Olympics: Much-needed focus on mental health

Months before the Tokyo Olympics, these words sound like stating the obvious: “I believed in an equation where gold medal equals happiness.”

That equation, as shared by Abhinav Bindra, makes total sense to the Indian athlete. Except he’s actually saying that it doesn’t. After winning gold in Beijing, an ambition that had driven Bindra’s life, he found himself staring into a void of purposelessness.

He competed in two more Olympics, was within a whisker of a second medal, and having retired five years ago, made it his mission to ensure that Indian athletes today are better prepared for both performance and success. Bindra, a member of the International Olympic Committee’s (IOC) athlete commission, is also part of the IOC’s Mental Health Working Group that drafted the Mental Health in Elite Athletes Toolkit, released on May 12.

The 100-page IOC Toolkit offers context and pathway about mental health issues among athletes using 14,689 pieces of research and public reports. The IOC’s medical and scientific commission, and athletes and their entourages worked alongside 23 experts to create structured methods of recognising and tackling mental health issues among top athletes.

The process first began with an IOC consensus paper released in February 2019 that outlined the issues at hand.

“You needed research and scientific back up to make a case and put forward best practices,” Bindra says.

After the paper, the issue of mental health in elite sport got a lot of traction at an athletes’ forum held in Italy in April. Bindra says, “We heard a lot of stories internationally with athletes coming out with their experiences and de-stigmatising mental health.”

The research that forms the base of the toolkit was focussed on North America and Europe.

Much needs to be done around the subject in India from scratch. This, while discussions around mental health among elite athletes is increasing. Former hockey captain Viren Rasquinha’s career straddled the new millennium at a time when, “the coach was supposed to be whole and sole. If you wanted to seek outside professional help it would be looked upon as crazy, looked upon negatively. The environment wasn’t right to seek professional help and there weren’t options either.”

Rasquinha is Director and CEO of Olympic Gold Quest and quantifies the importance given to mental health in elite athletes.

“From our athletes who qualified or were close to qualifying for Rio 2016, maybe 10 percent worked with sports psychologists.” In the run up to Tokyo, the figure is now “around 25-30 percent” of OGQ elite athletes having worked regularly with sports psychologists across the last five years.

The IOC Toolkit research findings state that the chief illnesses pertaining to sporting performances are depression, anxiety, eating and sleep disorders, alongside several others. Two studies from the British Journal of Sports medicine offer startling numbers. The first is a meta-study published in 2019 that found that over 33.6% of elite athletes surveyed suffered from anxiety and depression. The second study, before Rio, found that 49% of Olympic athletes surveyed fell under the category of “poor sleepers”– with diminished sleep quality, low energy availability and other related illnesses.

In order to tackle these problems before escalation, the IOC’s Toolkit has two measures: A Sport Mental Health Assessment Tool, developed for sports medicine physicians and health professionals, and the Sport Mental Health Recognition Tool, for athletes, coaches, family members, those who form the athlete’s entourage. The entourage include the wide circles of influence around an athlete connected through personal, performance, health, organisational and commercial relationships.

India’s athletes deal with a muddied overlapping of these circles. At the heart of an athletes’ mental health Bindra says, the “idea of psychological safety” in their immediate environment, is heavily dependent on that entourage.

“Making that environment safe for athletes is so very critical.” He hopes the IOC Toolkit will first “empower” the athlete’s entourage with “information and knowledge” and offer solutions.

The Olympics consumes the Indian sporting ecosystem whole in the 18-odd months leading to a Games. The first step towards a healthy mental environment around Indian sport lies in, Bindra says, “creating a psychologically safe relationship between athlete and coach, administrator and athlete. There’s a lot of work there needed, specifically to India.”

Imagine Rasquinha, India centre-half, trying to talk to his coach in the mid-90s about sleeplessness over selection or the fear of injury. (Four impact injury fractures on the fingers of his right hand in training, each rehab taking three months, would haunt anyone).

Indian sport’s often over-varnished guru-shishya parampara has often led to possessive, sometimes harmful relationships between athletes and coaches and/ or officials. Bindra says we need to start with a clearer understanding of how to have conversations with athletes.

“I don’t mean that athletes need to be mollycoddled all the time, but there have to be boundaries,” Bindra says.

While there are always “necessary, legitimate reasons” to deliver tough words to an athlete, the environment around the athletes still needs to be “psychologically safe.”

When the Olympics were postponed in 2020, Rasquinha says, OGQ found its athletes spiralling into the kind of directionlessness that dogged Bindra post-Beijing. Rasquinha’s athletes had found their raison d’etre taken away: “Athletes are very good when there is a fixed goal in front of them,” Rasquinha says. “Last year their fixed goal was the Olympics. That goal post got taken away literally overnight, every international tournament got cancelled. If there is no goal in front of you, how do you motivate yourself? That was the toughest part for us.”

The pandemic has gone some distance in de-stigmatising conversations around mental wellbeing; in India particularly, in order to fully internalise and embrace what the IOC Toolkit offers, our elite sports system could consider re-orienting its approach to mental health.

Bindra speaks “out of sheer experience of over two decades” when he explains that India’s focus on the mental side of sport tends to be on “performance” and “not mental well-being.”

“In reality, human well-being—mental, spiritual, emotional—has to be at the heart and centre of performance,” Bindra says.

At a time when there are more young Indians in sport, the idea of mental well-being and equilibrium, he says, must start early. “When you have more young people involved in sport, you’re going to have more young people failing in sport. That’s just the nature of sport, more fail than succeed.”

Indian sport also needs to equip our young with postsporting career skills. The sporting career ends “quite abruptly one day and then what are they going to do?” Bindra talks of setting in place programmes specific to athletes, regardless of other promises of government job security, “to skill up and scale up” towards post-career employability. To have, even while competing, dual-career lives.

Elite sport today, particularly in India, needs to re-examine the ‘single-minded focus’ method as the sole path to achievement. What athletes need is a sense of a life in “balance”. Bindra says, “When athletes have a degree of balance, I believe they will have a better chance of also succeeding in sport.”