Mental Health in Sports: Progress and Challenges Ahead of Paris Olympics

Biles, Osaka and Phelps spoke up about mental health. Has anything changed for the Paris Olympics?

Lydia Jacoby was a breakout star in the pool for the United States at the last Summer Games, earning a gold medal in the 100-meter breaststroke and a relay silver. Part of what comes to mind from those heady days in Tokyo? "People talking about post-Olympic depression," she said. She was 17 at the time, and her initial response when other athletes brought up the topic was: "Well, that doesn't apply to me." "I essentially did not understand the topic of depression," she said. "It wasn't until after the Games that I was like, 'Oh. ... OK. Yeah, I'm feeling this a little.'" Jacoby, who didn't qualify for the 2024 Olympics, is now fully aware of the phenomenon, went through it, moved past it and discusses it casually, all of which points to the way things have changed in just a few years when it comes to mental health. As the Paris Games open on Friday, followed by the Paralympics beginning Aug. 28, athletes have more access than ever to resources in that once-taboo realm and sound more willing than ever to use them. That seems particularly significant given that Jessica Bartley, the U.S. Olympic and Paralympic Committee's senior director of psychological services, says about half of the country's athletes at the past two Olympiads were flagged for at least one of the following: anxiety, depression, sleep disorders, eating disorders, substance use or abuse. "We really are just a part of the conversation now," Bartley said, "and not an afterthought or something when someone's struggling." Among the key questions now: Is everyone going to seek the help they need? And is enough help available? As for the first, Bartley said: "I'd like to think we're over the hump, but we're still not quite there. I feel like there is still some stigma. I think there's still some connections to 'weakness.'" And the second? "I do think there still could be more," track star Gabby Thomas said, "but, I mean, they're there." Three Olympians -- Simone Biles and Naomi Osaka, who participated in the last pandemic-delayed Summer Games, and are returning, and retired swimmer Michael Phelps, who has more medals than anyone in any sport -- provided some of the loudest voices in the growing global conversation in sports and society at large about the importance of protecting, gauging and improving the state of one's mind as much as one's body. Phelps spoke about having suicidal thoughts at the height of his career and helped produce a documentary about depression among Olympians. He also called on the International Olympic Committee and USOPC to do more. "I do think there's something to be said when a lot of really, really good athletes kind of talk about the same issue. I know all athletes don't feel the same way; you have to be a certain type or in a certain head space. Some people just feel things differently," said Osaka, a four-time Grand Slam champion and former No. 1-ranked player in tennis who lit the cauldron in Japan. She's been forthcoming about her bouts with anxiety and depression and was among the first sports figures to take mental-health breaks away from competition, paving the way for others. Osaka, in turn, said she felt "very heard" when she listened to Biles and Phelps. "I'm pretty sure a lot of different athletes also felt heard," Osaka said. "They didn't feel like it was a weakness or anything like that, so I'm really glad we all talked about it." Biles, who redefined excellence in gymnastics and picked up seven Olympic medals along the way, drew attention and, from some, criticism, for pulling out of events in Tokyo because of a mental block -- known in the gymnastics world as "the twisties" -- that made her afraid to attempt certain dangerous moves. That her explanations of what went awry came in such a public setting, as THE biggest star in Tokyo, only made it all the more meaningful to other athletes. "She didn't have to," said basketball player Breanna Stewart, a WNBA MVP. "She used her platform to help others." What Biles did resonated with athletes like canoeist Nevin Harrison, a gold medalist in Tokyo, who said "anxiety, fear, stress ... are all going to be huge parts in competing at such a high level." Biles made them see that there can be a way out. "I was, at one time, in those shoes," boxer Morelle McCane said, "where I was just like, 'It's do or die! It's do or die!'" Janet Evans won four swimming golds at the 1988 and 1992 Games and recalls the never-easing pressure to perform. In her day, she says, there wasn't nearly the empathy or outlets for help available as there