Icon info
Preventing sick leave, burnout and psychosocial…
Back to overview
Mental health 1
Human Resources

Preventing sick leave, burnout and psychosocial distress in the workplace: what does work?

Over the past decades, the focus on mental well-being in the workplace has been growing slowly but steadily. After the acceleration that covid brought on, and with the tight labor market in mind, more and more organizations are launching initiatives to give their employees a mental boost. Unfortunately, they are usually organized from a (well-meaning) gut feeling, rather than opting for avenues with scientifically proven effect.
by Eva Geluk, Kathleen Vangronsvelt, PhD | December 15, 2022
Share item
Mental health 1

Proliferation of wellbeing interventions

Some of the offerings: water and fruit subscriptions, yoga classes, and resilience training, ... In other words, there is a proliferation in the well-being intervention industry (Pijpker, Vaandrager, Veen, & Koelen, 2019) (Karkkainen et al., 2017; Karlson et al., 2010; Rooman et al., 2021; Salami & Ajitoni, 2016). The common thread in proposed interventions is often a certain ‘feel-good level’, a gut feeling that this should help.

Yet in Belgium, between 2016 and 2020, there was a 32,53% increase in long-term sickness due to burnout. On a human level, this is obviously a tragedy. Needless to say, it also puts pressure on our structures: the RIZIV records a 22,33% increase in costs in terms of social allowances. And the problem is not solved when people have 'recovered': 50% are afraid of relapsing, and for as many as 25% this actually happens (Geluk, Lenstra, & Stuer, 2000; Koopmans et al., 2011; Norder et al., 2015).

The problem is crystal clear: employers have the best intentions, but their interventions often do not work. So what does research tell us about what does work? We have listed three elements that may be keys to more successful support of employee mental health, through a focus on absenteeism.

What does work?

Priority 1: A holistic view of a complex playing field.

Sick leave due to psychosocial reasons can have multiple causes. Job content may be a direct cause: little autonomy plus a continuously high workload, for example, can lead to stress-related absenteeism, such as burnout. Personal health may be another cause, for instance, if someone has experienced previous, recurrent episodes of illness or has generally fragile health. In addition, gender, education level and personality play a role (de Vries et al., 2018). The consequence of this complexity is that you need to know what exactly is going on, before engaging in well-meaning but ineffective initiatives. If the job content is the cause, it makes no sense, for instance, to offer a yoga class or water and fruit subscription. After all, since those do not solve the fundamental problem.

"More and more companies realize that employees stay active and productive longer if they feel good in their jobs and at work. This 'feeling good' is a puzzle with a multitude of pieces. When personal aspirations, competences and values match the work content and the work environment and are supported by healthy leadership, employees feel they are doing something meaningful and making an effective contribution. That puzzle will often have to be done again to prevent absenteeism."

— Siviglia Berto, Managing Director of B-Tonic, subsidiary of Baloise

Priority 2: A clear route plan is crucial for a successful return to work.

Many companies do not have a real 'policy' for that yet. The following components make such a route plan a success: appointing a neutral supervisor (someone other than the person in charge) (Eskilsson, Norlund, Lehti, & Wiklund, 2021) (Dol et al., 2021) (Rooman et al, 2021); engaging in dialogue and discussing difficult topics, such as mental health; setting up training for the supervisor and the team, not just the individual; and exploring job crafting (de Vries et al., 2018; Eskilsson et al., 2021; Joosen et al., 2021; Mikkelsen & Rosholm, 2018; Pijpker et al., 2019; Smith et al., 2020).

From the start of the reintegration legislation in 2017, bpost chose to appoint a neutral supervisor within its psychosocial prevention service. This supervisor helps employees and managers follow up on reintegration processes, and forms the bridge between management and the occupational doctor. In addition, bpost started a pilot project in 2022 to optimize 'actively keeping in contact' with the long-term sick, for example to enable personalized work reintegration. This follow-up also enables the organization to detect certain aspects of employee absence, which, in turn, can lead to the installation of preventive actions at group level.

— A practical example

Priority 3: Provide managers with the necessary tools and skills to prevent employee dropout.

We know that there are roughly four mechanisms in which the manager can have an impact on employee dropout (Lokke, 2022). We also know that managers can be trained to strengthen their influence on not dropping out (Saruan et al., 2019). Only, we see that the interventions available today do not achieve their effects (Danheim et al., 2021; Kuehnl et al. 2019).

"We find that organizations that want to prevent employee absenteeism completely and that want to maximize employability, have every interest in supporting managers in their dealings with employees. Clear agreements and trust go hand in hand. Engaging in formal, but warm dialogue creates a positive dynamic. This allows people to think in terms of possibilities rather than limitations."

