The Struggle
Stress and mental health issues in professional sports
By Max Gabovitch
Butler University
Dwight Hollier was struggling. During his nine-year NFL career that included eight seasons with the Miami Dolphins and one with the Indianapolis Colts, injuries had taken their toll and were forcing him into retirement. He felt as though, without football, he didn’t know who he was.
Luckily, the former linebacker had taken steps during his playing career to set himself up for a successful life after his days on the field ended.
“I worked on and completed my master’s degree while I was playing. I went to work right away. I was hired and in (a) job in two months after I officially left the game. And I played nine years,” he said. “So I did a lot of things right, but still fell flat on my face in my transition and my struggle.”
Even as he struggled himself, he couldn’t help but think about the players who were forced into retirement earlier and without having taken the steps that he had to prepare for what’s next.
“If the average NFL experience is 2.7 to 3 years, then what happens to the guy who only plays that 3 years and didn’t have his undergrad degree and thought he was going to play 10 years?”
It’s that question that led him to his current job as the NFL’s vice president of wellness and clinical services. He now works to help the league’s players deal with transitioning, along with the many other stressors that they face. He also spends time trying to help address the mental health issues that those stressors can contribute to.
Chris Carr is the team performance psychologist for the Indiana Pacers. He also works with college athletes at Purdue and Butler universities and in the past has worked with National Football League, Major League Soccer and Major League Baseball teams. Now in his sixth season with the Pacers, Carr said that helping professional athletes deal with their stress is key to keeping players from experiencing further mental health problems.
“The primary issue is just, how do you manage stress,” he said. “How do you manage the demands of being a professional athlete?”
More Money, More Problems?
There are a number of major stressors that professional athletes deal with. But one of the more surprising ones may be money.
It’s no secret that there is a lot of money in professional sports. In the four major professional sports leagues, young men in their late teens and early 20s instantly become millionaires the second they are drafted.
Each league has had players sign contracts worth more than $100 million. But it’s not just the stars making big money. Among players in the four professional leagues, football players earn the lowest average salary at $2.1 million a year, according to Forbes. Basketball players top the list at an average of $6.2 million and that number is expected to reach $10 million for the 2020–2021 season.
However, all of that money comes at a price. The player’s financial situation often dramatically alters his relationships, something Seattle Seahawks wide receiver Doug Baldwin experienced firsthand.
“Think about the closest person in your family trying to take advantage of you because of where you are and the amount of money that you make,” Baldwin said. “For us, none of our profit is hidden. Everything is out in the open for the public to read. So even my family members get ahold of that and they expect certain things.”
Baldwin said he even had one relative who thought that his success meant that her financial needs would be taken care of, causing him a lot of stress.
“She expected that, now that I was in the NFL, she no longer had to work,” he said. “There was a big blow up between her and I about it, and it obviously damaged our relationship. There (are) people in an athlete’s family that perceive this money as an opportunity for them too, to come up in life, if you will.”
That incident happened before Baldwin’s salary increased dramatically with his latest contract extension, a four-year, $46 million deal that he signed in June 2016.
Many professional athletes do not have any experience managing finances. Those who spend large amounts of money constantly treating themselves, as well as friends and family, often find that the money doesn’t stretch as far as they thought it would.
When Sports Illustrated took a look at the issue in 2009, it found that 78 percent of former NFL players had gone bankrupt or were under financial stress due to joblessness or divorce within two years of retiring from football. The magazine also found that about 60 percent of former NBA players had gone broke within five years of their retirement.
Transitioning
Injuries also are a major stressor for professional athletes. In addition to being mentally difficult to deal with themselves, injuries are one of the reasons why the career span of athletes is extremely short.
The average length of a career for a professional hockey player is just 5.7 years, and that is the longest amongst the four major professional leagues. The average professional baseball player’s career lasts 5.6 years, while the average for professional basketball players is 4.8 years and professional football players’ careers last an average of just 2.7 years.
