Karen Nimmo: Mental health in sport – let’s reopen crucial conversation

OPINION:

Elite athletes’ mental health has been in the spotlight this year with big names such as tennis star Naomi Osaka and gymnast Simone Biles withdrawing from major international competitions. Their exits, and the tragic death this week of Kiwi cyclist Olivia Podmore have revealed the pressure placed on professional athletes, opening the door to previously taboo conversations. But is this enough? Clinical psychologist Karen Nimmo shares her insight on the immense pressure felt by high-performance athletes – and what needs to be done to help them.

A sports doctor once asked me to “fix” an athlete’s depression in three one-hour sessions.

When I protested because I couldn’t achieve the goal in three sessions, I was given another two. Then funding ran out. I was so worried about this young athlete I met her several times for coffee, for free.

It was my first warning bell about working in high-performance sport. The lack of funding, and the doctor’s cavalier approach to mental health and an athlete’s wellbeing and safety, worried me. And it sucked away my motivation.

I don’t work for High-Performance Sport NZ and I’m not contracted to any codes, so my view is that of a clinical psychologist, with a physical education background, looking from the outside in.

In my private practice I’ve continued to work with elite athletes and, over time, have seen the pressures on them wind up to breaking point. It’s been happening for years, not just in recent weeks.

But sadly it took cyclist Olivia Podmore’s tragic death to reopen the crucial conversation around mental health in sport.

High-performance sport is full of challenges. There have always been performance issues: How can I focus better, how can I recover from mistakes, deal with a loss of form, cope with a serious injury. Athletes are often at their most mentally vulnerable when they’re not playing, when they’re dropped/not-selected, injured or retired.

Clinically, the most common struggles are depression, anxieties, addictions. I can’t count the number of women and girls I’ve seen over the years with body image and eating issues, and this has increased with the social media pressures to look good (and post selfies) as well as perform well. A lot of athletes struggle hugely with career-ending injuries and the transition to retirement, because their identity is so tied to who they are in sport. It can take a long time to build their confidence as a person beyond sport and, years after retirement, people will refer themselves to, and pay for, therapy because they’re still struggling.

Beyond those issues, an immense stress comes from the daily grind of having to perform well just to keep your job. Then there’s the cut-throat environments; the relentless expectations of management, coaches, sponsors, fans and the athletes themselves; the stress of scrambling for funding; constant travel, media critiques and social media trolls. (On that note, anyone who lashes out at athletes online from behind the safety of their keyboards should STOP. Not only is it a poor reflection of who you are as a human, it’s dangerous.)

In the past year, Covid-disrupted training — and all the complexities that came with a global pandemic — has taken a hidden psychological toll, so it’s to our Olympic team’s absolute credit many of them did so well.

Conversely there were many countries disappointed with their medal haul, so you’d have to ask if the stress of the Covid experience had affected their mental state.

In terms of mental health, New Zealand does well for its size and resources. There’s good awareness and intent around mental health issues but not enough wraparound clinical support.

There’s also too much emphasis on winning. I get it: Elite sport is about performance at the highest level. Winning matters, we can’t move to a soft “everyone participates” model.

But why can’t wellbeing be as important as winning? Why can’t we begin to prioritise it now  —  before there’s another tragedy?

It’s healthy that we’re talking about mental health but there’s a risk that we keep talking – raising awareness, forming working groups to review the problem – but don’t take any action. And action is the key to change.

Here are my ideas as a clinical psychologist on what would help. I note some of these are likely to be already in place or in the planning.

• Prioritise mental health in elite sport.

• Fund it properly.

• Employ more qualified clinical psychology professionals who can oversee athletes throughout their careers (including retirement).

• Make sure all these professionals offer a fully confidential service, separate from their sport where appropriate.

• Ensure athletes’ support networks are watertight.

• Monitor athletes’ social media use and exposure. Teach them how to handle trolls and malicious criticism.

• Extend the time athletes are in their programmes so they don’t feel so much relentless pressure around being dropped.

• Allow athletes to have breaks with support and without being abandoned.

• Offer women athletes more women psychologists and support staff — or at least a choice as to who they see and work with. Women are not small men or subsets of them. They have some different needs as athletes and these need to be specifically catered for. This is becoming more important with increasing numbers of women entering the professional sport ranks and are more vulnerable than men to online abuse. It’s no co-incidence most of the high-profile athletes who have opened up on their mental struggles this year are women: tennis star Naomi Osaka, gymnastic great Simone Biles and, closer to home, Olympic rower Zoe McBride, Silver Fern netballers Ameliaranne Ekenasio and Maia Wilson, and Black Fern Chelsea Alley.

• Continue to encourage people to speak up about mental health issues but be aware that, beyond talking, people need the right help.

I heard Sport NZ boss Raylene Castle say this week that hearing the sad news of Olivia Podmore was the hardest night of her life. On the back of that, she said change needed to happen, that athlete well-being would be her legacy.

I couldn’t have been happier to hear that. Maybe this is the first real step in lasting change? Dare to dream.

Karen Nimmo is a clinical psychologist who has worked extensively with high-performance athletes.

Where to get help:

• 0800 543 354 (0800 LIFELINE) or free text 4357 (HELP) (available 24/7).
• https://www.lifeline.org.nz/services/suicide-crisis-helpline.
• YOUTHLINE: 0800 376 633
• NEED TO TALK? Free call or text 1737 (available 24/7)
• KIDSLINE: 0800 543 754 (available 24/7)
• WHATSUP: 0800 942 8787 (1pm to 11pm)
• DEPRESSION HELPLINE: 0800 111 757 or TEXT 4202
• NATIONAL ANXIETY 24 HR HELPLINE: 0800 269 4389
If it is an emergency and you feel like you or someone else is at risk, call 111.

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