

The SLOSH is a nationally representative cohort initiated in 2006 in Sweden, with follow-ups biennially. The participants of the cohort were recruited from the respondents of Swedish Working Environment Survey in 2003 to 2011. 16 Data for this study were obtained from 2012, 2014, 2016 and 2018 in SLOSH. Except the 4-year interval between 2014 and 2018 for WEHD, all available cohort waves had a 2-year follow-up interval.

For the concurrent analysis, we included participants who had information on workplace resources, sleep disturbances, and key confounders in 1 or more waves. For the longitudinal analysis, we further included only individuals who participated in all follow-up waves. For the analysis of changes in resources and changes in sleep, only participants of at least 2 consecutive waves were included. The flowchart of participants in each specific analysis is presented in Figure 1 .

We applied the framework of hierarchical dimensions of workplace psychosocial resources related to group-, leader-, and organizational-level variables, 4 including culture of collaboration (horizontal), support from colleagues (horizontal), leadership quality (vertical), and procedural justice (vertical) (eTable 1 in Supplement 1 ). Horizontal resources are resources from the same hierarchical level. 19 Vertical resources are resources from different hierarchical levels. 19 All resources were measured using validated items and were categorized according to previous practice into 2 or 4 groups, while considering harmonization across cohorts (eAppendix 1 in Supplement 1 ). 6

Culture of collaboration was dichotomized (low vs high) and was defined as the workplace collaborative efforts to achieve the best available results or to develop or apply new ideas. Coworker support was assessed as perceived colleagues’ support and was dichotomized (low vs high). The leadership variable included multiple dimensions, such as listening and appreciative, and was grouped into 4 levels (high, intermediately high, intermediately low, and low). The variable for procedural justice (ie, fairness in the principles and processes leading to decision-making) was also categorized into 4 groups (high, intermediately high, intermediately low, and low). Detailed descriptions of the variables can be found in eTable 1 in Supplement 1 . 6

Clustering of workplace psychosocial resources has been detected previously from these same cohorts using a latent class model. 6 We used the same predefined 5-class categorization in this study: general low, intermediate vertical and low horizontal, low vertical and high horizontal, intermediate vertical and high horizontal, and general high ( Table 1 ), because it showed better robustness across data waves, cohorts, and employment sectors compared with other categorizations (eAppendix 2 in Supplement 1 ). 6 Changes of resources were defined as moving from 1 class to another across 2 consecutive waves, implying improvement or decline of either or both vertical and horizontal dimensions (eTable 2 in Supplement 1 ).

Sleep disturbances were defined as self-reported difficulties in initiating or maintaining sleep, nonrestorative sleep, or daytime tiredness during the past 4 weeks (for WEHD and FPS) or 3 months (for SLOSH) according to the Karolinska Sleep Questionnaire (3 or 4 items; for WEHD and SLOSH) or Jenkins Sleep Problem Scale (4 items; for FPS) (eTable 3 in Supplement 1 ). Sleep disturbances were identified if respondents reported any of the symptoms at least often or all the time (in WEHD), 2 to 4 nights per week (in FPS), or 3 to 4 nights per week (in SLOSH), and the same criteria were used for indicating insomnia. 10 , 20 An alternative definition was applied to indicate the overall severity of the sleep disturbances (identified when the mean value was greater than or equal to the corresponding value of the aforementioned threshold).

Potential confounders were identified using directed acyclic graphs based on previous evidence, 21 and included age, sex, country of birth (categorized as Scandinavian countries, other European countries, and other continents), marital status (married or cohabiting, single, separated or divorced, and widowed), highest educational level achieved (≤9, 10-12, and ≥13 years), type of employment contract (permanent, and nonpermanent), preexisting comorbidities, and preexisting mental disorders. Information on these variables were extracted from national registers in Denmark, Finland, and Sweden, except that marital status and employment contract in SLOSH and marital status in FPS were self-reported. Information on country of birth was not available in FPS. Preexisting comorbidities according to the Charlson Comorbidity Index and preexisting mental disorders were detected using the International Classification of Diseases, Eighth Revision ( ICD-8 ), International Classification of Diseases, Ninth Revision ( ICD-9 ), and International Statistical Classification of Diseases and Related Health Problems, Tenth Revision ( ICD-10 ) codes from the national patient registries (eAppendix 3 in Supplement 1 ). Self-reported night shift work (yes and no) was also a potential confounder; however, night shift data were not available in FPS wave 2010 (wave 2).

