Toxic leadership and employee health: exploring psychosocial stress pathways in organizational settings

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.