Do athletes require different treatment for mental health and addiction?
They absolutely do. ‘You’re not special, you’re an addict like everyone else’ is the current attitude but that’s not true. If you can throw or hit a 100 mph fastball, you are special. Athletes may be privileged but they also lead complex lives. My theory is that really young guys–in their teens and early 20s–have an extreme disconnect between their physical ability and their emotional ability process being a high-profile college athlete, let alone a professional one.
Years ago, when I was in grad school at the university of Illinois, I was trying to argue that the athletic department needed their own mental health arm of the department, but it never gained support.
Tyler Skaggs isn’t an outlier, really. There’s already a huge problem with professional athletes and mental health and substance abuse, right?
Nobody in sports who can make any sort of impact–the executives, the player’s associations–wants to admit how many athletes are abusing pills and booze. The culture of drug use is incongruent with the branding of sports. It’s supposed to be about high-performing, exceptional humans, yet there’s a culture of secrecy and avoidance.
I have done work for a few professional baseball teams–mostly I’ve been called in as a fixer or as a clean-up crew for young athletes getting in trouble due to partying too much–but I have been to the Dominican to see players in the development leagues.
The compounds they usually stay at are clean and safe, the food is great, and the physical trainers are all there and attentive, but it didn’t seem like anyone asked them how their families were or “Are you happy?” When I brought this up to a few people in the organization, I was told “they are baseball players.” Oh, right, I forgot.
Pain is going to be a part of any system of elite athletes. With pain comes pain management and it’s an easy pitfall to overlap misuse of physical pain management as a self-directed treatment for emotional pain management. I had one athlete tell me “Yea, I liked the pills, they helped my knee but they also helped me avoid that I’m gay.” That’s an extraordinarily rare insight for any young man and like 20 years of therapy. Good for him for figuring that out.
How do you feel about the term “accidental overdose”?
The term is misleading. It’s not an “accident.” Tyler Skaggs, didn’t slip on a banana peel and ingest a lethal combo of chemicals. I think “unintended overdose” is more accurate. The language in this case matters. One of the issues with drug use is that the solution is education, but not understanding the risk is seldom the problem. Drug users aren’t dumb, they know that there is inherent risk with certain behaviors.
Most of these accidents are not accidents, but here’s what I think: People succumb to the complexity of drug use. I think mental illness shortens life spans. To me this is also an example of how little we truly understand about substance misuse.
Which sports have the biggest problem?
That’s a really tough question. Sports is a system awash in young male bravado which tolerates (and even encourages) drinking. What could go wrong? The drinking in the NHL is massive and widespread. They are also hardwired and encouraged to beat the snot out of each other. The NHL always seems like its substance misuse problem is ready to blow up publicly, but it hasn’t happened yet. And, honestly, is the NHL any worse off than the other pro leagues? Part of it is a numbers game. Basketball doesn’t have a large number of athletes, football has over 100 with a herd mentality. I’m not sure who wins this competition. They all have serious substance misuse and mental health issues and none of the leagues handle it particularly well.
Which teams/players have you worked with?
I wish I could say. If I could, it might help reduce the stigma and encourage a different approach, but I have NDAs (non-disclosure agreements) and confidentiality considerations. But I am always encouraging individuals and teams to be more public about this, to set a tone that there should be parity between physical and emotional health. If there were that culture in sports, there could be that culture in America-at-large. There is a moral imperative for the sports world to do better.
What I can say is I have made some progress but as is often the case, I have gone too far. Few people know September is “recovery month.” A few years back I had a meeting with the San Francisco Giants about a designated recovery night. The same way they have “stand up to cancer” or use pink bats for breast cancer month. To their credit, they were buying it until I said, “How about no beer sales on recovery night?” That was the end of that conversation.
Don’t you think suspensions for “conduct detrimental…” are antiquated?
I do. I think a zero tolerance drug policy breeds fear and lies. All drug policy is successful to the degree to which we can be honest about it. If people are incentivized to avoid, lie, and live in secrecy, they will. Punitive measures may need to be part of a plan but in and of themselves, they aren’t a treatment plan. The biggest issue with treating mental health with disciplinary action is that it’s largely ineffective and ultimately serves nobody.
Professional sports teams live in luxury–they have the best of everything. It’s actually a really strange thing that sports franchises don’t have the absolute best clinicians to provide care before a crisis happens. What would be the big deal if teams had staff social workers and mandated case management and weekly check in? Home visits to support the family? Referrals to couples, family, or individual therapy? Why not?
So, if there are any owners or GMs reading The Small Bow (Ed. Note: Ha), here’s my plea: You can avoid outcomes like Tyler Skaggs. You can do a better job protecting your investment in athletic talent by serving the individual and demonstrating genuine concern. You can set an example for a sports-obsessed culture that it’s ok to engage in mental health care.
How would you change the system?
I’d institute a mandated system-wide, bio-psycho-social policy initiative for all players and coaches that involves:
- Integrating the department of mental health into an organization’s culture;
- Weekly check-ins with a mental health professional for all athletes; and
- Home check-ins from social workers: they’d meet periodically with athletes’ families and conduct home assessment needs. I can’t imagine having a young wife with small children and being away for half the year. Actually, I can imagine that and it would be horrible.
Joe Schrank is Executive Editor of The Small Bow. If you’ve got a suggestion for a future “I’ll Ask Joe” please email us here.