are for today's Olympians. "We didn't talk about the struggles. No one taught me that it was OK to lose, right? I mean, I was Janet Evans, and when I went to a swim meet, I was supposed to win," said Evans, the chief athlete officer for the 2028 Los Angeles Games. "We talk about it now and we recognize it with our athletes. And I think that is an important first step." Which means that even 38-year-old rugby player Perry Baker has seen changes since his Olympic debut at Rio de Janeiro in 2016. "You had to tough it out. You kind of felt by yourself. You kind of felt like you couldn't talk to anyone," said Baker, who briefly was with the NFL's Philadelphia Eagles. The balance national Olympic committees must strike between caring about athletes as people but making sure the medals pile up is "threading a needle," Evans acknowledged. "We should go to the Olympics and Paralympics and win medals. But I don't think that should be at the cost of how we're preparing our athletes for the future," Evans said. "Both can happen." That's where Bartley and her counterparts in other countries and at the IOC come in. The Beijing Winter Games two years ago were the first with extra credentials issued for national Olympic committees to bring athlete welfare officers -- registered mental health professionals or qualified safeguarding experts -- and more than 170 from more than 90 countries will be in Paris. "We didn't have it in Tokyo, and now it will be implemented for every Games," said Kirsty Burrows, head of an IOC unit focused on athletes' mental health. "Because we really see the impact." There will be a 24/7 helpline with mental health counselors who speak more than 70 languages, a program started for the Beijing Games but now available to every Olympian and Paralympian until four years after the event. There's also AI to monitor athletes' social media for cyberbullying, and a "mind zone" in the athletes village with a yoga area, low lighting, comfortable seating and other tools "dedicated to disconnection, decompression," Burrows said. The USOPC went from six mental-health providers 3 1/2 years ago to 15 now; 14 will be in France. Last year, 1,300 Team USA athletes participated in more than 6,000 therapy sessions set up by the USOPC. "I expect the numbers to be even higher," Bartley said, "especially in a Games year."

Biles, Osaka and Phelps spoke up about mental health. Has anything changed for the Paris Olympics?

Lydia Jacoby was a breakout star in the pool for the United States at the last Summer Games, earning a gold medal in the 100-meter breaststroke and a relay silver. Part of what comes to mind from those heady days in Tokyo? "People talking about post-Olympic depression," she said. She was 17 at the time, and her initial response when other athletes brought up the topic was: "Well, that doesn't apply to me." "I essentially did not understand the topic of depression," she said. "It wasn't until after the Games that I was like, 'Oh. ... OK. Yeah, I'm feeling this a little.'" Jacoby, who didn't qualify for the 2024 Olympics, is now fully aware of the phenomenon, went through it, moved past it and discusses it casually, all of which points to the way things have changed in just a few years when it comes to mental health. As the Paris Games open on Friday, followed by the Paralympics beginning Aug. 28, athletes have more access than ever to resources in that once-taboo realm and sound more willing than ever to use them. That seems particularly significant given that Jessica Bartley, the U.S. Olympic and Paralympic Committee's senior director of psychological services, says about half of the country's athletes at the past two Olympiads were flagged for at least one of the following: anxiety, depression, sleep disorders, eating disorders, substance use or abuse. "We really are just a part of the conversation now," Bartley said, "and not an afterthought or something when someone's struggling." Among the key questions now: Is everyone going to seek the help they need? And is enough help available? As for the first, Bartley said: "I'd like to think we're over the hump, but we're still not quite there. I feel like there is still some stigma. I think there's still some connections to 'weakness.'" And the second? "I do think there still could be more," track star Gabby Thomas said, "but, I mean, they're there." Three Olympians -- Simone Biles and Naomi Osaka, who participated in the last pandemic-delayed Summer Games, and are returning, and retired swimmer Michael Phelps, who has more medals than anyone in any sport -- provided some of the loudest voices in the growing global conversation in sports and society at large about the importance of