By: Hannah Clark
In recent years, the intersection of mental health and sports has garnered increased attention. Simone Biles placed the importance of mental health on center stage in the 2020 and 2024 Olympic Games. The Tokyo 2020 Olympics marked a pivotal moment for mental health awareness in sports, largely due to Biles’ decision to withdraw from several events in the team final due to mental stress.[1] Biles opted out of participation due to suffering from the “twisties,” [referring] to a mental block that causes gymnasts to lose track of their position while midair,” which can have deadly consequences.[2] Biles exited the Olympics following her vault performance, and states, as soon as she landed the vault, she recalls thinking “’The world is going to hate me. I can [already] see what they’re saying on Twitter.'”[3] She also claims she thought she’d be “banned from America.”[4] Biles’ decision to prioritize her mental health, ignited a crucial conversation about the pressures athletes face and the necessity of mental health support.
This decision was controversial and met with much criticism by the American people, some regarding her as a “national embarrassment”.[5] However, Biles left with this message upon her exit from the Games: “Athletes must heed the needs of their minds as well as bodies before risking ‘what the world wants us to do.’”[6] As seen in the 2024 Paris Olympics, after taking care of her mental health through routine therapy, Biles’ record-breaking comeback proved her critics wrong. She earned three additional gold medals, making her the most decorated American gymnast in history.[7] Biles “shattered mental health stigma and is responsible for bringing mental well-being to the forefront of the conversation in elite athletics.”[8] This highlighted the importance of self-advocacy and acknowledged mental health as an integral component of athletic performance.[9]
Biles is not alone; other athletes, like Naomi Osaka, who withdrew from the 2021 French Open, have also prioritized their mental health over competition.[10] This shift is creating a positive domino effect. By speaking candidly about their struggles, these athletes are raising awareness and challenging the stigma surrounding mental health. They are empowering others by fostering open discussions about difficult truths. Attorney Sharon Masling, who has practiced disability law for 30 years, commented on the movement, stating “[athletes’] admissions of struggling with mental health concerns was groundbreaking for the professional sports culture.”[11] Not only have fans needed to cope with athletes’ changing priorities, but athletic organizations have also needed to pivot their practices, as the threat of losing athlete participation due to neglecting their mental well-being, is at its peak.
In response to this increased awareness, organizations are launching comprehensive initiatives to address these concerns. Professional leagues like the National Football League (NFL) are also launching initiatives aimed at supporting players’ mental wellness.[12] They’re offering counseling services, hosting workshops, and promoting open dialogue about mental health.[13] The NFL’s Comprehensive Mental Health and Wellness Committee is “comprised of experts [who develop] educational programs for players…regarding mental health and wellness.”[14] These changes represent a significant cultural shift in sports, highlighting the importance of mental well-being alongside physical prowess. Per the National Collegiate Athletic Association (NCAA), “[m]ental health exists on a continuum…[and] [care-seeking] for mental health issues [must be] as normative as [care-seeking] for physical injuries.”[15] As of August 1, 2024, the NCAA now requires Division 1 schools to provide mental health services to student-athletes.[16]
The U.S. Center for SafeSport, an independent nonprofit 501(c)(3) created in March of 2017, is “committed to building a sport community where participants can work and learn together free of emotional, physical, and sexual abuse and misconduct.”[17] Larry Nassar, former doctor for USA Gymnastics and now convicted felon, was indicted for the persistent sexual exploitation he subjected hundreds of athletes to over his career that spanned nearly three decades.[18] However, the incessant harm he caused remained unaddressed until December 2016.[19] The SafeSport initiative, designed to protect athletes from abuse and harassment, intersects with mental health advocacy by creating safer environments for athletes to thrive.[20] SafeSport’s mission is important and needed. However, it calls into question what was being done to protect athletes before its implementation in 2017. During a 2021 hearing with the Senate Judiciary Committee, Biles testified about the sexual abuse she suffered at the hands of Nassar, the effects of which surfaced in the 2020 Tokyo Olympics.[21] Biles closed her testimony by stating “The scars of this horrific abuse continue to live with all of us. As the lone competitor in the recent Tokyo games [as] a survivor of this horror, I can assure you that the impacts of this man’s abuse are not…forgotten.”[22] Needless to say, the $138.7 million settlement reached by the Department of Justice to compensate Nassar’s victims doesn’t erase his memory from the minds of those abused by him.[23]
The Americans with Disabilities Act (ADA) and Section 504 of the Rehabilitation Act play crucial roles in this conversation.[24] Both laws prohibit discrimination against individuals with disabilities, meaning athletes cannot be excluded from participation based on mental health issues if they meet the qualifications for the sport.[25] These legal protections are significant for athletes, especially in environments that often prioritize physical performance over psychological well-being. Under the ADA, athletic organizations must provide reasonable accommodations for athletes with mental health conditions.[26] These accommodations may include modified training regimens, access to mental health professionals, and support during competitions.[27] Similarly, Section 504 mandates that federally funded programs, including many college athletics programs, ensure equal access and accommodations for athletes with disabilities, including mental health issues. [28]
There is a growing recognition of the need for legal protections to support athletes’ mental health. Advocates like Simone Biles and other respected athletes expressing their needs has made the progress we’ve seen more achievable. Sports law practitioners and the legal system must remain vigilant in promoting athletes’ rights while encouraging organizations to adopt proactive measures prioritizing mental health. By fostering a culture of respect and safety, organizations can positively impact the mental well-being of their athletes. It is essential to not only comply with existing laws but also to develop best practices for training, support, and advocacy. Strengthening laws surrounding confidentiality in mental health care and ensuring athlete-patient privacy under the Health Insurance Portability and Accountability Act (HIPAA) is crucial.[29] This allows athletes to seek help without fear of repercussions or privacy breaches. The legal protections afforded by the ADA, combined with advocacy from athletes like Simone Biles, signify a shift toward integrating mental health into athletic success, promoting resilience and inclusivity in sports. As the landscape evolves, the legal community must craft policies that prioritize mental health as integral to achieving athletic excellence, ultimately laying the groundwork for a more equitable and supportive sports environment.
