Executive summary
Executives rarely lack access to care. What they lack is a low-friction path from recognising the problem to doing something about it. In a clinical review of 307 executives seen at CEREVITY between January 2025 and August 2026, the median interval from first clear recognition of significant mental health strain to a first clinical session was 21 months. Fifty-eight percent waited until a crisis or near-miss forced the issue. Fifty-two percent named professional image or career concerns as a primary reason. Forty-one percent said the waiting period itself made their symptoms worse. This is the Executive Help-Seeking Delay Index: the systematic postponement of care among people who move within days on almost every other high-stakes problem they own.
Senior professionals are trained and rewarded for escalating risk early, and they apply that discipline to every category of problem except this one.
The delay is not caused by ignorance or by cost, but by the perceived professional price of being seen to need help, uncertainty about where a record ends up, and a reasonable hope that the strain will lift when the current pressure cycle does.
Treat the interval itself as the clinical target, and remove friction at every point between recognition and a first session rather than arguing with the reasons for waiting.
Care begins while the person still has range, and treatment starts from a better position than it would have a year and a half later.
The problemThe same person who escalates a risk in days will carry this for a year and a half§
High-achieving professionals are trained to surface problems early, and they do, reliably, in every domain except this one. The exception is not explained by lack of information and it is not explained by cost. The large barrier studies are unambiguous about where the obstacle sits. In the National Comorbidity Survey Replication, among people who recognised a need for treatment and did not seek it, wanting to handle the problem on their own was the most common reason at 72.6 percent, and attitudinal or evaluative barriers outweighed structural ones by 97.4 percent to 22.2 percent.05 Across 24 countries in the World Mental Health surveys, the same pattern held: a desire to handle it alone was the leading barrier among those who perceived a need, at 63.8 percent, and attitudinal barriers dominated for mild and moderate cases while structural barriers mattered mainly for severe ones.06 For an executive, both of those describe a temperament the job selected for.
The second force is disclosure. A systematic review of 144 studies covering 90,189 participants found that stigma was associated with reduced help-seeking at a median effect of d = -0.27, and that of all the stigma-related barriers, concerns about disclosure and confidentiality had the highest median endorsement at 32 percent.04 That review identified military and health professions among the groups disproportionately deterred; it did not study executives, and we are not claiming it did. Where an adjacent professional population has been studied directly, the finding is consistent. Among 12,825 licensed American attorneys, the two most common barriers to treatment were not wanting others to find out they needed help and concerns about privacy or confidentiality, reported by 50.6 percent and 44.2 percent of those who had received treatment and by 25.7 percent and 23.4 percent of those who had not.12 Among 5,829 physicians, 39.9 percent said they would be reluctant to seek formal care for a mental health condition because of concerns about repercussions to their licensure.13 The pattern is not that senior professionals value their health less. It is that they have more to lose from being seen.
Of all stigma-related barriers to help-seeking, disclosure and confidentiality concerns had the highest endorsement. Clement and colleagues, systematic review of 144 studies, 90,189 participants
The evidenceWhat the research shows§
Two bodies of evidence are used here and kept apart. The first is a clinical review of 307 consecutive executive clients seen at CEREVITY between January 2025 and August 2026, a help-seeking sample rather than a population survey, with n and date range attached to every internal figure. The second is peer-reviewed epidemiology on treatment delay and its barriers, and the observational literature on what a longer untreated period does to outcomes. The second body is unusually important in this paper, because the question is not whether executives wait but whether waiting costs anything, and that is an empirical question with a more careful answer than the topic usually receives.
