How a former Kaiser Permanente CFO turned his own near-breakdown into a leadership playbook every executive needs, and why mental health literacy may be the highest-leverage skill you’re still missing.

Who on your team right now is quietly struggling, in a way you’ve noticed but haven’t named?

Sit with that question for a second. Because I think most of us, if we’re honest, can picture a face.

Someone whose energy has dropped. Someone whose patience is thinner than it used to be. Someone whose work is still getting done, but whose presence feels different in a way you can’t quite put your finger on.

And here’s the harder question: would you know what to say? If a colleague was drowning right in front of you, would you have the vocabulary, the courage, and the five minutes it takes to throw them a lifeline?

Here’s what struck me as I sat with this story: most leaders carry physical health literacy without thinking about it.

We’d know what to do if someone collapsed in a board meeting. We’d call 911, no hesitation, no awkwardness, no fear of overstepping.

But put us in front of a teammate quietly unraveling, and most of us freeze. Not because we don’t care. Because nobody ever taught us how.

Here’s what I learned from my chat with Adam Nemer on a recent episode of The Learning to Lead Show. He used to be the CFO and senior operations executive at Kaiser Permanente. He also founded Simple Mental Health and wrote a book called Simple Mental Health: The ROI of Vulnerability.

Adam lived with severe mental illness for seventeen years while managing a multi-billion-dollar health plan. Then, a five-minute chat with his boss changed everything. It saved his life and reshaped his view of leadership.

What he’s learned applies to every leader reading this, regardless of your industry. Here are seven of his most powerful lessons.

Adam Nemer did not come to this work as a clinician. He came to it as the patient who didn’t know he was a patient.

At twenty-nine, he found his father after his father died by suicide. Seventeen years later, he found his mother after a long battle with substance use and severe mental illness.

In between those two bookends, Adam built the kind of career most people would envy: CFO of a hospital, national finance leader on a multi-billion-dollar labor negotiation, head of operations for a regional health plan at Kaiser Permanente. By every external measure, he was thriving.

And all along, he was sick. For seventeen years, he checked every clinical box for severe mental illness. He had suicidal ideation most days. He kept it hidden behind a mask of competence he had, without realizing it, learned to wear implicitly.

Then his mother passed. The mask cracked. He showed up to work in a Levi’s t-shirt and flip-flops, hair Einstein-wild, patience gone, mean as hell to everybody.

And his boss, David Lake, who had spent the previous Sunday morning in a mental health first aid class at his church, slid a business card across the desk in a five-minute conversation that, by Adam’s own account, saved his life.

What happened next is the story Adam now tells from stages and pages everywhere. These are the seven lessons I want you to walk away with.

Here’s what I keep coming back to from Adam’s story. The reason David Lake was able to do what he did on that Monday morning had almost nothing to do with the mental health class he had attended the day before. The class gave him the vocabulary. But what gave him the courage was who he already was as a leader.

Adam credits one of David’s core leadership principles, err on the side of mercy over justice, with shaping the entire encounter. A leader who defaults to mercy asks questions rather than rendering verdicts.

A leader who defaults to mercy assumes there’s more going on beneath the surface than they can see. A leader who defaults to mercy slides a business card across the desk instead of writing someone up.

“When you choose as a leader to err on the side of mercy over justice, everything in your leadership approach will change.”

This is not a soft idea. It’s an operational one. The team member who shows up late three weeks in a row, who has stopped contributing to meetings, whose work has quietly slipped, can be treated as a performance issue or as a human being.

Mercy doesn’t mean avoiding accountability. It means starting with curiosity. It means giving yourself permission to ask the question before you reach for the policy.

Adam makes a point that should stop every leader in their tracks. We all carry physical health literacy around with us every day without thinking about it.

If someone started choking in a board meeting, we’d know what to do. If someone collapsed from a heart attack, we’d call 911. That literacy is so normalized, we forget we even have it.

