How the NBA Finally Learned to Start Taking Mental Health Seriously

In a little more than a month, a sea change has taken place in the NBA—and it all started with an unexpected and innocuous tweet. On Feb. 17, DeMar DeRozan, the Toronto Raptors All-Star guard, took to Twitter and wrote, “This depression get the best of me.”

There was a time, not that long ago, when an NBA player confessing an emotional or behavioral problem—even in a tweet which was quoting a song—might be met with scorn and eye-rolling comments about their masculinity. Instead, DeRozan was inundated with positive support and reinforcement, from other NBA players, the league, and fans alike.

A week later, DeRozan spoke with the Toronto Star, and opened up even more. He said his bouts with depression and anxiety began as a child, and will strike when he least expects it, as was the case when he returned to his hometown of Los Angeles over All-Star weekend.

“It’s one of them things that no matter how indestructible we look like we are, we’re all human at the end of the day,” he said. “We all got feelings… all of that. Sometimes… it gets the best of you, where times everything in the whole world’s on top of you.”

On March 6, the Cleveland Cavaliers’ Kevin Love detailed the panic attacks he’s experienced this season in a first-person article published by The Players’ Tribune, specifically citing DeRozan’s willingness to come forward as a reason he was doing the same. The dominoes continued to fall the following day, when Kelly Oubre Jr., a backup wing with the Washington Wizards, appeared on an NBC Sports podcast to say that he too has dealt with anxiety and depression throughout his life.

“People who are on the outside looking in don’t really understand, because they see us as superheroes, but we’re normal people, man,” said Oubre. We go through the issues that normal people go through times ten.”

That a professional athlete could struggle with depression, panic attacks, and anxiety isn’t surprising. According to the National Institute of Health, close to 45 million Americans, or 18.3 percent of all adults, are dealing with a mental health issue of some kind. Studies have shown that when it comes to depression, athletes may be at greater risk.

But how the general public is responding to their revelations has made all the difference. And it’s not hard to draw a straight line between the courage exhibited by DeRozan, Love, and Oubre to Monday’s announcement: The NBA and National Basketball Players Association will create and fund an independent program specifically focused on mental health.

Why has this taken so long? It’s hardly limited to athletes, but the stigmas surrounding mental illness, sad to say, are still widespread. Moreover, they feed directly into toxic notions of masculinity, one that sports culture often instills and propagates. For Love, the fear of being seen as mentally feeble and somehow less of a man meant he had to keep his problems buried for most of his life—if he wanted to play basketball for a living, that is.

“To me, it was [a] form of weakness that could derail my success in sports or make me seem weird or different,” Love wrote. But just ten games into the 2017-18 season, he was hit with a panic attack mid-game and he couldn’t play. Short of breath and unable to focus, feeling as if his heart was about to burst from his chest, he was, as he said, “freaking out.”

Love was pulled from the game and sent to a nearby clinic in Cleveland. After undergoing a battery of tests, none of which were able to detect any medical problems, he eventually did begin working with a therapist, with an assist from the Cavs. This too was a major hurdle for Love—and one he wanted to keep secret.

Why? “I didn’t want people to perceive me as somehow less reliable as a teammate, and it all went back to the playbook I’d learned growing up,” he said

The playbook Love refers to is this: “Be strong. Don’t talk about your feelings. Get through it on your own.” Even if unstated, these values are made clear, and had been drilled deep at an early age. As Oubre said, “When I was growing up, my dad always told me, ‘Don’t let anybody see you weak.’” While he was largely able to mask his feelings, “deep down inside, I’m going through a lot. Hell is turning over.”

The Daily Beast spoke with Jackson Katz, a gender violence prevention expert who works with athletes and members of the armed forces, and the author of The Macho Paradox. He was quick to highlight the importance of statements about mental illness by prominent athletes.

“These are men who are seen by so many as exemplars of masculine achievement and success and for them to acknowledge they’re human beings and they’re vulnerable is a brave act and a useful thing for the culture, if you will,” he said, because of the platform they have and the spotlight they command. Their words have the power to begin changing some long-held preconceptions about masculinity—specifically, the pretense that manhood and invulnerability are inexorably linked.

“I say pretense because it’s absurd,” he continued. “There’s no such thing as invulnerability. It’s an absurdity. It’s a fantasy... the idea that true manhood means pretending that you’re not vulnerable.”

But there are reasons why Love and Oubre had previously clung to the type of performative masculinity Katz described, where admitting to being clinically depressed or anxious would be seen as emasculating and a sign of personal failure. You don’t have to go far back into the NBA’s past to find examples of players whose mental health issues were met with derision, and teams who were either unable or unwilling to help improve their condition.

One of the most notable examples is Royce White, who was drafted in 2012 by the Houston Rockets despite having been diagnosed with Generalized Anxiety Disorder and Obsessive-Compulsive Disorder. He spent the bulk of his rookie year battling with team physicians over their prescribed treatments, preferring to abide by the counsel of his own doctors. After missing multiple preseason games, practices, and expressing a preference not to fly with the team, as it triggered his anxiety, he issued a statement, claiming that his openness about his mental health issues had only exacerbated the rifts between himself and the team.

But the perception, one the Rockets gave a gentle nudge to, was that White was a malingerer, and was using his condition to avoid responsibility for his inability to hew to an NBA schedule.

Midway through the season, he was released and sent to the NBA Development League. Following brief stints with the Philadelphia 76ers and the Sacramento Kings in 2014, White was drummed out of the NBA altogether. Since then, he’s been playing pro ball in Canada, all while advocating for better understanding, acceptance, and treatment of mental health issues, asking as he did when he was with the Rockets that an in-writing policy be put in place.