21 mo
median interval from recognising strain to a first clinical session
CEREVITY clinical review, n=307, 2025 to 2026
58%
waited for a clear crisis or near-miss before seeking help
CEREVITY clinical review, n=307, 2025 to 2026
52%
cited professional image or career concerns as a primary reason
CEREVITY clinical review, n=307, 2025 to 2026
41%
reported that the delay itself made their symptoms worse
CEREVITY clinical review, n=307, 2025 to 2026
Twenty-one months needs a frame of reference in both directions. Against the general population it is fast. In the National Comorbidity Survey Replication, delay among those who eventually made treatment contact ran 6 to 8 years for mood disorders and 9 to 23 years for anxiety disorders,02 and across 76,012 respondents in 15 countries median delays ranged from 1 to 14 years for mood disorders and 3 to 30 years for anxiety disorders.03 Against the standard this population applies to everything else it is extraordinary. The executives in this sample would not tolerate a 21-month lag between identifying an operational risk and acting on it, and most of them said so unprompted. The useful reading is therefore not that executives are slow relative to the public, but that they are slower here than they are anywhere else in their own lives, and the gap between those two speeds is the finding.
Whether the waiting itself does damage is the harder question, and the honest answer is narrower than the one usually given. The evidence does not show that people deteriorate while they wait. It shows that they respond less well to treatment once it starts. In 270 patients with a first lifetime depressive episode, remission was 21.1 percent among those untreated for six months or more against 33.7 percent among those treated earlier, an odds ratio of 0.5 that the authors reported was not explained by a wide range of demographic and clinical confounders.07 A meta-analysis found shorter untreated duration favoured both response and remission, though its pooled estimate rests on only three comparable studies,08 and a prospective cohort of 121 outpatients found adjusted odds of 2.8 for response at 12 weeks and 4.1 for remission at 24 weeks in those with shorter untreated duration.09 The most instructive study for this paper examined 715 outpatients waiting for care and found longer waiting associated with a less favourable treatment outcome, while finding no association between waiting time and clinical course during the wait itself.10 That is the precise claim: waiting does not obviously make people sicker while they wait, but it appears to make the treatment work less well when it finally begins. Why this population avoids the step at all is examined in why high performers avoid therapy.
| Indicator | CEREVITY sample (n=307) | External evidence | Source |
|---|---|---|---|
| Median delay, recognition to first session | 21 months | 6 to 8 years for mood and 9 to 23 years for anxiety in the general US population | CEREVITY01; Wang et al.02 |
| Waited for a crisis or near-miss | 58% | Attitudinal barriers outweighed structural ones by 97.4% to 22.2% in the same survey | CEREVITY01; Mojtabai et al.05 |
| Professional image or career as a primary reason | 52% | Disclosure and confidentiality concerns had the highest endorsement of any stigma barrier | CEREVITY01; Clement et al.04 |
| Reported the delay itself worsened symptoms | 41% | Longer waiting predicted worse treatment outcome but not deterioration during the wait | CEREVITY01; van Dijk et al.10 |
| What the delay costs at treatment | Not separately scored | Remission 21.1% after six months or more untreated against 33.7% treated earlier (n=270) | Bukh et al.07 |
| Whether the same pattern appears in adjacent professions | Not separately scored | 50.6% of treated attorneys cited not wanting others to find out; 39.9% of physicians cited licensure | Krill et al.12; Dyrbye et al.13 |
| What happens after someone finally presents | Not separately scored | Only 16.5% of people with 12-month major depression received minimally adequate treatment | Thornicroft et al.14 |
01, 04 CEREVITY clinical review, n=307, January 2025 to August 2026. Clinical, help-seeking sample; reasons and the worsening item are client attributions, not measured outcomes.
Clement, S. et al. (2015). Psychological Medicine, 144 studies, 90,189 participants. Disclosure and confidentiality had the highest median endorsement of any stigma barrier.
07, 12 Bukh, J. D. et al. (2013). Journal of Affective Disorders, n=270 with a first lifetime depressive episode. Odds ratio 0.5, 95% CI 0.3 to 0.9. Observational; no randomised evidence on delay exists.
Krill, P. R. et al. (2016). Journal of Addiction Medicine, n=12,825 attorneys. Figures are subgroup-specific, not whole-sample.
