Athletes and Mental Illness: A Closer Look at a Complicated Issue

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In early March of 1998 Chicago Bears defensive lineman Alonzo Spellman was embroiled in a series of bizarre incidents. It all started when he was about to take an NFL mandated steroid test in the office of his publicist. Something went awry and Spellman began to act belligerently. He kicked a chair and threw a coffee cup. He refused to leave the publicist’s home and a local SWAT team stormed in to monitor the situation. Former Bear Mike Singletary was called in to talk Spellman into surrendering, at which point he was admitted to a psychiatric ward. The next day Spellman walked out of the hospital wearing only his hospital pants. He surrendered to authorities and was readmitted.

Chicago talk radio exploded with rumors. Was is steroids, drugs, alcohol? The internet was still in relative infancy compared to today’s social media universe. Local radio stations actually employed fax machines to take messages from listeners. Email was emerging as an alternative for listener participation. Eventually, the media and the public got its collective head around the situation. Alonzo Spellman experienced a severe manic episode resulting from a bi-polar condition.

Athletes and Mental Illness: A Closer Look at a Complicated Issue

Flash forward to 2015. On October 21st of this year another Chicago Bears defensive lineman demonstrated some belligerent and bizarre behavior. Jeremiah Ratliff showed up at the Bears’ training facility and was involved in an altercation with team officials. Reportedly, he arrived in “no condition to work.” After an initial argument he returned multiple times triggering a reaction from Bears’ security personnel. The police were called, and after several days of speculation the police report revealed some disturbing details:

A redacted version of the police report indicated that during a prolonged argument with team officials, Ratliff stated “he felt like killing everyone in the building.” At one point, he also reportedly said “I am the devil” while indicating he “wished staff members’ children would die.”

Once again talk radio crackled with speculation. Media and fan reaction to the 2015 incident, however, revealed some nuance that has evolved around the often mysterious issue of athletes and mental health. People are more aware of the significance of mental illness in our society, and specific issues about the long-term effects of playing football are being discussed.

Both incidents in Chicago are among many involving athletes and mental health that have emerged in the 17 year span that separates them. Two recent stories highlight the complex and sometimes tragic dramas of athletes who can no longer cope with life on or off the field. In 2012 Thomas Johnson, a wide receiver at Texas A&M, walked off campus and spiraled into various states of mental illness. On October 12th of this year he stabbed a man to death while he was jogging in northeast Dallas. The victim’s wife subsequently committed suicide, citing her grief over her husband’s death. Last week at Fresno State a walk-on wide receiver sent out a terrifying message on social media that nearly shut down a campus with an enrollment of over 20,000. Christian Pryor was later arrested and charged with making a criminal threat.
A post on the social messaging app Yik Yak threatening a shooting on the Fresno State campus on Monday, November 2, 2015.

Mental illness is not an excuse for criminal behavior, but sometimes it is a contributing factor. Young athletes are often thrust into the public spotlight with little or no preparation for its advantages or pitfalls. Coaches, college administrators, and professional teams employ various methods with varying degrees of success to address mental health issues that affect athletes.

Dr. Richard Lustberg is New York psychologist who writes extensively on issues related to sports and psychology. His Psychology of Sports website is a wealth of information and opinion on mental health topics that affect athletes. Two very interesting posts include his thoughts on Jameis Winston, “Jameis Winston is Screaming Out for Help,” and several on Aldon Smith including “Aldon Smith – A Well Intentioned Sports Media Offers Misguided Solutions.” Dr. Lustberg has been featured in over a hundred newspapers, magazines, and online publications including The New York Times, CBS Sportsline and ESPN. In a phone interview with Dr. Lustberg he commented on the disparity of care that athletes might receive from institutions or teams they play for.

“Some college programs have better resources than others. At any level, no matter what high profile player you choose to look at, you’re only as good at handling situations as your staff. Some have better scrutiny than others.”

