Behind the Boardroom Door

A landmark study published by Birkbeck, University of London in late 2025 has brought into sharp focus a crisis that has long been hidden behind closed boardroom doors. The research, which surveyed 400 UK chief executives and managing directors, found that 62% reported symptoms consistent with clinical burnout, 44% had experienced anxiety severe enough to affect their decision-making, and 38% described persistent feelings of isolation.

These findings challenge the prevailing image of the CEO as an inexhaustible leader, always confident and in control. The reality, as the Birkbeck research demonstrates, is that many of the UK's most senior business leaders are struggling — and the vast majority are doing so in silence.

The Unique Pressures of the Top Job

The mental health challenges facing CEOs are distinct from those experienced at other organisational levels. The isolation of the role is profound — there is no peer group within the organisation, every relationship carries a power dynamic, and the CEO's mood and behaviour are constantly scrutinised and amplified throughout the company.

The weight of responsibility is another factor. UK CEOs are personally liable for an expanding range of regulatory requirements, from health and safety to data protection to environmental compliance. The Companies Act 2006 imposes duties of care, skill, and diligence that, in combination with modern regulatory complexity, create a persistent background anxiety that few other roles entail.

Working hours remain extreme despite the broader shift toward work-life balance. The Birkbeck study found that UK CEOs work an average of 62 hours per week, with 78% reporting that they regularly work weekends and holidays. The always-on nature of modern communications has eliminated the natural recovery periods that previous generations of leaders could rely on.

The Stigma Barrier

Perhaps the most troubling finding from the research is that only 12% of CEOs experiencing mental health difficulties had sought professional support. The primary reason cited was stigma — the fear that acknowledging psychological vulnerability would undermine confidence among investors, board members, employees, and customers.

This stigma is not irrational. While mental health awareness has improved dramatically in UK workplaces, the expectations placed on senior leaders remain largely unchanged. Boards that champion mental health initiatives for employees may simultaneously expect their CEO to demonstrate unwavering resilience and availability.

Several high-profile UK business leaders have begun to challenge this stigma. Antonio Horta-Osorio's decision to take a public leave of absence from Lloyds Banking Group for stress-related illness in 2011 was a watershed moment, but progress since then has been incremental rather than transformative.

Structural Solutions

Addressing CEO mental health requires structural changes rather than simply encouraging individuals to seek help. Leading governance experts recommend several approaches that UK boards should consider.

First, boards should normalise regular wellbeing conversations with the CEO, making these a standing item in the relationship between the chair and chief executive. Second, companies should provide confidential external coaching and psychological support as a standard benefit for senior executives, removing the need for individuals to seek help independently.

Third, boards should actively manage CEO workload, challenging the assumption that effectiveness requires constant availability. This includes setting clear expectations about working hours, holiday, and the delegation of responsibilities that do not require CEO-level attention.

A Business Case for CEO Wellbeing

Beyond the humanitarian imperative, there is a compelling business case for investing in CEO mental health. Burned-out leaders make worse decisions, damage organisational culture, and are more likely to depart unexpectedly — all outcomes that directly harm shareholder value.

The UK's most progressive boards are beginning to recognise that CEO wellbeing is not a personal matter but a governance responsibility. As the evidence base grows, the question for boards is not whether to act but how quickly they can implement the structural changes needed to support their most important and often most vulnerable leadership asset.