protecting, gauging and improving the state of one's mind as much as one's body. Phelps spoke about having suicidal thoughts at the height of his career and helped produce a documentary about depression among Olympians. He also called on the International Olympic Committee and USOPC to do more. "I do think there's something to be said when a lot of really, really good athletes kind of talk about the same issue. I know all athletes don't feel the same way; you have to be a certain type or in a certain head space. Some people just feel things differently," said Osaka, a four-time Grand Slam champion and former No. 1-ranked player in tennis who lit the cauldron in Japan. She's been forthcoming about her bouts with anxiety and depression and was among the first sports figures to take mental-health breaks away from competition, paving the way for others. Osaka, in turn, said she felt "very heard" when she listened to Biles and Phelps. "I'm pretty sure a lot of different athletes also felt heard," Osaka said. "They didn't feel like it was a weakness or anything like that, so I'm really glad we all talked about it." Biles, who redefined excellence in gymnastics and picked up seven Olympic medals along the way, drew attention and, from some, criticism, for pulling out of events in Tokyo because of a mental block -- known in the gymnastics world as "the twisties" -- that made her afraid to attempt certain dangerous moves. That her explanations of what went awry came in such a public setting, as THE biggest star in Tokyo, only made it all the more meaningful to other athletes. "She didn't have to," said basketball player Breanna Stewart, a WNBA MVP. "She used her platform to help others." What Biles did resonated with athletes like canoeist Nevin Harrison, a gold medalist in Tokyo, who said "anxiety, fear, stress ... are all going to be huge parts in competing at such a high level." Biles made them see that there can be a way out. "I was, at one time, in those shoes," boxer Morelle McCane said, "where I was just like, 'It's do or die! It's do or die!'" Janet Evans won four swimming golds at the 1988 and 1992 Games and recalls the never-easing pressure to perform. In her day, she says, there wasn't nearly the empathy or outlets for help available as there are for today's Olympians. "We didn't talk about the struggles. No one taught me that it was OK to lose, right? I mean, I was Janet Evans, and when I went to a swim meet, I was supposed to win," said Evans, the chief athlete officer for the 2028 Los Angeles Games. "We talk about it now and we recognize it with our athletes. And I think that is an important first step." Which means that even 38-year-old rugby player Perry Baker has seen changes since his Olympic debut at Rio de Janeiro in 2016. "You had to tough it out. You kind of felt by yourself. You kind of felt like you couldn't talk to anyone," said Baker, who briefly was with the NFL's Philadelphia Eagles. The balance national Olympic committees must strike between caring about athletes as people but making sure the medals pile up is "threading a needle," Evans acknowledged. "We should go to the Olympics and Paralympics and win medals. But I don't think that should be at the cost of how we're preparing our athletes for the future," Evans said. "Both can happen." That's where Bartley and her counterparts in other countries and at the IOC come in. The Beijing Winter Games two years ago were the first with extra credentials issued for national Olympic committees to bring athlete welfare officers -- registered mental health professionals or qualified safeguarding experts -- and more than 170 from more than 90 countries will be in Paris. "We didn't have it in Tokyo, and now it will be implemented for every Games," said Kirsty Burrows, head of an IOC unit focused on athletes' mental health. "Because we really see the impact." There will be a 24/7 helpline with mental health counselors who speak more than 70 languages, a program started for the Beijing Games but now available to every Olympian and Paralympian until four years after the event. There's also AI to monitor athletes' social media for cyberbullying, and a "mind zone" in the athletes village with a yoga area, low lighting, comfortable seating and other tools "dedicated to disconnection, decompression," Burrows said. The USOPC went from six mental-health providers 3 1/2 years ago to 15 now; 14 will be in France. Last year, 1,300 Team USA athletes participated in more than 6,000 therapy sessions set up by the USOPC. "I expect the numbers to be even higher," Bartley said, "especially in a Games year."

Biles, Osaka and Phelps spoke up about mental health. Has anything changed for the Paris Olympics?