Two different analytical approaches were used to determine the concurrent and longitudinal associations of clusters of workplace psychosocial resources with sleep disturbances and associations of changes in workplace psychosocial resources with changes in sleep disturbances (eFigure 1 in Supplement 1 ). In terms of missing values, we used complete-case analysis.

In the analysis for assessing the concurrent association between resources and sleep disturbances (eFigure 1 in Supplement 1 ), all available observations were included. To bridge the knowledge gap of varying follow-up intervals, we performed longitudinal analysis between workplace resources and sleep measured 2 and 6 years after the exposure measurement among individuals who participated in all follow-up waves (eFigure 1 in Supplement 1 ).

Next, we applied an emulated trial design to investigate the concurrent association between changes of resources and the risk of maintaining or developing sleep disturbances (eFigure 1 in Supplement 1 ). 15 To address the issue of reverse causation, we applied a stricter restriction criteria to changes of resources occurring prior to changes of sleep disturbances. eTable 2 in Supplement 1 shows restrictions in each analysis.

We used multiple logistic regression models for the analyses. Some individuals were included in more than 1 baseline for the analysis of the concurrent association and the longitudinal analysis with the 2-year follow-up interval. Generalized estimating equations were used to account for the intraindividual correlation. All potential confounders were adjusted in all analyses, except that night work was adjusted for in a sensitivity analysis restricted to individuals with this information. All analyses were repeated for the alternative definition of sleep disturbances.

We used SAS statistical software version 9.4 (Proc Genmod; SAS Institute) to perform cohort-specific analyses. Given the small numbers of cohorts, 22 fixed-effect meta-analyses were then performed to combine the cohort-specific estimates using R package meta version 4.16-2 (R Project for Statistical Computing). We used I 2 statistics to quantify the cross-cohort heterogeneity. P values were 2-sided, and statistical significance was set at P  = .05. Data were analyzed from November 2020 to June 2022.

A total of 114 971 participants with 219 982 participant-observations were included (mean [SD] age, 48 [10] years; 151 021 [69%] women). The 2 most common classes of work resources were intermediate vertical and high horizontal (55 608 participants [25%]) and general high (62 672 participants [28%]) were the 2 most common classes ( Table 2 ).

Using the largest available sample size (114 971 participants), we found relatively stable trajectories in the prevalence of disturbed sleep according to resource classes and cohorts (eFigure 2 in Supplement 1 ). In the confounder-adjusted model, compared with the general low resource class, having a general high level of resources was associated with an overall lower prevalence of sleep disturbances (odds ratio [OR], 0.38; 95% CI, 0.37-0.40). Although there was substantial cross-cohort heterogeneity ( I 2  > 80%), all cohort-specific estimates pointed to the same direction ( Figure 2 A).

A total of 18 462 individuals participated in all waves. Among 7491 individuals with baseline sleep disturbances, 5414 individuals (72%) reported sleep disturbances 2 years later, and 3095 individuals (41%) reported sleep disturbances after 6 years. When comparing general high with general low resources, the association between clustering of resources and sleep disturbances remained pronounced after 2 years (OR, 0.49; 95% CI, 0.46-0.53) and 6 years (OR, 0.52; 95% CI, 0.48-0.57) ( Figure 2 B).

There was a dose-response pattern for vertical resources when horizontal resources were high ( Figure 2 B). However, observing the contrast between intermediate vertical and low horizontal vs intermediate vertical and high horizontal, the role of horizontal resources was less clear in the presence of an intermediate level of vertical resources in the concurrent analysis (OR, 0.82; 95% CI, 0.75-0.89), and it lost statistical significance after 2 years (OR, 0.90; 95% CI, 0.81-1.00) and 6 years (OR, 0.94; 95% CI, 0.81-1.10). Nevertheless, when vertical resources were low, perceiving high horizontal resource was associated with a lower risk of sleep disturbances from the concurrent analysis to 6 years of follow-up ( Figure 2 B).

Among 51 259 employees participating 2 consecutive waves, 27 167 (53%) experienced a change in resources across 2 consecutive follow-ups ( Figure 3 A). Changes in vertical resources accounted for most of the change, including 8233 employees (16%) who experienced improvement and 8130 employees (16%) who experienced decline.

