Mental Health Was a Hot Topic During the Last Olympics. Has Anything Changed Since Then?

Three years ago, Simone Biles dropped out of the Tokyo 2021 Olympics after experiencing a mental block known as “the twisties.” Biles was faced with a fair amount of criticism for that move. But she also got a lot of support for publicly and openly taking care of her mental well-being, even at the expense of her ability to compete in the largest sporting event in the world.

Just a few months prior, tennis star Naomi Osaka had withdrawn from the 2021 French Open, citing struggles with depression and anxiety. And together, these two athletes launched what became an international conversation about mental health in sports.

In many ways in 2021, in the midst of the global pandemic, mental health was at the forefront of every conversation. So it’s not surprising that the world of professional sports was contending with its own mental health reckoning. At the time, officials seemed to be listening and eager to do better. But now, on the cusp of the next Paris 2024 Olympics, many people are wondering: has anything actually changed?

Experts Featured in This Article

Dominique Dawes is a three-time Olympian and the first Black gymnast to win an Olympic gold medal.

Natasha Trujillo, PhD, is a licensed counseling and sport psychologist.

How the Conversation About Athletes’ Mental Health Is Changing

Until well-known athletes began speaking openly about the mental health demands of their careers, many people hadn’t necessarily considered the stresses they’re often under.

“I think people look at athletes and they see a $100 million contract, or that they’ve broken all these records and have all [these markers of success], and they’re thinking, ‘They can’t be dealing with mental health [issues],'” Dominique Dawes, a three-time Olympian and the first Black gymnast to win an Olympic gold medal, tells PS. But, she adds, “It’s a myth that the world’s idea of success leads to fulfillment and happiness.”

Even setting aside external success, athletes are often lauded for their resilience and grit, which can create an environment where they don’t feel able to reach out and ask for help.

Looking back on her time competing at the Olympics in 1992, 1996, and 2000, Dawes wishes leaders had made space for athletes to be able to speak up about struggles without fear of losing opportunities.

“It was all about medals and money for the organization and less focused on the individual athletes,” Dawes says. “The mindset back then was all about winning and being champions. And I think that’s something that does need to change in some capacity. You want to bring home the gold medal, especially if you’re capable of winning gold. But there also needs to be a listening ear for these athletes to say, ‘Hey, I’m not OK.'”

To that end, Biles’s decision to withdraw from the Tokyo Olympics was incredibly brave. She was walking away from an opportunity many of the most talented athletes spend their entire careers hoping to get. Someone who was newer to their sport, or not as dominant, or with fewer (or no) sponsorships might not have been able to take the risk of prioritizing their own mental health, or to speak frankly about what they were going through.

This is one reason why Biles’s – and Osaka’s – decisions were so groundbreaking: not just to step back, but to be honest about why they were stepping back. In doing so, they opened the door to more productive conversations about athletes’ mental health. And hopefully, as a result, all athletes’ will enjoy better mental health-care.

Biles and Osaka weren’t the first athletes to ever talk about mental health, of course. Tennis alum Mardy Fish became a mental health advocate after an anxiety attack forced him to withdraw from a U.S. Open match against Roger Federer more than a decade ago. Swimmer Michael Phelps, the most decorated athlete in Olympic history, opened up in 2015 about dealing with anxiety, depression, and suicidal thoughts after each of his Olympic games ended. The 2020 documentary “The Weight of Gold” features several Olympians speaking up about the mental health challenges of competing at the highest levels in one’s sport.

But Biles and Osaka happened to be speaking at a time when more people were finally listening. And against public scrutiny and potential career ramifications, these trailblazers have helped remind the public that their international renown doesn’t negate their personal struggles.

What’s Being Done to Support Athletes’ Mental Health in Paris?

“We really are seeing a fundamental shift,” in how professional athletes and their support teams treat mental health, licensed counseling and sport psychologist Natasha Trujillo, PhD, tells PS.