Mental health literacy is the same skill set, but almost nobody has it. The ability to notice the signs that someone might be struggling. The ability to approach them in a safe, thoughtful, non-judgmental way. The ability to guide them to the resources where they can actually get help.

That’s it. That’s the whole toolkit. And it can be learned in a few hours.

“A senior leader at an $80 billion company put mental health literacy in his professional toolbox in a few-hour class at his church one day. That, in a five-minute conversation, helped save my life.”

Stay with me here. A few hours of training. A five-minute conversation. A human life. The ROI of mental health literacy is, by almost any measure, one of the most leveraged investments a leader can make.

Adam argues that teaching it should be as routine as the annual safety training everyone clicks through every January. It takes a single morning.

It costs almost nothing. And it could change the trajectory of lives inside your organization that you don’t even know are in trouble.

When Adam reflects on his early career, the first piece of advice he’d give his younger self is almost painful in its simplicity: be yourself.

He spent so many years hiding who he really was, convinced that if people knew the CFO of the hospital had these interests, or those questions, or this humanity, he couldn’t have the job. So he performed. He wore the mask. And the mask cost him.

Sound familiar? Because I think most leaders, somewhere along the way, learn to perform a version of themselves they think the role demands. The polished version. The unflappable version. The version who has it all figured out. And we keep performing it until we forget there was ever anyone else underneath.

The lesson isn’t that leaders should overshare or blur every boundary. It’s that the energy required to maintain a false version of yourself at work, year after year, is a quiet form of self-harm that compounds. And it costs the team too. Because teams that work for inauthentic leaders learn to be inauthentic in return. They perform safety instead of feeling it.

When Adam came back from his six-week medical leave and finally told his team what he’d been carrying, the most common reaction on the thank-you cards that showed up on his desk the next day was a single sentence: " Me too.

The people around him had been waiting, for years, for permission to be themselves. All he had to do was go first.

What David Lake did that Monday morning is the clearest picture of modern leadership Adam can point to. It wasn’t a grand speech. It wasn’t a strategic intervention. It wasn’t a performance plan. It was a short, caring, deliberate conversation at 8:00 AM that lasted less than five minutes and did more than a thousand trainings could have done.

But it didn’t happen by accident. Every detail was planned. Getting Adam to the office sixteen hours after the church class was its own logistical challenge.

David couldn’t call directly; he had his assistant call Adam’s assistant so the request wouldn’t feel like an ambush. He dug through his desk on a weekend to find an old business card for the EAP leader.

He workshopped what he was going to say with his church class because even after a workshop, he wasn’t sure he had the right words. And at the end, he made one more move to ensure Adam would actually follow through: he offered to call the EAP leader himself, so the call would be returned right away.

“That senior leader put mental health literacy in his professional toolbox in a few hours. And in a five-minute conversation, he helped save my life.”

Here’s what I’ve learned: leaders consistently overestimate the size of the intervention a person needs and underestimate the size of the intervention they can actually deliver.

Five minutes is not a small thing. Five minutes, at the right moment, by the right person, with the right words, can be the moment a human being’s whole life turns. The question is whether you’re ready to be the one who delivers it.

One of the most remarkable things about David Lake's response after Adam’s diagnosis was how unremarkable he made it feel.

When Adam called him that morning, he was about to reach out to the psychiatric crisis line, and David’s response was calm and clear. Turn off your computer. Turn off your phone. Don’t check in unless you want to. Your team and I have it covered. You’ll know when the right time is to come back.

Then a single thoughtful follow-up: would Adam be comfortable having the team told what was going on, in a way they’d keep confidential, so they could support him appropriately? Adam said yes. And that was that.

“David treated me no differently than if I’d called and said I had stage three prostate cancer and needed to go in for surgery that evening. He treated me no differently with my mental illness than he would’ve with a physical illness.”

Here’s the clarifying principle Adam gives every leader who asks him what they’re supposed to do when someone on their team is struggling with mental well-being: what would you do if they were struggling with their physical health?

