The hidden mental health struggles of the wealthy – as seen on Canadian Family Offices

When we think about highly successful individuals, qualities like innovative thinking, creativity and confidence naturally spring to mind.

You can read countless studies, articles and business biographies about how visionaries and C-suite executives share key personality traits that have led them to success and earned them a place in the high-net-worth category.

What we hear less about are the specific emotional and psychological challenges that successful people often face—challenges that can lead to mental health issues such as burnout, depression and substance use disorder.

“When people achieve a great deal of success in their work, it becomes a source of gratification and healthy self-worth,” explains Dr. Kam Balchand, a psychiatrist at The Residence at Homewood, one of Canada’s top private mental health treatment facilities. “And it can be tempting to invest more of themselves into work and avoid areas of their life that might be more challenging—where they feel less in control, more helpless.”

Furthermore, Dr. Balchand says this group can struggle with perfectionism. “They can have a mindset that is very achievement-oriented,” he says, “and we know that excessive and unhealthy perfectionism is a risk factor for depression, anxiety and distress.”

Those are among the conditions Dr. Balchand treats in his practice at The Residence at Homewood, which takes a highly customized approach to each patient. “The content of the sessions is tailored to each individual’s difficulties,” he says, “which allows us to address multiple areas, as opposed to focusing solely on a client’s mood disorder or substance use disorder, for example.”

At The Residence, an interdisciplinary therapeutic team is on-site every day, complemented by nursing staff who provide around-the-clock care and support. Treatment plans are multi-modal and multi-disciplinary, meaning clients can work one-on-one with a therapist or in a group setting, while also receiving recreation therapy or mindful meditation instruction. This holistic approach to care, says Dr. Balchand, helps clients develop healthy routines and habits in a therapeutic setting.

Located in Guelph, Ont., The Residence at Homewood is on the same 50-acre campus as the Homewood Health Centre—one of the country’s leading facilities for addiction and mental health treatment. Patients stay in a beautiful historic building, where they can feel comfortable and well cared for amid the exclusive amenities and serene atmosphere of a boutique luxury hotel.

Patients have access to an on-site gym, personal training, yoga, massage therapy, a strength and conditioning coach, a nutritionist, secluded and landscaped walking trails, and tennis courts. The campus is on a forested, private property where care is delivered in an environment that ensures privacy and confidentiality.

That is by design. Discretion is key for a cohort that Dr. Balchand says can be especially concerned with the stigma associated with mental health issues. “The stigma of having emotional difficulties is very real, especially if people equate mental illness with weakness,” he says. “For people used to being self-reliant, it can be difficult to come to terms with a problem they can’t solve themselves.”

Shame and guilt can also be barriers to seeking help. The wealthy and accomplished can be particularly susceptible to overwhelming guilt for experiencing any kind of mental distress. “We hear that a lot from clients, particularly when talking about depression,” says Dr. Balchand. “They feel that they should not be depressed. They say, ‘I’ve had a good childhood, a good life and all these comforts.’ This makes it harder to ask for help.”

Yet the risks of not asking for help can be substantial. Over time, disorders can become harder to treat, says Dr. Balchand, and can have detrimental ripple effects on family, which is why he recommends early intervention. “There’s a risk that people start to self-medicate,” he adds. “And if they’ve got an underlying vulnerability, what starts as self-medication can turn into addiction, disordered eating, or some other repetitive unhealthy behaviour.”

The Residence has the benefit of working closely with the Homewood Research Institute to develop and apply evidence-based therapies to treat substance use disorders. Clients have access to a support system that includes peers and networks, as well as medical detox management, self-help groups, SMART Recovery and/or 12-step approaches.

As well, The Residence now provides specialized therapies for treatment-resistant depression, including Ketamine Infusion Therapy, repetitive Transcranial Magnetic Stimulation (rTMS) and Electroconvulsive Therapy (ECT) administered under the care of a psychiatrist.

The care doesn’t end when clients leave treatment. Each client is provided a recovery management program consisting of a full year of individual and group sessions. The Residence also connects patients with professional supports so they can continue the work they started.

Dr. Kam Balchand is a psychiatrist at The Residence at Homewood. A Fellow of the Royal College of Physicians and Surgeons of Canada, he completed an undergraduate medical degree at the University of Toronto, postgraduate psychiatry training at the University of Manitoba, and a fellowship in Addiction Psychiatry at Yale University. Dr. Balchand provides assessment and treatment services to adults experiencing a range of difficulties including mood and anxiety disorders, substance use disorders, trauma-related disorders, and psychosis. He is an Assistant Clinical Professor, Adjunct in the Department of Psychiatry and Behavioral Neurosciences at McMaster University.