Lydia Jacoby was a breakout star in the pool for the United States at the last Summer Games, earning a gold medal in the 100-meter breaststroke and a relay silver. Part of what comes to mind from those heady days in Tokyo? "People talking about post-Olympic depression," she said. She was 17 at the time, and her initial response when other athletes brought up the topic was: "Well, that doesn't apply to me." "I essentially did not understand the topic of depression," she said. "It wasn't until after the Games that I was like, 'Oh. ... OK. Yeah, I'm feeling this a little.'" Jacoby, who didn't qualify for the 2024 Olympics, is now fully aware of the phenomenon, went through it, moved past it and discusses it casually, all of which points to the way things have changed in just a few years when it comes to mental health. As the Paris Games open on Friday, followed by the Paralympics beginning Aug. 28, athletes have more access than ever to resources in that once-taboo realm and sound more willing than ever to use them. That seems particularly significant given that Jessica Bartley, the U.S. Olympic and Paralympic Committee's senior director of psychological services, says about half of the country's athletes at the past two Olympiads were flagged for at least one of the following: anxiety, depression, sleep disorders, eating disorders, substance use or abuse. "We really are just a part of the conversation now," Bartley said, "and not an afterthought or something when someone's struggling." Among the key questions now: Is everyone going to seek the help they need? And is enough help available? As for the first, Bartley said: "I'd like to think we're over the hump, but we're still not quite there. I feel like there is still some stigma. I think there's still some connections to 'weakness.'" And the second? "I do think there still could be more," track star Gabby Thomas said, "but, I mean, they're there." Three Olympians -- Simone Biles and Naomi Osaka, who participated in the last pandemic-delayed Summer Games, and are returning, and retired swimmer Michael Phelps, who has more medals than anyone in any sport -- provided some of the loudest voices in the growing global conversation in sports and society at large about the importance of protecting, gauging and improving the state of one's mind as much as one's body. Phelps spoke about having suicidal thoughts at the height of his career and helped produce a documentary about depression among Olympians. He also called on the International Olympic Committee and USOPC to do more. "I do think there's something to be said when a lot of really, really good athletes kind of talk about the same issue. I know all athletes don't feel the same way; you have to be a certain type or in a certain head space. Some people just feel things differently," said Osaka, a four-time Grand Slam champion and former No. 1-ranked player in tennis who lit the cauldron in Japan. She's been forthcoming about her bouts with anxiety and depression and was among the first sports figures to take mental-health breaks away from competition, paving the way for others. Osaka, in turn, said she felt "very heard" when she listened to Biles and Phelps. "I'm pretty sure a lot of different athletes also felt heard," Osaka said. "They didn't feel like it was a weakness or anything like that, so I'm really glad we all talked about it." Biles, who redefined excellence in gymnastics and picked up seven Olympic medals along the way, drew attention and, from some, criticism, for pulling out of events in Tokyo because of a mental block -- known in the gymnastics world as "the twisties" -- that made her afraid to attempt certain dangerous moves. That her explanations of what went awry came in such a public setting, as THE biggest star in Tokyo, only made it all the more meaningful to other athletes. "She didn't have to," said basketball player Breanna Stewart, a WNBA MVP. "She used her platform to help others." What Biles did resonated with athletes like canoeist Nevin Harrison, a gold medalist in Tokyo, who said "anxiety, fear, stress ... are all going to be huge parts in competing at such a high level." Biles made them see that there can be a way out. "I was, at one time, in those shoes," boxer Morelle McCane said, "where I was just like, 'It's do or die! It's do or die!'" How different is it for today's Olympians? Janet Evans won four swimming golds at the 1988 and 1992 Games and recalls the never-easing pressure to perform. In her day, she says, there wasn't nearly the empathy or outlets for help available as there are for today's Olympians. "We didn't talk about the struggles. No one taught me that it was OK to lose, right? I