Simone Biles, the greatest gymnast in history, made a life-changing choice on Tuesday: She withdrew from the finals of the team competition, putting her own wellbeing first. Her team went on without her, winning silver as the Russian team took the gold. She told members of the media: "I'd just never felt like this going into a competition before and I tried to go out there and have fun... but once I came out here, I was like: No, the mental's not there, so I just need to let the girls do it and focus on myself".
Biles, who posted to Instagram earlier in the competition that she felt the "weight of the world" on her shoulders, showed significant strain during her most recent performance. But, along with all the achievements and medals she's acquired during her legendary career, this moment -- the best in the world putting her mental wellbeing first, saying openly "It's been really stressful these Olympic Games" may be her most defining one, showing others the importance of self-care.
This year, with the pandemic adding so much uncertainty and stress, Olympic athletes are struggling with even higher expectations and less support, facing the pain of competing without the family and friends who have encouraged them in getting this far, knowing that a single positive Covid test or unexpected outbreak could derail years of training.
Pandemic concerns and mental health struggles are also not mutually exclusive. Becca Meyers, a deaf and blind Paralympic swimmer who withdrew from the Games after she said her request to bring her mother as a personal care assistant was denied, has said the decision "tore her apart". The words she used to describe how she has been feeling are so telling: "I've always been known as Becca the swimmer and not Becca the deaf-blind person. And now I feel very worthless as a person. For someone who trained five years for this moment, especially an extra year with the pandemic, it makes it all seem like it was for nothing".
After facing harsh criticism over the withdrawal, the US Olympic and Paralympic Committee (USOPC) issued a statement defending the support it's providing to athletes during these Games: "We take pride in being the best-prepared [national Olympic committee] and [national Paralympic committee] in the world, and that includes supporting all athletes as they navigate the excitement, and complexity, of the Olympic or Paralympic Games".
I used to compete internationally in wheelchair track and field, fencing and cross-fit events. I know that as a top-performing athlete, you are often expected to be a superhuman -- at the peak, physically and mentally. I dealt with many issues around mental health. I competed in wheelchair track and road racing, which is a majority White sport. I spent years managing microaggressions around being mistaken for the only other Asian girl who competed nationally. I dealt with racial tensions and harassment on campus as a student athlete, as many of us pushed for the removal of a racist mascot that was a caricature of an Indigenous Illinois tribe.
I also understand the disappointment and concern that arise about whether one's body can hold out another year — or four — of at least two-a-day practices, six days a week. After a car accident in 2003 and pneumonia in 2004 sidelined me long enough to miss 100-meter qualifying times by a second, I knew that I might not make it to the next Paralympic Games four years later. I trained another year but was forced into early retirement after a surgery went awry. Much like other retired athletes, I spent years trying to recover emotionally and find a new path for myself.
While many Olympians and Paralympians are experiencing unprecedented mental health challenges due to the pandemic, their struggles foreground a broader problem in elite athletic spaces around mental health and inadequate support systems. A pre-pandemic study showed that up to 34% of elite athletes struggled with anxiety and depression, with 19% self-medicating with alcohol. That's significantly higher than among the average population.
While governing bodies have taken some steps to address the issue — such as creating mental health toolkits, providing webinars and giving free subscriptions to mental health apps — many of these efforts miss the mark or fall short of what is needed to fully support their athletes. Governing bodies must expand their mental health divisions to guarantee that all athletes can receive free basic treatment and provide more resources on how athletes can connect with mental health services on their own and ensure their policies and screening practices do not create barriers for athletes to continue to compete. They should also be sensitive to sexism and racism, providing basic training and external resources for coaches, trainers and athletes.
Mental health issues have long been their own largely hidden pandemic in elite athletic spaces. "The Weight of Gold", a recent documentary about gold-medal swimmer Michael Phelps' struggle with mental health, illuminates the stress and toll that training and competing at high levels takes on athletes. Coaches and trainers often focus on physical performance. Athletes are given tools to understand sports psychology. But other mental health issues, such as anxiety, eating disorders, or even "post-Olympic depression", take a back seat. So, when athletes, particularly athletes of color, start experiencing mental health issues and address them openly, they can be ostracized and penalized.
Naomi Osaka withdrew from media availability at the French Open while suffering from anxiety and, after being punished by organizers, left the competition entirely — earning criticism from luminaries in her sport. She has continued to write openly about her struggles with depression and anxiety and will be representing her home country of Japan in the Games. More recently, Sha'Carri Richardson was banned from competing in the upcoming Olympics after testing positive for cannabis, which she said she used to cope in the aftermath of her biological mother's death.
As a result of situations like these, many athletes may choose not to disclose their struggles, which can lead to disastrous consequences, including self-medication and suicide. Athletes of color are facing the added burden of racist expectations of perfection amid the numerous racial reckonings that have boiled over in the last few years.
In one study alone, 78% percent of athletes of color reported some form of mental health issue — and yet only 11% percent utilized mental health services. Measures taken by governing bodies and institutions to address their athletes' mental health remain of little use if athletes fear stigmatization or loss of privacy or agency. For instance, the United States Olympic & Paralympic Committee (USOPC) -- whose CEO released a statement Tuesday in support of Biles's decision to "prioritize your mental wellness over all else" -- uses a mental health decision tree. It encourages trainers and coaches "concerned there is immediate danger to athlete or others" to call 911 rather than deescalating and connecting with local mental health providers, which could put Black and brown athletes at increased risk for violent interactions with police. Athletes may also fear hospitalization: A study on the effects around fear of hospitalization showed individuals with mental health issues were less likely to be compliant with treatment.
All elite sporting institutions need to become more proactive in addressing mental health issues of athletes throughout their career and post-career. Coaches and trainers need to be better educated on how to ensure safe, healthy environments which foster mental health wellness. Athletes should have free access to at least basic mental health services, and there should be significant guidance and counseling for all athletes to address post-game and retirement concerns and help reduce "Olympic" or post-athletic career depression.
It's time to listen to the athletes emerging as leaders in their own right here. As Osaka put it, "It's OK to not be OK". In Biles' words, "We're going to take it a day at a time". We need to make it safe for elite athletes to seek help when they need it -- and ensure that such help is available to them when that need arises.
Mia Ives-Rublee is the director of the Disability Justice Initiative at the Center for American Progress. The views expressed here are her own.