In this last episode of our mini-series on long-term absence, we will zoom in on probably the most common current ground for long-term absence in Belgium, which is burn-out.

Burn-out was in the Belgian press again recently because of a decision in the Antwerp Employment Court that it is discriminatory for a health care insurer to limit payments to two years for disability arising from mental disorders, personality disorders, chronic fatigue syndrome or fibromyalgia, where for other physical disorders it had not imposed any such time limitation. The rationale behind it was that two years is a feasible recovery time for mental disorders, whereas for physical illnesses, the recovery time is usually shorter such that an upper limit was not necessary. The Court did not accept this argument and considered the distinction to be discriminatory.

The professional association of insurance companies, Assuralia, has already announced that it will review the decision and take the necessary measures, which will almost inevitably include insurers increasing the cost of this type of insurance or alternatively imposing a two year cap on all new claims irrespective of the type of illness.

Assuralia’s concern about the decision is warranted, as the number of burn-out cases in Belgium has increased 66% from 2018 to 2021. Seen at face value, that is very surprising. Surely the increased scope provided by the pandemic for flexible working, choosing your own hours, avoiding rush-hour, etc., should all mitigate against burn-out? And yet the numbers show a different story. Experts are calling for adjustments to the organisation of work and to employment conditions in order to fight this new pandemic.

The Belgian National Labour Council (NLC) has also pitched in on the topic in a recommendation for primary prevention, to avoid employees from dropping out with psychosocial complaints in general and burn-out in particular. This recommendation, Nr. 30 of 8 November, does not make for the most fascinating reading so we have taken it upon ourselves to summarise the main takeaways from it.

The NLC starts by reminding employers that they have a legal obligation to address any risk of burn-out in their employees. The Code on Wellbeing at Work provides that every employer must identify situations that may give rise to psycho-social risks at work, determine those risks (of which burn-out is just one) and evaluate them. Based on this risk assessment, an employer should take appropriate preventive measures to minimise so far as practicable the risk of employee burn-out (primary prevention).

The NLC gives six recommendations for the terms of a solid primary prevention policy to reduce the risk of burn-out:

Recommendation 1: An integrated and multidisciplinary approach

The priority in an employer’s prevention policy should always be primary prevention measures. Research has shown that wellbeing approaches to burn-out need to target the organisational structure to yield true primary prevention. This priority on the organisational also avoids the individualization of the problem, which is not only unhelpful but also contributes to the taboo surrounding burn-out and can also create resistance to the adoption of measures.

The organisational-level approach is thus best combined with attention to the resilience of individual employees. These can include training to increase knowledge and awareness of the issues of psychosocial risks and the work situation, as well as measures aimed at bringing about behavioural change. Special attention should also be paid to awareness-raising, education and behavioural change among managers. However, burn-out is undoubtedly also an individual question – some people have higher tolerances than others and even people of similar resilience can be affected in different ways if their own circumstances are different, e.g. if they have additional pressures at home or feel unappreciated, unrecognised or unfairly treated relative to others. Burn-out is absolutely not a question of workload in isolation.

Recommendation 2: Prior commitment to creating strong internal support

It is essential that primary prevention of burn-out has strong internal support before the policy is rolled out in the company. There is no benefit to fine words and understanding from HR and line management if senior management is clearly not interested in anything but outputs.

Recommendation 3: A tailor-made situation analysis and approach

Every policy should start from an analysis of the company’s specific situations and weak spots. A one-size-fits-all approach will simply not cut it. Acquiring knowledge on these company-specific bottlenecks will be the first challenge. Surveys and interviews with current and former employees will be an important step to fully understanding the problem, to which you could maybe sensibly add anonymised analysis of staff grievances and exit interview notes to uncover any recurring issues.

Recommendation 4: The approach should be embedded in the longer-term strategic policy of the company

The structural embedding of attention to burn-out in an integrated prevention policy can help guarantee the necessary resources (time, money, people), attention and multidisciplinary approach needed for burn-out prevention.

Planned actions for burn-out prevention are to be included in the employer’s broader annual action plan. This feeds into the global prevention plan which spans 5 years and should be continuously adjusted depending on the results of the implementation of the annual action plan.

Recommendation 5: Bottom-up participation and dialogue: the crucial role of employees

No policy will work if not supported by the employees and their representatives. The NLC recommends setting up a multidisciplinary taskforce and involving the employee representatives of the Health & Safety committee, works council or union delegation in every phase of the project.

Recommendation 6: The important role of expertise from the sectors

Sectoral support will make it possible to share best practices throughout the industry and an external perspective can help achieve a cultural shift, stay on track or support a broader vision of primary prevention.

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Are these recommendations ground-breaking or never-would-I-have-come-up-with-these-myself innovative? Hardly. The greatest merit of the NLC’s report is probably that it reminds employers that they have a legal obligation to address the risk of burn-out in their company, and that it offers something of a step plan to take on this challenge. With harassment and other types of psycho-social risks at work, we are already seeing current or former employees sue their company for not having done enough in terms of prevention. It is a given that burn-out will be next.