Change-Maker: NBA Leads the Break in Supporting Athletes' Mental Health
It was November 5, 2017 when Kevin Love, a power forward with the Cleveland Cavaliers, experienced his first panic attack. It was the third quarter and he thought he was dying. He ended up on the floor in his team’s locker room just trying to get enough air to breath. There was no one on the bench or in the locker room who knew what to do or how to help him.
This was the beginning of a concentrated movement in the NBA. On a topic that had been boldly broached by Larry Sanders, WNBA standout Chamique Holdsclaw, and Metta World Peace among others in years prior; it was finally propelled to the forefront with Love’s poignant narrative in The Players’ Tribune in March of the following year.
A month before Love recounted his experience, DeMar DeRozan, the then Toronto Raptor, shared his struggles with depression in a tweet. Phoenix Sun Kelly Oubre Jr. discussed his own mental illness a month later. Since then, Jahlil Okafor of the Philadelphia 76ers has openly talked about his struggles with anxiety.
Athletes, even those competing at the pinnacle of their sport, struggle with mental illness. This isn’t new information. The number of stories like Love’s, chronicled and shared on social media platforms, has increased exponentially in the last year and a half. In fact, The Players' Tribune alone documents 29 accounts of professional athletes who have shared their struggle with mental illness in the last four years. But don’t be fooled - mental illness is not a new battleground for NBA players. Their struggle has been long waged, often in solitude.
Even NBA legends like Paul Pierce and Jerry West have shared stories of their mental health struggles. Pierce was stabbed eleven times and struggled with depression and anxiety for years following the attack. West has shared his lifelong battle with depression.
Kevin Love. DeMar DeRozan. Kelly Oubre Jr. Paul Pierce. Larry Sanders. Jerry West. Keyon Dooling. Delonte West. Royce White. Bill Walton. Metta World Peace. Robin Lopez. Channing Frye. Chris Bosh. Among many, many others whose stories we may never hear. Franchise and role players alike. No one is immune to mental health struggles in the NBA.
In fact, John Lucas, a retired NBA player who runs a wellness aftercare program for athletes, estimates that nearly 40% of NBA players are experiencing a diagnosable mental health struggle right now and only 5% of those athletes are seeking help. You might call this an epidemic.
The trials and tribulations of being a professional athlete are often dismissed. These young men have money, status, and fame, how could they be struggling? They are the epitome of success, often coming from challenging backgrounds to make it to the most prestigious level in their field. But as we know, mental health does not discriminate based on wealth or athletic prowess, rather professional athletes are often more vulnerable to mental health struggles because of the unrealistic amount of pressure placed on them to succeed, their isolation from primary support systems, and the general instability of working in a field that has no guarantees.
As mental health has risen to the forefront of our collective consciousness, the NBA is poised to become a leader in supporting the mental health of its athletes. Often considered the most progressive of the professional sports leagues, the NBA has led the way in navigating challenging situations, redefining who and what the league represents multiple times since its inception.
When it became apparent that many players struggled with making sound financial decisions, the NBA instituted a Rookie Transition Program and encouraged young players to work with league-approved financial advisors to ensure they were investing their money properly and preparing themselves for long term success.
During the infamous cocaine crisis of the 1970s and 80s, the league introduced The NBA Drug Act in 1983 to curve the rampant drug abuse that had affected many of its players. They created drug rehabilitation and education programs to ensure players were aware of and understood what they were putting in their bodies and the consequences of those choices.
Even something as simple as the NBA dress code implemented by then Commissioner David Stern in 2005 changed the league’s image and redefined how it was represented.
The league is not afraid of change, nor is it afraid of being the change-maker. In contrast, the NBA has thrived because of these changes and its willingness to stand on the precipice of transformation.
The NBA’s response to its mental health epidemic will be no different.
Though a collective approach to mental wellness in the NBA is new, the integration of professionals from multiple disciplines (e.g., medicine, applied sport psychology) into team support systems is not. The Dallas Mavericks were the first team in the NBA to hire a director of sports psychology, 19 years ago, in Don Kalkstein. Kalkstein is still with the Mavs today and sends daily affirmations by text to each member of the team. The Indiana Pacers followed more than a decade later in 2011 providing athletes with the opportunity to work alongside Dr. Christopher Carr, the team’s performance psychologist. Both these franchises have worked to encourage an environment where players feel comfortable talking to their team’s doctors on a regular basis – not just when mental health struggles have become overwhelming. Over the years, other teams like the Bucks, Kings, and Celtics have hired sports psychologists to support both their athletes and coaches.