And how can coaches, colleges, and professional teams be more prepared to identify when athletes might suffer from mental health issues?

“Coaches, anybody in any relationship with a player. Any educator or employer obviously needs some degree of understanding of what is normal and what is not. They need resources to identify the problems. You bring staffs in and determine what is typical and what is not.

“It depends on the quality of the employer and the quality of assistants. Some pro teams have better programs than others. Some teams have educationally based programs. Some are not very good at diagnosing. Players and coaches are used to playbooks, and some teams use this approach to mental health education. You want to present it in a way that coaches and players understand. Sometimes teams have to look at specific situations more dynamically.”

Dr. Bradley Donohue is the Editor for Journal of Child & Adolescent Substance Abuse and a professor from the University of Nevada, Las Vegas Department of Psychology. He is the developer of The Optimum Performance Program in Sports; TOPPS. Their stated mission is “To assist athletes in achieving their goals in both sports and life. We are trained to address at all levels in life including school performance, academic performance, substance/impulse control, financial management, social/communication skills, emotional management, and career planning.”

In an email interview Dr. Donohue outlined some specific solutions to improve the quality of mental health care that athletes receive, and he offered some suggestions for ways the media can provide more enlightened reportage when such issues arise.

In what ways do you think psychologists and psychiatrists can help coaches and administrators be more prepared to deal with athletes that suffer from mental illness and in what ways can bad behavior be explained by mental health issues? For example, substance abuse is often a factor when athletes get into trouble.

Coaches, administrators and athletes are usually aware of various problem behaviors, such as substance abuse, violence, depression, anxiety disorders, eating disorders and so on. However, they usually are not aware that these things are symptoms of mental health disorders, heavily influenced by stress, and prevented when mental health is optimized through evidence-supported programs that are provided early in the development of these concerns. 

Unfortunately, psychologists have historically not administered evidence supported mental health optimization programs with athletes (especially those that have been specifically adapted to address the sport culture) because these programs have only recently been in high demand. There are studies funded by the National Institute of Drug Abuse (NIDA) to develop such programs, for example, Family Behavior Therapy (aka “The Optimum Performance Program in Sports”; Donohue et al., 2015). However, these programs are not widely available.

This is problematic because the practice of using mental health interventions that are not supported by evidence, and not adapted to sport culture, is likely to be ineffective, leaving athletes to generally doubt the merits of mental health optimization programs for athletes.

What are some ways  athletes can guard against stress and optimize both their mental health and sport performance?

Insist that administrative policies be updated to address current-day concerns. For instance, coaches are often considered by athletes as mentors who are available to confidentially help guide them in life decisions. However, some collegiate athletes report being stigmatized to report mental health concerns to their coaches because NCAA policy requires their coaches to report compliance violations (for example, drug use) to athletic administration. Although this policy may reduce liability, it can have the unintended result of restricting discussion of undesired thoughts and intentions .

Insist that athletic departments and professional and amateur leagues and organizations employ mental health professionals who are required to demonstrate that they can implement mental health/wellness optimization interventions that are supported by scientific research. These professionals should be required to attend workshops to enhance their skill sets, and demonstrate basic competencies and familiarity with evidence supported programming that are adapted to sport culture.

Participate in evidence supported mental health optimization programs, such as stress management, problem-solving and communication skills training, Family Behavior Therapy/The Optimum Performance Program in Sports, Mindfulness Acceptance Commitment, and various relaxation exercises.

Participate in pleasant family activities.

Focus on the process of what will lead to optimum performance (the task at-hand) not outcomes.

Avoid pressure words (I should, I need to, I must).

Use positive words (I can…, I will…).

Describe things without emotion – be neutral.

Focus on self and not others during competition unless the focus on others is strategic.

Many times athletes are surrounded by layers of enablers from a very early age. How do you begin to convince an athlete, and those in his or her immediate circle, that his or her behaviors display symptoms of mental illness?

