More than a third of school leaders in England needed support for mental health or wellbeing issues in the last 12 months, a survey has found.
Ofsted pressures were the factor which had the greatest impact on mental health, according to a poll by the National Association of Headteachers (NAHT).
It comes after a coroner ruled an Ofsted inspection "likely contributed" to headteacher Ruth Perry's death.
Mrs Perry took her own life after Ofsted downgraded her school in Reading from the highest rating to its lowest, citing safeguarding concerns.
In the survey of 1,890 school leaders in England between September and October, 38% reported they had accessed professional support for their mental health in the last year.
Another 11% said they wanted support but did not know how to get it, or were unaware it was available.
Some 84% of those surveyed also said their job had affected their sleep in the last 12 months.
