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Breathe in the A.I.R.

Published 28 June 2021 in Magazine ‚ÄĘ 8 min read

Alyson Meister and Dominik Breitinger offer a model for what individuals, leaders and organizations can do to boost wellbeing post-COVID. 

Closely trailing in the wake of the COVID-19 pandemic is a global mental health crisis. Declining mental health in the form of increased stress, anxiety, emotional exhaustion, depression and burnout, not only infiltrate our minds, homes, and places of work, but have dire financial implications for organizations and economies alike.  

It is no surprise that the WHO has included mental health amongst its sustainable development goals; the organization reports that 25% of the population currently suffer from depression or anxiety, suicide is now the second leading cause of death among 15 to 29-year-olds, and up to 50% of chronic sick leave at work is due to mental-health related issues. In the UK, stress, depression or anxiety account for 44% of all work-related ill health cases and 54% of all working days lost due to ill health. Similar numbers and trends are being reported across all industrial economies.  

These¬†already-alarming¬†effects have been exacerbated¬†due to¬†the¬†COVID-19¬†pandemic.¬†During the pandemic,¬†around‚ÄĮfour¬†in 10‚ÄĮadults (in the US)¬†reported¬†symptoms of anxiety¬†or¬†depressive disorder, up from‚ÄĮone in¬†10‚ÄĮin 2019.¬†In¬†Switzerland,¬†stress¬†and¬†depression¬†have¬†increased sharply across society since¬†2019. A¬†recent¬†global¬†survey¬†of 1,500 people from 46 countries shows¬†that,¬†overall,¬†perceived¬†well-being has declined by 85% in the past year,¬†and people are experiencing¬†increases in¬†loneliness and isolation,¬†as¬†well¬†as¬†stress¬†and¬†job demands, resulting in¬†growing disengagement at work.¬†Further, these devastating effects are disproportionally felt by¬†women and minorities, wreaking havoc on advances with respect to diversity¬†and inclusion¬†in organizations and leadership¬†across the globe.¬†¬†¬†

This has resounding consequences for not only individuals themselves, but for employers, insurance providers, economies and nation states. Lost productivity due to mental illness in Europe totals $140 billion a year and is forecast to contribute to $16 trillion in lost output globally by 2030. However, on the positive side, the World Economic Forum estimates that for every $1 spent caring for people with mental health issues, $4 are returned to the economy. Declining mental health is an epidemic that we simply cannot ignore, and organizations and their leaders have a critical role to play. 

So where do we start?  What can you do to address this?  On the following pages, we offer three steps that you can take, the A.I.R. framework, as individuals and leaders in organizations to begin to acknowledge, investigate and respond to mental health issues at work. 



The stigma attached to stress and mental health, and the pervasive myth that leaders must always project strength and invulnerability can leave mental-health difficulties neglected, ignored or downplayed. Further, there remains a huge disconnect between employee and employer perspectives on mental health at work. But unfortunately, when left unacknowledged and unattended, ongoing chronic stress, anxiety, and the cycle of overwork, can ultimately lead to severe illnesses, sick leave, burnout, and turnover of your best employees.  

So,¬†the first step is¬†becoming¬†aware¬†of¬†the¬†tipping point¬†‚Ästthat¬†point when moderate¬†(and sometimes¬†even¬†motivating)¬†levels of stress,¬†become¬†chronic¬†and depleting. This¬†involves¬†both¬†self-reflection¬†and recognition¬†of your¬†own¬†mental¬†and physical¬†state,¬†and an¬†exploration of the ‚Äėstate‚Äô of the team,¬†and ultimately the¬†organization.¬†¬†

At the individual level, symptoms¬†of worsening chronic stress¬†can¬†manifest in¬†several ways.¬†Sometimes,¬†these signs slowly surface, so that they can even feel¬†‚Äúnormal‚Ä̬†for quite some time.¬†¬†For example:¬†

  • Physical signs:¬†rapid and irregular heartbeat,¬†increased blood pressure,¬†headache,¬†stomach¬†ache, change in appetite, panic attacks, fatigue,¬†insomnia or interrupted¬†sleep;¬†
  • Mental and emotional signs: irritability, sadness, helplessness, boredom,¬†cynicism,¬†resignation,¬†‚Äúbrain fog‚ÄĚ,¬†indecision, forgetfulness,¬†and¬†lack of¬†focus;¬†
  • Behavioral signs: compulsive use of alcohol, stimulants or food¬†to cope, change in behavioral patterns,¬†more extreme and easily triggered¬†fight or flight¬†reactions, heightened sarcasm and criticism¬†of others.¬†

