A third of sickness absence in the Netherlands relates to work-related psychological complaints. That makes psychosocial workload not only the most common occupational disease but a subject no employer, HR professional or occupational physician can ignore. In 2025, 21 per cent of employees had burnout complaints, a significant rise on the 13 per cent in 2015. Stress on the floor leads not only to higher absence but to longer absence.
Work stress covers more than an overfull diary. According to RIVM, unwanted behaviour such as aggression, bullying, discrimination and sexual harassment also falls under psychosocial workload, as do problems in the balance between work and private life. These factors affect health, employability and cooperation within your organisation and form a risk to continuity. More than a third of employees think extra measures are needed, while 34 per cent of employers see work pressure as one of the most important occupational risks.
At Dokter Beter we recognise that work stress asks for more than individual resilience. Effective policy on psychosocial workload, a thorough risk inventory, attention to fitness for work and timely absence guidance all matter a great deal. In this article we set out how to recognise psychosocial workload and which steps you can take to prevent drop-out and strengthen sustainable employability.
What psychosocial workload covers in practice
For an employer's approach to work stress, it matters first to be clear about what psychosocial workload is. According to Arboportaal on psychosocial workload (in Dutch), it is stress arising from work pressure and unwanted behaviour, such as bullying, aggression and violence, discrimination and sexual harassment. RIVM also names problems in the alignment between work and private life, and far-reaching events at work, as contributors to stress.
That makes psychosocial workload broader than simply "being too busy". In practice we usually see a combination of factors:
- task demands that are too high, or constant time pressure
- little room to organise one's own work, or little influence over it
- unclear expectations or conflicting roles
- little support from managers or colleagues
- social insecurity or unwanted behaviour
- a long-running combination of work with informal care or private strain
For you as an employer that means policy on psychosocial workload belongs not only with absence guidance but in the daily design of the work. Anyone who only picks it up once someone drops out is late.
The legal obligations
An employer has not only a moral responsibility here but a legal one. The Working Conditions Act requires employers to pursue policy that prevents or limits psychosocial workload where it is a risk within the organisation. That policy has to be part of the wider working-conditions policy. The government page on making policy against psychosocial workload (in Dutch) and the Netherlands Labour Authority on work pressure and unwanted behaviour (in Dutch) are clear about that.
The basis lies in the risk inventory. In it you map:
- in which roles or teams psychosocial risks are in play
- which situations lead to work pressure or unwanted behaviour
- which causes lie under the problem
- which measures are needed
- how you review the effect of those measures
If psychosocial workload is missing from your risk inventory while it is in play, an important part of your risk analysis is missing. In our article on what a risk inventory and evaluation is and whether you are required to have one you can read how that basic obligation works within working-conditions policy. It also connects to the wider obligations under the Act, as we explain in what the Working Conditions Act means for employers in 2026.
Why early action pays off
The figures show why a preventive approach matters. According to TNO, 34 per cent of employers said in 2024 that work pressure is one of the most important occupational risks. More than half were working on an open culture to reduce psychosocial risks. At the same time, 21 per cent of employees had burnout complaints in 2025, while 15 per cent reported a stressful job according to the national working conditions survey by TNO and Statistics Netherlands.
Statistics Netherlands also shows that stressful work occurs more often in roles with a lot of responsibility and little room to organise one's own work. Employees with stressful work are absent more often and for longer. That matches signals from the NVAB that overstrain and burnout are among the most important causes of absence and cost employers a great deal every year.
For employers the consequences are concrete:
- a higher frequency of absence
- longer drop-out
- lower productivity and more mistakes
- more turnover
- more pressure on colleagues, which creates a vicious circle
Which is why it is wise to look not only at individual capacity but at how the work is organised. The NVAB emphasises that increasing resilience is valuable but not the only solution. When working conditions are structurally too tight, the risk remains.
How do you recognise the signals in time?
A good approach starts with spotting things early. That calls for attention to figures and to behaviour alike. Looking only at absence percentages is not enough, because by then you are often already a step behind.
Signals at the level of the organisation
Watch for instance for:
- rising short-term absence in particular teams
- structural overtime or many extra hours
- scheduling problems and difficulty filling gaps
- higher turnover or internal moves
- more reports of conflict, bullying or insecurity
- lower scores in employee satisfaction surveys
- complaints about work pressure, availability or the chance to recover
Signals in individual employees
Think of:
- irritability or emotional exhaustion
- concentration problems or more mistakes
- withdrawing, or conversely seeking conflict
- difficulty setting priorities
- regular absence through headaches, fatigue or sleep problems
- remarks such as "I am running behind" or "I have lost my grip on everything"
It matters that managers learn to recognise these signals and make them discussable. According to RIVM, little support from the manager goes together with more stress. Which is exactly why the quality of the conversation in teams matters so much.
