Simone Biles | The New Mental Health Champ

In the bedrooms of little girls across America, posters of Simone Biles adorn their walls. Be like Biles. As the world’s greatest female gymnast, she is their hero. But in the wake of the Tokyo Olympics, she is now a different kind of champion. She’s the de facto poster child for mental health.

From Shiny Gold to Shining Face of Mental Health

At age 24, of course, Biles isn’t a child at all. In fact, despite a 4-foot-8 frame that belies her age, she’s a mature, young woman who is considered ancient history by female gymnastics standards and seems unlikely to get any younger by the time the Paris Olympics roll around in 2024. The expectation heading into the Tokyo Games had been that, gold or no gold, these would be her last Olympics – that she’d quietly fade from public conscience after her final gravity-defying feat.

Then, in a completely uncalculated and unexpected manner, that all changed – not with another gold medal but with a resounding thud during the team vault. It was a disappointing result for all who watched. But the bigger gasps came when, after a virtual lifetime of training for this moment, Simone Biles decided to put her wellbeing ahead of her quest for another fistful of medals and withdrew from competition.

Mental health ahead of golden glory? For many, it was difficult to grasp, even though Naomi Osaka, the world’s reigning No. 1 tennis player, had recently withdrawn from the French Open and Wimbledon for precisely the same reason.

In that instant, however, Simone Biles transformed from the face of the American Olympic team to the face of a mental health champion. After 18 years in gymnastics, she was suddenly thrust into a thoroughly unexpected role – and a calling that may endure long after her life in leotards ends.

Make no mistake: Withdrawing from the team event was probably one of the most impossible decisions of Simone’s young life – if only for the responsibility she felt toward her U.S. teammates and the team gold medal that seemed a foregone conclusion.

“She felt the weight of the world for dropping out and thinking she was leaving them hanging and feeling like she wasn’t doing her job,” said Dr. Kamla Modi during an interview with InSync Healthcare Solutions. The former gymnast and director of learning and evaluation at The Jed Foundation, a mental health nonprofit for teens and young adults, added, “I think it probably crushed her to have to drop out and feel like she was letting the team down.”

That much was easy to understand. Five years earlier, Biles had led the U.S. team to gold in a crushing defeat of the Russian Federation in Rio. A similar result was expected in Tokyo, but the circumstances this time were different, beginning with expectations.

“She’s gone through a lot in the last five years,” says Modi. “She was the expected winner in 2016 but she wasn’t yet  an Olympic winner, so she was coming with a different mindset. She wanted to prove that she could be the best in the world.”

After Rio, she was that and more. But then came the distractions, including:

  • A nine-week run on Dancing with the Stars, where she and her dancing partner finished fourth.
  • The two-year Larry Nassar molestation legal case (2017-2018), in which Simone was forced to relive the trauma she’d endured by testifying against the serial sex predator.
  • Myriad endorsement offers and deals that had her hawking everything from cookies, clothing, leotards, and skin-care products to fitness shakes, teeth aligners, credit cards, and airlines. It made her millions but stretched her thin.
  • The pandemic, which delayed the Tokyo Games by an entire year. And as Modi noted, “Another year in a gymnast’s life is huge. At 24 you’re not expected to be the best in the world anymore … 24 is way over the hill in gymnastics.”

Nonetheless, with 32 Olympic and world titles, she was still the one to beat heading to Tokyo.

Her height aside, the sensational Simone was arguably America’s biggest and most marketable name. The NBC network, which paid nearly $8 billion for Olympic television rights, seized on the starlet’s popularity and plastered her face on screens in millions of homes during the months leading up to the Games. For Simone, it meant more unwanted pressure and burdensome expectations.

So high were those expectations that, in the end, she basically had nowhere to go but down. But that didn’t stop Simone from trying. At least not at first.

“You remind yourself, ‘I’ve been so blessed, and to whom much is given much is required, so I’ve got to show up,’ ” Chamique Holdsclaw, a gold medalist, and former WNBA All-Star, told InSync in an exclusive interview. “I know for myself, that’s something I went through mentally … where you’re like, ‘oh my god, I can’t do it.’ But you think about that little girl that is there supporting you. You think that little boy that has your shirt or jersey or something.

“You think, ‘OK, I’m going to push through,” said Holdsclaw, slapping the back of her hand for emphasis. “But sometimes, pushing through is not enough.”

