A succession plan can specify ownership, voting rights, and the timing of leadership changes. It may say less about a successor needing mental health treatment or deciding the proposed role is not right. Those are different situations. A resilient plan should accommodate them without turning health into a test of loyalty or treatment into a promise of family agreement.
Key findings
317 client family offices: the UBS 2025 survey sample.
53%: offices with wealth-succession plans for family members.
64% and 43%: those with plans identifying tax-efficient transfer and next-generation preparation as major challenges.
26%: the report’s figure for consulting the next generation from the outset.
1,587 businesses across 36 countries: the separate Deloitte 2025 family-business survey.
These figures describe governance and business intentions, not psychiatric diagnoses or treatment outcomes among successors. [1] [2]
Readiness and tax efficiency are different challenges
Source: UBS, May 2025. The denominator is the subgroup with plans, not every family or office. [1]
Preparedness may concern experience, skills, interest, governance, or communication. It should not become a mental health diagnosis. A successor reluctant to join the business may be making a reasonable choice rather than displaying a symptom.
The reverse matters too. Strong performance does not rule out a need for care. Clinical concerns should be assessed on their merits rather than filtered through the family’s preferred interpretation of succession.
Several business futures were under consideration
Deloitte’s survey asked about intentions over the following three to five years. Twenty-six percent planned outside investment or private equity, 19% anticipated greater ownership by nonfamily management, 12% planned a public listing, and 3% aimed to sell. These were intentions, not completed transactions or mutually exclusive outcomes. [2]
Source: Deloitte Private, October 2025. The survey does not identify mental health as the cause of these intentions. [2]
The planning implication is not a recommendation for a transaction. It is that succession need not be imagined as one inevitable transfer of an unchanged role on a fixed date. A rigid commercial narrative should not determine what clinical recovery must look like.
Identity is context, not pathology
A 2023 review of 99 academic articles examined incumbent and successor identities in family-business transitions. It described the interaction of business and family roles and identified gaps in cross-cultural and longitudinal research. It did not estimate psychiatric prevalence or test treatment for succession-related distress. [3]
A leadership conversation can also concern belonging, responsibility, and continuity. Recognizing those dimensions does not diagnose the family. It suggests that a technical plan may leave important questions unspoken.
For a clinician, the context may matter when the person chooses to discuss it. The clinical task remains assessment and care, not ensuring the family’s commercial objective prevails.
Keep three decisions separate
| Decision | Concern | Avoid assuming |
|---|---|---|
| Clinical care | Assessment, treatment, safety, and goals | Disagreement with a plan is a symptom |
| Operational continuity | Cover during absence or transition | A temporary absence means permanent incapacity |
| Long-term role | Interests, abilities, and informed choices | Treatment will restore enthusiasm for the expected role |
This is a proposed framework, not a legal determination about authority or capacity. A diagnosis should not become a shortcut to conclusions about every decision a person can make. Clinical, business, and legal questions require their own appropriate advice.
A temporary absence should not become a permanent story
Consider a hypothetical successor who starts treatment and reduces their workload. The family needs an operational plan. It does not follow that the person has lost every ability to contribute or that care must finish by a board meeting already in the calendar.
A useful discussion separates what can be decided now from what needs review. It establishes what the person wants shared. Clinicians advise within their role while other professionals address their own responsibilities; no one person automatically holds every kind of authority.
The opposite shortcut is also unhelpful. Returning to work should not establish full recovery solely because it is commercially convenient. Symptoms, well-being, and sustainability still matter after participation resumes.
The outcome should not be obedience
A treatment program should not promise to make a family member accept a chosen role. A person may improve clinically and choose another career, responsibility level, or transition pace. Those choices do not automatically mean treatment failed.
WHO’s person-centered guidance supports attention to rights and preferences rather than institutional convenience alone. In a family-business setting, that means keeping the recipient of care visible when other stakeholders have strong interests. [4]
A useful outcome framework includes the difficulties prompting assessment, appropriate clinical measures, functioning, and patient-defined goals. Family relationships may matter, but satisfaction with the succession timetable should not be the sole endpoint.