Many teams who had previously not invested in mental health support for their players are doing so now, with many choosing to hire clinical psychologists or sport psychologists. Clinical psychologists primarily serve as therapists who counsel players experiencing symptoms of mental illnesses, while also assisting them with family relationships and grief counselling. Sports psychologists work with players to improve aspects of on-court performance through visualization, mindfulness, and communication. Increased access to mental health professionals is a fundamental change that reflects the evolving attitude amongst NBA executives, franchises, and players towards mental health and wellness.
While the spirit behind the integration of practitioners into team structures is well intentioned and often beneficial, there are some challenges inherent in having teams sign the pay cheques of these professionals. We saw this dynamic come to fruition with former San Antonio Spurs star Kawhi Leonard, who felt like his quad injury was not properly diagnosed and that the team’s doctors placed the interests of the franchise ahead of his well-being.
The stigma and perceived fallout associated with sharing a mental health struggle magnifies players’ anxieties over the potential conflict of interest faced by integrated support team members. At the end of the day, the NBA is a business that generates billions for investors annually, and players are that business’s primary commodity. Being transparent about a mental health struggle may be perceived as a potential threat to a franchise’s bottom-line, fueling athletes’ concerns that this kind of admission will jeopardize their careers.
Stigma is the reason some NBA athletes have chosen not to disclose their mental health issues or receive treatment, as they are worried that doctors will share this information with team personnel, in the same way physical ailments are reported to staff.
To combat this, in a 2017 collective bargaining agreement brokered between the NBA and the NBA Players Association (NBPA), the NBPA requested, and was rewarded with, one of the most comprehensive mental health programs ever created in professional sport. The NBA hired a Director of Health and Wellness in Dr. William Parham and will continue to work with former NBA player Keyon Dooling who will serve as the liaison between the new program and the athletes.
One of the most proactive and important changes instituted is that players can seek treatment and counselling outside of the framework of their teams. This program is independently run and is funded by both the league and the NBA players’ union. Each city with an NBA franchise must have licensed mental health professionals – mainly psychologists, but also psychiatrists and social workers – available to NBA athletes. These mental health professionals are employees of the National Basketball Players Association and have no affiliation with the team itself, providing athletes with an independent and confidential outlet. Team doctors will continue to be available should an athlete have an established relationship with one, but they are no longer the only option.
This is the first prong of Dr. Parham’s four-part approach to his comprehensive plan. His other three initiatives, per The Bleacher Report, include (1) establishing a 24-hour hotline that players have unlimited access to, (2) creating an educational campaign targeting players to share the resources that are available to them, and (3) building relationships with NBA athletes to ensure they feel confident taking advantage of the new initiatives being put in place. The overarching goal is to change the narrative and stigma surrounding mental health, while using psychological well-being as a road to empowerment.
To go alongside Dr. Parham’s programs, the NBA will continue to work with Dr. Victor Schwartz, the chief medical officer for The Jed Foundation, who will provide advice for NBA programming, support and additional athlete resources. The Jed Foundation, founded by Donna and Phil Satow after the suicide of their son in 1998, is a nonprofit that focuses on protecting emotional health and preventing suicide in young adults.
While providing support for current NBA players is a priority, laying the groundwork for future athletes who are mentally healthy when they arrive in the NBA is of equal importance. As such, the NBA has looked to further enrich their Jr. NBA and NBA Fit youth programs with wellness messages and programs to reiterate that holistic health is pivotal to an athlete’s success. The Jr. NBA World Championships, in August of this year, will consist of mental wellness outreach programs and sessions to teach athletes life skills and a holistic approach to sport, as well as a community outreach project.
As the NBA and its affiliates begin to enhance the mental health resources available to the athletes, the biggest dilemma is moving past the stigma that has so long been associated with mental health. The reality is that this stigma will live as long as the athletes themselves equate mental illness with weakness. The November 5 panic attack Kevin Love experienced was originally met with derision and skepticism by his teammates.
Fortunately, this is an assumption that is slowly changing. Love’s decision to share his story has given other NBA players the courage to do the same, spurring an important – albeit, slow-moving – shift.
As the NBA makes mental health a priority and NBA players continue to speak to their own mental health struggles, society’s acceptance and support of these athletes will continue to grow and in doing so, will trickle down to the next generation of athletes normalizing the idea that mental health is inextricably linked to well-being and athletic performance.