Dr. Ben Miller: “The IOC should turn words into action and provide onsite mental health support to the athletes”

The issue of the mental health of athletes is in Tokyo 2020 in a foreground it had never had before. First it was Naomi Osaka, then it was Simone Biles, but they are not alone: the pandemic Games take an inevitable toll.

“What’s causing the most anxiety amongst Olympic athletes this year though is the fact that we’re still in the middle of a highly contagious and deadly pandemic”, said Dr. Ben Miller in an interview with Around the Rings. Miller is president of the Well Being Trust, a U.S. foundation that aims to shed light on mental health, an issue that people often prefer not to talk about.

Dr. Miller believes the International Olympic Committee (IOC) could do more to help athletes: “Before, during and after”.

- What did Simone Biles teach us?

- Speaking up on our mental health is hard even in the best of times. Simone Biles being able to do so at the pinnacle of her career, at the top of her sport and with so many eyes on her says a lot about the person she is. And our reactions to her doing so says a lot about our collective understanding of mental health, and public opinion about it. Simone Biles’ talking about her mental health has taught us three key things. First, the reporting that surrounded her announcement showed us that when it comes to athletes being unable to perform, we have a tendency to assume it’s for a physical reason. Second, Simone forced us to rethink what we consider to be poor mental health and reminded us of just how dangerous poor mental health can be. She didn’t name a diagnosable condition like anxiety, depression, or overtraining syndrome, but just said that mentally, she wasn’t “there,” and that alone could be enough to cause serious injury. Third, Simone revealed just how much competition can keep people from doing and saying what is right. Many people criticized Biles by saying that she was letting down her team and her country by standing up for her mental health, words that dismiss Biles’ struggle, advance stigma, and fail to acknowledge that Biles is a person just like you or I.

- Is there any difference between what she did and what Naomi Osaka did?

- Leadership comes in different shapes and sizes. Both Naomi Osaka and Simone Biles have given cover for countless other celebrities and Olympic athletes to speak up about their mental health. But the biggest difference between the two is that Naomi Osaka made it OK to talk about mental health as we’ve traditionally understood it – i.e. as depression, anxiety and other disorders – whereas Simone Biles said flatly and without any diagnostic labels that she was struggling with her mental health, and because of that, continuing on could have a negative impact on her physical health. Naomi Osaka largely initiated this critical conversation about athlete mental health, and Simone Biles took that conversation to the next level by broadening it, and presenting it on an international stage.

- If we compare the psychological pressure and mental stress suffered by the Olympic athletes of 2021, what difference is there with those of, for example, Barcelona 92, in the pre-Internet era?

- I imagine the internet has definitely had an impact on Olympic athletes’ mental health over the years, particularly where social media is concerned. Having photos and videos about your successes and failures so widely broadcast and open to public comment must be incredibly nerve-wracking. What’s causing the most anxiety amongst Olympic athletes this year though is the fact that we’re still in the middle of a highly contagious and deadly pandemic. The uncertainty, social isolation, and absence of fan support because of Covid-19 is surely contributing to athletes’ performance in some capacity.

- Let’s go even further back. What’s the difference between these games and those of Tokyo 64, when television did not show everything it shows today?

- Television reveals much more today than it did in 1964, but I think most of today’s Olympic athletes have grown accustomed to and, as much as one can, comfortable with the fact that they are being recorded from all angles. Truly, the biggest difference between this year’s Olympics and any other is Covid-19 – arguably one of the worst public health crises that has coincided with the Olympic games.

- How much do social networks help athletes today? And how much do they harm them?

- Social networks help athletes feel supported by their fans. Receiving encouraging messaging goes a long way whenever an athlete feels they didn’t physically perform their best, or, in the Simone Biles’ case, whenever they are facing public scrutiny. By the same token, social networks can harm athletes because they also open the door to negativity. Celebrities and Olympic athletes will always have “haters” that get to them despite an overwhelming number of people singing their praises. Just like anyone else, athletes need to protect themselves from allowing that kind of criticism to weigh too heavy on them.

- OBS, the television production company of Tokyo 2020, created an “athlete’s moment” in which family and friends connect with the athlete to greet him, in the middle of the stadium and virtually, after their performance. What do you think of this? What are the mental health implications of having that moment televised for the world to see?

- Having a very personal moment televised could change the dynamic between an athlete and their friends and family, if only because a camera can be intimidating. Friends and family could be slightly less expressive and slightly more uncomfortable with the camera rolling, so I would caution viewers on making any assumptions or comments about a person’s friend and family dynamic. But the good outweighs the bad here. Not being able to physically see or hear your biggest fans at one of the most important athletic performances of your career is disheartening and saddening, which can definitely impact performance. Having the option to connect with loved ones in this way is very thoughtful and impactful.

- COVID has clearly affected these games, including having no fans at the opening ceremonies. Psychologically, what did that somber opening ceremony in an empty stadium imply?

- That somber opening ceremony in an empty stadium was unfortunately a sign of the times. The world is still battling a deadly disease, no matter how we may all want to put that behind us. I’m sure that that was an eye-opening moment for athletes and spectators alike, a moment that athletes have had to put aside for the sake of their immediate performance, but a moment that must remain front of mind for the rest of us.

- Any urgent recommendation to the IOC to avoid new cases like those of Biles and Osaka? What can the Olympics do to help athletes’ mental health?

- The IOC should start by owning and reiterating the fact that mental health is a normal part of being a person. They should lead with language and put out public statements saying that while athletes may have incredible physical strength, athletes are people too. It’s OK for athletes to not be OK – physically or mentally. The IOC should then turn words into action. They should provide onsite mental health support before, during, and after the event so that physical therapists and trainers are just as accessible as mental health clinicians. That’s not the norm in most placs, sadly, but if the IOC leads the world in this way, that could change.

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