mean, I was Janet Evans, and when I went to a swim meet, I was supposed to win," said Evans, the chief athlete officer for the 2028 Los Angeles Games. "We talk about it now and we recognize it with our athletes. And I think that is an important first step." Which means that even 38-year-old rugby player Perry Baker has seen changes since his Olympic debut at Rio de Janeiro in 2016. "You had to tough it out. You kind of felt by yourself. You kind of felt like you couldn't talk to anyone," said Baker, who briefly was with the NFL's Philadelphia Eagles. The balance national Olympic committees must strike between caring about athletes as people but making sure the medals pile up is "threading a needle," Evans acknowledged. "We should go to the Olympics and Paralympics and win medals. But I don't think that should be at the cost of how we're preparing our athletes for the future," Evans said. "Both can happen." That's where Bartley and her counterparts in other countries and at the IOC come in. The Beijing Winter Games two years ago were the first with extra credentials issued for national Olympic committees to bring athlete welfare officers -- registered mental health professionals or qualified safeguarding experts -- and more than 170 from more than 90 countries will be in Paris. "We didn't have it in Tokyo, and now it will be implemented for every Games," said Kirsty Burrows, head of an IOC unit focused on athletes' mental health. "Because we really see the impact." There will be a 24/7 helpline with mental health counselors who speak more than 70 languages, a program started for the Beijing Games but now available to every Olympian and Paralympian until four years after the event. There's also AI to monitor athletes' social media for cyberbullying, and a "mind zone" in the athletes village with a yoga area, low lighting, comfortable seating and other tools "dedicated to disconnection, decompression," Burrows said. The USOPC went from six mental-health providers 3 1/2 years ago to 15 now; 14 will be in France. Last year, 1,300 Team USA athletes participated in more than 6,000 therapy sessions set up by the USOPC. "I expect the numbers to be even higher," Bartley said, "especially in a Games year."

Biles, Osaka and Phelps Spoke up About Mental Health. Has Anything Changed for the Paris Olympics?

Lydia Jacoby was a breakout star in the pool for the United States at the last Summer Games, earning a gold medal in the 100-meter breaststroke and a relay silver. Part of what comes to mind from those heady days in Tokyo? "People talking about post-Olympic depression," she said. She was 17 at the time, and her initial response when other athletes brought up the topic was: "Well, that doesn't apply to me." "I essentially did not understand the topic of depression," she said. "It wasn't until after the Games that I was like, 'Oh. ... OK. Yeah, I'm feeling this a little.'" Jacoby, who didn't qualify for the 2024 Olympics, is now fully aware of the phenomenon, went through it, moved past it and discusses it casually, all of which points to the way things have changed in just a few years when it comes to mental health. As the Paris Games open on Friday, followed by the Paralympics beginning Aug. 28, athletes have more access than ever to resources in that once-taboo realm and sound more willing than ever to use them. That seems particularly significant given that Jessica Bartley, the U.S. Olympic and Paralympic Committee's senior director of psychological services, says about half of the country's athletes at the past two Olympiads were flagged for at least one of the following: anxiety, depression, sleep disorders, eating disorders, substance use or abuse. "We really are just a part of the conversation now," Bartley said, "and not an afterthought or something when someone's struggling." Among the key questions now: Is everyone going to seek the help they need? And is enough help available? As for the first, Bartley said: "I'd like to think we're over the hump, but we're still not quite there. I feel like there is still some stigma. I think there's still some connections to 'weakness.'" And the second? "I do think there still could be more," track star Gabby Thomas said, "but, I mean, they're there." Olympians Simone Biles, Naomi Osaka and Michael Phelps opened doors Three Olympians -- Simone Biles and Naomi Osaka, who participated in the last pandemic-delayed Summer Games, and are returning, and retired swimmer Michael Phelps, who has more medals than anyone in any sport -- provided some of the loudest voices in the growing global conversation in sports and society at large about the importance of protecting, gauging and improving the