From leadership research to district action: Toxic leadership and employee health: exploring psychosocial stress pathways in organizational settings

AI-assisted editorial implementation guide. Proposed district actions are separate from the original authors’ findings and recommendations. Independent peer review of this guide is not asserted.

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Evidence and transfer

Education-related source: verify which participants, institutions and outcomes were actually studied before district adoption. Source publication type: research-article. License and identity checks do not establish study quality or causality.

Original authors’ abstract, reproduced under the source license:

Abstract Toxic leadership poses a profound threat to employee well-being, particularly within high-context, collectivist cultures where hierarchical norms often suppress resistance. Despite growing interest globally, its psychosocial effects in Middle Eastern organizational settings remain underexplored. This qualitative study examines how toxic leadership affects the health and well-being of employees working in healthcare, business, and education organizations in Jeddah, Saudi Arabia, with particular attention to lived experiences and culturally specific coping strategies. Using an interpretivist qualitative design, semi-structured interviews were conducted in English with 42 employees from healthcare (n = 10), business (n = 12), and education (n = 20) organizations in Jeddah. Participants were purposively selected based on self-reported experience of or direct observation of recurrent harmful supervisory behaviors. Data were analyzed using Braun and Clarke’s six-phase thematic analysis, resulting in seven overarching themes: (1) Silent Suffering, employees experience fear, suppression, and emotional paralysis; (2) Cultural Rationalization of Abuse, submission and religious values normalize toxicity; (3) Emotional and Mental Drain, including anxiety, burnout, and psychosomatic symptoms; (4) Coping Strategies and Resistance, faith, peer support, and avoidance tactics; (5) Leadership as Untouchable Power, reinforced by favoritism and wasta; (6) Organizational Silence and HR Inaction, ineffective grievance mechanisms and distrust; and (7) Normalization and Identity Conflict, ethical erosion and emotional numbness. Findings enrich the Job Demands-Resources (JD-R) and Conservation of Resources (COR) models by contextualizing them within Saudi cultural dynamics. This study underscores the urgency for culturally aligned leadership development, mental health integration, and anti-toxic policy frameworks in the Saudi workplace. Supplementary Information The online version contains supplementary material available at https://doi.org/10.1186/s12889-026-28813-z. Keywords: Toxic leadership, Psychosocial stress, Employee health, Organizational culture, Power distance

Study methods

This study employed a qualitative exploratory design grounded in the interpretivist paradigm. Interpretivism was considered appropriate because the study sought to understand how employees interpreted harmful leadership behaviors, psychosocial stress, workplace relationships, and coping within their particular organizational and cultural contexts. Rather than seeking to diagnose individual leaders or establish statistical relationships, the study focused on participants’ subjective experiences and the meanings they attached to those experiences.

Limitations

Future research should explore how toxic leadership is experienced across different regions of Saudi Arabia to assess cultural variability. Longitudinal qualitative designs could better capture the cumulative psychological toll over time and evaluate whether coping mechanisms evolve. A promising direction includes mixed-methods studies that integrate survey-based instruments with narrative data for richer insights. Another avenue lies in gendered experiences of toxic leadership. While this study included male and female voices, a gender-focused inquiry may reveal distinct coping styles or power negotiations. Finally, there is scope to examine the role of religious and spiritual coping in greater depth, understanding how faith can serve both as a buffer and a barrier in confronting toxic work environments.

A 90-day district inquiry

Days 1–15 · Appraise. Read the source methods, recruitment, comparator, outcomes and limitations. Record how the study setting differs from your district and which claim the design can support.
Days 16–30 · Design. Map one recurring source of staff workload with voluntary staff input. Agree one reversible schedule, support or task-allocation change and name its owner. Agree participation, privacy protections, baseline and stopping rules before starting.
Days 31–60 · Observe. Collect the pre-agreed measures, keep a log of implementation changes and invite confidential voluntary feedback. Preserve existing support for staff and learners.
Days 61–90 · Decide. Compare workload hours, a consistent voluntary wellbeing measure, absence and retention intentions with the pre-pilot baseline. Report response rates and avoid causal claims from an uncontrolled comparison. Make a dated decision to stop, revise or extend the inquiry.

Board decision brief

Present the local problem, source setting, evidence limits, intervention, responsible owner, total cost, measured changes and uncertainty. Separate staff perceptions, implementation measures and student learning outcomes.

Attribution and reuse

Megren Abdullah Altassan. Toxic leadership and employee health: exploring psychosocial stress pathways in organizational settings. BMC Public Health (2026-08-03). https://doi.org/10.1186/s12889-026-28813-z

Prepared 2026-11-07. Source authorship and DOI are preserved. The abstract and source passages are attributed extracts; this editorial guide is offered under the same CC BY 4.0 license.