As March Madness approaches, we at Paradigm Outcomes would like to turn our attention to a darker side of the lights and glitz of the All Stars. Even at the heights of fame and fortune, some basketball players fight a battle with mental illness and substance use issues. If a player’s physical performance is not up to par, the coaches work extra hard to get him there. If a player tears an ACL, they get cutting-edge medical care to get them back on their feet. But, if a player has psychosocial challenges, these often go unrecognized. The focus is on physical performance and less so on mental performance.

If a player struggles with depression, whether attributable to the physical injury or not, that very real illness can be swept aside, underestimated, or in some cases never acknowledged at all. In the traditionally macho sports culture talking about any “weakness” is usually not actively promoted. In another potential disservice, substance abuse regulations carry significant penalties, making it taboo to ask for help.

Unless teams are aware of and accountable to address players’ mental health and substance issue, they will not circumvent the problems that arise for their players and the deleterious effect it can have on job performance and quality of life. When you add an injury to the mix, these psychosocial factors can compound the problem and delay recovery. In this way, the life of a professional basketball player isn’t so different from anyone else coping with the stresses of a job or recovering from a complex injury.

This highlights two potential areas where we can assist our workers with their psychosocial issues: employee assistance programs help them cope with the stresses they may bring from outside, including ways to deal with work stress, and psychosocial assistance during recovery from injury.

Larry Sanders and the NBA

Larry Sanders spent five NBA seasons with the Milwaukee Bucks, a team that tried valiantly to make improvements to its mental health program in recent years. Licensed psychologist Ramel Smith, PhD, was brought on as an integral part of team support. Smith travels with the team and is available at every practice. Larry Sanders began working with Dr. Smith to combat anxiety and depression amid the intense pressures and lack of privacy he encountered as a young player in the NBA.

Mr. Sanders eventually departed from the NBA after releasing a video in which he talked candidly about his struggles with mental health during his seasons with the Bucks and the news stories that resulted. He has since described the quality of life decision he made to leave the team, based on his own life values and having nothing to do with the team or the fans.

A Widespread Problem

According to an ESPN story, mental health concerns are a widespread issue within the NBA. Executives, general managers, and head coaches often wind up counseling or evaluating struggling players who really needed professional assistance. Many of these players are young men who are suddenly under the watchful eye of the public who have very specific preconceptions and expectations of them. They may not have other people in their life to turn to when the pressures they face escalate.

To add to the problem, coaches and doctors are bound by confidentiality clauses not to speak about specific mental health cases. Though we know there are very real reasons for these protections, that veil of silence can further increase stigmas around seeking mental health services and make it harder for players who need to receive it.

A Difficult Road

An entire sports system dedicated to the physical health, and particularly physical performance, of its players can have a harder time implementing mental health treatments. Progress is more difficult to measure with depression or anxiety than with a sprained ankle. For players and coaches who are accustomed to concrete measurable results and linear paths to orthopedic recovery, the often subjective nature of mental health treatment and recovery can be particularly vague.

But if one changes the paradigm and see the issue of mental health as one of mental fitness and performance, there are better ways to build in the support, training and measurable outcomes that is needed. Much like the Bucks added Dr. Smith, teams can include rigorous attention to mental fitness and wellness.

Paradigm Outcomes and Mental Health

Sanders isn’t alone. Though teams like the Bucks have made strides in the right direction, mental health stigmas still abound both within and outside of basketball. Sander’s video on The Players’ Tribune website is a refreshing articulation of an insightful man who was able to overcome stigma and external expectations to choose his own path. In his case, it was a career change. But the very availability of a mental health resource like Dr. Smith in his time of need sounds like a game changer.

Paradigm Outcomes follows the Systematic Care Management^SM methodology we explicitly designed to address the biological, psychological and social needs of an injured person. This approach recognizes the impact catastrophic and complex injuries can have on one’s mental health and treats the whole person for improved long-term outcomes.

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