‘Way more common than people realize’: How some in MLB are bringing mental health into focus

(Content warning: This story addresses suicide and mental health issues and may be difficult to read. If you are in crisis, please contact the National Suicide Prevention Lifeline by calling or texting 988, or contact the Crisis Text Line by texting HOME to 741741.)

The messages came through immediately, the buzz of Rockies closer Daniel Bard’s phone a constant reaffirmation of his decision.

Hey, thanks for speaking out. 

I’ve gone through something similar. 

Bard would have more than 100 messages like this, many from current players, before the day was done. It was March 30, 2023. Bard had announced he would start the season on the injured list with anxiety. The news was largely greeted with acceptance and support on social media, by fans, reporters and former players.

Nine days later, the Detroit Tigers announced that outfielder Austin Meadows would also be going on the IL with anxiety. New Tigers president Scott Harris said in a statement,“The Tigers fully support Austin’s decision to step away from the team and prioritize his mental health.” Ten days after that, Oakland A’s reliever Trevor May went on the IL with anxiety, too. May said he’s been dealing with mental health issues since the COVID-19 pandemic started in 2020 and cited Bard and Meadows as inspirations in speaking out.

“I felt like being honest was going to take some of the load off of me,” Bard said of why he chose to not make up a calf or back injury. “And also, that this was a chance to make mental health being public OK for other guys.”

Bard, who spent seven years in retirement working his way back from the yips, had always wondered what would have happened if he had spoken up sooner. There were years, earlier in his career with the Boston Red Sox, where he silently struggled. He was demoted or designated. I should have been on the IL for that, he thought years later.

Perhaps baseball wasn’t ready for it.

In 2008, Oakland pitcher Justin Duchscherer was in denial. He would do anything to avoid the next day. He’d stay up until 4 or 5 a.m., close the curtains in his hotel room and sleep as late as possible, sometimes until 3 or 4 p.m. Duchscherer would then hop in the shower, get on the team bus, and — on most days he started — dominate. Duchscherer led the American League in ERA at one point. He made his second All-Star team.

After years of pushing, the then-30-year-old had finally gotten a chance to be in the A’s rotation. He didn’t want to risk losing that opportunity. So Duchscherer kept his inner struggles to himself.

“The whole world thought I had it figured out,” Duchscherer said last week on the phone. “People have no idea how f—ing dark and lonely it can be even when you’re at  ‘the top.’”

Duchscherer had hip surgery that offseason. His marriage officially ended at the end of 2008. After elbow surgery in early ’09, getting through each day was difficult. Duchscherer found himself crying for hours.That August, he stepped away from baseball. Not concerned with anything but survival, Duchscherer was finally honest: He had been diagnosed as clinically depressed.

“I went from being able to conquer the world to not being able to get on a plane for my own grandmother’s funeral,” said Duchscherer, ”because I ignored all the signs.”

The A’s were supportive. Other corners of the baseball world? Not so much. Earlier that season, in June 2009, the New York Times ran a story that questioned the validity of five players having been on the IL with social anxiety disorders. Dr. Allan Lans, a psychiatrist quoted in the story, who said he worked with athletes and teams including the New York Mets, suggested that players could be “finding an excuse for why your performance isn’t what it was before.”

Duchscherer, who spent the majority of the 2010 season on the IL, signed a one-year deal with Baltimore in 2011. He was categorized as “crazy” by people around the team in at least two situations directly witnessed by this reporter.

“Absolutely,” Duchscherer said of going public, “it altered the perception of me.”

In 2016, veteran reliever Sean Doolittle started seeing a therapist through the Oakland A’s. Two years later, he was formally diagnosed with anxiety and depression. Like Duchscherer, Doolittle’s on-field performance during that time left little by the way of red flags. In 2018, Doolittle pitched to a 1.60 ERA in 43 appearances with the Nationals and made his second All-Star team.

“I think a lot of people have some misunderstandings about what depression actually looks like,” said Doolittle, who has never publicly discussed his diagnosis before. “It’s not always curled up in the fetal position in a dark room. It manifests itself in a lot of different ways and it doesn’t just mean ‘sad.’ There’s a lot of other parts to it.”

Doolittle, like Duchscherer, wishes he had sought help sooner. He, too, fell victim to the baseball culture of “rub some dirt on it,” or get a shot and keep going.

“There was a lot of stigma associated with it,” said Doolittle, who debuted in the majors in 2012.  “I white-knuckled stuff for a while. Even then, I remember the mental coach would come around and guys would be like, ‘Who is this guy? Is he trying to break me down by staring at me from across the room?’ And they didn’t know what to make of him.”