What can you do preventively?
Prevention works best when you take measures at several levels: organisation, team and individual. The guide to psychosocial workload (in Dutch) offers practical footholds for that.
At the level of the organisation
At this level you can think of:
- a realistic division of tasks and staffing
- clear priorities from management
- a clear division of roles and responsibilities
- policy against unwanted behaviour with well-known reporting routes
- regular review of work pressure per department
- room for recovery, breaks and leave
- attention to hybrid working, availability and boundaries
An open culture helps, but only when it comes with adjustments to the work. If employees may freely say that work pressure is too high but nothing changes in planning or capacity, trust actually falls.
At team level
Within teams it helps to discuss regularly:
- what is causing the most pressure now
- which tasks could be dropped temporarily
- whether expectations are realistic
- how social safety stands
- where colleagues are missing support or alignment
The Social and Economic Council advises looking together with employees at exactly where high work pressure arises and then adjusting the division of work or the support. That sounds simple, but it calls for discipline and follow-up.
At individual level
Individual support can consist of:
- an early conversation with the manager
- coaching or guidance
- a referral through the occupational physician
- temporary adjustment of tasks or hours
- extra room to recover or adjusted goals
But individual measures are above all effective when the source of the strain is tackled as well.
The role of employee, manager and physician
An effective approach only works when responsibilities are clearly divided.
The employee
Employees may be expected to share signals in time, think along about solutions and keep to arrangements. That works better in a culture where reporting feels safe and is not seen as weakness or unwillingness.
The manager
The manager has a key role in prevention. They usually see changes in behaviour, performance or cooperation first. Important tasks are:
- opening the conversation without judgement
- making work pressure concrete
- helping to set priorities
- guarding boundaries
- passing signals on when support is needed
The occupational physician
The occupational physician looks independently at capacity, health risks and the relationship between work and complaints. In our article on what an occupational physician actually does you can read what that role looks like. When stress complaints are just starting, a physician can advise at an early stage on resuming work, adjusting tasks or further guidance. A walk-in clinic with the occupational physician can also help make problems discussable sooner, before any absence arises.
What to do when it leads to absence
When work stress or other psychosocial strain leads to drop-out, attention shifts from prevention to absence guidance and reintegration. You then face the obligations of the Gatekeeper Improvement Act. Timely steps matter there, such as the problem analysis by the occupational physician and the action plan between employer and employee.
With this kind of absence it is wise to ask not only what the employee needs in order to return but what has to change in the work to prevent a relapse. Otherwise someone returns to exactly the same risk factors.
Important points of attention are:
- distinguish between symptoms and causes
- make sure the build-up is feasible
- record arrangements well
- involve the occupational physician in time
- review whether work factors have really been adjusted
For the process side you can also look at our explanation of reintegration after long-term absence step by step. As cases get more complex, cooperation with the case manager, the manager and possibly an occupational and organisational expert plays a part as well.
From separate actions to structural policy
Many organisations respond to psychosocial workload with separate actions: a workshop, a coaching programme or a vitality week. That can help, but without structural policy the effect often stays limited. A mature approach consists of a fixed cycle:
- include psychosocial risks in the risk inventory
- analyse causes per team or role
- record measures in an action plan
- equip managers for spotting signals and holding the conversation
- make reporting routes and social safety clear
- measure effects periodically and adjust
That structural approach is exactly the line taken by Arboportaal, RIVM, the NVAB and the Labour Authority. For you as an employer it matters not only in order to meet legislation but above all to limit drop-out, unrest and long-running strain. For employees it means a safer and healthier working climate. And for the occupational physician it makes the difference between repairing afterwards and steering together, sooner, on sustainable employability.
Work stress asks for attention and action, so that people stay healthy and your organisation can move strongly forward.
By including psychosocial workload structurally in your working-conditions and absence policy, you increase your grip on work stress, social safety and sustainable employability. Not by reacting only at drop-out, but by spotting things early and taking targeted preventive steps together.
Key takeaways
- Psychosocial workload goes further than work pressure and also covers unwanted behaviour, unclear expectations, little support and a disturbed balance between work and private life.
- Make it a fixed part of your risk inventory and daily working-conditions policy, rather than acting only at absence or conflict.
- Spotting things early through team figures, behavioural patterns and open conversations helps prevent complaints, incidents and long-term absence.
- Prevention is most valuable when you look at the structure of the organisation, cooperation in teams, managers and individual support at the same time.
- The occupational physician can think along at an early stage about spotting signals, suitable support and limiting relapse, even where there is no absence.
- With targeted adjustments to tasks, rosters, communication and aftercare following incidents, you strengthen wellbeing and productivity alike.
By investing now in a considered approach, you create a safer and more predictable working environment in which people can keep working healthily. That way we build together, step by step, towards less absence, more resilience and lasting employability.