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By Linda Fensler, MS, CEAP

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The road to success isn’t always a smooth one. No one knew this better than Michael Snyder, a former CEO of Red Robin Gourmet Burgers and Brews. In 1979, Michael and his brother Steve opened their first store. In 2018, Michael was 68 years old. On December 2nd he walked into his front yard, put a gun to his head and ended his life. Michael never reached out for help; he suffered in silence. He left no note. No one knew the depth of his despair.

Could a trained mental health professional have recognized Michael’s cry for help? Mental health professionals know that the end stage of addiction and mental illness often leads to suicide. They recognize the need to identify behavioral changes early, to find a way to intervene before it’s too late. That said, identifying the impaired professional is difficult to do in a timely manner. Professionals, executives, CEOs and entertainers are often isolated by the nature of their work and insulated by those around them.

Death by suicide or overdose does not discriminate; it affects everyone. We have seen the increase in mental health concerns with COVID, while people are isolated in their homes. Medical professionals, too, have been reported to have significantly higher suicide rates than the general population. According to an article published in 2016, Tracy Gunter reported, “Medicine has been the deadliest profession in the United States for decades as physicians continue dying from suicide rates twice that of the general population.”

An article published in Lifestyle/Health & Wellness, in 2018, shares data collected by Dianna Kenny from a study through the University of Sydney. In the article, Dianne shares observations from Candice Lam Yue-Tung, a clinical psychologist who founded an organization that treats celebrities in Hong Kong and China. While keeping her patients’ identities confidential, Lam says half of them are either celebrities, bank CEOs, or mover and shakers in the  celebrities in Hong Kong and China. While keeping her patients’ identities confidential, Lam says half of them are either celebrities, bank CEOs, or mover and shakers in the political world. She shared her observations “… under more pressure than ordinary people, my patients suffer from a range of mental disorders – like panic attacks, insomnia, violent outbursts, substance abuse, eating disorders, suicidal thoughts, sex addictions and kinky or deviant sexual behaviors.”

EAPs help identify Problem Behaviors

Employee assistance programs (“EAPs”) provide individual counseling and problem identification for employees, family members and a wide-range of individuals needing help. EAPs expanded in the mid-80’s and now nearly all companies, both large and small, have free counseling through their EAP. EAP counselors are often first to identify impaired executives and other professionals. 

Working as an EAP Counselor myself, since 1989, I’ve observed the array of mental health disorders that plague C-level executives and professionals at a great rate, as identified by Candice Lam Yue-Tung. In my experience, the majority of C-level executives, professionals and those working in “the industry” have experienced higher levels of isolation, loneliness and mistrust. Many have trouble trusting those around them because of hidden agendas. Furthermore, they fear being misrepresented or harshly judged. One CEO told me, “I’m afraid to say anything when employees ask questions. My words are taken out of context exaggerated and downright misrepresented. A simple statement can be taken out of context, or totally changed, causing mass hysteria for thousands of employees. Sometimes it’s better to say nothing!”

Suppressed Dopamine Can Fuel Addiction

Some people surmise that the very traits required to get to the top are the same ones we see in the path to addiction. David J. Linden, a professor of neuroscience at John Hopkins University School of Medicine, found that certain people possess a genetic variant leading to suppressed dopamine signaling in the brain. As a result of this decrease in dopamine they are compelled to seek unusually high levels of stimulation or thrill-seeking behaviors, to give them the same level of pleasure that others achieve without the need for thrill-seeking behaviors. Not coincidentally, these very behaviors traits are consistent with the traits needed for success. When examining the traits of highly successful people we find risk-taking, a competitive nature, an ability to handle disappointments, obsessive behaviors, dedication and the ability to initiate new concepts. Highly successful people often become accustomed to a high-levels of anxiety, caused from strong competition and high expectations. These traits may develop into mental health concerns for the individual. Leaders with these traits may show signs of impairment. This is when someone needs to identify the problem - in the beginning. And yet, this is when people are often afraid to confront the individual needing help and the problem is left to feaster and grow.

Think about how difficult it would have been to identify and address a concern with someone like Sigmund Freud or Winston Churchill, both were heavy drinkers. In Linden’s article published in the New York Times in 2011, he states “ … in fact, the psychological profile of a compelling leader – think of tech pioneers like Jeff Bezos, Larry Ellison and Steve P. Jobs – is also that of the compulsive risk-taker, someone with a high degree of novelty-seeking behavior. In short, what we seek in leaders is often the same kind of personality type that is found in addicts, whether they are dependent on gambling, alcohol, sex or drugs.” 

Linden goes on to say, “Leaders in America rarely admit to addictions in public, but one recent example is Henry T. Nicholas, III, a founder of Broadcom, a multibillion-dollar company that makes microchips for cellphones, game consoles, wireless headsets and other electronic devices. Starting with a $10,000 investment, Mr. Nicolas and his partners created a company that now has 9,000 employees and 5,100 patents. Along the way, he struggled with alcohol, cocaine, and Ecstasy; he entered a rehab program in 2008.”

