min read

Opening up the conversation on founder mental health

What can we do to support founder mental health, and what does history teach us about the journey of entrepreneurship?

When mental health is in the media, we take notice at Big Health. Last month, a story that stood out was Tom Blomfield’s departure from Monzo, his experience of anxiety and the binary ways in which we often perceive mental health (“well” vs. “mentally ill”) despite these experiences being incredibly common.

Feedback to his piece was overwhelmingly positive: a collective sense of gratitude for his honesty, in stark contrast to the ‘hustle’ culture which still often pervades startups.

One of many supportive tweets

Here’s what you probably already know: leaders being candid about their mental health struggles is a good thing. Of 1,000 employees surveyed by Forbes, 62% said having someone in a leadership role speak openly about mental health would make them feel more comfortable talking about it themselves. These conversations can help create a more open culture and regular signposting to mental health resources (small plug: if you’re employed by the NHS, you can get free access to Sleepio and Daylight to help manage poor sleep, insomnia and anxiety).

As part of our mission to help millions back to better mental health, we were struck by the challenges that many startup founders face in managing their own mental health. In a 2019 survey of 270 entrepreneurs by WeAre3Sixty, 69% of founders had felt down / depressed whilst 68% experienced sleep problems. Founders were 5.5x lonelier than the UK average whilst self-reported symptoms of anxiety and depression were 3x higher. This can be even tougher for founders who are building solutions in the mental health space; like Peter Hames’ experience with insomnia, lived experience can be the trigger to build a new product or company.

This can be especially true for venture-backed founders, where there is strong pressure to deliver and be the next big thing. In fact, when you look back at the history of venture capital, you can see its origins in – strangely – the whaling industry. Risk-loving financiers would fund captains to try to capture elusive sperm whales. It was a perilous journey and a third of ships were lost at sea. These captains, like today’s founders, were navigating choppy waters in the hopes of achieving something big, and putting their all into it. Financiers hired agents (i.e. today’s VCs) to identify the best captains – but also to support those captains with anything they needed during the expedition to be successful. Agents were incentivised by a combination of fees and the profits from the ultimate sale of whaling products – a structure that exists to this day.

Money = Limited Partners, Agents = VCs, Captains = Founders, Whales = Startups

Shifting back to modern times (and sadly, away from whales), the venture community is increasingly recognising the importance of supporting founders’ mental health. Building a company is an emotional rollercoaster, and sustainably leading a company from inception to exit requires real, reliable support. For example, Octopus Ventures have committed to putting mental wellbeing front and centre of how they work with founders, including offering founders paid 1-2-1 therapy sessions with a Harley Street clinic. Others in the ecosystem are focused on creating safe spaces for founders to talk about what’s really going on for them. Hannah Keal, Managing Partner at Unleashed says:

“We judge ourselves by our intent, but others by their behaviour. So if a company’s stated values are around ‘being human’ and looking after their team, but the founder is working all hours and constantly on the edge of burnout, then that’s what will be emulated and take root in the culture. So investing in founders’ mental health not only creates good role modelling on a conscious level, but creates a wider culture of permission”

According to Paul Marks, founder of Healthy Returns, addressing the mental health issues faced by founders is a moral imperative, and for wise investors, it should be a function of doing business. The human sacrifice of driving value and business success comes with a huge psychological price, so we must act now to reduce founders’ mental and emotional suffering in order to help them sustain levels of peak performance to get the best out of them and their business.

Paul says that real change needs a positive platform to launch from, so recommends that:

‘We become more vocal about the importance of sharing mental health struggles, normalise the concept of seeking help when in need and ultimately make mental health a mainstream part of the startup culture rather than the niche’.

I’m curious what you think we as a system need to do to help founders’ mental health. At Big Health, we want to provide access to evidence-based mental health technology for everyone.

If you’d like to continue the conversation, reach out to me at

Subscribe to blog

During the COVID-19 public health emergency, Sleepio and Daylight are being made available as treatments for insomnia disorder and generalized anxiety disorder (GAD), respectively, without a prescription. Sleepio and Daylight have not been cleared by the U.S. Food and Drug Administration (FDA) for the treatment of insomnia disorder and GAD, respectively.

1. Qaseem, A., Kansagara, D., Forciea, M. A., Cooke, M., & Denberg, T. D. (2016). Management of chronic insomnia disorder in adults: a clinical practice guideline from the American College of Physicians. Annals of Internal Medicine, 165(2), 125-133.2. Riemann, D., Baglioni, C., Bassetti, C., Bjorvatn, B., Dolenc Groselj, L., Ellis, J. G., … & Spiegelhalder, K. (2017). European guideline for the diagnosis and treatment of insomnia. Journal of Sleep Research, 26(6), 675-700.3. Wilson, S., Anderson, K., Baldwin, D., Dijk, D. J., Espie, A., Espie, C., … & Sharpley, A. (2019). British Association for Psychopharmacology consensus statement on evidence-based treatment of insomnia, parasomnias and circadian rhythm disorders: an update. Journal of Psychopharmacology, 33(8), 923-947.4. King’s Technology Evaluation Centre. (2017, November 9). Overview: Health app: SLEEPIO for adults with poor Sleep: Advice. NICE. Espie, C. A., Kyle, S. D., Williams, C., Ong, J. C., Douglas, N. J., Hames, P., & Brown, J. S. (2012). A randomized, placebo-controlled trial of online cognitive behavioral therapy for chronic insomnia disorder delivered via an automated media-rich web application. Sleep, 35(6), 769-781.6. Carl, J. R., Miller, C. B., Henry, A. L., Davis, M. L., Stott, R., Smits, J. A., … & Espie, C. A. (2020). Efficacy of digital cognitive behavioral therapy for moderate‐to‐severe symptoms of generalized anxiety disorder: A randomized controlled trial. Depression and Anxiety, 37(12), 1168-1178.

DOC-3046 Effective 11/2023