Please Note: Cover photo from Angie Jaime, Athletes at the 2024 Paris Olympics Are Championing Their Mental Health, Teen Vogue (Aug. 5, 2024), https://www.teenvogue.com/ [https://perma.cc/6PF4-62TR].
[1] Savanna Stewart, Simone Biles stepped away from ‘corrosive’ gymnastics for mental health. Now she’s back,CNN SPORTS (Aug. 4, 2023 8:40 AM), https://www.cnn.com/ [https://perma.cc/5QT9-FWZZ].
[2] Id.
[3] Emma Hruby, Simone Biles talks Tokyo Olympics fallout in new interview,Just Women’s Sports (Apr. 18, 2024), https://justwomenssports.com/ [https://perma.cc/7348-9292].
[4] Id.
[5] Tonya Russell, Critics of Simone Biles’ withdrawing from Olympic events are cruel — and miss the point: Team USA isn’t helped by an athlete risking injury. I learned that the hard way.,THINK (Aug. 21, 2021 1:30 AM), https://www.nbcnews.com/ [https://perma.cc/WS5S-YEP8].
[6] Kevin Sherrington, Sparked by Simone Biles, athletes at Paris Olympics to have vast mental health resources, The Dallas Morning News (Jul. 22, 2024 6:00 AM), https://www.dallasnews.com/ [https://perma.cc/9R5M-RUF4].
[7] Kaetlyn Liddy, Simone Biles didn’t finish with gold, but the Paris Games still belonged to her, NBC News (Aug. 5, 2024 7:00 AM), https://www.nbcnews.com/ [https://perma.cc/F37R-4HV4].
[8] Grace Harrison, The Redemption Tour (Simone Biles’ Version), Steinberg Institute, https://steinberginstitute.org/ [https://perma.cc/X8VE-9B97].
[9] Id.
[10] D’Arcy Maine, Naomi Osaka withdraws from French Open, will ‘take some time away’ from tennis after controversy over media obligations, ESPN (May 31, 2021 2:07 PM), https://www.espn.com/ [https://perma.cc/8XSP-PHTL].
[11] Sharon Masling, The Legal Landscape for Athlete Mental Health: A Q&A with Attorney Sharon Masling, Sports Litigation Alert (June 3, 2022), https://sportslitigationalert.com/ [https://perma.cc/VYC2-4AU9].
[12] Comprehensive Mental Health and Wellness Committee, NFL Player Health and Safety, https://www.nfl.com/ [https://perma.cc/5S46-28FC] (last visited Oct. 10, 2024).
[13] Id.
[14] Id.
[15] Student-Athletes With Disabilities, NCAA, https://www.ncaa.org/ [https://perma.cc/W4V6-G83A] (last visited Oct. 10, 2024).
[16] Id.
[17] U.S. Center for SafeSport, https://uscenterforsafesport.org/ [https://perma.cc/4SHY-YDBP] (last visited Oct. 28, 2024).
[18] Who is Larry Nassar? A timeline of his decades-long career, sexual assault convictions and prison sentences, Lansing State Journal, https://www.lansingstatejournal.com/ [https://perma.cc/ZWA8-4ES3].
[19] Id.
[20] SafeSport, supra note 17.
[21] Rebecca Shabad, ‘We have been failed’: Simone Biles breaks down in tears recounting Nassar’s sexual abuse, NBC News (Sept. 15, 2021 8:24 AM), https://www.nbcnews.com/ [https://perma.cc/LQD8-GTVG].
[22] Id.
[23] Brian Bushard, DOJ Will Pay Larry Nassar Abuse Victims—Including Simone Biles, Aly Raisman—$138.7 Million, FORBES (Apr. 23, 2024 6:15 PM), https://www.forbes.com/ [https://perma.cc/MR7W-ZC63].
[24] Lee Green, Disabilities Law and Reasonable Accommodations in Sports, NFHS (Mar. 10, 2016), https://www.nfhs.org/ [https://perma.cc/K6S7-XSFC].
[25] Id.
[26] Sharon Masling, supra note 11.
[27] Id.
[28] Id.
[29] Regarding the protection of sensitive health information from disclosure without patient’s consent, see Health Insurance Portability and Accountability Act of 1996 (HIPAA), CDC (last visited Oct. 28, 2024), https://www.cdc.gov/ [https://perma.cc/P78Y-39AL].
