Mental-Health Days Are Only a Band-Aid for Burnout

Workers don’t need a new type of sick day. They need sustainable jobs.

A depleted-battery symbol over a calendar
Erik Carter / The Atlantic; Getty

Two and a half years into the pandemic, burnout is still here. It is reportedly widespread across industries such as medicine, teaching, and child care; by some measures, workplace stress has only increased even as day-to-day routines have looked more “normal.” To cope, Americans—especially younger generations—are turning to the “mental-health day”: an occasional day off, perhaps with little advance notice, justified as necessary for maintaining well-being. It is, in principle, a sick day for the mind.

Companies have begun to respond: Some are rebranding sick days as “wellness days,” which employees can take for physical or mental health. One survey of 455 employers found that 30 percent intend to offer mental-health days within the next two years, compared with 9 percent that do so now. The concept of the mental-health day has even found its way to schools. The website Parents recently published results of a survey showing that 56 percent of parents have allowed their children to take time off from school for their mental health, with another 32 percent willing to consider it.

But a mental-health day, although well meaning, is no permanent solution to the chronic exhaustion, cynicism, and feelings of ineffectiveness that are the markers of burnout. An occasional extra day off also cannot reach below the surface to where conditions such as anxiety and depression reside. If we want to improve workers’ mental health and address widespread burnout, we need to make much bigger changes to the American way of work.

It’s true that working less, in general, can help prevent burnout. That’s because workload is one of the six major aspects of a job in which a “mismatch” between a person and their work can lead to burnout, according to the psychologists Christina Maslach and Michael P. Leiter, the authors of the new book The Burnout Challenge, who have been at the forefront of burnout research for decades. Other researchers have found that taking more days off a month is associated with a lower prevalence of burnout in health-care workers. A 2014 study found that doctors in Japan who had two to four days off a month were at more than triple the risk of burnout compared with those who had eight or more days off.

But the first problem with the mental-health day is that no one seems to agree on the specifics of what it is. For some workers, it’s an official pool of paid time off they can draw from at will. Others, whose employer’s policy perhaps doesn’t offer such time off, claim the occasional mental-health day as a kind of de facto sick leave. Either way, the fundamental issue is that the odd day off is not the same as a consistently lighter schedule. It’s a Band-Aid fix, not a long-term solution that would actually make a worker’s day-to-day life more manageable. It might not even reduce someone’s workload, if they have to overburden themselves catching up after—or before—their rest. “Occasional mental health days are good things,” Leiter told me in an email, “but they have little impact on burnout. If people are going back to the same mismatches that have brought them to burnout, a bit of time off will be a nice bit of fluff.”

We might think of a mental-health day, then, as a form of workplace avoidance dressed in the language of self-care. One of the only academic papers on workers taking mental-health days looked at nurses and midwives in the Australian state of New South Wales, which includes Sydney. The researchers found that nurses who said they had taken what they described as a mental-health day in the previous 12 months were more likely to be shift workers, to spend much of their working hours on their feet, to have endured workplace abuse, and to feel they have accomplished less at work because of emotional problems. In short, the nurses who took mental-health days were having serious difficulties at work—and unsurprisingly had 55 percent greater odds of planning to leave their job. In this case, employees’ need for a mental-health day signified a bigger problem in the workplace.

The Australian nurses who took mental-health days also had 42 percent greater odds of experiencing symptoms of a common mental disorder, such as anxiety and depression. Taking individual days off as the only way to address such symptoms can be its own kind of risk. Saige Subosits, a psychotherapist in Pittsburgh, told me that mental-health days are not a “quick fix” for people with anxiety or obsessive-compulsive disorders. In fact, if they avoid their job out of fear without taking other steps to treat their condition, returning to the workplace might become even harder, Subosits said. She added that going to therapy can be a healthy reason to take regular time away from work. But it’s the therapy, not the time off, that helps someone’s condition improve.

The core issue is that mental-health days are an in-between concept, inadequate to address two quite different problems. People with common mental illnesses benefit most from sustained treatments such as therapy, not the occasional day off. In addition, everyone deserves to have sufficient vacation days to actually recharge—and a culture of taking time off without apology. Perhaps the rise of mental-health days reveals that we have so devalued leisure, we can justify time off only by appealing to an abstract and vague notion of wellness that will supposedly make us better workers.

Here’s another way to think about time off: “Any day off is a mental-health day,” Steve Unger, a 37-year-old telecommunications engineer in Little Rock, Arkansas, told me. Unger said he has no mental-illness diagnosis and feels no desire to avoid his work. “I don’t ever have that feeling that I just don’t want to do it today,” he said. When he takes what he calls a mental-health day, as he did eight Fridays in a row earlier this year, he might spend time with his family or go for a 10-mile run. Usually, he goes into such a day with “no intentions, no chores, no expectations of what I need to achieve during that day.”

Unger’s day-off activities align with today’s conventional wisdom about mental-health days: that people should spend them on classic leisure pursuits. In the survey published on Parents, only 23 percent of respondents whose kids took mental-health days said they spent some of the day seeing a mental-health professional; 37 percent of kids made art or music, and 30 percent spent time in nature.

For many students and workers, the mental-health day is simply a cry for time that’s not determined by work. In a Parents article reporting the results of the survey, one high-school student said that she feels like she can’t afford to take a mental-health day, even though her mother would allow it. “As an [International Baccalaureate] student, the thought of missing school is really terrifying,” the student said. Her daily volume of schoolwork seems impossible to make up after an absence. She said her coping strategy is to “just go until I have a little breakdown, and then I have to stop.”

If going to school is this intense, school needs to change, not the student. The same logic holds in the workplace. As John W. Budd, a professor of work and organizations at the University of Minnesota, told me in an email, mental-health days “don’t change, or even question, the nature of work that gives rise to excessive stress and other mental health challenges.”

To fix burnout on a large scale, then, we need to look at work itself. Employers should assign manageable workloads with plenty of built-in days off—Unger said he had seven personal days and 25 vacation days this year, and that his employer imposes few obstacles to taking them. As a society, we should also be open to trying new work structures—four-day workweeks, for instance, which can reduce burnout without sacrificing productivity. Time off from work is a good thing. But workers deserve something much better than a mental-health day: jobs that don’t strain their mental health in the first place.

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