As White explained to Vice Sports last year, if any player came down with a panic attack shortly before tipoff, the team would be able to fine or cut him, because the league lacks a specific policy prohibiting it. And while White says he was told that such behavior by a team would be beyond the pale, he wanted it spelled out—not solely for his own benefit, but rather in the hope that mental illness “will be treated like a medical condition and not like me being irresponsible.”

Similarly, Larry Sanders was a talented, rim-protecting center who abruptly left the Milwaukee bucks in December 2014. He had been dealing with depression and often took to self-medicating with marijuana, leading to multiple suspensions. When reports surfaced that he wasn’t really interested in playing basketball anymore, and would be seeking treatment, many saw Sanders as a selfish malingerer (at best) who should be grateful to be paid millions to play a child’s game, and that stroke of good fortune should override any and all life and health concerns.

White and Sanders are far from alone. There are a slew of players whose struggles with mental health have led to their being branded and dismissed as “crazy,” reduced to little more than a punchline.

After coming up big in Game 7 of the 2010 NBA Finals, Metta World Peace, who has been treated for anger management issues, thanked his psychiatrist during an on-court interview and has since worked diligently to advocate for mental health awareness. Delonte West suffered from bipolar disorder—which he disputes—and substance abuse issues. In his mind, those issues directly led to his exile from the NBA, even after he did get help.

Beyond the NBA, athletes throughout the sporting world have made public their struggles with mental health, including stars like Michael Phelps, Brandon Marshall, Jerry West, Joey Votto, and Chamique Holdsclaw. And that’s before we get to the problems facing college athletes and high-ranking amateur gymnasts, for whom eating disorders are endemic. ESPN’s Kevin Arnovitz also reported that there are far more NBA players suffering from mental illness and who haven’t been afforded the space to go public: “Virtually everyone in the league can rattle off names of current or former players who needed serious help but never found it.”

For its part, the NBA has been making major strides—especially when you consider that as recently as 2012, an unnamed NBA executive told Arnovitz, “We don’t do a very good job with mental health. We don’t have any answers, and we’re not doing a good job looking for them.” (The NBA and NBPA did not respond to multiple requests for comment.)

A year later, another unnamed general manager wanted to create a mental health services program within the organization because a player had not seen improvement working with an outside therapist. He approached the team owner to ask if financial resources could be made available, and the owner groused, “I just gave him $30 million worth of mental health,” referring to the player’s contract.

The belief that mental health and mental health treatment are of a different order than any other physical ailment, and the former isn’t a good enough reason to keep cutting paychecks, still lingers. To a certain extent, this is true: The path to overcoming mental health problems functions on a far different and often less quantifiable and trackable timeline than any physical injury.

Then there’s the money. Many fans still can’t seem to wrap their heads around the idea that mental illness doesn’t give a fig about someone’s eight-figure salary or attendant fame. The teams themselves have invested untold dollars into obtaining the best, most scientifically up-to-date treatments available when it comes to rehabbing physical ailments. That said, despite increases in mental health professions to team staffs, mental health spending still lags.

“It’s hard for people in my field to respect mental health,” Sanders told Arnovitz in 2015. “We say that the game is 90 percent mental, but yet mental health doesn’t get the respect of, like, an ACL. The game is 90 percent mental, but we’re going to ignore your mental health.”

For close to a year, the NBA has been promising to improve their mental health practices. Last year, Esquire spoke with the NBA president of social responsibility and player programs, Kathy Behrens, as part of a profile of White. She said that such a plan was in development, one that was “really more of an enhanced program to the offerings we have.” Behrens also touted the NBA’s mental health programs to NBA.com’s David Aldridge in 2016.

“Everybody is much more aware,” she said. “I think we’ve done a really good job with our guys about reducing that stigma [of mental illness].” But as NBPA President Michele Roberts told SB Nation during the 2018 All-Star break, these changes are long overdue.

“It’s a shame that this hasn’t been given attention a long, long time ago,” Roberts said. “We’ve been naive—I’m being kind when I say naive—in thinking that we didn’t have to address and make sure that we were giving as much attention to our players’ mental wellness, as we were their physical.”

And while it’s impossible to say how much the newfound openness to discussing mental health prodded the NBA and NBPA to wrap up negotiations, on Monday, they did just that. As first reported by Aldridge, the league and NBPA will be creating and funding a mental wellness program. It will include the establishment of a new position, the Director of Mental Wellness, and will provide services independent of any team-based mental health services.

The problem, as Aldridge noted, is that nothing in this new program addresses White’s demand for in-writing, uniform mental health protocols. (None of the four major pro leagues specifically address mental health in their collective bargaining agreements.) That is to say, if an NBA/NBPA wellness professional contradicts a team’s medical staff and determines that a player shouldn’t take the court, will the team be obligated to abide by those recommendations? And what will happen if they don’t?

Still, what DeRozan, Love and Oubre have done should not be overlooked. New programs are great, but unless players and teams can overcome the deeply-held biases about mental health, it won’t matter. And the impact it’s having on fans is nothing short of remarkable. DeRozan told Aldridge that strangers have been reaching out, telling him that his words enabled them to seek out help. “It’s incredible,” said DeRozan. “By far one of the most incredible things in my career that I’ve witnessed outside of basketball.”

The self-evident and yet radical notion spurred by all these players was that for anyone, no matter how difficult, painful, and frightening confronting past traumas and self-defeating behavior will be, please do it. “Everyone is going through something that we can’t see,” Love wrote. “I want to remind you that you’re not weird or different for sharing what you’re going through. Just the opposite. It could be the most important thing you do. It was for me.”