Leaders' mental health: why it's a question for the organisation, not just the individual

“I’m fine. Let’s get straight to the numbers.”

Monday, a quarter past eight, the boardroom on the fourth floor. The managing director says it before anyone has asked. His voice is calm, the words are right. But within the first ten seconds the twelve people around the table have read something else: that he has slept too little again, that his jaw tightened when he opened the first spreadsheet, and that today is not a day for bad news. The head of sales quietly moves his bad news to next week. Nobody writes that down in the minutes. But a decision has been made — and it wasn’t the director who made it.

The mental health of people in leadership is usually discussed as a private matter: whether the director gets enough sleep, whether he has anyone to tell how he really is, whether he will hold up. All of that matters. But in this post I would like to show the other side as well. How the person at the top feels is not only their personal business. It is one of the forces that shape everything that happens in the organisation beneath them — and that makes it a question for the organisation too.

When the weather in the room starts with one person

Emotions pass between people. Not figuratively, but quite literally: we unconsciously mirror the expressions, tone and posture of those we are with, and in doing so we begin to feel something similar. Psychologists call this emotional contagion. As early as 2002, Sigal Barsade showed in experiments with small groups that the mood of one group member — in her case an actor playing a cheerful or a gloomy colleague — changed the mood of the others and even affected how well the group cooperated and how fairly it shared out resources.

With a leader the effect is stronger still, because people watch them more closely than anyone else. In 2005 Thomas Sy, Stéphane Côté and Richard Saavedra showed that a leader’s mood is passed on to group members, who then coordinate differently and put in different amounts of effort. The person your job depends on is the one whose face you read most precisely. That is not a weakness in employees. It is an old and very sensible survival mechanism: in any group, the first thing we check is how the person with power is doing.

This is why the tiredness of the person at the top carries a different weight from anyone else’s in the building. Not because their feelings are more important, but because they spill further.

Why this is not just a private matter

The World Health Organization and the International Labour Organization estimate that around twelve billion working days are lost worldwide every year to depression and anxiety. That figure is about all employees, not only leaders. But when the two organisations issued their guidelines on mental health at work in 2022, they placed particular emphasis on training managers: how a leader handles their own workload and other people’s distress is one of the few levers an organisation actually has.

Research on leaders themselves points in the same direction. In a 2014 study titled The depleted leader, Alyson Byrne and colleagues followed leaders who were exhausted, poorly rested or under heavy pressure. These leaders more often slipped into poorer leadership — harsher, more absent, less inspiring — not because they were worse people, but because they had run out of the inner resources needed for self-control. A 2020 meta-analysis by Antonia Kaluza and colleagues brought together decades of research and found a reliable link: better wellbeing in leaders goes with more constructive leadership, poorer wellbeing with more destructive leadership.

How we read this matters. It does not say that exhausted leaders are bad leaders. It says that exhaustion is a state that turns good leaders into worse ones — for a while, and often without them noticing. That is precisely why it cannot be left to the individual alone.

Psychological safety: what Edmondson found by accident

In the 1990s Amy Edmondson was studying hospital teams. She expected the better teams to make fewer mistakes. The data showed the opposite: teams with better relationships reported more errors. When she looked more closely, she found they weren’t making more mistakes — they simply dared to admit them. In the weaker teams, errors stayed hidden.

From this came a concept now familiar in every larger organisation: psychological safety, a shared belief that within the group you can take a risk — ask a question, admit a mistake, flag a problem, voice an unpopular opinion — without being humiliated or punished for it. Edmondson has stressed many times since that psychological safety is not niceness and it is not comfort. It is the condition for people to tell the truth before the truth becomes too expensive.

And here the circle closes. Psychological safety in a group is shaped most strongly by whoever holds power. If a leader freezes at bad news, people bring bad news later. If a leader is so exhausted that every question feels like an attack, the questions stop. Nothing dramatic happened in the boardroom that morning. One piece of bad news simply waited a week. An organisation’s culture is made of thousands of moments like that.

