For years, competitive sports had a familiar vocabulary for distress. An athlete was tired, distracted, in a slump, or dealing with something personal. The language kept the problem vague and, just as important, kept it away from the game.
That separation is harder to maintain now. Mental health appears in athlete interviews, league programs, college-sports policy, injury conversations, and performance departments. Players speak about anxiety and depression while they are still competing. Teams increasingly employ or refer athletes to licensed clinicians. Coaches are expected to understand that an athlete can be physically available and still need help.
The change is substantial, but uneven. Greater visibility has made mental health part of the sports conversation. It has not guaranteed access, privacy or trust in every locker room.
Why Silence Fit the Culture
Sports did not universally ignore mental health in an earlier era. Clinicians, athletic trainers, families, and individual coaches did this work long before it became visible. The dominant culture, however, gave athletes strong reasons to keep it private.
Competitive environments reward control. Athletes learn to play through pain, accept public evaluation and avoid showing an opponent where they are vulnerable. Acknowledging anxiety, depression or emotional exhaustion could feel different from reporting a strained hamstring. The athlete might wonder whether a coach would see weakness, a front office would see risk or teammates would see unreliability.
Those fears were intensified by the structure around elite sport. Playing time, contracts, selection and sponsorships depend partly on an athlete being considered available. When the people responsible for care operate near the people making performance decisions, confidentiality can feel uncertain even when formal protections exist.
The scale of the issue also became harder to dismiss. A 2019 systematic review and meta-analysis in the British Journal of Sports Medicine found symptoms of anxiety or depression in about 34% of current elite athletes across nine studies involving 2,895 athletes. The authors cautioned that the evidence relied largely on self-reported symptoms, used varying measures and did not amount to a clinical diagnosis for one-third of athletes. It still challenged the idea that mental-health difficulty was an unusual exception at the highest levels.
Athlete mental health also extends beyond anxiety or depression. Injury can bring pain, isolation, medication, and fear about a career. Retirement can remove routine, status and a central source of identity. Substance use may begin as pain management, sleep support or escape before creating a separate problem. If drug use becomes difficult to control or begins damaging health, relationships or work, care may need to progress from a team conversation to clinical assessment and, for some people, structured drug rehabilitation.
The link between these issues should be handled carefully. A mental-health struggle does not imply substance dependence, and treatment needs vary. The broader change is that sports organizations are beginning to recognize a range of needs rather than treating every difficulty as a motivation problem.
When Athletes Changed the Language
Public disclosures mattered because athletes described the experience from inside active, successful careers. During NBA All-Star weekend in February 2018, DeMar DeRozan acknowledged his depression publicly. Weeks later, Kevin Love wrote in The Players’ Tribune about a panic attack he had experienced during a Cleveland Cavaliers game the previous November.
Love explained that he had treated mental health as somebody else’s problem and feared that asking for help could derail his success. He also credited DeRozan’s openness with helping him speak. The sequence showed how quickly permission can travel through a league: one player named the problem, another supplied detail, and a private subject became part of basketball’s public language.
When Policy Caught Up
Public language has value only if an athlete has somewhere credible to take the conversation. That has pushed mental health from awareness campaigns into operating policy.
The NCAA first published its Mental Health Best Practices in 2016. Its current standards, effective August 1, 2024, require member schools to make services and resources available consistent with those practices. The framework calls for written plans developed with licensed providers, annual screening for psychological distress, routine and emergency action plans, and qualified clinicians for evaluation and treatment.
Professional leagues have also made mental health more visible within athlete care. In SportsEpreneur’s interview on NBA and WNBA Mind Health, program director Dr. Kensa Gunter discussed the effort to move the conversation from stigmatization toward normalization, along with the role of leadership, injury recovery, and the connection between mental health and performance.
That connection changes how support is positioned. If mental health is discussed only after a crisis, athletes may still interpret care as a sign that something has gone wrong. When licensed professionals, referral pathways and recovery conversations are built into the environment, using them becomes less exceptional.
Where Access Still Lags
A policy can require resources without making every athlete comfortable using them. College programs differ sharply in budgets, local provider networks and staffing. Professional athletes may worry about privacy, career consequences or whether a clinician understands their culture, identity and sport. Olympic and individual-sport athletes often move between national bodies, private coaches, sponsors, and short-term competition environments, leaving responsibility for care less obvious.
Former athletes can fall outside systems designed for active rosters. Injury, deselection and retirement are precisely the moments when athletic identity, income and daily structure can change at once. A program that ends when eligibility or a contract ends misses a predictable period of vulnerability.
Coaches and performance staff also need a defined role. They can notice changes, create a safer environment, and know where to refer someone. They should not be expected to diagnose or treat. Blurring that boundary risks replacing clinical care with good intentions.
Athlete mental health is now part of the game in a way that was rare in public discussion a generation ago. The remaining test is operational: whether an athlete can reach qualified, confidential care without first becoming a public story, a performance problem, or a crisis.
Health note: This article is for general informational purposes only and is not medical or mental health advice. If you are concerned about your health, substance use, or mental well-being, speak with a qualified healthcare professional.
Related Content
AthMindset | Dr. Jessica Bartley, Director of Mental Health for Team USA
The Cost of Always Being On in Sports and Entrepreneurship
ALL IN: John Damon on Excellence, Showing Up, and Raising Your Standards
Content Disclosure: Some content on this website may include links to third-party products, services, or websites. While we may or may not receive compensation for the time and effort spent curating and creating this content, we do not receive payment specifically for the sale of products. We only share content and resources that we believe offer value to our readers and align with our editorial standards. All opinions expressed are our own, and any content or links are subject to review for quality and relevance. For more details, see our full disclaimer.
