Simone Biles leading a new generation of athletes who prioritize mental health | COMMENTARY

TOKYO, JAPAN - JULY 27: Simone Biles of Team United States supports her team mates by carrying their chalk after pulling out after the vault during the Women's Team Final on day four  on day four of the Tokyo 2020 Olympic Games at Ariake Gymnastics Centre on July 27, 2021 in Tokyo, Japan. (Photo by Laurence Griffiths/Getty Images)

To watch Olympic gold medal gymnast Simone Biles soar through the air is like watching a superhuman defy the laws of physics. So perhaps that’s why it is easy to forget that Ms. Biles is still human and subject to stress and illness, just like the rest of us.

When Ms. Biles recently bowed out of the team final and later the women’s all-around finals in the Tokyo 2021 Olympic Games, the news was shocking. She was slated to lead the U.S. Women’s Gymnastics team to another gold medal with her death-defying, high-flying routines. But in the vault now seen around the world, something happened to her in midair and she got lost.


The response to Ms. Biles’ decision to not participate in these events could largely be categorized into two groups. In the first, social media was abuzz with support for her decision to protect not just her mental health, but the very real risk of a serious injury. On the other side, a vocal contingent cried foul, vilifying her for wasting her spot on the Olympic team and jeopardizing the U.S. team’s quest for gold.

As a mental health provider who specializes in sports psychiatry, I can tell you that I am firmly in the first camp. I applaud Ms. Biles for prioritizing her health on the world’s largest stage and therefore protecting her well-being by pulling herself from the competition. Furthermore, here is a woman who has emerged from the wake of the trauma caused by former team trainer Larry Nassar, who infamously abused a generation of gymnasts. To me, the leadership role she has played in helping other gymnasts heal after abuse is testament to the fact that her inner strength is as steely as her physique.


And yet, as strong as she may be, it should come as no surprise that Simone Biles would experience mental health issues. She’s been a mental health advocate and has discussed her panic attacks and anxiety. Elite athletes face team peer pressure, the stress of meeting intense expectations, compounded by a hyper-structured schedule that leaves little time for rest and reflection. The intensity of an elite athlete’s daily life can leave them feeling depleted. Left unmitigated, these conditions put athletes at a higher risk for stress, which makes them more likely to experience depression and anxiety or, even more alarming, suicidal thoughts.

Often, it is only after a tragedy occurs that we ask the question, “Why didn’t they get help?” As a psychiatrist, I challenge us all to become more skilled at asking those questions along the way. And to encourage open and honest conversations about mental health and to regularly ask your family, friends and co-workers if they are OK.

The fact that Biles felt empowered to speak up for herself represents a seminal moment in history. She brought mental health to the forefront on the world stage. It’s a shift away from the “winning is everything” mentality toward a more holistic treatment of athletes and sport. Many gymnastics fans remember the legendary “Magnificent Seven” team from the 1996 Atlanta Olympics. In the finals, gymnast Kerri Strug visibly injured her ankle following an event. Her win-at-all-costs coach Bela Karolyi urged her to get back up there to do it again. Amazingly, she landed the stunt before collapsing in pain. Ms. Strug has said that she didn’t feel like she had the right to insist on protecting her health; winning was more important. I feel that it is a huge win for us all that in 2021, Ms. Biles had the courage to advocate for herself and, in response, her coaches and team rallied around her. Furthermore, her honesty chips away at the stigma too long associated with mental illness. If it’s OK for these athletes and others in the spotlight to seek help, then perhaps it’s OK for the rest of us to do the same.

Knowing how intrinsically connected Simone Biles’ mental health is to her physical health, I believe it’s high time we stop parsing between mental versus physical health and just treat all of this as health. The dualism of physical and mental health is counterproductive. Our minds and bodies are integrated, so it is important that our health care systems also care for the whole person. Simone Biles is leading a new generation of athletes who prioritize their health. That’s a whole lot more important than sticking the landing.

Dr. Deepak Prabhakar ( is the chief of medical staff and medical director of outpatient services for Sheppard Pratt. He specializes in sports psychiatry and works with athletes across the age spectrum and at all levels of competition.