Setting an example doesn’t happen on posters

Most organisations have their values written down somewhere. Among them there is often something about balance, health or respect. But people don’t read posters; they watch. What happens to the person who falls ill? Who sends emails at eleven at night — and who replies to them before midnight? Does anyone at the top ever take a holiday without being constantly “available just in case”?

A leader who hides their exhaustion is not protecting the team by doing so. They are teaching it that exhaustion must be hidden. I have written more about how costly it is to be a role model all the time in When you have to set an example: the tiredness you’re not allowed to show. Here I would add just one thought: an example is not only what a leader does, but also what they don’t allow themselves. If they don’t allow themselves sick leave, no one below them will take it with an easy heart.

This isn’t about a leader sharing their distress with everyone. The team is not the place for a leader to work through their fears — that would be a burden for the team as well. It is about something more modest: that their behaviour doesn’t claim a person can live without limits. Anyone who has read through a list of signs like the one in Burnout is not laziness: signs your nervous system is asking for a break knows that they are hardest to recognise in yourself precisely when the people around you are rewarding them.

What a leader brings with them from home

In relational family therapy, in which I am training, we look at a person through the relationships they grew up in. That applies to those at the top as well. The way someone leads is often very old. Someone who, as a child, looked after the moods of an ill or unpredictable parent can read people exceptionally well — and at the same time finds it hard to bear anyone being angry with them. Someone who grew up with a critical father may be very demanding of themselves, and the team around them feels the same chill they once felt. I wrote about how early patterns show up at work in Attachment at work: how the pattern shows with your manager and colleagues.

In many ways an organisation is like a family: it has unwritten rules, topics no one talks about, and roles people take on without anyone explicitly assigning them. When a leader cannot carry their own tension, they often unconsciously pass it on to a third party — a colleague who becomes the scapegoat, or a department that is always to blame. Family therapists call this triangulation. In a family it is the children who pay for it; in an organisation it is the people carrying tension that isn’t theirs.

So a leader’s mental health is not only a question of whether they get enough rest. It is also a question of whether they understand what drives them — and whether they have somewhere to look at that without being in role the whole time.

A conversation that comes too late

This is how a conversation might sound between a leader and his deputy, who has finally dared to say what everyone in the building has known for six months (a composite, not a real person):

“Why didn’t you tell me this back in the spring?”
“Because in the spring you were in such a state that none of us dared tell you anything.”
“What state was I in?”
“Tired. Every piece of bad news felt like a personal insult to you. People learned to come to you only with good news.”
“I thought nobody noticed.”
“We all noticed. You were the only one who thought we didn’t.”

Nobody in this conversation is malicious. The leader thought he was protecting the team by not showing his tiredness. The team thought it was protecting the leader by not bringing him bad news. Both were protecting — and that is why the problem grew for six months longer than it should have. This is the most common way exhaustion at the top becomes an organisation’s problem: not with an outburst, but with silence.

What an organisation can do — and where its role ends

If the mental health of leaders is a question for the organisation, what can the organisation actually do? A few things come up again and again in research and in guidelines:

• A workload that is humane at the top as well. If a leadership role means being reachable every day at every hour, exhaustion will sooner or later be systemic, not personal.
• Rules that apply to leadership too. Holidays, sick leave and an evening without messages have to be things that people at the top take as well — otherwise they stay on paper.
• Room for mistakes without humiliation. Psychological safety does not start with a workshop, but with how the board responds when someone tells it something unpleasant.
• Access to help that is genuinely confidential. A leader won’t seek help if they fear that someone who decides on their contract will find out.

Slovenia’s Health and Safety at Work Act requires employers to address psychosocial risks and to promote health in the workplace. We usually read this as an obligation towards employees. But leadership is part of the workforce — and it applies to them too.

At the same time there is an important boundary here. An organisation is not a therapist and must not become one. How someone feels, what they bring from home and what is happening in their marriage is not information an employer should have. The organisation can create conditions in which looking after yourself is possible and acceptable. What a person does with that remains their own. I have described how this works in therapy in Confidentiality in therapy: what stays between us and where the limits are.

