Work-related violence is often discussed as a people problem. Leaders hear about difficult clients, aggressive patients, bullying colleagues, and “bad behaviour.” Those factors matter, but they are not the full story. Violence risk is also shaped by how work is designed, resourced, and led.
One driver keeps showing up in the research, and it is often missing from prevention plans: role overload.
Role overload occurs when the volume, pace, or complexity of work exceeds the time, resources, authority, or support available to do it safely and well. A short spike can be managed. A sustained mismatch becomes a risk exposure.
A large body of international research links higher role overload with higher rates of bullying, verbal abuse, threats, and other forms of work-related violence. I’ve read hundreds of journal articles on this over the past 5 years and thought I’d share some insights.
This article translates that evidence into practical implications for safety, HR, and business leaders. You will see what role overload is, why it raises risk, when the risk spikes, and what can be changed in work design to reduce exposure.
Start with a clear definition of violence
Work-related violence includes a broad range of behaviours. It is not limited to physical assault. In practice, violence is usually reported in these forms:
- Bullying and repeated negative acts
- Harassment and intimidation
- Verbal abuse and threats
- Aggression from clients, patients, customers, or the public
- Physical violence
In most sectors, psychological violence is more common than physical violence. It is also easier to normalise, minimise, and tolerate, so it can persist until it becomes a pattern.
NOTE: The definition of work-related violence / occupational violence and aggression differs greatly amongst academia, regulators, and practitioners. Australian regulators tend to restrict it to physical violence, aggression, verbal abuse, and threats directed at workers. Academic definitions often go broader and include bullying, harassment, and intimidation. I’ve gone with the latter as my research was academic in nature. It also shows the relationship between role overload and bullying and harassment which is helpful for leaders.
The evidence is broad, and it is consistent
The research spans frontline environments, such as hospitals and schools, and it also covers office-based settings. In preparing this article, I drew on over 60 different papers but for effiency (maybe also laziness), I only referenced a small portion of those. It’s a LinkedIn article, not a literature review.
Included in the literature were:
- Healthcare, education, public administration, transport, security, and general workforce settings
- Over 40 countries across Europe, Asia, Oceania, and the Americas
- Cross-sectional studies, longitudinal studies, systematic reviews, and one meta-analysis
- Samples ranging from small emergency department teams to national workforce surveys with tens of thousands of workers
Importantly for leaders, the overload signal is not limited to self-report surveys. It has also been observed in studies using incident reports and administrative workload indicators, which means operational metrics can be used to monitor risk, not only perception surveys (Huang et al., 2020; Giusti et al., 2024).
Researchers do not always use the label “role overload.” Many papers measure the same underlying issue using terms like workload, job demands, time pressure, job strain, effort-reward imbalance, or excessive overtime. The labels vary, but the practical problem is the same.
What the numbers mean for leaders
Across quantitative studies, higher role overload is associated with higher exposure to work-related violence in almost every case.
In large workforce surveys, the uplift in risk is often incremental. Many studies report odds ratios around 1.2 to 1.5, which means exposure rises meaningfully as demands rise (Brown et al., 2011; Conway et al., 2021).
In high-acuity settings, such as hospitals, psychiatric services, and emergency departments, the jump can be much larger. Odds ratios above 4 have been reported, and job strain has predicted later violence exposure with an odds ratio of 7.7 in a longitudinal hospital study (Magnavita, 2013; Balducci et al., 2020).
An odds ratio compares the odds of an outcome between two groups, an odds ratio of 1 means no difference, greater than 1 means higher odds in the exposed group, and less than 1 means lower odds.
A meta-analysis of 20 datasets found a moderate pooled relationship between role stress and bullying (r = 0.34) (Silviandari, 2018).
One nuance is worth calling out: studies that capture the mismatch between demands and resources, such as job strain (high demand with low control) and effort-reward imbalance, often report larger effects than workload-only measures. That is consistent with what teams describe in practice: pressure becomes combustible when people feel both overloaded and unsupported (Balducci et al., 2020; Palma-Contreras & Ansoleaga, 2020).
Put simply, when people are pushed past capacity for long enough, the odds of aggression, conflict, and bullying tend to rise.
Overload often comes first
A fair question is whether violence creates workload stress, rather than workload stress raising the risk of violence. The best way to test this is to track people over time.
Several longitudinal studies show that higher workload or job demands at baseline predict later exposure to bullying or violence, sometimes years later (Balducci et al., 2020; Conway et al., 2021; Sigursteinsdottir et al., 2020).
In other words, role overload does not just coexist with violence. It often comes first.
A reinforcing cycle can also be created. After violence occurs, mental health can be affected, job strain can rise, and teams can become less able to cope. That increased strain can raise the risk of future incidents (Magnavita, 2013). The cycle is hard to break unless operating conditions are changed.
Why psychological violence tracks workload so closely
Not all violence behaves the same way. The overload link is strongest for psychological violence, such as bullying, harassment, verbal abuse, and intimidation.
These behaviours become more common when workloads are heavy, time is tight, and people are stretched (Feijó et al., 2019; Trépanier et al., 2021). Small conflicts escalate faster, patience shrinks, and poor behaviour is less likely to be challenged.
Physical violence is shaped by additional drivers, including clinical acuity, substance use, and acute distress. Even so, overload still matters, particularly when wait times blow out, service deteriorates, and teams are left without the time or staffing to intervene early (Balducci et al., 2024; Mishra et al., 2024).
This distinction matters because psychological violence is often treated as a culture problem or an interpersonal issue, rather than a work design issue.