The frameworkA model you can name and own§
Five stages recur in the clinical sample, compressed here into four phases because the final stage, reaching care, is the exit from the cycle rather than a position inside it. The model is descriptive rather than diagnostic, and it is built around one property: every phase produces a locally reasonable decision, and the damage is done by their accumulation rather than by any single one of them.
CEREVITY model
The Delay Cycle
A four-phase description of how someone who has correctly identified a problem ends up not acting on it for a year and a half. Each phase is a defensible judgement in isolation, which is why the cycle is so stable and why arguing with any one step rarely interrupts it.
Recognition of rising strain
The person identifies the problem accurately, often with more precision than a layperson would manage, and takes no step toward care. This phase is frequently datable to a specific week.
Calculation of professional risk
The decision turns on visibility rather than on symptoms. Who would know, what a record would look like, and how the fact of being in treatment would be read by a board, an investor or a partnership. Fifty-two percent of this sample named this as a primary reason.
Deciding to wait for a better moment
Action is deferred to after the raise, after the close, after the quarter. The reasoning is sound each time it is applied, and the supply of better moments never runs out.
Worsening or normalisation
Either the symptoms grow, or the person adapts to them until the current state stops registering as abnormal. Normalisation is the more common outcome in this sample and the more dangerous, because it removes the trigger that would have prompted action.
The exit from this cycle is usually a crisis: 58 percent of this sample waited for one.01 The clinical objective is to make the exit available earlier and cheaper than a crisis, which is a design problem rather than a persuasion problem. Every point of friction between recognition and a first session, every form, every wait, every question about where the record goes, is an opportunity for the cycle to reassert itself.
SCHEMATIC Schematic, not measured data.
Descriptive model derived from patterns observed in the CEREVITY clinical review, n=307, January 2025 to August 2026. The curves are illustrative and carry no units.
By professionHow it presents across roles§
The delay is one behaviour, but what the person believes is being risked by acting, and which calendar they are deferring to, changes with the seat. The three groups below are the ones represented in the CEREVITY sample.
CEOs and senior executives
This group is the most sensitive to perception and has the fewest people who can observe them without also evaluating them. The board assesses them, the executive team takes its emotional cue from them, and peers in the same industry are a reference set rather than a confidence. That produces a specific version of the delay: not reluctance to accept help, but an inability to identify a single relationship in which seeking it would be free of consequence. The national data explains part of the pattern without being about executives at all. Wanting to handle the problem alone is the single most common reason people who recognise a need do not act on it, at 72.6 percent,05 and that disposition is not a flaw in a chief executive, it is most of why they hold the job. Clinically this segment presents with the most polished self-account and the longest interval, and they are the group most likely to arrive after a specific precipitating event rather than a gradual decision. What shortens the delay here is almost never encouragement. It is a precise answer to a procedural question about where a record goes, followed by an appointment that can be booked without an intermediary. Internal provision rarely satisfies the first condition, for reasons set out in why executives do not use an EAP.
Individual confidential therapy for chief executives
Organizational the partnership model for corporate organizations
Founders
For founders the delay is tied to a fundraising calendar, which gives it a structure the other two groups do not have. There is always a round closing, a diligence window open, or a board update due, and each of those is a locally excellent reason to defer. The result is a pattern of deferral that is not open-ended but repeatedly renewed, which is harder to interrupt because the founder can always name the specific thing they are waiting for. Investor visibility compounds it: the concern is not only that a record exists but that a change in the founder's behaviour, a standing appointment in a calendar, an unavailable Tuesday morning, becomes information. The occupational evidence on disclosure applies squarely, with confidentiality concerns the most endorsed stigma barrier in a review of 144 studies.04 Clinically this group presents earlier than executives on average and in worse condition when they do, because the fundraising calendar tends to break rather than ease. The intervention that works is scheduling that survives an unpredictable diary, and explicit attention to the fact that the better moment the founder is waiting for has been deferred at least three times already, which most can confirm once asked.