state of one's mind as much as one's body. Phelps spoke about having suicidal thoughts at the height of his career and helped produce a documentary about depression among Olympians. He also called on the International Olympic Committee and USOPC to do more. "I do think there's something to be said when a lot of really, really good athletes kind of talk about the same issue. I know all athletes don't feel the same way; you have to be a certain type or in a certain head space. Some people just feel things differently," said Osaka, a four-time Grand Slam champion and former No. 1-ranked player in tennis who lit the cauldron in Japan. She's been forthcoming about her bouts with anxiety and depression and was among the first sports figures to take mental-health breaks away from competition, paving the way for others. Osaka, in turn, said she felt "very heard" when she listened to Biles and Phelps. "I'm pretty sure a lot of different athletes also felt heard," Osaka said. "They didn't feel like it was a weakness or anything like that, so I'm really glad we all talked about it." Biles, who redefined excellence in gymnastics and picked up seven Olympic medals along the way, drew attention and, from some, criticism, for pulling out of events in Tokyo because of a mental block -- known in the gymnastics world as "the twisties" -- that made her afraid to attempt certain dangerous moves. That her explanations of what went awry came in such a public setting, as THE biggest star in Tokyo, only made it all the more meaningful to other athletes. "She didn't have to," said basketball player Breanna Stewart, a WNBA MVP. "She used her platform to help others." What Biles did resonated with athletes like canoeist Nevin Harrison, a gold medalist in Tokyo, who said "anxiety, fear, stress ... are all going to be huge parts in competing at such a high level." Biles made them see that there can be a way out. "I was, at one time, in those shoes," boxer Morelle McCane said, "where I was just like, 'It's do or die! It's do or die!'" How different is it for today's Olympians? Janet Evans won four swimming golds at the 1988 and 1992 Games and recalls the never-easing pressure to perform. In her day, she says, there wasn't nearly the empathy or outlets for help available as there are for today's Olympians. "We didn't talk about the struggles. No one taught me that it was OK to lose, right? I mean, I was Janet Evans, and when I went to a swim meet, I was supposed to win," said Evans, the chief athlete officer for the 2028 Los Angeles Games. "We talk about it now and we recognize it with our athletes. And I think that is an important first step." Which means that even 38-year-old rugby player Perry Baker has seen changes since his Olympic debut at Rio de Janeiro in 2016. "You had to tough it out. You kind of felt by yourself. You kind of felt like you couldn't talk to anyone," said Baker, who briefly was with the NFL's Philadelphia Eagles. The balance national Olympic committees must strike between caring about athletes as people but making sure the medals pile up is "threading a needle," Evans acknowledged. "We should go to the Olympics and Paralympics and win medals. But I don't think that should be at the cost of how we're preparing our athletes for the future," Evans said. "Both can happen." That's where Bartley and her counterparts in other countries and at the IOC come in. The Beijing Winter Games two years ago were the first with extra credentials issued for national Olympic committees to bring athlete welfare officers -- registered mental health professionals or qualified safeguarding experts -- and more than 170 from more than 90 countries will be in Paris. "We didn't have it in Tokyo, and now it will be implemented for every Games," said Kirsty Burrows, head of an IOC unit focused on athletes' mental health. "Because we really see the impact." There will be a 24/7 helpline with mental health counselors who speak more than 70 languages, a program started for the Beijing Games but now available to every Olympian and Paralympian until four years after the event. There's also AI to monitor athletes' social media for cyberbullying, and a "mind zone" in the athletes village with a yoga area, low lighting, comfortable seating and other tools "dedicated to disconnection, decompression," Burrows said. The USOPC went from six mental-health providers 3 1/2 years ago to 15 now; 14 will be in France. Last year, 1,300 Team USA athletes participated in more than 6,000 therapy sessions set up by the USOPC. "I expect the numbers to be even higher," Bartley said, "especially in a Games year." Copyright 2024 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.