In the analyses of improvement ( Figure 3 B), 72% to 75% of employees reported persisting sleep problems between baselines and follow-up. Compared with the stable resource group, the participants who experienced improvement in either vertical or horizontal had reduced odds of sleep disturbance (vertical improvement: OR, 0.71; 95% CI, 0.65-0.79; horizontal improvement: OR, 0.83; 95% CI, 0.71-0.98; improvement on both dimensions: OR, 0.53; 95% CI, 0.46-0.62).

In the analyses of declined resources ( Figure 3 B), nearly one-fourth of employees developed sleep disturbances from baseline to follow-up. Individuals who experienced a decline in both vertical and horizontal resource dimensions had the highest odds of developing sleep disturbances (OR, 1.74; 95% CI, 1.54-1.97) compared with individuals with unchanged resources. A decline in vertical or horizontal resources were also associated with higher odds of developing sleep disturbances (vertical decline: OR, 1.49; 95% CI, 1.37-1.62; horizontal decline: 1.31; 95% CI, 1.13-1.51), which suggests there may have been an additive pattern across different resource dimensions.

Similar findings were observed when changes in resources occurred before changes in sleep disturbances. However, these temporal associations were weaker, less precisely estimated, and did not achieve statistical significance at conventional levels (eFigure 3 in Supplement 1 ).

Additional adjustment for night shifts did not materially change the results (eFigure 3 and eFigure 4 in Supplement 1 ). Results were similar when applying the alternative definition of sleep disturbances (eFigure 5 in Supplement 1 ).

The findings of this cohort study, including data on 219 982 participant-observations from 114 971 participants in 3 large longitudinal cohorts, suggest that better psychosocial resources at work were associated with lower risk of sleep disturbances, both concurrently and longitudinally, with vertical resources of greater importance in the long term. Supporting modifiability of sleep disturbance risk by targeting workplace psychosocial resources, we observed that improvements in workplace psychosocial resources were associated with a reduced risk of persisting sleep disturbances and deterioration of resources was associated with the development of sleep disturbances.

Our findings are generally in line with several previous smaller-scale studies, 1 , 2 , 7 , 9 - 11 and add to this literature by examining clustering of vertical and horizontal psychosocial resources at work with an emulated trial design in observational data. We demonstrate that the clustering of vertical and horizontal resources is important to consider for long-term sleep patterns and that ignoring clustering of different hierarchical level of resources may partly explain the lack of association between resources and sleep, as some of the associations seem to be synergistic. 12 - 14 Moreover, our findings on changes in resources confirm findings from a single-cohort study, suggesting an association between changes in relational justice and changes in sleep. 10

According to the effort-recovery model, improved psychosocial resources from work could contribute to a better switch-off from work, in turn leading to better recovery process from work, including improved sleep. 23 Conversely, a decline in workplace resources can be a stressor that can potentially trigger dysregulation of the hypothalamic-pituitary-adrenal and sympathetic-adreno-medullar axes, which can adversely affect sleep. 2 Other potential mechanistic pathways involve reductions in potential consequences of low psychosocial resources, such as workplace bullying, mental health problems, and problematic health-related behaviors. 24 - 26

Our findings suggest that vertical resources might be more crucial than horizontal resources in associations with long-term sleep disturbances. In the presence of high horizontal resources, vertical resources showed a long-term dose-response association, while the same association was not observed for horizontal resources, given an intermediate level of vertical resources was present. This finding is plausible, considering the greater power of leaders to affect a positive working environment, 4 such that vertical resources may promote horizontal resources in the long term. 27 A study by Framke et al 28 suggested workplace horizontal social capital may be particularly relevant for sleep disturbances; however, their study was based on a smaller occupation-specific sample. Future investigations of the interactive cross-dimensional mechanisms of work resources may facilitate the design of cost-effective strategies for the prevention of sleep disturbances.

The concept of workplace psychosocial resources overlaps a number of occupational and organizational theories, including the demand-control model, the job-demand resource model, the effort-reward imbalance model, and the concept of organizational justice. 29 , 30 A 2017 study by Nielsen et al 4 proposed that workplace resources at the individual (eg, psychological capital), group (eg, team climate), leader (eg, leadership quality), and organizational levels (eg, perceived organizational support and justice) may be associated with better job performance and well-being among employees. Following this framework, we have shown that vertical (organization or leader) and horizontal (the work group) clusters of resources were associated with health-related outcomes. 5 , 6 Our findings further highlight the potential benefits of multilevel workplace interventions in promoting sleep of employees.