Signs of Impairment

So, how do we get help for the high achievers? First, we must identify the signs of impairment. If someone is impaired by a behavioral problem or a substance, those around him or her will notice changes in daily mood and functioning. My 25 years of counseling experience spans corporate and educational settings in Chicago, Las Vegas, Central Florida and Northeastern Indiana, where I have observed the following: Inappropriate or broken communication, poor hygiene, poor decisions, erratic mood swings, temper tantrums, disappearing acts, changes in staffing, manic behaviors, sudden weight loss or gain, broken promises, excessive rumors surrounding the person and, in later stages of psychosis or dependency, you may see paranoia.

Identify the Problem and Offer Help! 

After the signs of impairment have been identified and are shared with a professional, whether it’s an EAP or another mental health professional, a strategy to confront the individual must be developed. If there is no relationship between the EAP or counselor, because of the hierarchy of power, the EAP or counselor will need to find a trusted person close to the impaired executive or leader and work through them. It may be necessary to counsel the trusted friend, relative or partner of the impaired person, in order to make the right connection that will lead to the best possible outcome. I learned early on, as a counselor, it’s more important to work with the person who has the best rapport and trust of the impaired individual and lead them in how to make the connection, rather than insisting on handing the case yourself and risking push back by the impaired professional, who may not know or trust you. As a professional mental health worker, you need to put ego aside and keep your eye on the ball, so to speak. The outcome of health and wellness for the impaired person is always the main goal. How you get there is to develop a plan, stick to it, and alter it as needed. The ultimate goal is to connect the person with the best counseling plan, psychiatric care or inpatient treatment needed and to maintain good follow-up.

Of course, it’s always more effective and faster when the EAP within the organization can identify and confront the impaired leader directly, if the relationship and the trust is there.

The CEO or leader in any organization shoulders the responsibility of creating a vision for the company’s future growth. Together, with the executive team, they must develop a plan of action to achieve their vision. If the EAP is part of this process, confronting the impaired executive will be easier and more direct. In this case, the EAP, along with those around the person will notice the impaired behaviors first-hand. 

If the EAP is not part of the executive team, establishing rapport with the VP of HR will be important. In this way, there will be a direct connection to the executive team and with the people who surround the top-level executive, who may be impaired. If this connection does not exist, the EAP could connect with a Board Member, a colleague or a personal friend, who will advocate for the EAP and help make the necessary connection. 

For the reasons mentioned here, it’s important to place the EAP high enough in the organizational chart to reach all employees, not just the support staff. If a company wants to provide help for all employees, including the highest level of leadership, the EAP simply must report to the highest level of leadership, or have a connection to it. There must be a rapport that extends upward to help facilitate executive health and wellness and to gain the respect and leverage needed to serve all employees under the umbrella of the EAP.

When Making the Referral

After identifying the impaired executive and providing the number of sessions allowed by the company’s contract with the EAP provider, the best long-term treatment provider or treatment center will need to be identified. In some cases, the EAP will refer out immediately to maintain consistency in treatment and to give the “free EAP session” to family members of the impaired. When the EAP makes a referral out to a treatment center or to a clinical professional, they will require on-going communication with the facility or counselor to follow the case. This will facilitate ease in coming back to work and teh EAP can manage the re-entry and develop a return-to-work plan.

A high level of privacy is required. If the impaired person is a CEO, a surgeo or a celebrity, they will need a program that protects their reputation and will minimize the risk of onfidentiality breaches.

There are a few in-home programs that will allow a high-level person to recover at home, while making use of digital options. With the erise of COVID-19 work-at-home recommendations, it's even more important to find digital tools and progras using artificial intelligence, to meet the needs of confidentiality and immediate access. These types of services are rapidly surfacing to meet the 24/7 needs of those suffering from potential relapse, while recovering at home.

Summary

Identifying impaired professionals in our fast paced, competitive work environment, is necessary for the future growth and development of industry today. As stated here, it's not easy to identify a C-level executive, a professional or a top performer and get them help in a timely fashion. There are barriers that include the reclusive lifestyle of high level leaders and the protected work environment that insulates them from recognizing a problem. People around them often enable their toxic actions and protect them from teh consequences of their behaviors. Furthermore, their high income an dflexible work schedles can easily accommodate addictive behaviors, without having to realize the results of their impaired judgment.

The high level executive has a level of freedom and protection that exceeds the general working population. And, according to the research of Dr. David J. Linden, a professor of neuroscience at John Hopkins Univesity, there is a genetic variant leading to suppressed dopamine, leading us to the conclusion tha tpeople with this genetic variant may need a higher level of stimulation. We further conclude, that although thses people lack a normal level of dopamine, they are often risk-takers and innovators, the vary traits needed in our leaders of today. Leaders with these traits are needed to mov eus forward and to repair the amage done to both small and large businesses, following COVID-19.