Like Hollier, Sean O’Donnell found it difficult to end his time as a professional athlete. He played much longer than the average player, seeing action in more than 1,200 games over 17 seasons in the National Hockey League including stints with the Los Angeles Kings, Minnesota Wild, New Jersey Devils, Boston Bruins, Phoenix Coyotes, Anaheim Ducks, Philadelphia Flyers and Chicago Blackhawks. Still, when his time came to hang up the skates, he struggled to adjust.
“I had a hard time,” he said. “I missed the camaraderie. I missed the guys. I missed the routine. You know, yes you’re other things — you’re a husband, you’re a parent — but you’re an athlete. You wake up and, in the summertime, ‘OK, I’m going to train these five days a week.’ Then the season starts: ‘The bus is at this time, mealtime is at this time, we’re going to be in this city on this day.’ It’s pretty structured as far as what your schedule and what your itinerary is. And you get accustomed to that.”
Watchful eyes
In his work with professional athletes across a number of leagues, Carr, the Pacers psychologist, has seen how the intense attention from the public can weigh on players. He said that now more than ever, athletes are struggling to find time away from the spotlight.
“These players are operating under a huge magnifying glass, so all of their behaviors and conduct are super analyzed,” Carr said. “Social media has now made it difficult for players and athletes at this higher level to have (any) kind of privacy or their own kind of lifestyles without being under that microscope.”
As the Seattle Seahawk’s Baldwin has become a bigger star on the field, the attention he receives away from it has grown as well. He said that, while he appreciates the support from fans, it can be frustrating when they feel entitled to his time.
“When I’m out in public with my family in Seattle, people just don’t understand that that is a very sacred moment for me,” he said. “I only get to see them so often. But fans still expect me to stop what I’m doing — stop eating, stop spending time at an event with my family — and take pictures with them or sign autographs or spend time talking with them.
“Typically I kindly and politely decline (and) I get an attitude about it. I’m ridiculed as being an asshole because I don’t take care of my fans. From one standpoint, I can understand why they would be that way. But from my standpoint… I’m not going to spend time away from my family when I don’t have that much time as it is.”
Help
Al Jefferson was still a teenager when he began his professional basketball career. While he instantly became a millionaire when the Boston Celtics selected him with the 15th pick in the 2004 NBA draft, Jefferson was only 19 years old and had just graduated from high school.
A couple of months after being drafted, he went through the NBA’s rookie transition program, which is jointly run by the league and the NBA Players Association. All incoming first-year players are required to attend the four days of seminars and workshops that are aimed at preparing them for every potential stressor or issue they may encounter as a professional athlete. There are sessions addressing everything from financial management and professionalism to sexual health, stress management and gambling.
Jefferson, who just completed his 13th NBA season and first with the Indiana Pacers, said he may not have fully appreciated the program at the time, but came to see the benefit he got from it as his career progressed.
“It was long and sometimes it was boring, but overall I think it was very helpful,” he said. “It’s what you need, believe it or not, because I don’t care how much you think you know. You don’t know.”
The program started in 1986, making the NBA the first of the leagues to have a rookie orientation program. Since then, the other leagues have followed suit and created their own rookie programs.
Major League Baseball began their rookie career development program in 1992. The four-day rookie orientation is very similar to the NBA program and is also run jointly by the league and the Major League Baseball Players Association.
However, there is a big difference in who attends the respective programs. The NBA has just a two-round draft, meaning that there are only 60 drafted rookies. Even if all of those players were able to make a roster, it is a manageable enough number that the league is able to include all rookies in the transition program.
The MLB has a 40-round draft in which more than 1,000 players are drafted each year. Then those players are typically assigned to a minor league affiliate of the team that selected them. And they have to work for years just to have a slim chance of earning a promotion to the majors. So, instead of trying to put together a program for all of those drafted players, each of the 30 clubs sends two to three prospects that they believe will spend their first significant time in the major leagues that year to participate.