You may also experience¬†notable¬†signs¬†in yourself¬†(and others)¬†of burnout¬†at work. The¬†WHO¬†highlights that those who are experiencing burnout suffer (a)¬†ongoing¬†feelings of energy depletion or exhaustion, (b) increased mental distance from¬†their¬†job, or feelings of negativism or cynicism related to¬†their¬†job, and (c) reduced professional efficacy¬†at work¬†(e.g., how satisfied you feel with¬†even your most positive¬†accomplishments).¬†For example,¬†in an interview,¬†one¬†senior¬†investment banker mentioned ‚Äúwhile I¬†should¬†be excited about my latest deal¬†that I worked so hard for,¬†these days¬†I just can‚Äôt¬†find¬†the energy to even really care anymore.‚Ä̬†Importantly, those at risk¬†of¬†burning out may be very committed¬†top performers¬†that remain silent about their struggle.¬†¬†While¬†we all experience¬†these¬†symptoms and¬†feelings¬†towards our work¬†at some point,¬†if this is an ongoing and unrelentless experience,¬†you‚Äôll need to¬†take action.¬†¬†


The most likely causes of chronic stress and burnout at work lie at the cultural and systemic level, not on the shoulders on those individuals experiencing it. Thus while it’s necessary to treat the symptoms of stress and burnout, as a leader it is critical to investigate the underlying root causes, so you can better address the cause, and ultimately the mental health needs of your team. 

What might some of these root causes be? Through decades of research, Maslach and Leiter highlight six predictors of workplace burnout:  unmanageable workload; lack of a sense of control or authority over one’s own work and environment; insufficient rewards or appreciation for one’s contributions, lack of community or sense of inclusion and belonging, little perceived fairness in decision-making, and underlying employee values-conflict with the organization. Adding to this, in a survey of 7,500 full-time employees, Gallup adds: lack of role clarity, and inadequate communication from senior management.  

The¬†new normal¬†of¬†life during¬†COVID-19¬†has¬†clearly¬†exacerbated some of these levers¬†of stress and burnout, as well as triggering new ones.¬†People are working¬†longer¬†hours,¬†yet¬†finding¬†themselves¬†less¬†on top¬†of¬†things. Working hours alone have long been associated with declines in quality of sleep and¬†mental health.¬†In the era of the¬†home office, it‚Äôs¬†difficult¬†to retain¬†work-home¬†boundaries, develop¬†a sense of work community, or feel recognized for the hard work you‚Äôre doing.¬†Further, this is exacerbated by the silent¬†grief¬†and ongoing uncertainty confronting many¬†of us.¬†Having surveyed over 300 executives at IMD over the past year,¬†constant¬†time pressure,¬†lack of social¬†work¬†interaction¬†and blurred boundaries¬†were¬†the¬†most commonly¬†noted¬†chronic stressors.¬†As one executive mentioned:¬†‚ÄúI¬†rallied¬†all of my¬†energy¬†for the first year¬†of COVID, but now, it feels I have nothing left to¬†give;¬†it‚Äôs¬†relentless‚ÄĚ.¬†



While the situation is alarming, with awareness and action we can take collective action and turn a vicious cycle into a virtuous one.  What can you do to confront chronic stress and pending burnout? Tied to some of the root causes you’ve identified for this, there are a few steps that you might take as an individual or a leader in an organization. Addressing stress and burnout requires a multi-faceted approach Рin reality, there will be a combination of these (see boxes) that together can address this ongoing challenge.  

A failure to acknowledge the importance of mental health can hurt productivity, relationships, and ultimately the bottom line. Yet, this vicious cycle can be interrupted; with awareness, investigation and intentional response, we can support our people, organizations, and the broader community to thrive through the pandemic and beyond.   

A stress-free guide to beating burn-out 


As an individual 

  • Cultivate a¬†stress mindset; when it‚Äôs possible try to reframe stressful episodes as enhancing and¬†positive; levels of stress can also prepare you for optimal performance.¬†
  • Identify a range of self-care tactics that work for you, which you can employ regularly.¬†Reflect on your physiology and your mind-body connection. There are certain¬†hormones¬†that contribute to feelings of well-being that you might try to stimulate. The role of exercise,¬†intentional breathing¬†and¬†sleep¬†cannot be understated as well in self-regulation and restoration during times of stress.¬†
  • Learn to¬†recognize your own stress¬†tipping point¬†and¬†early¬†burnout¬†indicators;¬†¬†
  • Explore the¬†levers of burnout at work: Do you feel the hours you are putting in are sustainable? Do¬†you feel valued, appreciated, included? Do you consider your work meaningful and purposeful?¬†Is there something you can do to move one of these needles?¬†
  • Define and¬†stick to¬†your¬†important¬†boundaries¬†and values¬†‚Ästat¬†work and¬†offline,¬†to¬†realize¬†of¬†all of¬†your important identities¬†that might have been relegated to the¬†back-burner.¬†
  • If you are comfortable, share your¬†stress and burnout¬†concerns¬†with someone¬†trusted¬†in your organization¬†‚Äď ideally your manager¬†or an HR representative¬†
  • If your mental health is already destabilized¬†and overwhelming, consult a specialized physician for advice and¬†guidance.¬†Coaching or therapy can¬†be highly supportive¬†to prevent chronic stress becoming¬†pathological.¬†¬†

