Entrepreneur Mental Health: How a Venture Capitalist Can Help

by: Ryan K. Louie, MD, PhD and Amit Garg, MS, MBA


The topic of mental health of entrepreneurs is surfacing in the startup community, putting a spotlight on health issues of the mind that are not always seen on the outside. Entrepreneurs face many pressures in their personal and private lives during their startup careers. The emerging field of the psychiatry of entrepreneurship highlights these mental health concerns of the startup world. Cultural norms of the workplace often reward shows of confidence and strength, while penalizing displays of vulnerability or weakness. The stigma of mental health can be daunting in the general public, and the startup community is no exception. Entrepreneurs might hesitate to get the care they need, and instead carry a hidden burden within themselves. Constant stress and burnout are becoming common issues that many people have come to expect as givens, if they want to race in the startup lane. Depression and sadly the suicide of startup founders have been reported in several recent articles in the technology press. With these developments, it’s time for us all to take a moment to ask some questions. Innovation ecosystems such as Silicon Valley pride themselves on the creativity, tenacity, and passion of entrepreneurs to make things happen. But in the creation process of companies, does startup culture have to mean that the mental health of entrepreneurs goes downhill? What can we as a community do to make positive change in entrepreneur mental health? What can be realistically changed in the daily work flow and life of the entrepreneur?


One starting point for a new conversation on startup mental health is from the perspective of the venture capitalist (VC) community that supports startups. Besides providing financial and knowledge resources, VCs play key roles in mentorship and the shaping of culture as they interact with entrepreneurs.

Here are 3 examples of where we see challenges in startup environments, and some practical things that VCs can do to help promote wellbeing of entrepreneurs:


Turning a vulnerability into a strength

“Fake it till you make it” is the reigning mantra in business, even more so in the risk-fraught startup world. Showing vulnerability publicly like the recent post by Buffer’s CEO — a refreshing attitude of radical transparency — is still the exception. Entrepreneurs are by definition individuals who defy existing paradigms and must project confidence and conviction in order to succeed. As such, VCs have an important role to play in creating a safe environment for founders to be able to discuss, at least privately, all the issues plaguing their business. Of all the different constituents a founder has — employees, lawyers, clients, suppliers, partners, advisors, etc. — we would argue that the investor is the one who will be able to best contextualize dispassionately how the challenges and the promises of a startup play out against each other. Indeed, a VC has the biggest responsibility in understanding the full picture, not just the marketing of the company, and providing the critical tools for the entrepreneur to manage his / her fears and failures. It’s a social contract — the player has to be open with the coach and the coach has to be helpful to the player. Together, they are strong.


Make mental health and wellness as metrics rewarded in a startup

Companies have long tried to provide incentives to employees that have healthy behaviors, the obvious logic being that healthier employees are more efficient and create a happier culture. Startups like Jiff are in the sole business of helping other companies create health benefits platforms. But for the large part that has been about physical not mental health and focused on corporates not startups. Part of the challenge is while we can partly quantify physical health (blood glucose, heart rate, etc.) it’s very hard to measure exactly what mental health is. There are significant efforts around it, for instance BioBeats takes your heart rate variability and converts it into a measure of stress, helping to provide wellbeing insights for employees. Business has often framed conversations around the bottomline and topline (i.e. costs and revenues). It’s about time we formalize a third metric which is centered on culture, of which mental health is a critical component. In the fast-moving world of a startup we talk all the time about pageviews or churn, but it should go without saying that an individual’s skills and health are what really enable them. The VC’s role here is to help founders think about this dimension from day 1.


Build trust and show entrepreneurs that their health is valued

Employee wellbeing is the foundation of a startup culture and one obvious starting point that a VC can influence. Zappos really pushed for the concept of Chief Happiness Officer. AirBnB has pushed for Chief Employee Experience Officer. Even an organization like the Golden State Warriors, which you might not think of as a “startup” but has effectively been rebooted through a VC mindset, offers some powerful lessons around nurturing its employees. These approaches have plenty of critics but we commend these companies for taking them — it’s definitely better than doing nothing and just waiting for problems to go away. Instead, these companies are innovating and creating a visible daily statement that shows they care. What a VC can really influence here is to help embed wellbeing into the startup’s DNA by requiring a true commitment from management. As well-meaning as they might be, these initiatives can easily degenerate into fluff. Wellbeing is the right thing to do — good for people and good for business. A happy startup is a startup more likely to succeed. And that applies to people starting anything.


Genuine support for mental health should be included in every startup package for entrepreneurs. With a more transparent and open conversation about mental health that’s built on trust, the startup community can venture forward towards a more positive environment for entrepreneurs and their endeavors.


Ryan is a psychiatrist specialized in entrepreneur mental health. Amit is an operator / entrepreneur turned venture capitalist currently investing out of Samsung’s early stage fund in Silicon Valley. For full disclosure: Ryan has no financial disclosures. Amit represents Samsung’s investment in BioBeats.