The National Football League worked with their players association to begin the NFL rookie symposium in 1997. However, it became apparent in recent years that the program was not reaching all new players. While the approximately 250 players chosen in the NFL draft were required to attend, undrafted rookies who signed with a team as a free agent were not invited.
The individual teams did have shorter introductory education programs for all of their rookies during the spring, but those undrafted rookies were still missing out on a lot of important information.
As an undrafted rookie himself, Baldwin went through the Seahawks’ team orientation but was not invited to the rookie symposium. He said that even in the shortened program he took part in, many of his fellow rookies did not feel compelled to take it seriously.
“They tried to address certain issues that come with being a celebrity, having the recognition out in public,” he said. “They tried to address those issues. However, to be completely honest with you, when I came in, some guys come in like, ‘Oh yeah, we know how to handle ourselves. We’ll be fine,’ and don’t really pay attention to it. So a lot of guys don’t really absorb that information. So they still have issues and then they come back to realize, ‘OK, well there are some of those things that we learned in those classrooms that would have been really beneficial in the long run’… So they do certain things. It’s just very hard to get through to the human brain when they think that they know it all, especially at such a young age.”
Getting players to pay attention also proved to be an issue at the rookie symposium. It was reported that Ryan Leaf, the second pick in the 1998 NFL Draft, showed up to the symposium and proceeded to lay out across three chairs and sleep through the entire program.
Just before the NFL draft last April, the league announced a major change to the orientation process. It decided to scrap the rookie symposium, replacing it by expanding each team’s individual programs.
At the time, Troy Vincent, the NFL executive vice president of football operations, cited the fact that the league wanted to reach all rookies as one of the key reasons for the move. He said that the league found that, on average, 55 percent of each team’s rookies were signed as undrafted free agents.
Under the new program, each team’s player engagement director works with the league to put together a schedule for their orientation. The NFL provides the teams with some content and an expense budget for the program, and mandates certain topics be included — such as social responsibility, benefits, mental health and respect at work. There are also other topics for teams to choose from as they put their schedule together before submitting it to the league for approval.
“It was long and sometimes it was boring, but overall I think it was very helpful. It’s what you need, believe it or not, because I don’t care how much you think you know. You don’t know.” — Indiana Pacers center Al Jefferson on the NBA rookie transition program
The National Hockey League lagged behind for a long time until finally starting its rookie orientation program in 2013. Like the three other leagues, it is run and funded jointly by the league and the NHL Players Association. In fact, the creation of the program was one of the few things that the league and players agreed on during extended collective bargaining negotiations that led to a nearly four-month lockout and a shortened 2013 season.
The NHL program lasts two days and covers many of the same topics as the other leagues’ rookie orientation programs. Each team can send up to three players to the program including not only rookies, but also players who have been in the minor leagues and are likely to see their first significant time in the NHL during that upcoming season.
Mental Health
While the rookie programs are helpful in teaching players how to manage the stresses that come with being a professional athlete, they don’t prevent all mental health issues.
When those problems do arise later, it can be extremely difficult to catch them early on. That’s because players are reluctant to open up about their problems and seek help. The NFL’s Hollier said that it is difficult for anyone with mental health issues to be vulnerable and seek help, but that it is especially tough for athletes because of the culture that exists in sports.
“If you’ve played athletics and were coached by similar people that I was coached by, at some point during that experience someone told you to suck it up, to brush it off, to get back in there, and god forbid you shed a tear,” he said. “These were just not macho things that athletes did.
“So when you hear those words — suck it up, get back in there, push through — and you hear that over and over again throughout the course of your athletic experience, it becomes your way of dealing with things, and that is to handle it yourself, to brush it off. Don’t seek help, but try to handle it yourself. And that’s something that men in general struggle with. But I think it’s more intense in the athletic world because those are topics that repeatedly come up during the course of your athletic experience.”
Dr. David McDuff has been the team psychiatrist for the Baltimore Orioles for more than 20 years. He took the job in 1996, at a time when Major League Baseball was becoming the first of the four major pro sports leagues to recognize and try to address the need for mental health services for players.