Sparked by Simone Biles, athletes at Paris Olympics to have vast mental health resources

History teaches us that movements require a moment. Nothing crystallized the cause of civil rights like Rosa Parks refusing to give up her seat on a Montgomery, Ala., bus in 1955. For the plight of the mental health of athletes, the moment came when Simone Biles gave up her seat at the Tokyo Olympics. Biles' message upon her exit -- athletes must heed the needs of their minds as well as their bodies before risking "what the world wants us to do" -- was a clarion call that echoes at the doorstep of another Olympics. The message resonated with Ilona Maher, a U.S. Rugby team member who passes it on to her TikTok audience of 1.1 million. "Here's the best gymnast in the world who's so amazing at what she does," Maher said this spring at the U.S. Olympic and Paralympic Summit. "And she's having bad days. People want to understand why. "For me, it was like showing how human we are." Biles' withdrawal came on the heels of a sexual assault scandal that resulted in a life sentence for U.S. Gymnastics' former team doctor, as well as hundreds of lawsuits against the USOPC and U.S. Gymnastics, among other institutions. It precipitated seismic changes not only in governance, but also in treating the mental health of USOPC athletes. Since the Tokyo Olympics in 2021, the number of licensed psychologists on the USOPC staff has increased from six to 15. The organization also consolidated its mental health and mental performance departments into a "psychological services team" with a network of more than 300 providers. Mental health screenings of up to three times a year can lead to red flags for everything from sleep and eating disorders to body-image issues to "suicidal ideation." Going into the Paris Olympics, the International Olympic Committee responded to increasing mental health concerns, as well. According to a report in The Guardian, the IOC will hand out 2,000 licenses for the Calm app along with a mental fitness helpline; provide a "mental decompression zone" during the Games; and use AI to "identify and suppress" abusive posts or comments on social media, an attempt to create a buffer zone around athletes. Dr. Jess Bartley, the USOPC's senior director of psychological services, declined to comment on the impact of Biles or any athlete in particular because of privacy concerns. But she acknowledged the impact of high-profile athletes and celebrities in destigmatizing conversations about mental health. "I think having some of those in the spotlight speak up is really valuable," she said. The increased emphasis was apparent at the summit, where athletes' mental health was the subject of one panel discussion. The panelists spoke freely of their mental struggles evolving from issues of body image, injury and isolation. The most compelling testimony might have come from Jaleen Roberts, a two-time Paralympics silver medalist in track and field born with cerebral palsy. The pandemic-precipitated postponement of the Tokyo Olympics until the summer of 2021 caused Roberts to fall into what she called "a super deep depression" that eventually led to thoughts of suicide. "I remember driving," she said, "and I called my mom and told her, 'You know, this is not looking very good for me. Like, I think I need help.'" Roberts' mother told her to drive immediately to the home of her track coach. A conversation there led to a three-day evaluation in a psychiatric hospital and a diagnosis of bipolar disorder, for which she's under medication. Even after getting help, Roberts said she found it difficult to resume training and decided it was because she had no female athlete with a disability to look up to. She resolved to become a role model instead. "We have to be these superheroes that deal with everything on our own," she said, "and we can't just have a bad day because we're doing this incredible thing. That's not true. "I don't want another athlete getting to the point where they feel like they have to end their life when they're alone." Tara Davis-Woodhall recalls a similar story. Winner of the long jump at the World Athletics Indoor Championships this year and a favorite for gold at her second Olympics, her bubbly persona is evident to a half-million Instagram followers as well as 782,000 subscribers to the YouTube channel she shares with her paralympian husband, Hunter Woodhall. They might be the most celebrated couple in track and field. Their 2022 wedding at D'Vine Grace Vineyard in McKinney was covered by People magazine. The various media have also documented her troublesome mental health journey, which began her first year at the University of Texas after transferring from Georgia in the fall of 2020. Despondent at being unable to compete because of transfer rules and a fractured vertebrae, she didn't leave her room for a week, occupying what she called "a dark place." "I didn't want to be here anymore," she said at the summit. Through her own initiative as well as the help of a psychologist and therapist, she said she crawled out of that hole and learned to express her