When Team USA Gymnast Simone Biles withdrew from the 2020 Olympics Gymnastics all-around final and team final, her decision provoked a conversation that aims to help end the mental health stigma surrounding athletes.

Biles had explained that her withdrawal was not because of a physical injury but her mental health. Her exit did not necessarily mean that she was upset with her performance or wanted to quit because of expectations. It was because of her psychological state that could put her at risk of physical injury and worsen her mental health.

Mental health continues to be overshadowed in the athletic community, as being an athlete can be astonishingly challenging due to the pressure to perform. Among elite athletes, 35% suffer from a mental health crisis resulting in stress, burnout, eating disorders or anxiety and depression, according to Athletes for Hope.

Biles spoke on the significance of mental health among athletes and the importance of making your mental health your top priority. 

“I say put mental health first because if you don’t, then you’re not going to enjoy your sport and you’re not going to succeed as much as you want to,” Biles said in a press conference in Tokyo on July 27. “It’s okay sometimes to even sit out the big competitions to focus on yourself because it shows how strong of a competitor and person that you really are rather than just battle through it.”

Mental health concerns don’t only occur at a professional level; they can begin in childhood and adolescence, and results have shown the dramatic impact on college athletes. 

Coordinator of Sport Psychology Services at Oregon State University Fernando Frias explained when and how mental health concerns rise amongst athletes. 

“Every person reacts to stressors and life phases differently,” Frias said via email. “It is common, however, that change and life transitions, whether expected or unexpected, cause elevated distress for many. For example, beginning collegiate sport, leaving collegiate sport, injuries, coaching changes, breakups, etc.”

Student-athletes have too often been conditioned to hide their weakness of mental illness when challenged with stressors that are part of performing at a high level athletically, socially and academically.

“In some ways, the culture of competitive sport is opposed to mental health help-seeking,” Frias said. “The very characteristics that promote athletic excellence—tolerating discomfort and pushing beyond perceived limits, etc.—make it hard for some to acknowledge mental health concerns.”

Physical injuries such as broken limbs and pulled muscles that are visible tend to take precedence over mental health. When athletes are physically injured, they are granted time off to rest, recover and get healthier. When a mental health crisis occurs, however, the nature of athletics is to push through and continue on, as everyone has to deal with pressure. 

Former Oregon State Gymnast and Dam Worth It campaign co-founder Taylor Ricci spoke on the importance of mental health conversations surrounding student-athletes. 

“There’s definitely a stigma that exists across society, but I think, in the world of athletics, it’s almost like [there is] this extra stigma that exists,” Ricci said. “It’s like this extra layer of armor that athletes wear that makes them feel like they have to be tough and not show any form of weakness.” 

There is a recurring phrase used within the athletic community to “play through the pain.” However, when athletes suffer from a mental health crisis, the consequences can be detrimental. 

“Athletes are seen by everyone when they are supposed to be at their prime, which is on the competition floor, on the golf course or on the field, and people don’t see the hours of training that come before that,” Ricci said. “People don’t see what happens the minutes [and] the days before a game, and they don’t know what’s going on in athletes’ lives. From a sports standpoint, everything could be great, but an athlete could be dealing with a personal illness, something going on in their family, relationships could be strained—you just never know what’s going on in the backside.”

Several authors (including Lopez & Levy, 2013; Moreland, Coxe & Yang, 2018) argue that the consistent negative stigmas surrounding mental illness have led to a significant under-utilization of mental health services by athletes. Athletes for Hope explained that 33% of college students experience a mental health crisis including significant symptoms of depression and anxiety. Among that group of college students, 30% seek help; however, only 10% of student-athletes with mental health conditions seek help. 

“Personally as an athlete, I think about what the stigma was for me, and a big one was I didn’t want to miss out on competing time,” Ricci said. “I didn’t want to say to my coach ‘I’m anxious’ or ‘I’m dealing with mental health concerns’ and then get pulled from the lineup. As a teammate, I didn’t want to express that I was struggling mentally so that my teammates wouldn’t lean on me for help or support because that’s not what I wanted either.”

Athletes are now using their status to encourage change within the athletic community and promote a positive discussion about mental health. Ricci used her experience as a former Division I athlete to create a supportive environment for student-athletes suffering from mental health. 

Ricci and Nathan Braaten co-founded the Dam Worth It campaign in November of 2017. The organization uses the influential platform of sports to create a community dedicated to help end the stigma around mental health. 

“During my senior year at Oregon State, I lost a teammate to suicide,” Ricci said. “About 12 months prior, my co-founder of Dam Worth It, Nathan Braaten, who was a Men’s Soccer player at Oregon State also lost a teammate to suicide. So, it was in about a span of one year at Oregon State where we lost two student-athletes to suicide… Dam Worth it came out of that.”

What began as a catch-up coffee between the athletes became a five-hour-long meeting dedicated to helping student-athletes suffering from mental health. 

“We wanted to use our platform [and] use our voices to try and prevent another team or another student at Oregon State from having to go through [what we did],” Ricci said. “We knew as students that we didn’t have the money to bring on 10 new sports psychologists or 10 new counselors to our campus, but we did have the capacity to talk about it and try to end the stigma.”

A year after the program was founded, it was also expanded to all OSU students seeking mental health support, not only student-athletes.

Athletes and students looking for mental health support can visit the Dam Worth It website for more information.

“I want student-athletes struggling with mental health issues to know that help is available and that they are surrounded by a caring support network,” Frias said. “Asking for help is a sign of strength.”