Based on our research developing TOPPS with athletes at the University of Nevada, Las Vegas, family members, including coaches, teammates, parents and close friends are beneficial to the development and maintenance of mental health optimization. Unfortunately, the vast majority of mental health professionals fail to incorporate family into their practice.  Involving family members in mental health optimization and wellness programs provides an opportunity to understand and provide skills training to assist the athlete within the context of family.

How can the media improve depictions of athletes that suffer from mental illness? What can writers and reporters look for in situations when there might be a mental health issue involved?

I believe it is important that writers and editors in media recognize that their stories may have a significant impact, both positive and negative, on the welfare of athletes who have experienced significant stressors or difficulties with mental health.  Supportive articles, such as this one assist in determining solutions to problems. 

To some extent most undesired behaviors can be symptoms of mental health illness, and mental illness is often associated with stress. For instance, athletes that have committed crimes or used drugs (both symptoms of mental health disorders) may be influenced by impoverished or stressful environments where traumatic experiences, delinquent peers, violence, lack of parental oversight, and other risk factors are present. Therefore, the accuracy and quality of reporting of potential mental health concerns may be enhanced by investigating these experiences, compassionately mentioning these factors, and urging rehabilitation rather than public scrutiny which increases stress, discourages motivation to pursue care, and has a negative impact on mental health.

Are athletes any more susceptible to struggles with mental health than the general population?   

It is important to appreciate that at least 25% of individuals in the United States are estimated to experience a mental health disorder each year and stress increases the probability of experiencing a mental health disorder. Thus, athletes are particularly likely to benefit from mental health optimization programs.

When asked about media coverage Dr. Lustberg offered some more succinct advice for members of the media, “Don’t write articles about mental health when you don’t know crap about it.”

“Like anything else there are varying degrees of sophistication when dealing with mental health issues. I’m finding that many reporters are coming into a story with their own ideas. Then they go out there and attempt to validate their perception. They find somebody with a quote who is validating this perception. Then they write about it.”

And how can the relationship between the media and the public raise the bar on coverage involving athletes and mental health? Dr. Lustberg added:

“The pressure in on the public. The public has to ascertain fact from fiction, and quality from entertainment. There is so much pressure to provide content. The NFL, and all sports, deserve credit. They are getting better at handling situations that involve mental illness.”

Too many times sports is a window with a view of the worst our society has to offer. When athletes get into trouble there is a rush to dissect and sensationalize situations involving myriad issues that usually require closer examination. Sports culture often obscures public perceptions. Machismo, unrealistic expectations, and ignorance combine to dictate a distorted narrative that is damaging to individual athletes and the public at large. Sports fans, teams, and the media have come a long way in terms of widening perspectives. But, like so many hot button issues, we have a long way to go toward developing a greater understanding of mental illness. Sports has proven to be an arena that allows for greater education. Let’s hope that we all can develop a greater understanding of mental health and how that can affect anyone’s motivations.

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4 COMMENTS

  1. I am glad to see that the issues surrounding mental health and athletes are being talked about! There needs to be more discussion and more solutions to help struggling athletes.

  2. I think that this is a great idea! Being friends with several different athletes from different sports, I see first hand their struggles regardless of their sports. They all have trouble with time management, financial issues, and substance abuse that can all be stopped if they had some sort of guidance. I think it’s great that programs like TOPPS are being created to offer student athletes guidance.

  3. Athletes and mental health is such an important topic that is not talked about nearly enough. As a collegiate athlete myself, I have seen how serious these issues can become and how negligent athletes are to seek out help in fear of backlash. I love to see awareness being brought to this topic!

  4. “Mental illness is not an excuse for criminal behavior, but sometimes it is a contributing factor.” Great article! This sheds some light on the issue that is mental illness and the struggles one may go through. Speaking about mental health is something that needs to expand and improve, hopefully through more articles like this!

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