Confidentiality should survive the family meeting
When a family funds treatment, several people may expect updates. The arrangement should clarify what the patient agrees to share and why. An operational update is different from access to detailed clinical records.
Payment should not be treated as automatic permission to circulate a diagnosis among relatives or advisers. The service should explain applicable confidentiality arrangements and their limits in the setting involved. This article is not a universal legal answer.
Agreeing on roles before information circulates can prevent misunderstandings. A sensitive report is difficult to retrieve once distributed. The patient should understand who receives practical information and who needs clinical detail.
The 2026 figure is not a fall from 53% to 35%
UBS’s 2026 report found 35% with a defined succession plan for the family office itself. The 2025 figure concerned wealth-succession plans for family members. Describing them as a decline from 53% to 35% would compare different questions. [1] [5]
This is a useful test for any provocative comparison. The source question must survive alongside the number. Similar words can describe different processes, and a changed question cannot automatically become a deteriorating trend.
What an original study could investigate
A contemporary study could ask successors and incumbents separately about health-related absences, help-seeking, and role changes. It should examine experiences, not just whether a policy exists, and include the recipient’s view of pressure and autonomy.
Financial circumstances, business size, generation, and country need separate definitions. Not every next-generation family member is a successor, and not every succession disagreement reflects illness. Supportive experiences should be reported alongside gaps.
No such survey was conducted for this article. Business surveys provide context, not a hidden prevalence estimate for successor distress. A new study would require its own methods and appropriate safeguards.
Questions worth asking before a crisis
Can responsibilities be covered without unnecessary clinical disclosure? Is there an independent route to assessment? Who coordinates care across countries? Can the succession plan accommodate reassessment rather than require a fixed clinical result?
These questions do not ask a family to predict every illness. They ask whether the arrangement is flexible enough not to treat a health need as a governance failure. They also prevent an assumed readiness from replacing a conversation with the person expected to lead.
A private provider should explain what treatment can and cannot promise. It can assess and address clinical needs. It should not sell guaranteed commercial continuity or family agreement as a health outcome.
Evaluate flexibility rather than agreement
A family could review whether its plan accommodates an unexpected absence, whether appropriate clinical advice is available, and whether the person understands information-sharing arrangements. Those are process questions. They do not establish that the plan improved mental health or prevented a future crisis.
Clinical outcomes require their own measures. The recipient may value reduced symptoms, sustainable responsibilities, or a clearer understanding of personal goals. A business may value continuity. Both perspectives can be discussed without treating commercial agreement as proof of recovery or disagreement as evidence that treatment failed.
That separation makes the discussion more useful for advisers. It identifies which decisions they can help organize and which require clinical or other professional expertise, rather than expecting one succession document to answer every question.
What the numbers cannot tell us
The surveys do not establish that successors are unusually likely to be unwell. Readiness concerns and business intentions are not diagnoses. The evidence does not determine an individual’s capacity, appropriate role, or treatment needs.
The bottom line
A resilient plan leaves room for a real person. Treatment, time, a different role, or no change may be appropriate depending on circumstances. Tax efficiency and a carefully drafted timetable are useful achievements, but they cannot answer whether the plan supports the person who must live with it.
For journalists
Key comparison: among surveyed offices with wealth-succession plans, 64% identified tax-efficient transfer and 43% next-generation preparation as major challenges.
Important caveat: these are business-planning measures, not mental health rates; the 2025 and 2026 succession questions differ.
Suggested attribution: THE BALANCE analysis of succession research and its implications for person-centered care planning.
Methodology and sources
The article separates financial governance, organizational identity, and clinical care. Intentions are not presented as completed transactions or causes of illness. No original clinical or succession-outcome dataset was analyzed.
- UBS. Global Family Office Report 2025, May 21, 2025.
- Deloitte Private. Global Family Business Insights, October 20, 2025.
- Li, Wang, and Cao. Identities in family-business succession: review of 99 articles, March 2023.
- WHO. Person-centered and rights-based community mental health services, 2021.
- UBS. Global Family Office Report 2026, May 28, 2026.
