The stressful, hostile, and toxic workplace: an advanced understanding of a common clinical complaint

Andrew O. Brown*, Greg P. Couser, David Evan Morrison, Gaurava Agarwal

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Patients frequently attribute symptoms and distress to their workplace. Such workplaces are characterized as “stressful,” “hostile,” or “toxic.” Such phrases cannot serve as a substitute for clinical assessment of the patient’s work problem. Proper assessment en-tails understanding the situation at the workplace and the patient’s re-action to the situation. This article discusses several ways in which legal and psychiatric frameworks used to assess workplace problems can be mutually incompatible. Poor clinical and functional outcomes, such as chronic anxiety or depressive symp-toms, separation from the workplace facilitated by prolonged claims of work incapacity, long-term unem-ployment, and patient involvement in protracted litigation, can occur in the absence of informed and proac-tive clinical engagement. This article identifies steps to consider when a patient presents with work com-plaints. Active and skillful engagement with patients who present with a workplace problem not only miti-gates negative clinical and functional outcomes but also promotes the psychological, social, and economic well-being of the patient. [Psychiatr Ann. 2021;51(2):70-75.].

Original languageEnglish (US)
Pages (from-to)70-75
Number of pages6
JournalPsychiatric Annals
Issue number2
StatePublished - Feb 2021

ASJC Scopus subject areas

  • Psychiatry and Mental health


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