Autonomy at work, can (too) high autonomy cause health complaints and sick leave?

Autonomy is seen as a core aspect with work. High autonomy can be used in work design for alleviating negative consequences of work, as well as being a design principle for handling interdependencies. However, high autonomy is also suggested to be a burden and not necessarily beneficial. The aim of this study is therefore to explore how high autonomy may be a cause for long-term sick leave among knowledge workers. The study is designed as an explorative case study, with 5 highly educated female workers (age range 28–52) with a present or former long-term work–related sick leave (burnout, fatigue, stress, depression, MSD). The interviews followed an interview guide with open questions, where freedom was used as a proxy for autonomy. The analysis was performed by using Balance-theory. The results showed that although appreciating their autonomy in the task performance allowing for individual planning, independency, skills discretion and creativity, autonomy was an ambiguous term. One challenge was how to handle tasks with high autonomy at the individual level. Stress and health complaints arose also when high autonomy was not balanced by structures in the organizational domain. Findings are in line with contemporary studies questioning the ultimate positive associations of autonomy and high autonomy as a leverage. The results indicate that for specific groups of workers, high autonomy should be balanced with predictable organizational structures, not being a leverage in itself.