feelings. Talking about it on her platforms, she said, gives her "a purpose." Many athletes face pressures that require some sort of mental health care, Bartley said, but Olympic athletes, in particular, may be more susceptible. Training for an event that comes once every four years presents unique challenges. The problem with losing is obvious, but winning isn't always a panacea, either. Ryan Crouser, a two-time gold medalist in the shot put who won four NCAA titles at Texas, painted a vivid image of what athletes call "post-Olympic blues." "I'll just say that you expect it to be this huge, life-changing moment," he said at the summit. "And it is, but you spent years and years putting that moment on this pedestal that it'll be life-changing. Then, you wake up the next morning, and it's like, 'Dang, I'm sore.' You're expecting everything to be vibrant, all rainbows and sunny. But, from a neurological standpoint, you just had the biggest dopamine hit of your entire life, winning that Olympic gold and standing on the podium. "So then you're going through a massive, massive dopamine withdrawal. So you think you should be happy. And everyone around you says you should be happy, but your brain has no dopamine. And you're way down here and you just feel bad. "It's like, 'I should be feeling good right now. Why am I not feeling good? I'm letting myself down. I'm letting all these people down that want me to be happy and share in that happiness.' "It's hard to say to them, 'I feel terrible. I feel super depressed.'" The USOPC's psychological services team administers something called the Patient Health Questionnaire (PHQ 9) to monitor the athletes' moods. The nine questions require checkmarks on how often over the previous two weeks -- not at all, several days, more than half or nearly every day -- they experienced one of the symptoms described. The first question is, "Little interest or pleasure in doing things." No. 5 is "Poor appetite or overeating." No. 6? "Feeling bad about yourself -- or that you're a failure or have let yourself or your family down." The last one: "Thoughts that you would be better off dead, or of hurting yourself." If the sum reaches a threshold constituting a red flag, the team usually responds within 15 minutes, Bartley said. Suicidal ideation or self-harm takes precedence. Athletes receive a follow-up call that can lead to a conversation, additional screening or contact with another mental health professional. "We will track them down at the Games if they have not gotten back to us," Bartley said, "just to make sure they know what their resources are. We'll continue to follow up with them." More than half of athletes flag for sleep issues, the biggest area of concern. Next is body image or eating disorders, followed by anxiety and depression. Few are flagged for substance use or abuse, Bartley said. The psychological services team screens just once a year, Bartley said, but some disciplines, such as skiing/snowboarding, swimming, gymnastics, figure skating and speed skating, test more often. The psychological services team is also a mandatory reporter to the U.S. Center for SafeSport, codified in 2017 to resolve abuse and misconduct reports throughout the USOPC. Bartley called it "amazing" to see the welcoming reaction from athletes who flag. Any further help is covered by their elite athlete health insurance. There are no copays and no deductibles in network. Former Olympians are currently covered two years into retirement; Bartley says their goal is to stretch it to 10. Mental health is increasingly a topic of conversation among athletes, Crouser said, but some are still afraid to talk about their feelings. The reticence answers why protocols weren't instituted sooner. "I get asked that question a lot," Bartley said. "And the reality is, the stigma when I was coming in is still kind of there. The walls are coming down. More and more athletes are talking about it. We have kids that are more open about their mental health now. It's a hot topic. So I think we did it at just the right time." Simone Biles made it the right time. Jade Carey, the woman who replaced Biles in the all-around in Tokyo, summed up the feelings of her peers when she said she saw "pure strength" in Biles' decision to withdraw from five events after experiencing what gymnasts call "the twisties," a mental block in midair. Public reaction to her stunning withdrawal wasn't as supportive at first. But, after Biles returned from a two-year hiatus to win a record eighth all-around title at the U.S. Gymnastics and a sixth world all-around title, a different narrative developed. By the time she broke her own record in June with a ninth all-around title in Fort Worth, automatically qualifying her for the Olympic Trials June 27-30 in Minneapolis, she'd developed another legacy. Not that Biles is particularly comfortable on a pedestal for mental health. She told Vanity Fair in its January issue that she promises only to be "open, honest and vulnerable." For the sake of the movement, maybe that's enough. 2024 The Dallas Morning News. Distributed by Tribune Content Agency, LLC.