The stress epidemic: How Belgium is coping with workplace burnout

Often described as overachiever syndrome, burnout has been dubbed the health epidemic of the century. While Belgium has traditionally lagged in confronting mental health issues in the workplace, it is now waking up to the reality of what it costs individuals and businesses.

In 2016, 80,000 Belgians suffered burnout according to the National Institute for Sickness and Invalidity, at a cost of €600 million – that’s 10% of the annual health budget. Both the number of cases and the cost in reimbursements have doubled in the past 10 years. Burnout is prevalent in Belgium’s expat community, too; a population that’s particularly workorientated and often faces the additional challenge of not having an adequate support network.

While burnout can be difficult to define and diagnose, it is widely accepted as being chronic stress resulting in physical and mental exhaustion and breakdown, frequently accompanied by alienation from workplace activities and reduced performance.

Since November 2016, burnout has been recognised by Belgium’s health ministry as a work-related illness, leading to a series of prevention initiatives. Employers are now responsible for acknowledging the risk of burnout and taking measures to combat it and there is a new reporting system to make it easier for employees to report problems that could lead to full-on burnout.

'Improving services across Europe'

Belgium and the European Union are finally placing mental health higher on their agendas, says Ophélie Martin of Brussels-based NGO Mental Health Europe (MHE). “The recent proclamation of the European Pillar of Social Rights is an opportunity to improve services across Europe that will contribute to preventing mental ill health, promoting the wellbeing of millions of people in Europe, and supporting people living with mental ill health and psychosocial disabilities,” she says.

The umbrella group, which represents organisations and individuals across Europe, lobbies the European Parliament on a series of mental health and human rights issues. After a series of World Mental Health Day events in the parliament this autumn, it launched an infographic on mental health in the workplace. Drawing on a number of international sources, it shows that work-related stress is the second most reported work-related health problem and has become one of the leading causes for absenteeism and early retirement in the EU. It reports that 79% of managers in Europe are concerned about stress in their workplace, but less than 30% of workplaces have procedures in place to tackle it.

Employees in the EU highlighted numerous factors that cause stress, including unmanageable workloads, unrealistic expectations, ambiguity about their role, low job satisfaction and personal accomplishment, lack of recognition, an unhealthy work-life balance and workplace harassment.

No longer taboo

MHE’s campaign promotes positive health in the workplace by encouraging bosses to champion positive mental health, creating a culture of openness that stops mental health being a taboo subject. It focuses on managers’ attitudes as the most important factor in ensuring a positive workplace that respects the individual, encourages feelings of equity and fairness and a work-life balance, and pays attention to interpersonal relationships.

Martin points to the evidence that inexpensive mental health programmes in the workplace are cost-effective. “Mental health at work should be addressed through a public health perspective: positive mental health will benefit employees, employers and society as a whole,” she says. “There is a need to raise awareness about the importance of the issue: we all have mental health, including at work.”

For Belgian psychologist David Vandenbosch, increased professional mobility and new media are some of the reasons why burnout has become frequent. “Even for people who welcome change, a new job is stressful. Smartphones, laptops, the fact we’re supposed to be reachable around the clock, they all mean our system can never switch off,” he says.

Vandenbosch, the co-founder of stress management clinics in and around Brussels, works on building resilience within businesses as well as individuals, and he recognises that laws don’t go far enough. “A new code on employee wellbeing provides psychosocial audits for those susceptible to stress in the workplace. If you ask people to work a lot, you need to give them the means to do so, so we try to make managers aware of not continually applying pressure on employees.”

The new classification of burnout has had an additional benefit. “Employers once worried about taking on someone who had suffered it now find that a person with experience of chronic stress is much more solid and can be a positive element in a team,” he says. “They are more efficient and know about things like setting personal limits.”

Work-life balance

Clinical psychologist Nicole Josephson has a similar experience of workplace issues and regularly treats burnout sufferers as a therapist at the Community Help Service (CHS) in Brussels, a mental health service and helpline for the international community, as well and private practices in Brussels and Antwerp. She pinpoints young and ambitious expat professionals as classic burnout victims. “They put everything into their work and as they come from another country, they don’t yet have a social circle, which makes it harder to keep that all-important work-life balance. I think there are a lot of careers in Brussels where people feel they should be available around the clock.”

Josephson notes that it’s more socially acceptable to admit to burnout than having a nervous breakdown or depression. There are also underlying factors to the condition. “It’s common to have unhealthy relationships at work or a relationship that has been provoking a memory of one that is problematic, she says.

“Personality factors include being anxious, which tends to make you more perfectionistic, hard-working and ambitious. Having difficulty expressing your discomfort and liking being in control predispose you to overwork, leading to your whole world becoming skewed as all your energy goes into one place. If work is problematic and you cannot find satisfaction in another are or in another relationship to help counterbalance this, all you are getting is reinforcement of your work identity.”

While there’s a possibility of burnout in all jobs and levels of responsibility, it usually occurs when you don’t have a sense of control. “It helps when you feel you can make decisions for yourself, decide on your own projects,” says Josephson. She believes managers are more susceptible when they have to report to someone else or if they have difficulty managing their team. “I’ve seen a lot of people burn out if their authority is disregarded, if they don’t feel they can move their staff in the right direction, if they take their job seriously and want to make a difference,” she says.

'Learning to walk again'

While some cases are less severe, recovering from burnout can be lengthy. “Some people can get over it quite quickly, but others may need at least a year, especially if they have ignored their own internal messages that things are going wrong. Recovery may be devastating and in a psychological sense is almost like learning to walk again,” says Josephson.

There are wider implications for expat families. “At CHS we treat children, adults and families. With children, we see a lot of anger at being moved and leaving friends. They pick up on tension and stress in the family even if it’s not verbally expressed, which can be a surprise for parents and difficult for them to know how to cope with,” she says.

While Josephson thinks Belgium has been slow to recognise psychotherapy as a profession and the importance of supporting people in the workplace, “reflecting the national bias not to talk about problems”, she has noticed a changing attitude. “It’s maybe a swinging of the pendulum, but we are seeing more people in Belgium taking parental leave and working shorter hours. Millennials in particular are questioning the work ethic of the older generation and showing more of an interest in traditional values and going back to nature, so there is some optimism for the future,” she says.

This article first appeared in ING Expat Time