This study has some limitations. We applied a novel clustering of workplace resources based on predefined information on 4 important workplace resources. Thus, caution should be taken when generalizing our findings to other workplace resources, such as job control, rewards, and autonomy.

We included more than 100 000 participants with 6 years of follow-up measured up to 3 times and reported results from both concurrent and longitudinal analyses. Although we applied an emulated trial design, reverse causation cannot be fully ruled out due to lack of statistical power to draw solid conclusions on temporality. Furthermore, it is likely that sleep, stress, and workplace resources are affecting each other in a dynamic manner, which may create feedback loops over time. Future studies with larger sample sizes are needed to disentangle these intertwined mechanisms. Our population-based sample included employees from different occupational groups, industries, and employment types. Although point estimates varied substantially across these cohorts, most cohort-specific results pointed to the same direction, implying the validity and generalizability across countries and different settings. The data sets were only followed until 2018, which is before the COVID-19 pandemic began. Therefore, future studies are needed to understand whether, for example, the COVID-19–related changes in work-from-home opportunities would modify the observed associations. Other potential modifiers, including age group, gender, employment sector, educational level, and occupational grade, should be explored in future studies to detect at-risk groups that would benefit most from interventions.

With a large sample size and repeated follow-ups, we assessed the general association between resources and sleep as an extension to prior studies, allowing for direct comparisons with previous findings addressing different follow-up lengths and observing short- to long-term transitions. Five combinations of vertical and horizontal dimensions of resources enabled us to weigh the importance of 1 dimension at a time, with or without the presence of the other. A further step was taken to analyze the associations with changes in resources, mimicking a trial, which can be informative for intervention development when data from an actual trial are not available.

In this cohort study including 3 Scandinavian cohorts, nearly half of the employees experienced a low level of 1 or more vertical or horizontal dimensions of workplace psychosocial resources, which included procedural justice, leadership quality, coworker support, and culture of collaboration. Favorable resources at work were associated with a lower risk of sleep disturbances, and improvements in resources were associated with lower risk of sleep disturbances. Our findings justify future intervention studies to examine the extent to which improvements in workplace psychosocial resources could facilitate remission or recovery from sleep disturbances and prevent development, deterioration, or prolongation of sleep disturbances among employees.

Accepted for Publication: March 27, 2023.

Published: May 9, 2023. doi:10.1001/jamanetworkopen.2023.12514

Correction: This article was corrected on June 21, 2023, to fix an error in the affiliation listed for Dr Nordentoft.

Open Access: This is an open access article distributed under the terms of the CC-BY License . © 2023 Xu T et al. JAMA Network Open .

Corresponding Author: Tianwei Xu, PhD, Stress Research Institute, Stockholm University, 106 91 Stockholm, Sweden ( [email protected] ).

Author Contributions: Dr Xu had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Xu, Rugulies, Magnusson Hanson, Rod.

Acquisition, analysis, or interpretation of data: All authors.

Drafting of the manuscript: Xu, Rod.

Critical revision of the manuscript for important intellectual content: Xu, Rugulies, Vahtera, Stenholm, Pentti, Magnusson Hanson, Kecklund, Mathisen, Nordentoft, Kivimäki, Rod.

Statistical analysis: Xu, Pentti, Magnusson Hanson.

Obtained funding: Nordentoft, Kivimäki, Rod.

Administrative, technical, or material support: Xu, Pentti, Magnusson Hanson, Nordentoft.

Supervision: Rod.

Conflict of Interest Disclosures: None reported.

Funding/Support: This project was supported by the Danish Working Environment Foundation (grant No. 13-2015-09; Dr Rod). Dr Xu was supported by a grant from the Swedish Research Council for Health, Working Life and Welfare (grant No. 2020-00040). Dr Kivimäki was support by the Academy of Finland (grant No. 329202 and 350426) and Finnish Work Environment Fund (grant No. 190424). Dr Magnusson Hanson was supported by a grant from the Swedish Research Council for Health, Working Life and Welfare (grant No. 2019-01318). Dr Vahtera was supported by the Academy of Finland (grant No. 321409 and 329240).

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Data Sharing Statement: See Supplement 2 .

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Simone Biles and Gen Z’s Recruitment Playbook

How mental health and performance can engage the next generation of workers..

