This chapter examines the human cost of the New Public Management (NPM). In order to do this, it draws on the literature covering the NPM and higher education as well as a series of semi-structured, in-depth interviews undertaken by the authors in the course of a research investigation into the implications and consequences of the NPM. The focus of the chapter is on 'stress' or mental strain, an important dimension of any 'human cost' deriving from change. It has even been described as one of the largest work-related diseases today, not least in England. The chapter explores the impact of the NPM in relation to what has conventionally been called 'stress' or 'strain', not least because this seems a significant part of the way in which the interviewees both experienced and understood their situation. Certain work environments can induce strain, and that this can result, in turn, in the development of different diseases.