Individual confidential therapy with no investor trail
Organizational founder mental health as portfolio risk management
Partners and high-earning professionals
Partners in law, accounting, consulting and medicine face a delay driven by standing rather than by hierarchy. Compensation is frequently tied to origination or production, partnership review is periodic and peer-administered, and a perception of reduced capacity has direct financial consequences that arrive on a known schedule. This is the segment where the external evidence is strongest, because the population has been studied directly. Among 12,825 American attorneys, 28 percent reported symptoms of depression, and the two leading barriers to treatment were not wanting others to find out and concerns about privacy or confidentiality.12 Among physicians, 39.9 percent reported reluctance tied to licensure specifically.13 Clinically this group is the most likely of the three to have already tried something informal, a conversation with a colleague, a coach, an app, before reaching a clinician, and the most likely to describe their own situation as not serious enough to warrant more. That comparison is being made against their peer group rather than against any clinical threshold, and correcting it is often the whole of the first session's work. Two further features are specific to the partnership track. Review is peer-administered, so the people who would notice a change in capacity are the same people who vote on compensation, which removes the separation between a health matter and a commercial one. And origination credit accrues to individuals rather than to teams, so a quiet period is visible in a number long before anyone would describe it as a problem. Both push in the same direction: toward absorbing the strain privately for as long as the numbers hold.
Individual therapy for attorneys
Organizational confidential therapy for equity partners
The stakesThe cost of inaction§
The first cost is the obvious one and the hardest to quantify: 21 months of a treatable condition, carried.01 The second and third are more specific, and one of them is frequently overstated in material of this kind, so it is worth stating with its limits attached.
Treatment works less well when it starts later
Forty-one percent of this sample said the waiting made their symptoms worse, which is their own attribution rather than a measured outcome.01 The published evidence supports a narrower claim than that and supports it reasonably well. Remission ran 21.1 percent among patients untreated for six months or more against 33.7 percent treated earlier,07 and longer waiting predicted worse treatment outcome in 715 outpatients, with no association found between waiting time and clinical course during the wait.10 So the defensible statement is that delay appears to reduce how well treatment works, not that it causes deterioration in the meantime.
Crisis is an expensive way to enter care
Fifty-eight percent of this sample waited for a crisis or near-miss.01 That is the least controllable moment to begin, both personally and organisationally: the entry is involuntary, the circumstances are visible to more people than the person would have chosen, and the first session is spent on containment rather than on the material that produced the strain. The same care, begun eighteen months earlier, starts from a different place entirely. The waiting is not passive either: across ten studies analysing more than thirteen thousand secrets, it was the background rumination on a withheld matter, rather than the effort of concealing it, that predicted lower wellbeing.15
The pathway leaks after the delay ends
Reaching a clinician is not the end of the problem. Across 21 countries, of people with 12-month major depressive disorder, 56.7 percent recognised a need for treatment, 71.1 percent of those made at least one visit, and only 41.0 percent of those treated received care meeting minimal standards, leaving 16.5 percent of all cases adequately treated.14 An executive who has spent 21 months deciding to act has a low tolerance for a poor first experience, which makes the quality of the first contact disproportionately important in this population.
01, 07, 02 CEREVITY clinical review, n=307, January 2025 to August 2026.
Bukh, J. D. et al. (2013). Journal of Affective Disorders, n=270. Remission 21.1% at six months or more untreated against 33.7% treated earlier.
Wang, P. S. et al. (2005). National Comorbidity Survey Replication, n=9,282. A different population and interval, shown for scale.
The solutionWhat effective care looks like§
If the barrier is attitudinal and disclosure-driven rather than structural, then the intervention is not education and it is not encouragement. It is the removal of friction at every point between recognition and a first session, and the removal of the specific exposure the person is weighing. That means a route that generates no insurance claim and no employer record, so the question about where a record goes has a real answer rather than a reassuring one; clinicians who understand executive environments well enough that the first session is not spent on context; access fast enough that the decision does not have to survive a wait; and formats that fit a diary the person does not fully control. Arguing with someone's reasons for waiting is the least effective available move, because those reasons are mostly correct.