Naomi Osaka a Victim of Her Own Success

By no means is Biles the only high-profile Olympian/athlete to ever wrestle with mental health issues. A sampling from recent history includes:

  • Aly Raisman, a six-time Olympic medalist (3 golds) and former teammate of Biles, suffered from PTSD in the aftermath of sexual abuse from Nassar
  • Michael Phelps, the holder of a record 28 Olympic medals (23 gold), received help to cope with depression and suicidal thoughts
  • Lindsey Vonn, a three-time Olympic skiing medalist and eight-time world champion, battles depression
  • Serena Williams, the winner of four Olympic gold medals and 23 Grand Slam tennis events, has spoken openly about her bouts with depression, including postpartum depression after the birth of her daughter in 2017
  • Naomi Osaka, the winner of four Grand Slam tennis events, famously revealed her own dealings with anxiety and depression after withdrawing from this year’s French Open rather than participate in an obligatory, stress-inducing press conference

The first hint of Naomi’s problems emerged after she crushed Serena, her childhood idol, in the finals of the 2018 U.S. Open for her first Slam victory. It was viewed by many as a passing of the torch from the longtime champion to “the future of women’s tennis.” Yet rather than revel in the greatest achievement of her fledgling career, she instead cried and apologized to the crowd.

“I’m sorry it had to end like this,” she told them.

“Imagine all these cameras for so long hovering (around) Serena Williams. And then it was a shift — BOOM! Naomi … is now tennis’ darling,” said Holdsclaw, who got her first taste of the limelight while leading the University of Tennessee to three national titles. “I mean, that takes a second to get adjusted to … you can tell that it’s a bit overwhelming for her.”

“It’s easier in a way to be the underdog and work your way up and for people not to be even talking about you,” adds Modi. “But everyone’s coming in and saying she’s the best in the world. … It’s very hard to handle the pressure.”

Shortly after her first-round victory at the French Open this year, Naomi removed any doubt about the status of her mental health after she was threatened with suspension, accepted $15,000 in fines, and withdrew from the tournament rather than attend a mandatory post-match press conference.

“Believe it or not, I am naturally introverted and do not court the spotlight,” Naomi wrote in a first-person account for Time Magazine in July. “I always try to push myself to speak up for what I believe to be right, but that often comes at a cost of great anxiety. I feel uncomfortable being the spokesperson or face of athlete mental health as it’s still so new to me and I don’t have all the answers. I do hope that people can relate and understand it’s OK to not be OK, and it’s OK to talk about it.”

If Simone was the face of the U.S. Olympic team, then Naomi was the same for the host nation of Japan when she was selected to light the Olympic torch at the opening ceremony. But after an unceremonious third-round exit from these Games, she admitted her attitude “wasn’t that great because I don’t really know how to cope with that pressure.”

Holdsclaw expressed regret that so many detractors labeled Naomi “a quitter” — and admiration for Naomi for standing up and admitting she was mentally drained, anxious, and “just needed a break.”

“We think that they (great athletes) are always supposed to be on,” says Holdsclaw, “but you have to take care of yourself. And here are these young people, which I’m so proud of (for) saying, ‘Hey, I need a timeout.’ Man, they’re so brave and so amazing.”

Warning Signs Were There for Simone

In some respects, Simone was a bit of a late bloomer when it came to gymnastics. While many tykes are tumbling and doing balance exercises by ages 2 or 3, Simone didn’t get her first real whiff of gymnastics until she attended a daycare field trip at age 6. Even then, she was 8 before she began training, and 11 before she was competing at an elite level.

Modi notes that some girls are star gymnasts by age 12, heading to the Olympics before they’re 16, but that even at age 18 she advises against applying too much pressure on them to become a champion.

“There’s been plenty of warning signs around that,” she says.

For anyone paying close attention, there were plenty of warning signs around Simone, too, as the Tokyo Games approached.

“She had alluded to it being a very hard year and not knowing if she could make it,” says Modi. On the other hand, she admitted, it was difficult to recognize the stress and pressure that was squeezing Simone “because she always puts on such a happy face when she’s competing. When the camera’s on her, she always puts on her best self.”

“It’s hard to understand” that she’s experiencing any anxiety, Modi continues, “because when you see her compete, you’re like, ‘Oh, it just seems so effortless.’ Like, she’s just so talented and so good and doesn’t ever seem to falter, (so) how could she possibly be stressed and burnt out and exhausted? But in interviews leading up to the Games … she was talking very honestly about not really being very sure if she could make it all the way through and even make it to the games.”

