On July 27, at the Tokyo Olympics, Simone Biles – the world’s most decorated gymnast and face of Team USA – withdrew from the team final, saying: “Mental is not there.” Her decision challenged a sport long defined by one demand: faster, stronger, more resilient. And it exposed a reality often ignored behind medals and records – mental health in sport.

During Mental Health Awareness Month, this conversation feels especially urgent. Not just for elite athletes, but for everyone who moves, competes, or simply tries to stay active. Because 1.1 billion people live with a mental disorder, yet only one in three receives adequate support – while most adolescents and many adults still don’t get enough physical activity..

The Myth of the Unbreakable Athlete

Elite sport glorifies toughness. Show weakness, and you lose – not just the competition, but the respect of teammates, coaches, sponsors. This belief runs so deep in sports culture that many athletes stay silent for years, even as they’re falling apart inside.

Michael Phelps knows that silence well. The most decorated Olympian of all time, with 28 medals including 23 gold, has spoken openly about his struggles. “After every Olympics I think I fell into a major state of depression,” he admitted. After the 2012 Games, he no longer wanted to be alive. Therapy was the turning point and he went public, because he understands what happens when people don’t.

“Throughout my career, I had a team of people around me paying attention to my physical health. But mentally, that wasn’t the case,” he said, reflecting on his years at the top.

Naomi Osaka knows that imbalance too. When she announced at the 2021 French Open that she would skip press conferences to protect her mental health, she was fined $15,000 and threatened with disqualification. She withdrew from the tournament entirely. Later, Osaka admitted she initially felt “ashamed” for standing up for herself.

Ashamed. For protecting her own wellbeing.

A System Problem, Not a Personal One

What Biles, Osaka, and Phelps have in common is that they dared to make public what millions of athletes experience privately. According to McLean Hospital, around 35% of elite athletes struggle with mental health issues including anxiety, depression, and burnout.

And yet, sport’s standard response has often been the same: perform, push through, stay quiet. Mental health support exists – but usually in the form of individual tools handed to athletes while the environments that create the pressure go untouched.

According to Vella & Rice (2026), mental health in sport is still treated primarily as an individual problem. Athletes are given mindfulness exercises and referred to therapy – while toxic team cultures, impossible expectations, and coaches who punish vulnerability remain unchanged. Those are the real risk factors that too rarely get addressed.

Being Mentally Healthy Isn’t the Same as Having No Mental Illness

One of the most important ideas missing from mainstream sports culture is this: mental health isn’t a switch that’s either “fine” or “broken.” Vella & Rice describe it as two parallel dimensions – general wellbeing on one side, clinical symptoms on the other.

That means an athlete can win gold and still be suffering. It means someone can be free of any diagnosable condition and still be burning out. Phelps described seeing himself for years as a swimmer rather than a human being – a distortion that fueled his success and nearly destroyed him at the same time.

Success does not equal wellbeing. That’s not a weakness – it’s biology.

The Signs We Keep Dismissing

Warning signs of mental health struggles in athletes are well-documented: sudden behavioral changes, withdrawal from the team, irritability, disrupted sleep, declining performance, and persistent negative self-talk.

The problem isn’t that we don’t know these signs. It’s that we’ve built a culture where they’re explained away as “bad form,” “overtraining,” or simply “part of the game.”

During the Tokyo Olympics alone, the US Olympic and Paralympic Committee’s mental health team received around ten requests for support daily. Most didn’t come from athletes themselves – they came from people around them who noticed something was wrong. That gap – between what athletes show and what they feel – is where the real danger lives.

The Gender Blind Spot Nobody Talks About

There’s another layer here that rarely gets attention: men in sport are particularly underserved.

Phelps has spoken about how, during his career, speaking up about mental health would have felt like handing competitors an advantage. That’s not personal weakness – that’s a culture that equates toughness with silence.

Traditional mental health assessments tend to focus on internalised symptoms like sadness or withdrawal. But men often express distress differently – through irritability, risk-taking, or aggression. In high-performance environments that reward exactly those behaviors, these signals get overlooked. According to Vella & Rice, this may mean mental illness in male athletes is significantly underdiagnosed.

Things Are Changing, Slowly 

At elite level, some organizations are beginning to embed mental health professionals within teams, introduce regular screenings, and treat wellbeing as an organizational responsibility rather than a personal problem.

Following Biles’ withdrawal in Tokyo, an IOC spokesperson acknowledged that “more could be done” on athlete mental health – a statement that was both obvious and, in the context of how these conversations usually go, a step forward.

But progress at the top doesn’t automatically filter down. The WHO estimates that nearly 1 in 7 people globally live with a mental disorder and in high-income countries, only one in three receive effective support. Sport reflects society. And in both, the gap between awareness and action remains enormous.

The Real Strength

Simone Biles returned to competition at the Paris 2024 Olympics. She came back not only performing at her best, but now widely recognized as a leading advocate for mental health in sport.

That arc – stepping away, getting support, coming back on her own terms – is not a story of failure. It’s the clearest illustration of what treating mental health seriously actually looks like.

Biles put it simply: “The Olympics was not how I expected it to go, but putting my mental and my physical health first will probably be one of my greatest accomplishments.”

The future of sport belongs to athletes, coaches, and organizations who understand that. Mental health isn’t a side issue to performance. It is performance. And the strongest thing an athlete can do – sometimes –  is ask for help.