That single question answers almost every other question. You’d ask how they’re doing. You’d check in. You’d cover their work. You wouldn’t violate their privacy, but you also wouldn’t pretend nothing was happening.

You don’t need a book. You don’t need a class. You just need to treat mental illness with the same matter-of-fact humanity you’d already bring to physical illness. The playbook has been sitting in front of you your whole life.

After his medical leave, Adam came back with a different set of eyes. He was running an operations team of four hundred people, which meant that, statistically, at least eighty of them were walking around carrying some version of what he’d just lived through. He couldn’t unknow that.

So he did something nobody had asked him to do. He volunteered to pilot a half-day mental health first aid workshop for each of them. Claims processors. Executives. Supervisors. All of them.

In groups of thirty, they learned the same few things David Lake had walked into that office knowing. How to notice. How to approach. How to guide.

And while the training rolled out, Adam modeled the second half of the playbook himself, being open every day about what was happening with his mental health, in front of senior leaders and staff alike.

Guys, I’m having an anxiety attack. I need to step out. I’ve got a therapy appointment I’m late for.

Normalization, in real time, at the top of the org chart.

Two years later, that region was at the top of Kaiser’s nationwide health plan operations. The only five-star-rated Medicare plan in the system. Top six percent of Medicare plans in the country. Highest employee engagement in the company.

And Adam will be the first to tell you that they didn’t install a new technology, redesign their process, or hire a famous consultant. They trained people in mental health first aid. They normalized the topic. They talked about it out loud.

“All I wanted to do was help people, not hurt. We became the highest-performing region in our company, the highest-performing company in our region, and one of the highest-performing in the nation.”

The numbers around this are not subtle. Depression alone causes an average productivity drop of thirty-five percent, two full days of a workweek invisibly lost.

Employees struggling with mental health take five times more unplanned absences a year. Fifty percent of millennials and seventy percent of Gen Z-ers have left a job citing mental health reasons.

These are not soft statistics. These are bottom-line numbers. And the only reliable way to move them in the right direction is to stop pretending the topic doesn’t exist.

Adam Nemer spent seventeen years hiding in plain sight inside one of the largest care organizations in the country. He built a career most people would envy while carrying every clinical symptom of severe mental illness alone.

And the thing that finally cracked the silence wasn’t a clinician, a retreat, a self-help book, or another leadership training. It was a colleague who took a Sunday-morning class and had the courage to apply what he learned the very next day.

That’s what I want every leader reading this to keep in their bones. A Sunday morning church class. A five-minute Monday morning conversation. A life saved. A career reborn. A movement started. That is what mental health literacy, in the professional toolbox of a good person, can do.

One in four of the people in your meetings today is carrying something you cannot see. Most of them will not get help for more than a decade. And the single most determinative factor in whether they do, statistically, repeatedly, across every study that has measured it, is whether somebody in their life has the courage to have a five-minute conversation.

That somebody could be you. That conversation could be today.

Pick one principle from this list, just one, and put it into practice this week. Not all seven. Just the one your gut already knew you needed when you read it.

• Maybe it’s defaulting to mercy with the team member you’ve quietly written off.

• Maybe it’s signing up for a mental health first aid class — or bringing one into your organization.

• Maybe it’s having the five-minute conversation you’ve been putting off with someone who’s clearly drowning.

• Maybe it’s telling your team one true thing about your own story that gives them permission to tell theirs.

Whatever it is — take the step. Then come back next week and take another one. That’s how mentally healthy cultures are built. One five-minute conversation at a time.

Be like Dave.

• Breaking The Silence: Leadership and Mental Health with Adam Nemer

• Simple Mental Health: The ROI of Vulnerability — Adam Nemer

• The Five Dysfunctions of a Team — Patrick Lencioni

• The Odyssey — Homer

• Shakespeare’s Tragedies (especially King Lear)

• Disturbing the Peace — Václav Havel

• The 7 Habits of Highly Effective People — Stephen R. Covey

• LinkedIn

• Website

• Book-Simple Mental Health