“Those are definitely warning signs – when you’re exhausted, when you’re burnt out, when you’re saying things like ‘I have the weight of the world on my shoulders.’ Like, shame on you, NBC, for putting her as your poster child for the games — for putting her on your advertisement for the games months and weeks in advance. That happens in sports. That’s part of sports. Not that it’s OK in any other sports, but never have we seen a gymnast as prominent (as Biles) leading up to the Olympic Games.”

Kamla Modi, Ph.D

Holdsclaw suggests that the constant barrage of attention can suck the joy out of the sport for many gymnasts, especially during their formative years when they’re thinking, “I love the sport and just want to go out there and play.”

And that, says Modi, was the final warning sign for Simone:

“I don’t know if they had seen this (in her) before, but a clear warning sign for stress in sports is not really enjoying or loving what used to be really enjoyable. After pulling out of the team finals, Simone said, ‘It wasn’t fun for me anymore. I wanted to come here and have fun.’”

And for Simone, “fun” is the operative word. A motivational quote on one of her many posters advises youngsters to “remember to have fun” because “when I’m smiling and having fun, I perform my best.”

“Fun” is not the first word that instinctively comes to mind when discussing a high-level competition like the Olympics, says Modi, “but she was coming in wanting it to be fun, and it no longer was fun for her. So, if she was coming in and she’s starting to warm up and she’s starting to do podium training and she’s not enjoying herself the way she used to, there’s something else going on there. So, that’s a clear sign for athletes that that should be paid attention to.”

Part of the fun of any major event like this is the opportunity for athletes to share the moment with family. And Simone admitted how hard it was on her not to have her parents in the stands in Tokyo.

“She said in previous Olympics it was a ritual for her to get into the arena and spot her parents,” said Modi, “and that would make her feel OK. That would make her feel secure. And so, obviously, her parents were not in the stands.”

But, she added, no one’s parents were in the stands.

The pandemic played no favorites.

Simone Fearless in Her Stands on Mental Health

This was not the first time Simone had made a stand for mental health at an Olympic competition. She’d done the same in Rio in 2016 after hackers leaked confidential medical records from the World Anti-Doping  Agency database that revealed her use of prescription medication for ADHD.

Rather than retreat, however, Simone did the opposite. She turned the tables on the hackers by publicly acknowledging her ADHD diagnosis, and that she’d used Ritalin to control her ADHD symptoms since she was a child.

Having ADHD, and taking medicine for it is nothing to be ashamed of nothing that I’m afraid to let people know.

— Simone Biles (@Simone_Biles) September 13, 2016

The tweet was a shot across the bow to anyone who dared to stigmatize her or anyone else afflicted with ADHD. It was a bold and significant stand by the diminutive gymnastic giant and just a warmup for what was to happen five years later in Tokyo.

The idea that a young woman would devote so much of her life to this one moment — and then withdraw because of a case of the “twisties” when that moment finally arrived — was initially stunning,  disappointing, and incomprehensible to so many who’d followed her and the hype leading up to the Games.

“I think it was shocking to all of us because we love her and we love what she’s brought to the sport – such class and excitement,” says Holdsclaw. “But it’s a part of me as a spectator and a person who was a high-caliber athlete to say, you know what? I totally understand. I’m going to give her that space.”

The majority of Americans share that sentiment.

A poll of 2,875 U.S. adults conducted by Axios found that 62% supported Simone’s decision to withdraw from competition for mental health reasons — and 51% “strongly” supported her decision. Only 13% opposed her decision.

The poll also found that 61% of Americans believe that the mental health of Olympic athletes is not taken seriously. Another 33% believe it is.

Simone’s Sound Decision Signals Historical Shift

The truth is that Simone could have retired from gymnastics after her five-medal performance in Rio, and no one would have blinked. Even at 19, what more did she have to prove?

As it turns out, maybe more than we knew.

Though she hasn’t stated it so publicly, it’s possible she had an ax to grind with the organization that for decades had ignored the abuse that Nassar was inflicting on countless female gymnasts — herself and so many of her friends included.

“She had some things that she probably wanted to prove to USA Gymnastics, that she was going to come back out there and defy obstacles (after) everything she’s gone through, and that USA Gymnastics was complicit in a lot of these things that happened,” Modi suggests. “And so, her mindset was so different than it was before. She wanted to be part of the team victory, but she also was kind of doing this for herself and doing this for her own closure in the sport, too.”

