Burnout Becomes an Occupational Phenomenon in the ICD–11

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The World Health Organization stated its intention to include job burnout in its 11th version of the International Classification of Diseases (ICD-11) to be officially implemented in January 2022. Although this is a classification of diseases, WHO has made a follow-up announcement to clarify that burnout is not a disease, but an “occupational phenomenon.”

WHO defined burnout as, ‘chronic workplace stress that has not been successfully managed.’ The definition took a stand on contested issues regarding burnout by defining burnout as a syndrome of exhaustion, cynicism, and inefficacy rather than as just another name for exhaustion. WHO further implicitly distinguished burnout from depression that has long-standing definitions with the ICD and explicitly stated burnout as connected to the workplace rather than as a general life malaise.

This move opens new avenues for supporting individuals and organizations experiencing burnout. Inclusion in a disease classification allows policy shifts to provide financial support to therapeutic interventions intended to alleviate burnout. It also increases possibilities for people to gain disability coverage when burnout interferes with their capacity to work effectively.

But there are potential downsides.

It is hard to find a way to medicalize burnout to a greater extent than including burnout in a disease classification, even if one cautions that it is an occupational phenomenon. Many have noted limitations of medical approaches to life problems; for a recent example, see Barbara Ehrenreich’s, Natural Causes: An Epidemic of Wellness, the Certainty of Dying, and Our Illusion of Control. Identifying a condition as something like a disease implicitly locates the problem within the person, while burnout is best seen as a breakdown of the working relationship of people with their workplaces. There is a risk of interpreting the phrase, ‘not been successfully managed,’ as a personal failure of individuals, giving workplaces a free pass. Such interpretations would put all the focus on building employees’ resilience to tolerate incompatibly managed workplaces rather than improving the working relationship. The clarification of ‘occupational phenomenon’ helps but needs further exploration to make a difference.

Even more ominous is an implicit invitation for pharmaceutical relief that would further delegitimize employees’ position vis-à-vis shortcomings in their workplaces.

So, this move is momentous with many upsides. But it reaffirms the responsibility of researchers and organizational practitioners to promote broad perspectives on burnout as context dependent. It is important to recall that the major global increases in lifespan over the previous century had more to do with public health initiatives for clean water and the like, than specific therapeutic treatments. So, improving workplaces is the long game.

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