According to the Centers for Disease Control and Prevention, one in five Americans will experience a mental illness in a given year.

“It’s way more common than people realize,” Duscherer said. “There are guys in every clubhouse hiding it every day.”

Mental health struggles are not new to baseball. But in 2023, the way the sport talks about it is starting to change. Some teams are taking big steps forward. Some in the game see mental health as the next frontier in player development.

Still, problems persist. There remains confusion about mental health versus mental skills and who is qualified to do what. There are questions about whether certain organizations’ public sentiments match their private actions; and a subset of players who either don’t fully understand the nature of mental health issues, or worry about the impact being open about them could have on their career.

“We have come so far,” said assistant general manager Andy McKay, who is part of a Seattle organization that has devoted significant resources to mental health, “and still have so far to go.”

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Travis Kuhn, a Top 30 Mariners’ prospect, grew up in a household where you didn’t talk about mental health issues, even though he has a family history of them. Kuhn thinks it’s important to be vocal about it now. He has been seeing an external therapist for years.

Except now, whatever his insurance doesn’t cover, Seattle does. The Mariners started fully funding external therapy for all players and staff at all levels last year. This spring in big-league camp, Kuhn watched the support staff explain how the confidential process works — it funnels through mental health coordinator Christian Guzman — and how the organization would never have a way to track the outside therapy services. He already knows six or seven guys on his current Double-A team who use or have used the service.

“We have a group of people in key leadership positions who feel very strongly about this,” said McKay, who has a background in performance psychology. “If somebody is dealing with anxiety, to me that’s no different than ‘I’ve got a broken finger, I need some help.”

Seattle will also cover initial external treatment for a player’s family and spouse; this year, the organization is also rolling out a spouse support group. The Mariners’ previously only offered the EAP (employee assistance program), a league-wide initiative that provides free and confidential counseling and assessments to any player, coach, their families or team employees. Each program is club-specific and generally includes a designated amount of free counseling sessions, most commonly 3-5, depending on the organization’s contract.

“A lot of friends of mine (in other organizations) who have reached out about mental health … they only have access to the EAP,” Kuhn said, “The EAP is a bit of a flawed system in my eyes, because in my experience with it, I was going through a lot of personal stuff I wanted to get past, and four sessions wasn’t going to be enough for me… And I understand guys who see it the same way: How much can we get through in a few sessions and how much can we actually maintain?”

Former catcher JP Arencibia, Toronto’s first-round draft pick in 2007, struggled with panic attacks starting in 2011. He chose to not tell anyone, fearing even using the team’s EAP program could compromise his arbitration the following season.

“There wasn’t really (an) example that would tell you, you’re open to speak freely,” said Arencibia, who was later diagnosed with anxiety and depression-related issues. “I was scared. I was going to go from the league minimum to (filing at) 2.8 million; would they want to give me that money if they thought I was ‘damaged goods’ and having panic attacks? No, probably, so I kept quiet about it.”

It’s impossible to get a sense of how many teams provide only the EAP system, as multiple organizations declined interview requests, in two cases blocking their mental health professionals from participating in this story. (The Athletic did not reach out to all 30 teams.) Most of the people interviewed for this story felt that the EAP alone is not enough.

The Rays — an early adopter in investing in mental health — have done considerable work expanding their in-house mental health program over the past two years. They conduct three confidential mental health screens (in spring training, mid-year and the end of the season) and have embedded licensed psychologists and mental health workers at every single minor-league affiliate. They have added a team psychologist on retainer in Florida and North Carolina to cover their minor-league teams and players.

“We know it’s a priority,” said Vince Lodato, who has spent more than 20 years as the Rays’ mental health consultant and is the executive director of the National Sports Performance Institute. “We aren’t waiting for someone to need medication or to be hospitalized. We are very proactive and have always had a fully integrated program from the draft to development all the way to the big leagues.”

Lodato said the Rays have placed a premium on privacy. No one has access to the mental health screens but him. Nothing goes into a player’s file or the team’s records. If a player wants help outside of the team’s group of paid consultants, they can arrange that. As a licensed clinician, Lodato provides a firewall of privacy. Sometimes, he has to explain to coaches they can’t be in the room for his visits.

“If a guy wants to loop in the mental health coach or another affiliate (if he gets promoted) to coordinate care, they can,” Lodato said. “The players control the flow of information and confidentiality. Without that, you may as well strip the whole system down and get rid of it.”

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Mental health is not the same thing as “mental skills.”

Multiple people interviewed for this story pointed out that Bard coming forward not only advances the mental health conversation, it spotlights how intrinsically connected mental health is to mental skills and performance, the latter a topic that has become much more accepted over the past few years.