If her initial withdrawal from the team competition was a surprise, so too was her comment after returning to the competition to win the bronze in the balance beam. Talking on NBC’s TODAY Show after the medal ceremony, she said, “[The bronze] means more than all the golds because I’ve been through so much the last five years and the last week while I’ve been here.”

The bronze meant more than her four golds from Rio? How can that be? Maybe it’s because she didn’t expect to medal. Because she didn’t expect even a bronze. Or because, unlike her other medals, she had to overcome such incredible adversity to earn it.

In fact, she said, “I didn’t really care about the outcome. I was so happy that I made the routine and then I got to compete one more time.”

Such an attitude toward Olympic competition defies the win-at-all-cost mentality that prevailed under former U.S. coaches Bela and Marta Karolyi, who sometimes forced girls to train on broken bones and other injuries at their sprawling, secluded ranch near Houston, according to some of the gymnasts.

Nothing epitomized the Karolyi tactics more than 25 years ago — the year before Simone was born — when Kerri Strug vaulted to gold after suffering two torn ligaments and a sprained ankle on her previous attempt. Strug’s success in the vault was the difference between silver and gold after two failed vaults by teammate Dominique Moceanu (who was competing with a stress fracture of her right tibia.)

Strug’s guts-for-glory moment was immortalized with a photo of Bela Karolyi carrying Strug in his arms after her wildly celebrated vault lifted the team to gold. Aaron Reitz, the Texas deputy attorney general, compared that moment to Simone’s withdrawal when he tweeted: “Contrast this with our selfish, childish national embarrassment, Simone Biles,” he said.

After intense backlash from the Twitter community, he deleted the tweet. Later admitting to speaking out of ignorance, Reitz apologized, tweeting, “I can’t imagine what Simone Biles was gone through.”

To be fair, few could.

“We’ve heard stories about gymnasts getting paralyzed because their coaches told them to continue or because they just made the wrong call,” says Modi. “(Simone is) mature enough and self-aware enough to know her own body and say, ‘This isn’t good for me to do.’ She made the right call at the end of the day. She saved her life. She saved herself from major injury.”

Moceanu had a tweet of her own for Simone, though it differed a bit from that of Mr. Reitz when she said:

I was 14 y/o w/ a tibial stress fracture, left alone w/ no cervical spine exam after this fall. I competed in the Olympic floor final minutes later. @Simone_Biles decision demonstrates that we have a say in our own health—”a say” I NEVER felt I had as an Olympian.

— Dominique Moceanu (@Dmoceanu) July 28, 2021

Time for Coaches to Get with the Program

“Gymnastics has typically been a sport where the coach is really in charge and the athlete has no agency and no independence or autonomy,” says Modi. “So, the fact that Simone could exercise this independence on the world stage in a ‘little-girl sport’ is huge. And I hope that will encourage others to assert themselves more, and to say, ‘This is what I need for my body, my mind and my health.’”

Which is precisely what Simone did for herself in the heat of the moment, knowing her decision would be scrutinized by the media and an international audience insisting on explanations.

“I think at this high level you may think you don’t have the option to drop out,” says Modi. “You (think), ‘I did this. I made the team. I can’t disappoint my fans. I can’t disappoint my team.’ It’s so hard to reflect upon this at the Olympic level. There’s so many other factors here, but I think being able to check in with the athlete and say, ‘I’m noticing some things in your practice. I notice that you’re not really enjoying yourself. Is there something else we can talk about?’”

It’s a conversation that ultimately falls to the coach, who spends untold hours each week with their young proteges and is uniquely positioned to detect personality shifts, to be aware of their developmental needs, and “to realize that mental health is such an important aspect of sports,” Modi says.

“Many coaches already understand this, but many are going to do it ‘old-school’ and do it the way they had when they were athletes many, many years ago. So, that speaks to the type of training that coaches need, too — health-related training — and understanding what mental health is. To talk about it and to detect when things are going wrong and how to intervene.”

Kamla Modi, Ph.D

There’s a whole world of sports psychology that can be rolled into training, Modi says, and that mental conditioning is just as important as strength conditioning.

“This idea of perfectionism and mental toughness can also include getting help, too,” she adds. “It can also include a greater awareness of yourself and what you need, and being able to signal to others that this is an off day, I’m going to have to take a step back, and to know when it’s not safe to keep pushing through.”

Be like Biles.

