Who Is Managing the Psychosocial Hazards of the CEO?

This week the NSW Government launched a dedicated Psychosocial Advisory Service, developed with the Black Dog Institute. It came with a number worth reading twice.

Psychosocial complaints to SafeWork NSW have risen from 10% of all requests to 20.5% in four years. More than 3,000 requests in 2025/26. NSW's largest-ever psychosocial compliance blitz issued more than 80 improvement notices across more than 200 workplaces.

The named hazards driving those complaints: workload, lack of role clarity and inadequate support.

The release is aimed at protecting workers. It should be. The data represents real harm to real people, and the legal framework now backing it, with codes enforceable in NSW since 1 July 2026, is long overdue.

But I want to ask a question the release did not ask.

Who is managing the psychosocial hazards of the CEO?

The Person at the Top of the Risk Register

In aged care and healthcare, the most senior leaders carry something that rarely appears in a job description and almost never appears in a governance framework.

They are accountable for the psychological safety of everyone in their organisation. They are expected to model composure, clarity and genuine care in every public moment. They absorb the weight of the decisions that do not have good options. They carry the things that cannot be delegated: the family whose loved one did not receive adequate care, the worker who is breaking under conditions nobody has resourced adequately, the board expectation and the regulator scrutiny and the workforce crisis arriving simultaneously.

And they do this without any formal structure for the psychosocial hazards of their own role.

No workload audit. No role-clarity review. No mechanism for the board to understand what the CEO is actually carrying rather than what they are reporting.

The people most exposed to the hazards SafeWork is now actively enforcing are often the people least likely to have any structured protection from those hazards themselves.

Why This Is a Governance Problem, Not a Wellness One

I want to be precise about why this matters beyond the individual leader.

When a CEO or senior executive operates under sustained, unmanaged load, several things happen. None of them are visible on the dashboard.

• Attention narrows. The leader who is depleted cannot hold the breadth of perspective the role requires. Decisions become more reactive and more defensive.
• Presence erodes. The genuine, attentive presence that makes leadership credible and human stops being possible to sustain. It is replaced by performed presence, which people around them can usually sense even when they cannot name it.
• The culture takes the shape of the leader's depletion. Cultures where workload is unreasonable, where role clarity is absent, where support is inadequate, these are often cultures where the person at the top has been operating in those conditions longest and has, over time, normalised them for the entire organisation.

This is why psychosocial governance that focuses only on the frontline misses the upstream source of many of the problems it is trying to address.

The improvement notices SafeWork NSW is issuing are naming the symptoms. The cause, in many cases, is a leadership layer that has been absorbing more than it can sustainably carry and has begun to make the decisions that reflect that depletion.

What Boards Are Not Yet Doing

The Aged Care Act 2024 makes boards legally accountable for the cultures their organisations operate in. This is an important and correct development.

But I want to ask boards a more specific question: what do you actually know about the load your CEO is carrying right now?

Not what they report. Not what the performance dashboard shows. What is true.

In most of the organisations I work with, the honest answer is: not much. The governance rhythm for CEO performance is typically backward-looking and output-focused. Did we meet our targets? Are our compliance documents in order? Is the board satisfied with the quarterly report?

None of those questions get near the actual psychosocial load of the most senior leader in the building. And yet that load determines, more than almost any other factor, the quality of judgment and culture the organisation will produce.

Boards that are serious about psychosocial governance need to put the executive team on the risk register alongside everyone else. Not as a performance question. As a sustainability question. As a governance question.

What a Different Approach Looks Like

The organisations I work with that genuinely manage executive load well share a few specific practices. None of them are about wellness programs.

• The board chair has a regular, informal conversation with the CEO that is not about the business. Not performance. Not strategy. The actual experience of leading this organisation right now. That conversation creates visibility that no report can provide.
• Executive load is part of the board's risk conversation, not its HR conversation. Treated with the same seriousness as financial risk, regulatory risk and reputational risk, because the consequences of its failure are comparable.
• The CEO has a structured external support relationship, coaching or peer supervision, that is funded by the organisation and valued by the board. Not as a remediation tool but as a standard governance practice.
• The leadership team has a mechanism for carrying difficulty collectively rather than routing it entirely through the CEO. Decision-sharing structures that distribute weight rather than concentrating it at the top.

These are not soft practices. They are the structural interventions that keep the judgment, presence and genuine leadership capacity of the person at the top intact. And that, in turn, is what keeps the culture beneath them human.

The Question Worth Asking Your Board This Week

SafeWork NSW is asking organisations to demonstrate that they have identified their psychosocial hazards, managed them to at least the standard of the Code, and produced evidence that those controls actually operate in practice.

I want to suggest that any board that takes this seriously should begin by asking a question about the person sitting at the head of the table.

What is the psychosocial load of our CEO right now? What are the workload, role clarity and support conditions they are operating under? What does our board actually know about the human experience of leading this organisation in 2026?

The answer to those questions will tell you more about the psychosocial risk profile of your organisation than any compliance document you have produced.

And the conversation that follows them, if it is honest, is where genuine executive self-leadership and genuine board governance finally start to look like the same thing.

Annastacia Wainaina is a Culture Strategist, Global Keynote Speaker and Host of The Human Edge Podcast. She works with boards and executive teams in aged care, healthcare, emergency services and complex people-heavy industries.

Free Leading Under Pressure Field Guide: pressure.annastaciawainaina.com
Executive coaching and board facilitation enquiries: annastacia@annastaciawainaina.com

Sources: NSW Government ministerial release, 22 September 2026 · SafeWork NSW 2025/26 psychosocial requests data · Aged Care Act 2024 (in force November 2025) · NSW Managing Psychosocial Hazards at Work Code of Practice (enforceable 1 July 2026)