As a leader of others  

  • As a leader,¬†recognize the¬†important¬†role you play¬†in the¬†mental-health¬†of your employees.¬†¬†You are a role model (whether you like it or not).¬†How do you lead?¬†What do you celebrate? What do you role model?¬†What conversations do you ignite¬†and¬†what kind of¬†relationships do you develop?¬† Reflect on how¬†you¬†are¬†“being‚Ä̬†at work, because people are watching.¬†
  • Cultivate¬†your ability to show¬†vulnerability,¬†empathy, and compassion for others¬†so¬†to build¬†psychological safety, the foundations of effective teams and leadership.¬†
  • Have the¬†conversation¬†and¬†have¬†candid¬†check-ins¬†regularly with your people: It is surprising what you can learn when you¬†actually¬†ask¬†how others are feeling, and¬†how¬†their stress might be best addressed. Avoid making assumptions based on outward performance¬†and appearance ‚Äď acknowledge the individual cognitive behavioral diversity in action and reaction.¬†
  • Explore the foundations of burnout in your team culture: are there small shifts you can make to make a difference when it comes to recognition, or perceived fairness? Workload management?¬†Is it communication that your people need?¬†¬†
  • Support your people to¬†manage their¬†workload¬†and time boundaries.¬†Do¬†others¬†know what‚Äôs expected (and not expected) of them?¬†¬†Workload¬†skyrocketed¬†during times of covid¬†among your most dedicated¬†employees,¬†but¬†is not¬†necessarily¬†sustainable.¬†¬†

As an organization overall 

  • Make a¬†genuine, transparent and¬†consistent¬†commitment¬†to¬†mental-health¬†at¬†work,¬†develop¬†and communicate¬†a¬†tangible¬†strategy,¬†and dedicate resources¬†to¬†this.¬†How will you¬†get¬†started?¬†¬†
  • Through¬†ongoing¬†quantifiable pulse-checks,¬†discover¬†what is happening with your workforce.¬†Identify¬†(and¬†address)¬†early warning signs¬†when it comes to the¬†various¬†systemic levers of burnout.¬†If you track where you stand, you can also¬†track positive change¬†and what works; it won‚Äôt be the same for your entire workforce and different strategies can work for different groups.¬†
  • Recognize and reward progress¬†throughout the organization:¬†How will managers be held accountable ‚Äď and celebrated – for the¬†culture¬†they¬†cultivate and role¬†model in their teams, not just their team‚Äôs performance¬†results?¬†¬†
  • Provide employees and managers¬†with¬†the training,¬†tools, and support¬†needed¬†to identify and address mental-health concerns in the workplace.¬†What do you have available now? What resources can you consolidate and communicate?¬†
  • Care for your culture: (how) do you value your employees?¬†Do you notice and express appreciation for their individual contributions¬†and whole identity? Who¬†is considered to be¬†super employee/hero and why?¬†What level of¬†equity and¬†inclusion do people feel across the business?¬†¬†An open, stigma-free¬†culture about mental illness will¬†manifest such spirit¬†itself.¬†


Alyson Meister - IMD Professor

Alyson Meister

Professor of Leadership and Organizational Behavior at IMD

Alyson Meister is Professor of Leadership and Organizational Behavior and Director of the Future Leaders program at IMD Business School. Specializing in the development of globally oriented, adaptive, and inclusive organizations, she has worked with of executives, teams, and organizations from professional services to industrial goods and technology. She also serves as co-chair of One Mind at Work’s Scientific Advisory Committee, with a focus on advancing mental health in the workplace. Follow her on Twitter: @alymeister.

Dominik Breitinger

Head of Innovation and Partnerships at E4S

Dominik Breitinger is Head of Innovation and Partnerships at Enterprise for Society Center (E4S), created jointly by the University of Lausanne, EPFL and IMD. He has 15 years of cross-industry business experience from managerial roles in strategy consulting to international organizations  including the WEF and WBCSD.


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