A Door of Possibilities Swings Wide Open

An interesting development in the aftermath of the Tokyo Olympics is what happened to all the endorsement deals Simone had signed in the afterglow of her gold rush of 2016. Did the luster suddenly disappear? Did Corporate America pull the rug out from under her?

Not quite.

Instead, corporate sponsors are publicly supporting Simone for her position on mental health, just as others had supported Naomi after withdrawing from the French Open.

Simone’s agent, Leigh Steinberg, went so far as to allude to this as “her finest moment.”

“Athletic achievement is valuable,” he told FOX Business, “but helping people deal with life problems is an even greater service.”

As a revered role model to thousands of young gymnasts for the past several years, the expectation now is that she will serve as a role model to a much broader cross-section of America, and for a cause that extends far beyond gymnastics.

What at first may have been viewed as a missed Olympic opportunity for Simone has instead transformed into an opportunity to positively affect the lives of others on a far grander scale. To address an issue which, as Simone describes it, has for so long been “pushed under the rug.”

As she told reporters after winning the bronze in the beam, the decision to withdraw from earlier events is a point of pride because it definitely brings “a light to the conversation of mental health.”

Her actions on that matter cannot be overstated.

“This is something that impacts a lot of us,” says Holdsclaw. “We’ve all suffered from fatigue. We all have mental health challenges, if not directly then indirectly with family members.”

“I think once Simone tells us her journey, it’s going to inspire us even more to just be comfortable with who we are, and to allow us to have that safe space to dive into our emotions and our feelings. I think this is like a coming-of-age story for her.”

Chamique Holdsclaw

Adds Modi: “I think there’s definitely power in (her being) a role model, ending an important message that will help people do what they haven’t done before. In terms of people of color who typically don’t ask for help or seek out counseling services that’s definitely a challenge. Again, Simone could use her platform to support people and to really encourage them to go get help.”

Statistically speaking, African Americans experience a much greater unmet need for mental health services and receive less quality care than others. Likewise, African Americans are misdiagnosed at a higher rate within the mental health delivery system.

And that’s where Simone, in her own words, can “bring light to the conversation.” As Modi explains, “The power of the role model that looks like and that you identify with is very, very strong.”

As such, Simone’s biggest performance may be yet to come.

“We look at Simone, we think dominance,” observes Holdsclaw. “You know, like a fierce competitor, just the way she moves her body, the posture and the class. And now, here’s somebody who is a sign of strength who has a whole other side – that she’s going to allow us to see her vulnerability. That she was not always walking around as just this amazing, strong individual. You know, she has setbacks, too.”

“That’s the thing. She’s going to use this setback as a setup for something even greater. And it’s going to be something I feel like more people can identify with. We all have those setbacks.”

Simone says she hasn’t ruled out one more run at the Olympics in 2024. But even if she never competes again, her legacy as an extraordinary athlete and individual is already cemented.

“At 24 years old, she has a lot of life to live,” says Holdsclaw. “And yes, we’re always going to admire her Olympic greatness, but now, here comes the true story, which is going to echo for years to come, is being able to overcome something. Yeah, there was a little change to the narrative but I think the end of the story is going to just be beautiful.”

Qualifacts’ InSync Congratulates New Mental Health Champs

InSync Healthcare Solutions salutes and supports Simone Biles and Naomi Osaka and all that they represent to the mental health community —today and going forward. As a leader in mental health EHR software that is designed specifically for behavioral health practices, InSync offers everything from group scheduling and group notes to telehealth, e-Prescribing, eMAR, and custom forms.

For a closer look at how our interoperable, mobile-friendly and configurable software system can increase efficiencies and workflows in your mental health practice, schedule a demo now with one of our experts. We’re happy to answer questions and explain how we can tailor our system to meet your needs while saving you time and money.


Time Magazine: Naomi Osaka: ‘It’s O.K. Not to be O.K.’

Axios: Exclusive poll: Americans care about Olympians’ mental health

The Undefeated: Naomi Osaka suffers the agony of victory over idol Serena Williams Simone Biles’s ADHD medication is banned in Japan, but a Tokyo 2020 exemption allowed them for athletes

ESPN: Bravo, Simone Biles, for taking stand against ADHD stigma Simone Biles on her beam bronze: ‘It means more than all the golds’ Texas deputy attorney general Aaron Reitz calls Simone Biles an ’embarrassment’

Fox Business: Simone Biles boosts endorsement potential despite Olympics withdrawal

New York Post: Texas deputy AG apologizes for calling Simone Biles a ‘national embarrassment’

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