Executive Mental Health

While the human mind doesn’t magically change when someone gets promoted to senior leadership, the context, pressure, and responsibilities certainly do. Here is where mental health comes in: a leader with resilient mental health will shine whilst a leader who struggles with mental health will collapse under pressure.

What Is Executive Mental Health?

Executive mental health refers to the psychological wellbeing, emotional regulation, and performance resilience of people in senior leadership roles. We're talking about CEOs, directors, line managers, partners, and founders—anyone with serious skin in the organisational game. It’s not just about preventing burnout. It’s about equipping leaders to handle:

• Decision fatigue and ethical dilemmas

• High-performance expectations

• Constant change and uncertainty

• Workplace politics and power dynamics

• Isolation at the top

Sound familiar? If you’re reading this as a line manager or senior leader, you’ll know exactly what I mean. This isn’t about coddling. It’s about capacity—keeping leaders mentally agile and emotionally grounded so they can lead, not just survive.

Psychological Strain at the Top

The late, great Peter Drucker once said, “Management is doing things right; leadership is doing the right things.” But who supports the people making those ‘right’ decisions under intense pressure?

According to the Job Demands-Resources (JD-R) model (Bakker & Demerouti, 2007), jobs with high demands (like leadership roles) require equally high resources to maintain performance and wellbeing. Without those resources—such as psychological support, coaching, or peer connection—burnout is almost inevitable.

Moreover, role conflict and role overload (Kahn et al., 1964) are common in executives. You're managing stakeholders, teams, strategy, budgets—and your own imposter syndrome, all before 9 a.m.

The Oxygen Mask Rule

If you've flown on a plane, you’ve heard it: “Put your own oxygen mask on first before helping others.” Executive mental health is the leadership equivalent. Many leaders—especially those who genuinely care—put everyone else first. Their team’s needs. The company’s vision. The next deadline. They think self-care is selfish. But without attending to their own mental health, their ability to lead others tanks. You can’t pour from an empty teacup, no matter how fine the china.

With many senior leaders, I don’t just see stress, I see moral fatigue, values dissonance, and unprocessed grief over decisions made during restructures or redundancies. I know an operations manager whose role was “being the emotional shock absorber for the whole company.”

Many are brilliant at hiding it. So brilliant that their own collogues won't know they are hanging on by a thread. With such people we can create mental ‘decompression zones’ in her week, aligning her leadership values with how she gave feedback, and reframing her inner critic from a saboteur into a quality-control consultant. That’s executive mental health in action. It's not just therapy. It’s strategic psychological support.

Leaders Are Human Too

We expect our leaders to be decisive, calm, innovative, inspirational—and available at all hours. But that’s not leadership. That’s sacrifice. And it’s not sustainable. Executive mental health isn’t a luxury. It’s a leadership essential. The next time you hear a colleague say, “I’m too busy for that mental health stuff,” ask them this: “Can your team afford for you to burn out?”

Chances are, they can’t.

If you’re in a leadership role (or support those who are), here’s how to take action:

1. Normalise talking about mental health at senior levels. Psychological safety is a cultural issue, not just a personal one.

2. Offer leadership-specific mental health services. Therapy and coaching tailored to executive pressures.

3. Encourage mental fitness, not just crisis management. Regular check-ins, supervision, and reflective spaces build resilience.

4. Educate boards and senior HR on the costs of burnout. Not just sick days—but lost insight, poor decision-making, and talent attrition.

5. Model the behaviour. Leaders who prioritise their mental health signal permission to others.

References

• Bakker, A. B., & Demerouti, E. (2007). The Job Demands–Resources model: State of the art. Journal of Managerial Psychology, 22(3), 309–328.

• Kahn, R. L., Wolfe, D. M., Quinn, R. P., Snoek, J. D., & Rosenthal, R. A. (1964). Organizational stress: Studies in role conflict and ambiguity. Wiley.

• Drucker, P. F. (2006). The Effective Executive. Harper Business.