How overload turns into aggression
Three pathways show up repeatedly in the evidence, and they will feel familiar to anyone who has led a stretched team.
Service quality drops. When work is rushed, staffing is thin, or systems are clunky, delays rise and mistakes are made. Frustration builds among clients, patients, customers, and coworkers, and that frustration can spill into aggression (Havaei & MacPhee, 2020; Balducci et al., 2024).
Self-control is reduced. High demands drive stress, fatigue, and irritability. De-escalation becomes harder, and conflict is triggered more easily (Sun et al., 2021; Stapinski & Gamian-Wilk, 2023).
Informal controls break down. Under pressure, teams communicate less, supervision is reduced, and poor behaviour is left unchecked. Bullying and aggression are more likely to persist when leaders are not present, and peers do not have the time or energy to intervene (Zahlquist et al., 2019).
Across many studies, stress sits in the middle of the story. Overload increases stress, stress raises the risk of violence, and violence further damages wellbeing and performance (Sayin et al., 2021).
When workload pressure becomes a safety problem
Role overload does not automatically lead to violence. Risk rises when high demands are paired with weak controls, low support, or a climate where poor behaviour is tolerated.
The evidence also suggests that overload is sometimes a conditional risk. In other words, workload predicts bullying more strongly when social support and job recognition are low, and perceived organisational support is weak (Trépanier et al., 2021; Harlos et al., 2023).
Organisational Support
Organisational support is a major buffer. When workers feel backed by the organisation, recognised for the pressure they are under, and given practical help, overload is less likely to escalate into violence (Harlos et al., 2023; Trépanier et al., 2021).
Fair workload distribution is consistently protective. For example, when workload allocation is seen as fair, violence risk is reduced across multiple forms of aggression (Thapa et al., 2025).
Leadership
Leadership quality matters. Supportive leaders spot overload early, reset priorities, and step in when standards slip. Where leadership is hands-off, the overload to conflict pathway is more likely to be activated (Ågotnes et al., 2023).
When leadership is weak or absent, overload-related frustrations can be displaced onto coworkers, or customers, and low-level issues can be allowed to persist until they become incidents.
Work Climate
Climate sets the rules people follow when no one is watching. In hostile or uncivil climates, workload pressure and role stress are more likely to turn into bullying and intimidation (Zahlquist et al., 2023).
Individual Factors
People are not affected evenly. Trait anxiety, poor coping strategies, and impaired mental health can increase susceptibility under overload conditions (Reknes et al., 2019; Balducci et al., 2020). This helps explain why the same operating conditions can produce different outcomes across a team.
This is not about blame. Violence remains a work health and safety issue, and controls should be designed for real human limits.
Why organisations miss the workload connection
Many organisations manage work-related violence after the fact. Training focuses on de-escalation, reporting systems, and incident response. Those controls matter, but they rarely change the operating conditions that keep producing incidents.
Role overload often stays off the risk register because it is treated as normal. Chronic understaffing, unrealistic KPIs, constant change, and sustained overtime can be written off as “business pressure,” even when they are driving predictable harm.
From a psychosocial risk perspective, this is a blind spot. The evidence suggests that overload is not only a wellbeing issue. It is a violence risk factor, and it can be managed like other risk factors when it is treated as operational reality, not personal weakness.
What leaders can do differently
Preventing work-related violence is not only about behaviour. It is also about the decisions that shape work, including demand, capacity, role clarity, staffing, and service expectations.
Violence risk is influenced when priorities are set without trade-offs, when backlog becomes normal, or when overtime is used as a long-term staffing strategy. Early-warning indicators should be watched, and they should be acted on, including wait times, complaints, incident hotspots, fatigue signals, and unplanned absenteeism.
Role overload should be treated as part of the violence control plan. If it sits outside your prevention strategy, the strategy will tend to stay reactive.
What to do now
- Make overload measurable. Track demand versus capacity using staffing gaps, overtime, queue lengths, caseload, rework, and break compliance.
- Set priorities with explicit trade-offs. When everything is urgent, standards drop, and conflict rises. Decide what will not be done, delayed, or simplified during peaks.
- Fix the friction. Remove avoidable admin, broken workflows, and system issues that consume time and increase delays.
- Strengthen supervision where pressure is highest. Visible leadership, fast support, and clear behaviour standards reduce the chance that frustration gets taken out on others.
- Build controls for third-party aggression. Staffing plans, escalation pathways, security support, and service recovery should be matched to demand, not to “average days.”
- Link workload data to incident data. Trend violence reports against wait times, caseload, overtime, turnover, and staffing gaps to identify predictable spike conditions, and target controls where demand regularly outruns capacity (Huang et al., 2020; Giusti et al., 2024).
- Review incidents as operating-model signals. Ask what demand, capacity, and service conditions were present, not only who was involved.
Key takeaways for safety, HR, and business leaders
- Role overload is a validated risk factor for work-related violence, particularly bullying and verbal abuse.
- The risk is strongest in high-demand service environments, such as healthcare and human services, but it exists across all sectors.
- Overload often precedes violence, and it can trigger self-reinforcing cycles of harm.
- Psychological violence is most strongly linked to workload, and it is often normalised or ignored in practice.
- Fair workload distribution, organisational support, and effective leadership consistently reduce risk.
- Violence prevention strategies that ignore work design are incomplete.
- Managing psychosocial risk requires managing effort and resources, not just offering resilience training.
If violence is showing up in your organisation, ask the harder question: are people being asked to carry more than the system can safely support, and what would you need to change to bring demand back in line with capacity?
References
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