— Bart Teuwen, absenteeism expert at Mensura group

Antwerp Management School, Bpost, Mensura en B-Tonic (a subsidiary of Baloise) joined forces to develop solutions for successful reintegration and prevention. By putting theory into practice and measuring the impact, we are building an arsenal of interventions that actually work. For everyone.


  • de Vries et al. (2018). Determinants of Sickness Absence and Return to Work Among Employees with Common Mental Disorders: A Scoping Review. Journal of Occupational Rehabilitation, 28(3), 393-417. doi:10.1007/s10926-017-9730-1
  • Dannheim, I., Ludwig-Walz, H., Buyken, A. E., Grimm, V., & Kroke, A. (2021). Effectiveness of health-oriented leadership interventions for improving health and wellbeing of employees: a systematic review. Journal of Public Health, 1-13.
  • Dol, M., Varatharajan, S., Neiterman, E., McKnight, E., Crouch, M., McDonald, E., . . . MacEachen, E. (2021). Systematic Review of the Impact on Return to Work of Return-to-Work Coordinators. Journal of Occupational Rehabilitation, 1-24.
  • Eskilsson, T., Norlund, S., Lehti, A., & Wiklund, M. (2021). Enhanced Capacity to Act: Managers’ Perspectives When Participating in a Dialogue-Based Workplace Intervention for Employee Return to Work. Journal of Occupational Rehabilitation, 31(2), 263-274. doi:10.1007/s10926-020-09914-x
  • Joosen, M. C., Lugtenberg, M., Arends, I., van Gestel, H. J., Schaapveld, B., Terluin, B., . . . Brouwers, E. P. (2021). Barriers and Facilitators for Return to Work from the Perspective of Workers with Common Mental Disorders with Short, Medium and Long-Term Sickness Absence: A Longitudinal Qualitative Study. Journal of Occupational Rehabilitation, 1-12.
  • Karkkainen et al. (2017). Systematic review: Factors associated with return to work in burnout. Occup Med (Lond), 67(6), 461-468. doi:10.1093/occmed/kqx093
  • Karlson, B., Jönsson, P., Pålsson, B., Åbjörnsson, G., Malmberg, B., Larsson, B., & Österberg, K. (2010). Return to work after a workplace-oriented intervention for patients on sick-leave for burnout-a prospective controlled study. BMC Public Health, 10(1), 1-10.
  • Kuehnl, A., Seubert, C., Rehfuess, E., von Elm, E., Nowak, D., & Glaser, J. (2019). Human resource management training of supervisors for improving health and well‐being of employees. Cochrane Database of Systematic Reviews(9).
  • Løkke, A.-K. (2022). Leadership and its influence on employee absenteeism: a qualitative review. Management Decision.
  • Mikkelsen, M. B., & Rosholm, M. (2018). Systematic review and meta-analysis of interventions aimed at enhancing return to work for sick-listed workers with common mental disorders, stress-related disorders, somatoform disorders and personality disorders. Occupational and environmental medicine, 75(9), 675-686. Retrieved from https://oem.bmj.com/content/75/9/675.long
  • Pijpker, R., Vaandrager, L., Veen, E. J., & Koelen, M. A. (2019). Combined Interventions to Reduce Burnout Complaints and Promote Return to Work: A Systematic Review of Effectiveness and Mediators of Change. Int J Environ Res Public Health, 17(1). doi:10.3390/ijerph17010055
  • Rooman, C., Sterkens, P., Schelfhout, S., Van Royen, A., Baert, S., & Derous, E. (2021). Successful return to work after burnout: an evaluation of job, person-and private-related burnout determinants as determinants of return-to-work quality after sick leave for burnout. Disability and Rehabilitation, 1-10.
  • Salami, S. O., & Ajitoni, S. O. (2016). Job characteristics and burnout: The moderating roles of emotional intelligence, motivation and pay among bank employees. Int J Psychol, 51(5), 375-382. doi:10.1002/ijop.12180
  • Saruan, N. A. M., Yusoff, H. M., Puteh, S. E. W., Fauzi, M. F. M., & Manaf, M. R. A. (2019). Organisational Intervention on Absenteeism among Workers: A Systematic Review. Jurnal Pengurusan(57).
  • Smith et al. (2020). Are there differences in the return to work process for work-related psychological and musculoskeletal injuries? A longitudinal path analysis. Social Psychiatry and Psychiatric Epidemiology, 55(8), 1041-1051. doi:10.1007/s00127-020-01839-3

Share article

About the authors

Related content

Boogkeers campus AMS management school

AMS insights