NBA mental health amid pandemic, protests, political upheaval

On a Saturday afternoon in mid-April, a few weeks after he was traded to the Nuggets, Aaron Gordon sat in the hotel room he was temporarily living out of and reflected on the most challenging season NBA players had ever dealt with.

While bouncing around the country as a deadly transmittable virus continued to spread, players had been contending with health and safety protocols that induced isolation, obliterated daily routines and separated them from partners, children, friends and family. Novel stressors had been stacked on top of the countless professional and personal reasons players might feel anxious during any typical season.

Meanwhile, their bodies were being ground down by the compressed 72-game schedule. The physical injuries potentially caused by such a grueling endeavor have received ample attention; no shortage of media hands have been wrung over Kevin Durant’s strained hamstring, LeBron James’s high ankle sprain or Jamal Murray’s torn ACL. But comparatively little notice has been paid to an unseen element of players’ well-being, one affected as much if not more by this season’s atypically harsh conditions: mental health.

Illustration by Alex Nabaum

“Although we have special gifts and talents that make us seem more than human, at the end of the day we’re just people,” Gordon says. “With the same struggles and the same sufferings, the same day-to-day anxieties and insecurities that the rest of the world is going through.”

Players’ traumas have been layered. In addition to working through a global health crisis and performing in public before a mourning, increasingly fractured country, they were also confronted by a racial reckoning and social justice movement that called out for their contribution.

As Gordon sat in his hotel room, the trial of Derek Chauvin for killing George Floyd was days away from reaching a verdict, after weeks of heartbreaking testimony from eyewitnesses and Floyd’s loved ones. All season—and long before it began—relentless signs of racial inequality were “a constant strain on my mental health,” Gordon said. “I’m employed by the NBA. My job is to come out and compete and help my team win. But there’s just certain things that you can’t get out of your mind. It’s another reason why I do all of this mental health and mental training, because of how unfairly America treats Black men and Black women. And we’re still expected to come out, compete and act as if it’s not happening. It’s strenuous. Daily.”

NBA players are not a monolith, making it impossible to know precisely how mental health has affected their ability to perform this year. And there are innumerable variables that go into any game’s final score, with mental health being just one. But it’s also impossible to imagine a scenario where some thoughts and emotions felt off the floor would not carry over onto it. This was a season, after all, that featured notably uneven play: For most of this year, particularly after the All-Star break, the percentage of games that ended in a blowout was dramatically higher than usual.

“On the court, you want to be icey. You want to be really cool. You want to be composed,” Gordon says. “And when your mental is not right on the court, you do stupid things, like get technical fouls or compound mistakes. Like, say you miss a shot, you’re mad that you missed a shot so you turn around and foul somebody 80 feet away from the basket.”

Largely thanks to the need for teams and the league to preserve privacy, there is no available data on whether more players have taken advantage of mental health resources or whether they have experienced mental illness in greater numbers this season (according to a poll conducted by the American Psychological Association in November, 74% of psychologists reported seeing more patients with anxiety disorders compared to before the pandemic; 60% said the same for depression disorders). Anecdotally, though, in interviews with psychologists, psychiatrists and licensed mental health professionals who have experience treating NBA players, all agree that the need for help has swelled.

“The normal pressures that every player has had to contend with have been increasing in proportions that frighten me, frankly,” says Michele Roberts, the executive director of the National Basketball Players Association (NBPA). She adds that more players have called her about mental health resources in the past eight months than in her previous seven years on the job. “They’re expected to go out two or three times a week, perform at the highest level, and at the same time be husbands, fathers, boyfriends, sons, and on top of that deal with normal consequences of living in a pandemic. … We as a community don’t allow athletes the space to be vulnerable, and that’s wrong. They have as much right to be vulnerable as the rest of us. And in some ways, unlike many of us, they’ve got more reasons to be vulnerable.”

