Leading an association can be an incredibly rewarding career, but it often comes with significant costs to the mental and physical health of chief staff executives (CSEs). After several discussions surrounding this topic, four executive directors created a plan to collect real data outside of individual support circles.

A recent survey of nearly 150 chief executives reveals that many are struggling with physical and mental health issues including high levels of stress and burnout. The findings underscore the urgent need for improved governance, support systems, and greater awareness of personal well-being among nonprofit leaders. We outline some of the results below, with plans to offer additional results and further discussion through industry podcasts, association conferences, and ASAE leadership councils.

Stress, Health, and Work-Life Balance: A Shifting Paradigm

In the survey, 85% of the chief executives reported their personal health and well-being had been negatively impacted by their role, and 60% of respondents said they struggled with sleep or used sleep medication. Additionally, 89 of 147 respondents admitted that at some point, their professional performance had suffered due to de-prioritizing their mental or physical health.

While the notion of work-life harmony has gained popularity, many CSEs have discovered that harmony alone is not sustainable. Even though leaders are entrusted with guiding their organizations, they must remember they are not their organizations. True leadership thrives when personal boundaries are respected, allowing executives to recharge and lead with clarity and purpose.

Yet setting these boundaries remains challenging. The pressures of social media further complicate matters. Platforms like LinkedIn may cause comparisons to peers or increased pressure to perform and can become sources of anxiety or unwarranted judgment. Demanding board members and the mentoring of staff can mean extended working hours, along with an expectation that executives should “give back” to the community.

Governance Challenges and Leadership Transitions

The pressures on nonprofit CSEs are often compounded by governance models and governance cultures. Volunteer boards and executive committees may have limited experience providing healthy oversight or fail to prioritize the executive’s personal needs, such as vacation days or mental health breaks. For executives working for professional service companies or management companies, there may be less pressure as the board is the client and not the boss.

In many cases, nonprofit boards operate under an “organization first” mentality, expecting leaders to remain accessible to multiple stakeholders at all times. The challenges of managing staff, board members, committees, and volunteers—often with conflicting urgencies—leave little room for executives to set boundaries. This lack of separation between personal and professional life can lead to severe stress and burnout.

The survey data suggests that executives who have been in their roles between zero and four years are more likely to leave if the role does not meet their expectations, potentially creating a leadership void in the sector. Longtime CSEs, on the other hand, often stay on despite high stress, lacking an exit strategy or support for a healthy transition.

Self-Harm, Gender Disparities, and Physical Health Concerns

Worryingly, six respondents disclosed experiencing suicidal thoughts, underscoring the gravity of the mental health crisis among association leaders. Chronic health issues were also prevalent. Of the 147 respondents, 34 reported muscle or joint pain, and others reported stress-induced conditions such as migraines, gastrointestinal problems, high blood pressure, and emotional swings.

The survey also highlighted notable gender disparities in health outcomes. Among respondents identifying as women, nearly half (41 of 86) said that their physical health was a lower priority than their professional responsibilities, compared to only 19 of 61 respondents identifying as men. Furthermore, while 80% of men who responded engaged in physical activity more than twice a week; only 56% of women reported the same. Unfortunately, these findings reinforce what we’ve long suspected—a systemic issue where women in leadership roles are disproportionately sacrificing their physical well-being for professional responsibilities.

Building a Path to Healthier Leadership

Given the challenges facing CSEs, it’s clear that the association sector needs to rethink how it supports its leaders. Recruiters can play a key role in identifying and onboarding executives, not just as talent matchmakers but also as allies who promote sustainable work practices. Boards and governance structures must also evolve to offer more proactive oversight of CSE well-being, ensuring executives take time off, receive professional support, and maintain healthy boundaries.

While the traditional model of leadership is surely changing, the shift comes with growing pains. As newer CSEs demonstrate a willingness to step away from roles that prove unsustainable, the sector must develop more robust succession plans. Without these changes, the nonprofit world risks facing a leadership void, with fewer individuals willing to take on the responsibilities of a CSE.

Addressing these challenges requires a cultural shift within nonprofit governance, better onboarding processes, and a commitment to executive well-being through the availability of physical and mental health resources. New and seasoned leaders must work to create healthy governance cultures in collaboration with volunteer boards. To create a healthy, inclusive, and rewarding work environment that considers the whole person, executives need to model the behavior. Now more than ever, it is essential to foster healthier leadership practices, because when executives flourish, the entire organization and those we serve do too—along with the association profession as a viable career pathway for a more diverse population.