Mental Health in the C-Suite

Welcome to the HBR Executive Agenda for October 2, 2025. In This Issue: Mental Health in the C-Suite Is It Time to Refresh Your ELT? Mental Health in the C-Suite Business executives aren’t immune to mental health issues. But many won’t talk about them, fearing that such admissions could diminish their authority. Lew Frankfort has been to the top of the corporate world—and endured emotional and physical maladies along the way. He has strategies for coping with these challenges and for opening up about them. Frankfort is chairman emeritus of Coach, the fashion brand, and was its CEO during an era of explosive growth from 1985 to 2014. In an HBR Executive Live interview last week, he talked about his success and his struggles—themes that he explores in his new book, Bag Man: The Story Behind the Improbable Rise of Coach. Frankfort had recurring nightmares about failure, even after he’d solidified his role as a successful, well-respected, well-remunerated CEO. It immobilized him at times, leading to backaches, lack of sleep, and a general loss of confidence. To cope, he experimented with a long list of treatments: exercise, meditation, medication, power naps, massage, acupuncture, and therapy. The combination enabled him to reset during difficult days and stay healthy over the longer term. Eventually, he reasoned that his fears were the flip side of his desire to succeed, and he found peace amid the perpetual inner struggle. “Having a healthy dose of fear while driving for excellence is a very forceful combination,” he says. “The fear of failure never allowed me to be complacent.” Those coping skills have also helped with depressive episodes that he has experienced since the 1990s. Frankfort urges executives to reach out for help. He tapped into his company’s executive-coach network, which included licensed psychologists, who could help in his darkest moments. “I went through a lot of group and individual work to become a better version of myself,” he says. When is it appropriate to share your struggles with the team, or even more broadly with the entire company? Frankfort acknowledges that every case is unique, but he errs on the side of openness. When he developed prostate cancer in 2003, he felt that it was his fiduciary duty to share the news with his board and senior leadership team. (He is now in remission.) But he chose not to share his mental health issues—except with his executive coach, the head of HR, and one or two close colleagues. These days he favors radical transparency. “Helping people understand that they’re not alone is really critical,” he says. “Most people are aware that there are ups and downs, and that there are things one can do to mitigate against them.” A shared sense of vulnerability can make companies healthier. “It’s liberating when someone can say, ‘I need help’ and feel the empathy,” says Frankfort. “Organizations can flourish when they understand the human condition.” You can watch my full interview with Frankfort here. And mark your calendars now for our next two HBR Executive Live conversations: On October 22 at 11 am ET, I’ll be talking to former PepsiCo CEO Indra Nooyi about how to innovate at the core and for the future. On November 10 at 11 am ET, I’ll be talking to incoming Target CEO Michael Fiddelke about how to balance tradition and change at a big, brand-name company. These conversations are exclusively for HBR Executive subscribers. Stay tuned for more details about registration. I look forward to seeing you there. Is It Time to Refresh Your ELT? By Ann Hiatt In the past month alone, a third of my clients have quietly initiated overhauls of their executive leadership teams. These aren’t reactive moves due to a crisis—these leaders are looking to make strategic upgrades to their teams. One CEO put it bluntly: “We’re asking for bold bets, but still leading with cautious operators.” Another said: “I can’t afford another year of incrementalism.” If this sounds familiar, you’re not alone. Quiet ELT resets are underway across industries—from fintech and SaaS to media and manufacturing—as CEOs realize the speed and complexity of their business has outpaced the skill sets or energy levels of key leaders. Those who act early are seeing sharper focus, faster decisions, and renewed momentum. How to Know When It’s Time to Make a Change Too often, CEOs wait too long out of loyalty, fear of disruption, or a lack of internal signals. But here are the clearest indicators I’m seeing from inside boardrooms and C-suites: Your strategy has changed but your leadership hasn’t. You’re aiming for a product-led model, services expansion, or AI-first operating rhythm, but your ELT is still built for the old game. Look at how much time they’re spending on legacy metrics vs. future bets. You’re solving the same problems every quarter. If the same issues—execution delays, cross-functional friction, missed customer needs—keep resurfacing, it’s often a signal that the team isn’t growing at the rate of the business. You’re asking for transformation but getting optimization. Incremental improvements are important, but transformation demands risk-taking, learning agility, and decisive leadership. Are you seeing bold moves or just better dashboards? There’s energy asymmetry across the team. Some execs are visibly energized by change; others are stuck in old loops. One founder recently told me: “Half the team sees the next chapter. The other half is still clinging to the last one.” You’ve stopped learning from each other. When ELT meetings become performative updates instead of real debate, challenge, or ideation, you’ve likely outgrown your current lineup. What Other CEOs Are Doing Without naming names, here’s what I’m seeing my clients doing as they shake up their teams: Product-centric companies are replacing go-to-market execs with platform thinkers. Ops-heavy orgs are elevating experience designers and cross-functional connectors. Pre-IPO leadership teams are bringing in CFOs and CHROs who’ve been through scale and downturns. AI-curious orgs are hiring innovators, not just technologists, to embed change across business units by testing new workflows. And in all cases I’m seeing a growing openness to fractional or interim leaders as bridges. These hires can move fast, take risks, and build internal muscle while testing fit. Your Move If you’re sensing the fit is off, don’t wait for performance reviews or a bad quarter to make a call. Now is the time to move quickly—with clarity, empathy, and conviction. Ask yourself: Who are the leaders of the next chapter? Where are we stretching… and where are we stuck? What’s the boldest move I’m not making, because I’m protecting comfort over capability? Once you have a sense of your roadmap, you can bring in an executive recruiter to help with new hires and your HR leader to help upskill those members of your ELT who need a little help to get where you need them to go. Ann Hiatt is an executive leadership consultant and author of the 2021 book Bet On Yourself.

Mental Health in the C-Suite

Summary.

Exclusive Benefits

Partner Center