Heavy Is the Head that Wears the Crown: The State of CEO Mental Health
Workspan Daily
June 26, 2024
Key Takeaways

  • Stress and anxiety are mounting. A recent survey identified a major uptick in CEOs reporting mental health challenges.
  • Even leaders battle mental health stigma. Among other findings, 81% of CEOs reported organizations often view someone with mental health issues as “weak or a burden” — a compelling reason for them (and others) to avoid help.
  • Progress likely starts at the top. If CEOs don’t focus on their own mental health, it’s not only a potential risk for them, but it can also negatively impact an organization’s overall competitive edge/bottom line. 

The old saying goes, “It’s lonely at the top.” And for America’s CEOs, life at the top increasingly can pose a mental health risk, according to a recent survey.

A new report from Businessolver, a provider of benefits and HR technology solutions, revealed 55% of CEOs have experienced a negative mental health issue within the past year — an eye-popping 24-point jump over 2023 and a level not seen since the pandemic.

Businessolver’s ninth annual State of Workplace Empathy Study, which surveyed more than 3,000 American workers, HR leaders and CEOs, also found:

  • 52% of CEOs view their company’s culture as toxic.
  • 81% of CEOs agreed with the statement, “Companies view someone with mental health issues as weak or a burden.”
  • 65% of CEOs agreed with the statement, “I feel intimidated by my coworkers.”
  • 54% of CEOs agreed with the statement, “I will not be respected as much if I demonstrate empathy.”

Clearly, most surveyed CEOs believed all is not well in the organization and in the C-suite. However, the upside is CEOs surveyed also were not shy in revealing their mental health status.

Read: Mental Health in the New Workplace

“We commend the CEOs who took part in this study for approaching it with honesty and openness, particularly given the persistent stigma that surrounds mental health,” Jon Shanahan, Businessolver’s president and CEO, said in a press release unveiling the report. “The more that leaders are in touch with and willing to share their own struggles, the greater the opportunity for empathy across the organization.”


“The more that leaders are in touch with and willing to share their own struggles, the greater the opportunity for empathy across the organization.”
— Jon Shanahan, president/CEO, Businessolver


An addendum to the study (coming in July) will reveal the behaviors most strongly correlated with positive perceptions of empathy, according to Shanahan.

“The idea of Part 2 [of the report] is helping organizations construct a game plan for putting empathy into action,” he said.

Self-Care Is Critical

Karishma Patel Buford, the chief people officer at Spring Health, a mental health benefits solution provider, said it makes sense that organizations focus on cultivating a culture that values self-care. This can mean offering mental health benefits or ensuring sufficient paid time off is taken, among other strategies.

But, Patel Buford added, progress likely begins with CEOs (and other top executives) utilizing these offerings themselves. It can mean leading with vulnerability by sharing personal stories and acting as vocal advocates for mental health, while openly prioritizing their own well-being.

“By doing so, the organization can normalize self-care and the conversations around mental health, encouraging employees to prioritize it without fear of stigma,” she said, adding that organizations also can realize a solid return on investment when they prioritize workforce-wide mental health.

“Neglecting leadership’s mental health can impact productivity, attrition and absenteeism due to burnout and stress-related illnesses,” Patel Buford said.

CEOs Face Intense Stress

Amanda Augustine, a career expert for TopResume, said CEOs and other members of an organization’s executive leadership team often experience high levels of stress and poor work-life balance due to the demanding nature of their roles — most directly, the ever-present pressure to meet performance expectations.

In fact, Augustine noted a 2021 study by the National Bureau of Economic Research estimated CEO lifespans decreased by 18 months solely due to the stress of an economic downturn.

“Organizations that fail to address this issue face significant risks that may negatively impact the business for years to come,” she said. “These include, but are not limited to, a decline in decision-making capacity, increased turnover among leadership, a toxic work environment and, finally, poor financial performance.”

So, what can organizations do to help their top executives understand it is okay to engage in “self-care” as a precursor to caring for their organization and their workforce?

“Most of all, organizations — especially HR leaders — can encourage other top executives to lead by example,” Augustine said.

Such examples may include using mental health benefits, participating in open communication on work-related stressors, taking days off, and more.

Anxiety Comes with the Title

Morra Aarons-Mele, author of “The Anxious Achiever” and host of a podcast of the same name, explained that, unfortunately for leaders, anxiety does come with the territory.

“Anxiety is often about the future, and leaders are paid to think about the future — the worst-case scenarios and also the possibilities,” she said. “Data shows many high achievers experience more anxiety. It’s the most common global mental health challenge. Anxiety simply is part of leadership.”


“Anxiety simply is part of leadership.”
— Morra Aarons-Mele, well-being author and podcast host


Many leaders she works with find themselves repeating patterns that get them into trouble or make them unhappy.

“It takes courage to face your demons — or your soft underbelly, as I like to call it,” Aarons-Mele said, explaining that typical ways leaders act out anxiety include controlling behavior, shutting out advice, impulsiveness, overworking, micromanaging, anger, being a “know it all,” avoidance and perfectionism.

There is perceived “shame and stigma” in discussing mental health at work, and anxiety is conflated with weakness, she said, but noted the opposite is actually true — she believes leaders who understand how their anxiety shows up at work are stronger, more attuned and much better people leaders.

“When you’re in tune with your emotions and what they’re trying to tell you, you become a self-aware, conscious and thoughtful leader,” Aarons-Mele said.

CEOs Must Step Up

Brian Macias, CEO at Embrace Pet Insurance, agreed that chief executives paying attention to their own mental health is critical — for themselves and the greater organization.

“Imagine you’re a cup constantly pouring out support and guidance to your team. If you don’t take the time to refill your own cup, you’ll eventually run dry,” he said. “You can’t pour from an empty cup. And if you’re always pouring into others’ cups, who is going to fill yours? Prioritizing your well-being ensures you can effectively lead and support your team.”


“You can’t pour from an empty cup. And if you’re always pouring into others’ cups, who is going to fill yours?”
— Brian Macias, CEO, Embrace Pet Insurance


Among other steps in a self-care tool kit, Macias touted regular exercise, daily “gratitude journaling,” taking time for mindfulness, and even getting enough sleep as several ways to improve cognitive function and, as a result, boost decision-making capabilities.

“By focusing on ways to boost mental health, you’re not just taking care of yourself, you also are setting a positive example for your team and the entire organization,” Macias said. “A mentally healthy CEO leads with clarity, compassion and vision — driving the organization toward sustained success and growth.”

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