CEREVITY is a nationwide network of independent licensed clinicians, matched to the person and delivered by secure video on a fully private-pay basis, with no diagnosis code travelling through an insurer and no record inside an employer's systems. Every one of those properties exists to remove a specific point of friction identified above rather than as a feature list. Sessions run in three formats and no others. The 50-minute format carries continuity where a calendar allows it, and extended 90-minute sessions give room to material that a single hour tends to leave half-opened.
Where someone has carried something for a year and a half, which is the median case here, 3-hour therapy intensives reach in one sitting what weekly work would spread across a quarter, and they suit a person whose availability arrives in blocks rather than weekly slots. The approach behind this model sets out how clinicians are matched to the pressures of a role rather than to a diagnosis alone. What none of this does is make the first step feel small; it makes it cheap to take, which in a population whose obstacle is perceived cost is the more useful property.
ImplementationHow to put it into practice§
Four steps. The first two are for the individual, the second two for the organisation or adviser that would rather not encounter this at the crisis end.
- 01
Name the delay itself as the clinical issue
Ask when the person first clearly recognised the problem, and treat the interval since as the presenting complaint. It is more answerable than any question about symptoms, because recognition is usually datable, and it converts a vague sense of struggling into a number the person can act on. It was a median of 21 months in this sample.01
- 02
Answer the record question before discussing the clinical one
Disclosure and confidentiality concerns are the most endorsed stigma barrier to help-seeking,04 and among attorneys who had been treated, half named not wanting others to find out.12 A precise answer about what is generated, what is stored and who can see it does more to shorten the delay than any argument about the value of therapy. How this shows up in practice is described in what high performers say about asking for help.
- 03
For organisations: count the friction points and remove them
Between recognising a problem and a first session, count every step: a form, an intermediary, an approval, a wait, an unanswered question about records. Each one is a place the delay cycle restarts. Since attitudinal barriers outweigh structural ones by a wide margin in the population data,05 the structural work that matters most is the work that removes an attitudinal objection, and confidentiality is the objection.
- 04
Do not wait for a visible reason to act
Fifty-eight percent of this sample entered care through a crisis or near-miss.01 Designing a pathway that only activates at that point means designing for the most expensive and least controllable version of the problem. Normalisation, not escalation, is the more common trajectory in this sample, and a normalised state produces no trigger at all.
RecommendationsWhere to start§
Clinical
Treat any lag beyond a few months as a signal in its own right
The interval is measurable, dateable and independent of how the person describes their mood, which makes it a better instrument than a symptom question in a population practised at answering symptom questions well. Where the strain is tied to sustained consequence rather than to temperament, this is the population treatment for anxiety tied to consequence, not temperament is built around.
Clinical
Screen for depression rather than accepting the pressure explanation
Executive strain is almost always described in the language of workload, and what is frequently underneath it has never been assessed. Twenty-eight percent of 12,825 attorneys reported symptoms of depression,12 which is the sort of base rate that makes high-functioning anxiety and depression therapy worth reaching for before settling on a workload narrative.
Structural
Design for speed and confidentiality as structural properties, not promises
Both are things a person can verify or not. A promise of confidentiality answers a different question than an arrangement that generates no record, and in a population weighing professional exposure the difference is the entire decision.
Structural
Measure the delay and report it
Track the interval between recognition and first session across whoever you are responsible for. It was a median of 21 months here. Unlike stigma it is a number, and unlike attitudes it responds to changes you can make this quarter.
FAQCommon questions§
Where does the 21-month figure come from?
Why would executives delay longer than other groups?
Does waiting actually make things worse?
How does private-pay billing work?
How is my privacy protected?