How Athlete Mental Health Went From Taboo to Part of the Game
For years, competitive sports had a familiar vocabulary for distress. An athlete was tired, distracted, in a slump, or dealing with something personal. The language kept the problem vague and, just as important, kept it away from the game.
That separation is harder to maintain now. Mental health appears in athlete interviews, league programs, college-sports policy, injury conversations, and performance departments. Players speak about anxiety and depression while they are still competing. Teams increasingly employ or refer athletes to licensed clinicians. Coaches are expected to understand that an athlete can be physically available and still need help.
The change is substantial, but uneven. Greater visibility has made mental health part of the sports conversation. It has not guaranteed access, privacy or trust in every locker room.
Why Silence Fit the Culture
Sports did not universally ignore mental health in an earlier era. Clinicians, athletic trainers, families, and individual coaches did this work long before it became visible. The dominant culture, however, gave athletes strong reasons to keep it private.
Competitive environments reward control. Athletes learn to play through pain, accept public evaluation and avoid showing an opponent where they are vulnerable. Acknowledging anxiety, depression or emotional exhaustion could feel different from reporting a strained hamstring. The athlete might wonder whether a coach would see weakness, a front office would see risk or teammates would see unreliability.
Those fears were intensified by the structure around elite sport. Playing time, contracts, selection and sponsorships depend partly on an athlete being considered available. When the people responsible for care operate near the people making performance decisions, confidentiality can feel uncertain even when formal protections exist.
The scale of the issue also became harder to dismiss. A 2019 systematic review and meta-analysis in the British Journal of Sports Medicine found symptoms of anxiety or depression in about 34% of current elite athletes across nine studies involving 2,895 athletes. The authors cautioned that the evidence relied largely on self-reported symptoms, used varying measures and did not amount to a clinical diagnosis for one-third of athletes. It still challenged the idea that mental-health difficulty was an unusual exception at the highest levels.
Athlete mental health also extends beyond anxiety or depression. Injury can bring pain, isolation, medication, and fear about a career. Retirement can remove routine, status and a central source of identity. Substance use may begin as pain management, sleep support or escape before creating a separate problem. If drug use becomes difficult to control or begins damaging health, relationships or work, care may need to progress from a team conversation to clinical assessment and, for some people, structured drug rehabilitation.
The link between these issues should be handled carefully. A mental-health struggle does not imply substance dependence, and treatment needs vary. The broader change is that sports organizations are beginning to recognize a range of needs rather than treating every difficulty as a motivation problem.
When Athletes Changed the Language
Public disclosures mattered because athletes described the experience from inside active, successful careers. During NBA All-Star weekend in February 2018, DeMar DeRozan acknowledged his depression publicly. Weeks later, Kevin Love wrote in The Players’ Tribune about a panic attack he had experienced during a Cleveland Cavaliers game the previous November.
Love explained that he had treated mental health as somebody else’s problem and feared that asking for help could derail his success. He also credited DeRozan’s openness with helping him speak. The sequence showed how quickly permission can travel through a league: one player named the problem, another supplied detail, and a private subject became part of basketball’s public language.
When Policy Caught Up
Public language has value only if an athlete has somewhere credible to take the conversation. That has pushed mental health from awareness campaigns into operating policy.
The NCAA first published its Mental Health Best Practices in 2016. Its current standards, effective August 1, 2024, require member schools to make services and resources available consistent with those practices. The framework calls for written plans developed with licensed providers, annual screening for psychological distress, routine and emergency action plans, and qualified clinicians for evaluation and treatment.
Professional leagues have also made mental health more visible within athlete care. In SportsEpreneur’s interview on NBA and WNBA Mind Health, program director Dr. Kensa Gunter discussed the effort to move the conversation from stigmatization toward normalization, along with the role of leadership, injury recovery, and the connection between mental health and performance.
That connection changes how support is positioned. If mental health is discussed only after a crisis, athletes may still interpret care as a sign that something has gone wrong. When licensed professionals, referral pathways and recovery conversations are built into the environment, using them becomes less exceptional.
Where Access Still Lags
A policy can require resources without making every athlete comfortable using them. College programs differ sharply in budgets, local provider networks and staffing. Professional athletes may worry about privacy, career consequences or whether a clinician understands their culture, identity and sport. Olympic and individual-sport athletes often move between national bodies, private coaches, sponsors, and short-term competition environments, leaving responsibility for care less obvious.
Former athletes can fall outside systems designed for active rosters. Injury, deselection and retirement are precisely the moments when athletic identity, income and daily structure can change at once. A program that ends when eligibility or a contract ends misses a predictable period of vulnerability.
Coaches and performance staff also need a defined role. They can notice changes, create a safer environment, and know where to refer someone. They should not be expected to diagnose or treat. Blurring that boundary risks replacing clinical care with good intentions.
Athlete mental health is now part of the game in a way that was rare in public discussion a generation ago. The remaining test is operational: whether an athlete can reach qualified, confidential care without first becoming a public story, a performance problem, or a crisis.
Health note: This article is for general informational purposes only and is not medical or mental health advice. If you are concerned about your health, substance use, or mental well-being, speak with a qualified healthcare professional.
Related Content
AthMindset | Dr. Jessica Bartley, Director of Mental Health for Team USA
The Cost of Always Being On in Sports and Entrepreneurship
ALL IN: John Damon on Excellence, Showing Up, and Raising Your Standards
Content Disclosure: Some content on this website may include links to third-party products, services, or websites. While we may or may not receive compensation for the time and effort spent curating and creating this content, we do not receive payment specifically for the sale of products. We only share content and resources that we believe offer value to our readers and align with our editorial standards. All opinions expressed are our own, and any content or links are subject to review for quality and relevance. For more details, see our full disclaimer.