In 2020, the United States Olympic and Paralympic Committee (USOPC) vowed to delegate resources to athletes for their mental health. As of May of this year, the USOPC employed 14 full-time licensed mental health staffers, according to Forbes. To cast a wider net, it offers a mental health registry, an online database that helps link athletes with more than 300 licensed, vetted mental health professionals.

Licensed clinical mental health providers and psychiatrists are listed along with contact information, states they’re licensed to practice in, and which, if any insurance they accept. (The USOPC also offers a mental health fund to pay “outstanding costs from medically necessary or sports-related healthcare, per its website.)

The USOPC has also trained 800 coaches, staff, athletes and others in Mental Health First Aid.

A $10 million donation last year from the Rieschel Family Foundation is funding the USOPC’s five-year plan to build Team USA’s mental health program. Phase one involves expanding resources to ensure that every athlete has access to a licensed mental health provider. In the coming years, the USOPC also plans to develop new programming for athlete advocacy and sustain that programming through the 2028 Olympics.

A spokesperson for the USOPC was not available for further comment.

Outside of the USOPC’s efforts, USA Gymnastics even brought therapy dogs to the Olympic trials last month. While petting a pup before a floor routine isn’t curing any serious mental illnesses, some in the sports industry are hopeful that increased awareness will bring about positive change.

Additionally, this year the Olympics will also have a dedicated hub to promote athletes’ mental health for the first time ever, being called the Athlete365 Mind Zone x Powerade.

It’s a space within the Olympic Village fitness center that the Olympic Committee dubs a “safe and welcoming space for [athletes] to tune in to your emotional needs, prepare your mind for your next training session or event, and check in with a trained staff member for further support.” Its staffers are all trained in mental health first aid, per the website. The soothing space is equipped with yoga mats, comfy chairs, a VR meditation zone and more.

And while experts applaud these steps forward, some say the work is far from over.

What Still Needs to Be Done to Support Athletes?

“Although I want to be optimistic and point out that we have definitely made strides and we’re in a different place than we were, there really is still so much work to be done,” Dr. Trujillo says.

While the USOPC’s most recent annual impact report found that more than 1,000 athletes and 82 teams requested mental health services last year through that registry, Dr. Trujillo says that more can be done to ensure more athletes actually use the mental health resources being offered to them. “My perception as an individual is that [the USOPC registry] is underutilized and in talking with other colleagues I think we share that, but I do know that their team is working hard to make that more accessible,” says Dr. Trujillo, one of the counselors on the registry. “It’s just one of those things that they need to keep pushing.”

While it may be tempting to interpret the lack of engagement with mental health resources as signs that athletes don’t actually need them, the truth is that there’s still a stigma around getting mental health help, Dr. Trujillo says. So to make the resources actually accessible requires creating an environment in which athletes feel comfortable using them.

“It’s hard to get an athlete into an office like mine if they don’t have support. And some of them will be very secretive and not tell anyone. But when you have people in your space encouraging mental well-being, athletes are so much more likely to reach out,” Dr. Trujillo explains.

Dawes agrees, saying that making real strides involves ensuring that leaders and organizations surround athletes with the “right” people who will advocate for their physical and mental wellbeing on and off the field, court, or mat.

Mental health is becoming less stigmatized in general, and that acceptance is slowly but surely trickling down into the sports world. The proof is in the fact that more athletes are speaking up about how their prep routines involve mental work as well as physical. Sunny Choi, the first female breakdancer to represent the U.S. at the Olympics, has said talk therapy had the biggest improvement to her game. Runner Nikki Hiltz recently shared about their pre-Olympic Trials prep work, which included weekly therapy, journaling, and 100 straight days of meditation.

“Mental health is a part of training,” Dr. Trujillo says. “When it’s normal for your sports psych to be on the sidelines along with your physical therapist or your team doctor or your trainer, when that’s normal and no one bats an eye, that tells you it’s integrated.”

Hannah Yasharoff is a journalist based in Washington DC specializing in entertainment, wellness, and lifestyle topics. Previously, she was an entertainment and wellness reporter at USA Today for more than five years before serving as a health and wellness reporter for The Messenger.