“It’s easy to say, ‘Hey, my confidence is not there on the baseball field,’” said Arencibia, who noted he had a college mental performance coach in the early 2000s.  “But when you tell somebody that works for the team and makes decisions that you are panicking at night and don’t want to get out of bed anymore — those are not conversations you want to have with those people.”

It is not required for teams to employ mental skills coaches, though most do. There also aren’t specific mandates as to who those people are and what their background should be. Since 2016, baseball’s collective bargaining agreement has stipulated that each club should provide players with access to a licensed psychologist in a private space. (For many teams, the league-mandated licensed EAP person satisfies that requirement.)

“Internally, we have had to work hard to differentiate (between mental health and mental skills),” McKay said. “There is some overlap. We want our people to be mentally healthy and functioning in the world when the game ends and we want them to be relentless, aggressive competitors when they are on the field. And that’s two very different mentalities. Mental health is the foundation of it all, though.”

For Arencibia, baseball was his out, until his on-field performance started suffering. For Doolittle, some of his darkest days mentally have been on the IL. Duchscherer likened the effect of professional baseball stress as adding to an already-boiling pressure cooker: Eventually, it spills over.

“I’ve worked on myself as a person, not just as a player,” Doolittle said. “I’ve worked hard to not have my entire identity wrapped up into being a player, but you do realize how tied together it is and how stresses and anxieties in your personal life might affect your performance, your recovery. Educating players on how much it’s actually tied together might further encourage guys to get help.”

This year, the Royals promoted Melissa Lambert to director of behavioral science. What makes her role unique is that the organization didn’t put her in an office; they put her in the dugout.

Like Tampa Bay, Kansas City – which will have five people by the end of the year in a department led by senior directorial of behavioral science Ryan Maid — has prioritized having licensed clinicians in all mental skills roles at all levels. In January, the Houston Astros hired licensed clinical therapist Justin McKissick to work as a mental health and performance coach based in the team’s spring site in West Palm Beach. The Brewers also have adopted this approach.

Having a licensed therapist means confidentiality — the number one concern of many players — and safety. Many in the industry fear that by not uniformly mandating that mental skills coaches have proper licensing, early warning of signs of a mental health issue could be missed. “It’s dangerous,” said one clinician. Conversely, one baseball executive pointed out that players sometimes struggle to build relationships with  licensed therapists and may feel more comfortable opening up to someone intimately familiar with the grind of a season. It’s a complex issue, with no single clear-cut answer.

Lambert, who spent the prior two seasons mainly working with the Royals minor leaguers, is hoping to bring both: The trust factor of being in the dugout and the credentials to deal with not only mental performance but also more serious issues.

“When I first got into baseball I learned really quickly, there’s a lot of discussion of: Is this mental performance or mental health? I don’t think it’s ever that black-and-white,” Lambert said. “If there’s high stress involved in a game, or a manager is managing high-pressure situations, it carries over into home life or off the field. Very quickly, something that starts as performance-based can evolve off the field and become anxiety or depression.”

The Royals, and other teams who have embedded clinicians with the team, believe that having a point person like Lambert enables outside referral to go more smoothly and allows the organization to manage situations before they become potential crises. Other teams, like the Mariners, have focused more on beefing up external mental health support for players. But both groups tend to agree that having access to licensed mental health clinicians — who are bound by law to confidentiality — is key.

“Not everyone wants everyone to know about it, and that’s OK,” Kuhn said. “We aren’t looking for 80 percent of athletes to be vocal, we just want 100 percent of athletes to be OK.”

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Diamondbacks prospect Jamison Hill has the phone number for the National Suicide hotline in his Instagram profile. Hill frequently posts uplifting messages on social media, things like, “Your life matters” or “What you’re feeling won’t be there forever.” Hill struggled with anxiety and depression during high school and college, and the way he sees it, he can reach a lot of people that way. Men, and he believes Black men in particular, are often taught to not talk about mental health. If his posts can lessen that stigma, if they can help even one other person, then it’s a worthy endeavor.

Bard is a legend in Hill’s eyes, the big-leaguer who was instrumental in Arizona’s mental support staff, a resource the 24-year-old Hill uses in some capacity daily. “It’s the biggest thing I love about the organization,” he says.

Even five years ago, it would have been difficult to find minor league players willing to publicly speak out about mental health. Still, it’s a risk. Bard, May and Meadows are all on 40-man rosters with access to unparalleled big-league benefits and a $720,000 minimum salary. Bard is in the first year of a two-year, $19 million deal with the Rockies.