MethodologyHow this paper was built§
Methodology
This Index has two components, reported separately throughout, and no figure from one is used to support a claim about the other. The clinical component is a review of consecutive executive clients seen through CEREVITY between 1 January 2025 and 31 August 2026. After inclusion criteria were applied, senior executive responsibility recorded at intake and sufficient clinical contact for the relevant variables to be assessed, 307 clients remained. Variables were recorded from structured intake and clinician-documented review: the interval between first clear recognition of significant mental health strain and a first clinical session, whether a crisis or near-miss precipitated entry to care, the stated primary reason for the delay, and whether the client attributed a worsening of symptoms to the waiting period. The external component draws on peer-reviewed epidemiology, systematic reviews and observational outcome studies, identified through PubMed, Europe PMC and Google Scholar and through direct retrieval from publishing organisations, covering 1990 to 2026. Sample sizes are stated wherever a source is used: Wang and colleagues 2005 (n=9,282), Wang and colleagues 2007 (n=76,012 across 15 countries), Clement and colleagues (144 studies, 90,189 participants), Mojtabai and colleagues (NCS-R Part II, with the barrier analysis on n=783 who perceived a need), Andrade and colleagues (n=63,678 across 24 countries), Bukh and colleagues (n=270), Ghio and colleagues 2014 (10 studies identified, 3 pooled), Ghio and colleagues 2015 (n=121), van Dijk and colleagues (n=715), Penttila and colleagues (33 samples), Krill and colleagues (n=12,825 attorneys), Dyrbye and colleagues (n=5,829 physicians), Thornicroft and colleagues (n=51,547) and Slepian and colleagues (ten studies, more than 13,000 secrets). Limitations are material. The CEREVITY sample is clinical and help-seeking and cannot support a claim about executives who never reach care, who are by construction excluded. Recognition is self-reported and dated retrospectively, which is subject to recall effects, and the stated reason for the delay is the client's own attribution rather than an observed cause. The 41 percent who reported that waiting worsened their symptoms is likewise an attribution and is reported as one. On the external side, no peer-reviewed literature on help-seeking delay in executives specifically could be located; the adjacent professional evidence used here concerns attorneys and physicians, who are not interchangeable with executives, and Clement and colleagues identified military and health professions rather than executives among the groups disproportionately deterred by stigma. The duration-of-untreated-illness literature is entirely observational, confounding by indication is structural and cannot be removed by adjustment, the Ghio 2014 pooled estimate rests on three comparable studies with heterogeneity the authors themselves flag, and in psychosis, where the question has been studied most heavily across 33 samples, the correlations between longer untreated duration and poor outcome run only 0.13 to 0.18.11 No randomised evidence on delay exists and none could ethically be produced. The Wang comparators are general-population figures included for scale rather than as matched controls, and the 2005 survey was fielded in 2001 to 2003, so help-seeking norms will have shifted since.
References
- 01CEREVITY. (2026). Executive Help-Seeking Delay Index: clinical review of 307 consecutive executive clients, January 2025 to August 2026. Internal clinical data, not publicly posted.
- 02Wang, P. S., Berglund, P., Olfson, M., Pincus, H. A., Wells, K. B., and Kessler, R. C. (2005). Failure and delay in initial treatment contact after first onset of mental disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62(6), 603 to 613. n=9,282. pubmed.ncbi.nlm.nih.gov
- 03Wang, P. S., Angermeyer, M., Borges, G., Bruffaerts, R., Chiu, W. T., de Girolamo, G., and colleagues. (2007). Delay and failure in treatment seeking after first onset of mental disorders in the World Health Organization's World Mental Health Survey Initiative. World Psychiatry, 6(3), 177 to 185. n=76,012 across 15 countries. pmc.ncbi.nlm.nih.gov