Major League Baseball started by mandating that each team have an employee assistance program. These programs, which are commonly referred to as EAPs, offer free resources such as short-term confidential counseling and referrals to help employees deal with personal and work-related problems.
The United States Office of Personnel Management, a federal governmental agency, adds that, “EAPs address a broad and complex body of issues affecting mental and emotional well-being, such as alcohol and other substance abuse, stress, grief, family problems, and psychological disorders.”
These programs are common in every industry. Three-quarters of companies with between 251 and 1,000 employees have an EAP, according to the American Psychiatric Association. And that number is even higher for larger companies.
Since the MLB mandate, each team has begun and developed its own EAP. However, not all of these programs are equal in terms of the actual help they offer their players. McDuff is frequently in the Orioles locker room and on the field during practice to allow players the ability to grab him if they want to talk. Some teams just have brochures that they hand out to players, giving them a phone number for an off-site provider that they can call for counseling.
The Cleveland Indians have one of the more extensive mental health programs in the league. Charlie Maher is a sports psychologist and has been the team’s director of psychological services since 1995. He said that one of the biggest challenges he faces is trying to get players to slow down in an increasingly fast-paced world.
“They have to learn to be patient,” Maher said. “They have to learn to stay with the process. They have to learn to find the small victories every day.”
Sports psychiatrists and psychologists like Maher are adamant that having properly trained and licensed mental health care providers such as themselves on-site is essential for having a successful program that players actually use and find helpful. Because many employee assistance programs across all industries do not include on-site resources, they typically don’t see utilization rates above 5 percent. But McDuff, who also formerly served as the team psychiatrist for the Baltimore Ravens, said that by being in the team facilities on a regular basis, he has been able to achieve utilization rates as high as 60 percent some years.
“If a player doesn’t see you, they will not call you,” he said. “But when they see you, they go, ‘I need to talk to you.’
“Your continued presence starts to instill in them a trust of you because they see you around in the training room, on the practice field and they start to think, ‘He must be one of us,’” he added.
Following professional baseball’s lead, the National Football League began pushing teams to make mental health services available to their players in the late 1990s. While they did not make it a requirement, McDuff said he believes that all 32 teams now have some kind of mental health provider on their medical staff.
The NFL has gone even further in recent years, creating mental health resources at the league level to supplement what the individual teams provide. In 2012, they introduced a league-wide employee assistance program that is operated by an outside company, Cigna. The program provides eight free and confidential counseling sessions for each issue a player encounters. In addition to current players, these services are also available for former players and anyone living in the household of an eligible current or former player.
Also in 2012, the league provided a grant to establish the NFL life line, an independently operated, around-the-clock phone line that connects current and former players, coaches, team and league staff and their families to trained counselors who can help individuals work through personal or emotional issues.
The Seahawk’s Baldwin, who earned his first pro bowl selection last season, said that while it is great that the league has these resources, many players don’t know anything about the individual programs such as the league-wide EAP.
“We don’t necessarily hear about all the programs on a consistent basis,” he said. “It’s just not part of our curriculum when it comes to the NFL. They make you aware that there are programs available. They just don’t name specifically what they are or what they do. They just say that if you have any issues, go to your player development guy and he’ll be able to help you.”
Hollier said that the league uses “a lot of different channels” to inform players about the mental health resources that they provide and that he is “always looking to do a better job” at distributing information about the various programs.
Neither the NBA nor the NHL has done much to address mental health concerns at the league level. Teams in both leagues are not required to provide resources to help players with mental health issues. Carr, the Indiana Pacers team psychologist, said that about eight to 10 of the NBA’s 30 teams have a dedicated mental health care provider that is regularly on-site.
The NHL does have a substance abuse and behavioral health program that it runs jointly with the NHL Players Association. It is mandatory for players who test positive for performance-enhancing drugs to take part in the program, but it is unclear if players can enter the program voluntarily to receive mental health services. The league, through a spokesman, declined to comment on the program, citing confidentiality concerns.
