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Breathe in the A.I.R.

Published 28 June 2021 in Magazine • 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 four in 10 adults (in the US) reported symptoms of anxiety or depressive disorder, up from one in 10 in 2019. ISwitzerland, 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 – that 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 ‘state’ 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 “normal” 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, “brain fog”, 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 “while I should be excited about my latest deal that I worked so hard for, these days I just can’t find the energy to even really care anymore.” 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’ll 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’s difficult to retain work-home boundaries, develop a sense of work community, or feel recognized for the hard work you’re 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: “I rallied all of my energy for the first year of COVID, but now, it feels I have nothing left to give; its relentless”. 



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 – in 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’s 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 – at 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 – 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” 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 – 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’s 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’t 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 – and celebrated – for the culture they cultivate and role model in their teams, not just their team’s 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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