Posted August 26, 2024 | Reviewed by Michelle Quirk

• Gen Z thrives in environments that prioritize well-being and innovation.
• With 10,000 baby boomers retiring each day, the demand for skilled labor across industries is growing.
• Update your Gen Z recruitment playbook by focusing on creativity and growth opportunities.

Simone Biles’ influence has only grown since winning gold. Two weeks after citing therapy as part of her pre-game routine , Biles is still offering the most compelling evidence yet of the profound connection between mental health and peak performance . Her openness to discuss mental health offers insights on ways to attract and retain Generation Z.

Rethinking Performance and Well-Being

For Gen Z, mental health is not an add-on to their well-being but a core component that directly impacts their effectiveness in the workplace. Unlike earlier generations who might have treated mental health as separate from their professional responsibilities, Gen Z recognizes its integral role in their overall success and job satisfaction.

Traditional performance metrics in the workplace have typically focused on how employees meet organizational goals , emphasizing productivity , efficiency, and output. However, to truly engage Gen Z—a generation distinguished by its innovative mindset—it’s essential to broaden these metrics to include factors such as creativity and adaptability.

The New Gen Z Recruitment Playbook

This shift in performance metrics presents a novel strategy for attracting and retaining top talent from Gen Z. With approximately 10,000 baby boomers retiring daily, various sectors, especially those requiring skilled labor like manufacturing, health care, and construction, are feeling the strain on the labor market (BLS, 2021). This demographic change is driving a heightened demand for skilled workers, as employers struggle to fill the vacancies left by retiring employees.

Now more than ever, recruiters and hiring managers must adopt a new playbook focused on well-being and performance. Here are six key strategies for your Gen Z recruitment playbook:

1. Project Ownership

Gen Z thrives on seeing the impact of their work. Offering roles where they can lead initiatives from start to finish harbors internal validation, fostering a sense of ownership that aligns with their desire for meaningful work.

Recruitment Playbook: Communicate in job postings and interviews that candidates will have decision-making power, resource management responsibilities, and accountability for outcomes, positioning your company as one that values and trusts its employees.

2. Autonomy and Flexibility

Work-life balance is critical for Gen Z, who value flexibility in how and where they work.

Recruitment Playbook: Highlight flexible work policies as key benefits in recruitment materials to attract candidates who seek autonomy and control over their work environment.

3. Innovation and Creativity

Gen Z thrives on innovation and looks for opportunities to bring fresh ideas to the table. By offering roles tailored for candidates who are eager to introduce new skills and inject creativity into the workplace, your recruitment strategy will stand out from the competition.

Recruitment Playbook: Share examples during recruitment of how your company provides platforms for innovation, signaling that their contributions will be valued. Showcase opportunities like innovation labs, hackathons, and cross-functional collaborations that allow them to drive new ideas and foster growth.

4. Growth Opportunities

Professional development is a top priority for Gen Z. They seek roles with clear pathways for growth, including leadership training, mentorship, and advancement opportunities.

Recruitment Playbook: Clearly communicate growth potential within your organization, including access to training programs and career development workshops.

5. Mental Health Support

A workplace culture that normalizes mental health discussions can be crucial in retaining Gen Z employees.

Recruitment Playbook: Advertise your company’s mental health support, from counseling services to wellness programs and mental health days. Showcase how your organization helps employees maintain workplace boundaries .

6. University and Startup Partnerships

University partnerships can provide access to a talent pool that is already developing skills aligned with organizational goals.

Recruitment Playbook: Partner with innovation programs and startup incubators within universities to connect with Gen Z students and graduates.

Simone Biles underscores the strong link between mental health and performance, especially for a generation that considers mental wellness vital to success. To attract and keep Gen Z talent, prioritize mental health and develop a work environment that encourages well-being and innovation.

American Psychological Association. (2020). Stress in America: A national mental health crisis .

Schroth, H. (2019). Are you ready for Gen Z in the workplace? California Management Review , 61(3), 5–18.

Twenge, J. M. (2017). iGen: Why Today’s Super-Connected Kids Are Growing Up Less Rebellious, More Tolerant, Less Happy—and Completely Unprepared for Adulthood. Atria Books.

Bureau of Labor Statistics (BLS). (2021). The impact of Baby Boomer retirements on the U.S. labor market.

Damian Salas, MBA , is Co-Founder of GREW and Partner at Open Minds Psychological. He is Professor at the Charles D. Close School of Entrepreneurship at Drexel University.

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