O’Donnell, the former professional hockey player, now serves as a color commentator on Fox Sports broadcasts of Los Angeles Kings games. He said that regardless of the resources available in each league, he thinks the stigma surrounding mental health issues both in the sports world and society as a whole is beginning to fade.
“It used to be if you needed help or you needed someone to speak to to handle different things, you were weak,” O’Donnell said. ”And now that’s not the case. In fact it’s gone the other way now where when someone says, ‘listen, I can’t handle this. I need to speak to somebody,’ it’s almost a sign of strength. We’re not there yet, but the mentality is changing and we’re (heading) in the right direction.”
Head Injuries
The importance of professional sports leagues and teams addressing mental health issues has risen to new heights over the last decade, due to research linking repeated head injuries to the development of chronic traumatic encephalopathy.
CTE, as it is more commonly referred to, is a degenerative brain disease with symptoms such as depression, loss of impulse control, aggression, impaired judgment and memory loss. Research has focused largely on former NFL players because the physical nature of football leads to more head injuries. But NHL players are also at high risk for developing the disease.
In 2011, a group of 4,500 former professional football players filed a class-action lawsuit against the league, claiming that it hid evidence showing the long-term health dangers associated with head injuries. The league did not fully admit that a link existed between CTE and football-related injuries until 2016, when it reached a $1 billion settlement in the case.
Dr. Ann McKee — one of several doctors at Boston University who studies the brains of former NFL players — diagnosed CTE in 90 of the 94 former players she looked at. Currently, CTE can only be diagnosed through an autopsy following an individual’s death.
There have been quite a few cases of former players committing suicide and being diagnosed with CTE since research began. The NFL’s Hollier said that the May 2012 suicide of Hall of Fame linebacker Junior Seau, who was confirmed to have had CTE, as well as the deaths of many other former players caused concern. More people started paying attention to the need for better resources and understanding of mental illness.
“Those tragedies were also an opportunity to get the stigma of mental health and help-seeking behavior out of the shadows and really start to address it,” Hollier said. “Those EAP and NFL life line were resources that were made available, along with the communications that went with them, were about really beating down the walls of stigma and talking about mental health.”
The NFL has also donated at least $130 million since 2012 to fund research on concussions and ways in which equipment can be upgraded to better protect players from head injuries.
While Hollier and his colleagues at the NFL have worked to better help players with mental issues as a result of CTE research, the NHL continues to deny that a link exists between concussions and the disease.
In July 2016, NHL Commissioner Gary Bettman wrote in a response to an inquiry from a U.S. senator that “the relationship between concussions and the asserted clinical symptoms of C.T.E. remains unknown.”
More than 100 former professional hockey players are involved in a class-action lawsuit against the league, making similar claims as their professional football counterparts. The league has vowed to fight the lawsuit.
The hockey league has filed its own lawsuit against the Boston University research team after it refused to turn over all of the information related to their study, including the identities of the individuals whose brains were studied. The NHL’s demand comes despite the fact that the researchers have published more than 60 peer-reviewed studies.
Conclusion
Hollier retired from playing in the NFL following the 2000 season. He has worked diligently since joining the league office to make dealing with the issues that players run into a little bit easier.
In addition to the employee assistance program and NFL life line, he has helped to create the bridge to success program. It is an annual four-day event that is open to players and their spouses or significant others and addresses the transition out of professional football. The program connects attendees with transition coaches — former players who have been trained to help with transition issues such as financial success, mental and physical health, and career development.
The program is just another example of how Hollier has helped make the NFL a leader among professional sports leagues in addressing players’ mental health needs. He said that he has had conversations with executives at the other leagues about the programs that they offer. But the former linebacker also said he does not try to measure the NFL’s offerings against those of other leagues.
“I haven’t done anything to try to compare resources,” Hollier said. “I know that we try to do the best we can do for our players and their families.”