Exercise: your week as your team sees it

This exercise is for anyone who leads people — from a department head to the chair of the board. It takes about fifteen minutes and you can do it today.

1. Take your last working week. Go through your calendar and sent emails. Don’t judge, just write down: at what times you sent messages, when you were in back-to-back meetings, when you ate.
2. Find three moments when you were under pressure. What happened in your body? How did you respond to the people who were with you at the time?
3. Look at the same moments from the other side of the table. What did someone who depends on you read from your behaviour? What did they learn about what can be said to you?
4. Choose one message you send through your behaviour but would rather not. For example: “We don’t rest here” or “I don’t like bad news.”
5. Decide on one small action for next week that sends a different message. Perhaps one evening without email, perhaps the sentence “thank you for telling me early” at the first piece of bad news.

If you feel shame at the third step, that’s all right. It isn’t proof that you’re a bad leader. It’s proof that you care how people feel around you — and that is a good place to start.

Where this view doesn’t hold

This post argues that a leader’s state spills over into the organisation. That is true, but it has limits I don’t want to blur.

First, a leader is not responsible for every emotion in the organisation. If a colleague has depression, it didn’t arise because the director was in a bad mood on Monday. People bring their lives, illnesses and histories to work. If we attributed everything to the leader, we would be making the same mistake families make when they blame one person for everything.

Second, sometimes the problem isn’t the leader but the structure. Impossible deadlines, too few people, owners demanding growth at any cost — under such conditions even the most mature leader will be exhausted. Therapy can help you understand which part of this is yours and which isn’t, but it cannot fix an organisation. Sometimes the healthiest decision is to change jobs.

Third, there is a danger that leaders’ mental health becomes just another performance metric: “Be resilient, because it’s good for business.” That would be misguided. A person has a right to rest and to help because they are a person, not because it pays off commercially. If looking after yourself becomes one more item on the list to be completed flawlessly, the old trap is back — the one I described in The “never enough” syndrome.

And fourth: the links I have cited are averages. Some leaders become even more focused and more humane under pressure. Research doesn’t speak about you; it speaks about what is worth paying attention to.

When to seek help — and where

People in leadership positions often wait longer than others. Some because they are used to solving things on their own. Others because they fear what it would mean if someone found out. Others still because their problems don’t seem “real” to them — they have a good job, after all. Many successful people also carry the doubt described in Impostor syndrome: why successful people doubt themselves, and experience asking for help as proof that they really are impostors.

A few signs worth acting on: sleep that doesn’t recover even on holiday; an irritability you never used to know; a sense of being constantly on edge, even when there’s no crisis; more and more alcohol or pills to calm down in the evening; the thought that everyone would be better off without you. For physical symptoms and insomnia, your first port of call is your GP, who can judge whether a psychiatrist should be involved too. For the long-lasting tension described by the concept of chronic stress, psychotherapy often makes sense.

If thoughts of suicide appear, don’t wait. In Slovenia you can call the crisis line Klic v duševni stiski on 01 520 99 00 (every day from 7 pm to 7 am) or the Samaritans helpline Samarijan on 116 123 (24 hours a day). In an emergency, call 112 in Slovenia.

Therapy for people at the top is nothing special — and that is exactly its value. It is one hour in which you are not the director, not the role model, and you don’t have to have the answer. Those who allow themselves this often feel, for the first time in a long while, that they can show vulnerability without anything collapsing. I see people in person in Ljubljana, and I also work in English. When it turns out that someone’s patterns of leadership began far back in their family, a longer session with a genogram, A Look into the Past, can be a good place to start.

What to remember

• A leader’s mood passes on to the team — people read the face of whoever holds power most closely.
• Exhaustion turns good leaders into worse ones for a while; that is why leaders’ mental health is not just their private business.
• Psychological safety doesn’t start with a workshop, but with how leadership responds to bad news.
• An organisation can create conditions in which self-care is possible — what a person does with that remains confidential and their own.
• A leader isn’t to blame for everything in the organisation and isn’t obliged to be resilient for the sake of business: they have a right to help because they are a person.