- 04Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., Morgan, C., Rusch, N., Brown, J. S. L., and Thornicroft, G. (2015). What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychological Medicine, 45(1), 11 to 27. 144 studies, 90,189 participants. cambridge.org
- 05Mojtabai, R., Olfson, M., Sampson, N. A., Jin, R., Druss, B., Wang, P. S., Wells, K. B., Pincus, H. A., and Kessler, R. C. (2011). Barriers to mental health treatment: results from the National Comorbidity Survey Replication. Psychological Medicine, 41(8), 1751 to 1761. pmc.ncbi.nlm.nih.gov
- 06Andrade, L. H., Alonso, J., Mneimneh, Z., Wells, J. E., and colleagues. (2014). Barriers to mental health treatment: results from the WHO World Mental Health surveys. Psychological Medicine, 44(6), 1303 to 1317. n=63,678 across 24 countries. pmc.ncbi.nlm.nih.gov
- 07Bukh, J. D., Bock, C., Vinberg, M., and Kessing, L. V. (2013). The effect of prolonged duration of untreated depression on antidepressant treatment outcome. Journal of Affective Disorders, 145(1), 42 to 48. n=270. pubmed.ncbi.nlm.nih.gov
- 08Ghio, L., Gotelli, S., Marcenaro, M., Amore, M., and Natta, W. (2014). Duration of untreated illness and outcomes in unipolar depression: a systematic review and meta-analysis. Journal of Affective Disorders, 152 to 154, 45 to 51. Ten studies identified, three pooled. pubmed.ncbi.nlm.nih.gov
- 09Ghio, L., Gotelli, S., Cervetti, A., Respino, M., Natta, W., Marcenaro, M., Serafini, G., Vaggi, M., Amore, M., and Belvederi Murri, M. (2015). Duration of untreated depression influences clinical outcomes and disability. Journal of Affective Disorders, 175, 224 to 228. n=121. pubmed.ncbi.nlm.nih.gov
- 10van Dijk, D. A., Meijer, R. M., van den Boogaard, T. M., Spijker, J., Ruhe, H. G., and Peeters, F. P. M. L. (2023). Worse off by waiting for treatment? The impact of waiting time on clinical course and treatment outcome for depression in routine care. Journal of Affective Disorders, 322, 205 to 211. n=715. pubmed.ncbi.nlm.nih.gov
- 11Penttila, M., Jaaskelainen, E., Hirvonen, N., Isohanni, M., and Miettunen, J. (2014). Duration of untreated psychosis as predictor of long-term outcome in schizophrenia: systematic review and meta-analysis. British Journal of Psychiatry, 205(2), 88 to 94. 33 samples. pubmed.ncbi.nlm.nih.gov
- 12Krill, P. R., Johnson, R., and Albert, L. (2016). The prevalence of substance use and other mental health concerns among American attorneys. Journal of Addiction Medicine, 10(1), 46 to 52. n=12,825. pmc.ncbi.nlm.nih.gov
- 13Dyrbye, L. N., West, C. P., Sinsky, C. A., Goeders, L. E., Satele, D. V., and Shanafelt, T. D. (2017). Medical licensure questions and physician reluctance to seek care for mental health conditions. Mayo Clinic Proceedings, 92(10), 1486 to 1493. n=5,829. pubmed.ncbi.nlm.nih.gov
- 14Thornicroft, G., Chatterji, S., Evans-Lacko, S., Gruber, M., Sampson, N., and colleagues. (2017). Undertreatment of people with major depressive disorder in 21 countries. British Journal of Psychiatry, 210(2), 119 to 124. n=51,547. pmc.ncbi.nlm.nih.gov
- 15Slepian, M. L., Chun, J. S., and Mason, M. F. (2017). The experience of secrecy. Journal of Personality and Social Psychology, 113(1), 1 to 33. Ten studies, more than 13,000 secrets. columbia.edu
Licensed Clinical Social Worker
Martha Fernandez, LCSW is Co-Founder of CEREVITY and a Licensed Clinical Social Worker licensed in California, seeing clients by telehealth nationwide through CEREVITY's network of independent licensed clinicians. USC-trained and bilingual in English and Spanish, she works with founders, executives, attorneys and pilots on burnout, anxiety and depression in high performers, on trauma, grief and high-stakes transitions, and on couples and relationship strain under pressure. Her clinical work draws on cognitive behavioral therapy, acceptance and commitment therapy, behavioral activation, and narrative and solution-focused approaches. She is the author of Wired to Burn.
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