Heading into this season, commissioner Adam Silver knew potentially detrimental trade-offs would have to be made for games to be played. But as the year played out, he worried about the impact partial seclusion would have on players and their families. “I’ve been most concerned about how isolating both the pandemic has been generally, but more specific, the protocols that we and the players association felt were necessary to keep them COVID-free throughout the season,” Silver says. “We knew operating would entail enormous sacrifices … and there’s no question that it’s weighed heavily on all of us.”

Silver knew canceling the season would have created its own set of problems, including a massive financial hit for players, teams and employees throughout the league. It also would not have inoculated players from the pandemic’s impact on their day-to-day lives, from isolation to their risk of getting infected. But it’s still imperative to understand exactly what the sacrifices were. Next season is likely to be a return to “normal,” but even then there is little doubt that the mental health challenges presented by the 2020–21 season have altered and elevated the issue in a league that was already starting to pay attention. What this year has also told everyone involved: NBA teams and players are only scratching the surface of how consequential mental health really is.

“When your mental is not right on the court, you do stupid things,” says Gordon.

Kyle Terada/USA TODAY Sports

Before the bubble started, Roberts thought players’ games might actually benefit from being separated from their friends and family for such a prolonged period of time. There’d be nothing to distract them.

“I now know that was stupid,” she says. “It was a dumb thought. They don’t need to be isolated from their support systems to be better basketball players. In fact, quite the opposite: If they’re not sleeping well because they miss their families, if they’re engaged in borderline depression because of having to contend with isolation, that will impact their game.”

Down in Orlando, players were required to use an app that asked roughly five questions each morning about their health. One was, Would you like to talk to a mental health professional today? “I think we learned that you need to do more than tell them that there’s a program available or give them a brochure,” Silver says. “Like all effective communication, repetition is critically important. It’s unpredictable when someone might feel that need to talk to someone.”

Coming out of the bubble—a logistical success for the NBA in the sense that no players tested positive and a champion was crowned—the league knew how psychologically damaging that environment was and wanted to avoid anything like it in the future.

“As we began to discuss this season … it’s not to say [another bubble] was ruled out completely,” Silver says. “I think if the course of the pandemic had left us with no choice, we probably would have considered it again. But we knew it was our last option, not our first option.”

The league and union then negotiated parameters to push through a condensed 72-game, bubble-free regular season—starting after an all-too-brief offseason—that would include health and safety protocols. Games tipped off Dec. 22, quickly revealing the extent of the challenge. “Being in these big arenas, no fans, quick turnaround from last season, you’re going to have some people who are still getting their mind into the season,” Trail Blazers guard Damian Lillard said shortly after play kicked off.

About a week later, the NBA sent a private memo titled “Mental Health and Wellness Requirements and Recommended Practices for NBA Teams” to its 30 organizations. It was the third iteration of a similar document delivered over the last few years, and it featured input from psychiatrists, psychologists, physicians, trainers, coaches and “other mental health and wellness providers who work with NBA teams.”

For several obvious reasons, this version was more urgent than the first two. “We’re already on an 80-year upswing of anxiety, depression and mental health issues,” says Cavaliers forward Kevin Love, the NBA’s most outspoken mental health advocate. “And when you factor in COVID and social injustice [and], I mention it because it affects me and the people close to me, the wildfires and how all of the West Coast got ravaged, and then everything that happened with the election and before [Donald] Trump was out of office, there’s a heaviness to this time that we’re in.”

The NBA’s letter was filled with suggestions and mandates (some old, others new) that sought to help players navigate uncharted waters. It outlined how to preserve treatment-related confidentiality and called on teams to set up telehealth services so players could participate in talk therapy while avoiding any physical risk. Right before the 2019–20 season began, all 30 teams were required to employ at least one licensed mental health clinician; players were reminded to save that person’s number in their cellphone.

The memo wasn’t attempting to solve such a broad issue so much as reiterate how serious it is, and why, especially now, mental health deserves even more attention than it currently receives.