Occupational burnout

What is burnout syndrome?

The reference description is that of the World Health Organization’s ICD-11, which in 2019 included burnout in the chapter on factors influencing health status or contact with health services, under the code QD85. The WHO defines it as a syndrome conceptualized as resulting from chronic workplace stress that has not been successfully managed, and specifies that it refers specifically to phenomena in the occupational context and should not be applied to experiences in other areas of life. It is not a medical diagnosis of illness or a mental disorder; it is an occupational phenomenon.

The three dimensions are derived from the model developed by Maslach and Jackson in the 1980s, which remains the basis for assessment tools: emotional exhaustion, depersonalization or cynicism, and low personal accomplishment or efficacy. The INSST (National Institute for Safety and Health at Work) includes them in NTP (Technical Prevention Notes) 704 and 705, which describe the process of development, consequences, assessment, and prevention of the syndrome.

Burnout has been studied primarily in professions involving care for people (healthcare, education, social services, customer service), but it can occur in any activity with high emotional and organizational demands sustained over time and with limited resources to cope with them.

Causes: organizational factors

Professional burnout is a process that develops over months or years and whose causes lie in working conditions. The most documented are:

• Sustained work overload. Quantitative and emotional demands exceeding available resources and time.
• Lack of control. Limited autonomy to decide how to organize work and meet demands.
• Insufficient reward. Lack of recognition, compensation, or prospects perceived as disproportionate to the effort.
• Community deterioration. Isolation, unresolved conflicts, lack of support from superiors and colleagues.
• Lack of fairness. Perception of unfair treatment, favoritism, or arbitrary decisions.
• Values ​​conflict. Discrepancy between what the person considers right and what the organization requires them to do, common in care professions.

Individual characteristics modulate the response, but do not explain the phenomenon: when several people from the same service show signs of burnout, the cause lies in the organization.

How to assess and prevent

1. Evaluation of the psychosocial factors of the job or unit with a validated method, with the participation of the workers’ representatives, as required by Law 31/1995 and verified by the Labor Inspectorate in accordance with Technical Criterion 104/2021.
2. Use of specific professional burnout instruments (such as the Maslach Burnout Inventory or other validated ones) only as a complement, in a collective and anonymous manner, without labeling people.
3. Identification of organizational causes in each unit: workload, control, recognition, support, equity, and conflict of values.
4. Organizational measures (primary prevention): staffing and workload sizing, autonomy, recognition, supportive leadership, clear procedures for dealing with conflicts and aggression, recovery time.
5. Support measures (secondary prevention): training in managing emotional demands, supervision and peer support spaces, confidential help programs.
6. Attention to affected persons (tertiary prevention): health surveillance, health referral when appropriate, planned return to work and adaptation of the job.

Organizational application

• Management and leadership. They decide on workloads, staffing levels, objectives, and leadership style; their involvement is a prerequisite for any prevention program.
• Prevention service. Evaluates psychosocial factors, proposes measures and coordinates health surveillance, guaranteeing confidentiality of health data.
• Human resources. Policies for recognition, development, work-life balance and action in the face of conflicts, harassment and violence, especially in positions involving care for people.
• Workers’ representatives. They participate in the evaluation, the measures, and the monitoring.
• Working people. They receive information about risk factors and have channels to report situations of overload without negative consequences.

Individual well-being measures (workshops, mindfulness, physical activity) can help, but they do not replace action on the organization of work and should not be presented as the main response.

Limits and common mistakes

1. Presenting burnout as a recognized disease or as a clinical diagnosis; the ICD-11 classifies it as an occupational phenomenon and the associated health disorders have their own diagnoses, which can only be established by health professionals.
2. Using burnout questionnaires to identify and label specific people, instead of evaluating work units and conditions.
3. Attributing burnout to a lack of resilience or to the person’s vocation, rather than to working conditions.
4. Respond with individual training without modifying workloads, staffing, or organization.
5. Ignoring the conflict of values ​​and emotional demands, which are determining factors in care professions.
6. Processing health data without the confidentiality guarantees of Law 31/1995.

In Spain, occupational burnout is not included in the list of occupational diseases; health damages that are proven to be work-related can be classified as a work accident under the terms of Social Security legislation and jurisprudence, on a case-by-case basis.

Regulatory framework and references

• Law 31/1995, articles 14, 15, 16 and 22. Duty of protection, principles of preventive action, risk assessment and health surveillance with confidentiality.
• Technical Criterion 104/2021 of the Labour and Social Security Inspectorate . Verification of the assessment and management of psychosocial risks.
• NTP 704: Burnout syndrome (I): definition and generation process (INSST, 2005) . Description of the syndrome and its generation process.
• NTP 705: Burnout Syndrome (II): Consequences, Assessment and Prevention (INSST, 2005) . Consequences, assessment tools and preventive measures.
• ICD-11, QD85 Burnout (World Health Organization) . Classification of burnout as an occupational phenomenon and description of its three dimensions.

The European Framework Agreement on work-related stress (2004) and the WHO guidelines on mental health at work (2022) recommend prioritizing organizational interventions. In Colombia, Resolution 2764 of 2022 adopted the battery of instruments for assessing psychosocial risk factors, and the table of occupational diseases includes burnout syndrome.