An interesting footnote to the recent NBA playoff matchup between the Toronto Raptors and the Cleveland Cavaliers was that the series featured two players who have unintentionally emerged as for the league. It began during All-Star weekend in February, when Toronto guard DeMar DeRozan elicited widespread for a about his depression. Inspired by the candidness of his fellow hooper, Cleveland鈥檚 Kevin Love subsequently published a on the Player鈥檚 Tribune about suffering a mid-game panic attack. The article went viral, and Love in response. The NBA, perhaps feeling the pressure to issue a response of its own, recently announced that it would be creating a new position for a . The recent focus on psychological well-being feels like a welcome change of tack for the league.
One might wonder, however, why it鈥檚 still a big deal when two professional basketball players open up about an issue that affects in a country reputed to have the highest rate of antidepressant use in the world. Mental illness, it seems, is ubiquitous in America. But among the nation鈥檚 sporting elite, the subject still feels like a repressed secret.
鈥淚 think that鈥檚 the biggest burden on American sport culture,鈥 says Brent Walker, an executive board member with the . 鈥淚鈥檝e heard repeatedly from professional and elite athletes how they don鈥檛 want to admit having to having a weakness鈥攎ental [illness] being one of those.鈥
While it obviously isn鈥檛 only a burden in America, other countries seem to be doing more about it. Late last year, the was founded at the University of Ottawa, with the hope of 鈥渄esigning, implementing, and evaluating a novel mental health care model for Canadian competitive and high-performance athletes and coaches.鈥 Meanwhile, in March, the British government鈥檚 Department for (DCMS) announced via that it would be implementing a Mental Health and Elite Sport Action Plan to 鈥渂reak down the stigma around mental health.鈥 The move was partially inspired by a number of prominent British athletes, including former Team Sky cyclist , opening up about their struggles with depression. At its core, the initiative is a push to provide better resources for athletes by educating coaches and national governing body officials about the telltale signs of mental illness and by making psychological support more widely available.
What might 鈥渂reaking down the stigma around mental health鈥 look like in practice?
I put that question to Emma Boggis, one of the architects behind the British plan and chief executive of the . Boggis, whose organization works with national governing bodies to support both professional athletes and weekend hobbyists, cited a program by (essentially the UK equivalent of the USATF) called . The campaign asked running clubs throughout the country to designate mental health ambassadors as a point of contact for members who may be suffering from anxiety or depression. While #runandtalk is meant to help athletes at all levels (not only elites), it鈥檚 an example of how the national sporting infrastructure can be infused with a mental health agenda.
鈥淲e want the system to be requiring things,鈥 Boggis says, explaining that an action plan ultimately has the best chance of succeeding when its components are mandated by government policy.
In this respect, the UK has a distinct advantage over the United States. Across the pond, it鈥檚 common for organizations like England Athletics to be government-funded鈥攚hich is rather useful when the government is trying to enforce an idea like the Mental Health and Elite Sport Action Plan.
鈥淚t almost becomes a condition of onward funding that organizations demonstrate that they are taking mental health seriously and that they are doing some of the things set out,鈥 Boggis says. 鈥淚t鈥檚 what we might call a 鈥榮tick approach.鈥 While that maybe isn鈥檛 the best motivation, you can see how, practically, it can be quite a strong motivation for some.鈥
The fragmented nature of the American athletic landscape poses a central challenge to tackling an issue like mental illness.
From an American perspective, the whole concept of the government providing more health resources for athletes might seem, well, foreign. Unlike many other countries, there is no sports ministry in the United States. (The is the closest thing we have, but its projects tend to fall more under the category of 鈥溾濃攖hat is, the practice of enlisting celebrity athletes to serve as cultural ambassadors abroad.) Instead, athlete health programs are provided, with varying degrees of effectiveness, by the individual leagues and governing bodies, like the NBA or . In theory, the absence of government bureaucracy could make these organizations more nimble in dealing with issues of mental illness, but only if they are willing to recognize these issues in the first place. If Kevin Love鈥檚 example is any indicator, some sports still have a ways to go鈥攁nd not only the bastions of old-school machismo like pro football and basketball.
鈥淧robably 75, 80, 90 percent of athletes coming off an Olympic Games go through some kind of post-Olympic depression. And that鈥檚 something we have to be able to figure out and help people get through,鈥 Michael Phelps recently told David Axelrod in a .
鈥淚鈥檓 somebody who鈥檚 gone through at least three or four major depression spells after games that, you know, I鈥檝e put my life in danger.鈥 Phelps added, before calling out the U.S. Olympic Committee (USOC) for not doing more to help Olympic athletes reenter civilian life. Given for not always providing Olympic athletes with the support they need鈥攆inancial or otherwise鈥攊t鈥檚 encouraging that Phelps, arguably the most famous Olympian of all time, is putting pressure on the organization to do better.
Perhaps that鈥檚 what the American version of the 鈥渟tick approach鈥 to forcing better athlete care looks like: high-wattage megastars like Phelps using their clout to improve the status quo in their respective sports. But while the celebrity pulpit may be a useful way to get the ball rolling鈥攁fter all, the UK action plan was also initiated thanks to some of pro-athlete depression鈥攊t鈥檚 up to the governing bodies to act.
Of course, these individual governing bodies are still going have vastly different resources at their disposal. And for certain sports, like ultrarunning, no governing body exists. The fragmented nature of the American athletic landscape poses a central challenge to tackling an issue like mental illness. It鈥檚 great that a billion-dollar league like the NBA has decided to hire a director of mental health and wellness or that the NCAA can offer support to collegiate athletes鈥攂ut ultimately that鈥檒l be of little use to the 24-year-old who wants to make it as a pro runner. This is the sort of person who would benefit greatly if something like the Canadian Centre for Mental Health and Sport existed on our side of the border.
鈥淚 think it has incredible potential,鈥 , Canadian ultrarunner and mental health advocate, told me about the new initiative in his native country. Krar has lived in the United States since 1996; reflecting on the situation in his adopted home, he added, 鈥淪o many semiprofessional athletes, they come out of college and they鈥檙e dead broke trying to make a living out of running. I鈥檓 sure there are a lot of younger athletes out there who don鈥檛 seek treatment just because they can鈥檛 afford it.鈥
This is a complicated issue, and it hardly seems irrelevant to this debate that Canada has universal health care while the United States does not. And even if it were feasible to replicate here, a top-down, far-reaching action plan like what we鈥檙e seeing in the UK may have its limitations. But the very existence of these initiatives implies that these countries are taking athlete mental health more seriously than before. It鈥檚 about time we followed their lead.