“We all know it’s a business and certain guys are higher on the totem pole because of money,” Hill said. “Someone (undrafted) like me, who didn’t sign for much, if I were to do (what Bard did), who knows what would happen when I came back? But, at the end of the day, you have to put yourself first.”

Both Hill and Kuhn pointed to the improved conditions for minor leaguers, which include team-covered housing and bigger paychecks, as enormously beneficial in helping remove some of the biggest off-field stressors. Still: How would it be perceived if a minor league player stepped away from the game for mental health reasons? How much would it cost a young big-league star headed to arbitration or free agency?

“There’s always the over-arching concern of, ‘How can this affect my career, the perception of me?’” said Kuhn, who sought outside therapy while dealing with a personal event when he played in the Arizona Fall League in 2021. “It can make you really hesitant to take up those resources, even if it’s the right thing you need.”

That stigma persists even in pockets of the big-league level, even as Bard and others hope to lessen it each time someone comes forward. One baseball executive, who does believe in the benefits of mental health, said he thinks many managers don’t entirely see its value, regardless of what they say publicly. Competition is fierce, empathy can be scarce and the culture of play hurt is prevalent.

“I would argue if a player is self-secure enough to say ‘I need help’ … that’s a positive. You want somebody who has that kind of strength,” Doolittle said. “But I get that it’s starry-eyed, that there’s still some stigma attached.”

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Bard took another major step on April 19: he returned to a major-league game. He has allowed just one earned run, a home run, in his first seven outings.

“For this to move forward, guys are going to have to be able to come back and play again,” Arencibia said, citing Royals pitcher Zack Greinke as a rare example, “and not feel like this person (who spoke up) got blackballed from the game.”

Greinke nearly quit baseball in 2006 and was diagnosed with depression and social anxiety disorder. He began seeing a psychologist and taking antidepressants, returning to the Royals rotation in ’07. Still, baseball is littered with guys who don’t get the help they need for too long. Arencibia didn’t get professional help or take medication until he stopped playing. Former Angels top prospect Brandon Wood dealt with debilitating anxiety and panic attacks and medicated with alcohol; he was out of the game before he was 30.

Bard recognizes that for some guys, going on the IL with a phantom injury is still a better option than opening up. That there is no one-size-fits-all approach. But he hopes players who are struggling, who feel like they have nowhere to turn, know they can talk to him. Many already have.

“We need to be in touch with ourselves enough to be able to recognize when to get help,” Duchscherer said. “I learned that s— the hard way.”

Duchscherer, Hill and Doolittle said they’d like to see more education for players about the advantages of prioritizing mental health before things spiral.

Change in baseball can be painful. The sport is in its second decade of arguing about analytics. It wasn’t so long ago that minor league teams only had one coach: their manager. Or that big league organizations prohibited heavy lifting. Even seven years ago, as Doolittle said, big-league mental skills coaches were met with trepidation. Today, they’re almost universally seen as an extension of the medical staff. In D.C., mental performance consultant Adam Wright’s office is right next to the training room, and it’s not uncommon to see a dozen guys go in before a game. Doolittle, who is currently rehabbing, talks to Wright every day.

“It’s progressing,” Lambert said. “I think a lot of organizations are moving in the right direction. I think it’s just slow.”

Added McKay: “You are always going to have the naysayers and people in the back rolling their eyes. I think the mental health evolution will follow the same trajectory as mental skills and strength and conditioning. It takes some time, it’s new, it scares people — and then it becomes a normal piece of the fabric of sport.”

Kuhn believes there’s still a lot of work to do in the sport in normalizing people with bipolar disorder, ADHD and suicidal thoughts, among other conditions.

“There’s a lot of players who go undiagnosed because of the fear of having a disorder tied to their names,” Kuhn said. “I’m familiar with a lot of people who struggle with bipolar disorder, ADHD, these things are tough to deal with and I haven’t seen them mentioned a lot at the pro sports level. I see that as the next level of acceptance.”

Former player Drew Robinson has been open about surviving a suicide attempt in 2020, and now serves as a mental health advocate for the Giants, in an effort to make the topic less taboo. Arencibia said the Mets have encouraged him to share his story with players. You can leave the stadium at night, he tells them, but you can’t ever leave what’s going on between your ears.

Arencibia spent countless nights alone wondering if he’d ever “return to normal.” He hopes more teams make external professionals available in a confidential way so players can get the help that he didn’t.

“I wish,” Hill said, “more athletes knew they weren’t alone.”

(Top image: John Bradford / The Athletic; Photo: Harrison Barden / Colorado Rockies via Getty Images)