Simone Biles's withdrawal from Olympic event could 'normalize' mental health conversations, experts say

The decision of U.S. Olympic gymnast Simone Biles to withdraw from the women's team final to look after her mental health could go a long way toward dispelling stigmas around the issue in sports, experts said.

"There has always been, within the athletic world, the emphasis on appearing physically fit and appearing mentally fit," Katy Kamkar, a clinical psychologist at the Centre for Addiction and Mental Health in Toronto, told CBC Sports on Tuesday. "And that can further perpetuate a kind of silent suffering and self-isolation.

"So the more we are able to have a very supportive, empathetic conversation that, same as goes with physical health problems, we are able to normalize the conversation."

Biles, a gymnastics icon with four Olympic golds and 19 world championship titles to her name, withdrew from Tuesday's final following the vault event. On Wednesday, USA Gymnastics announced she had also withdrawn from Thursday's all-around competition.

The organization says Biles will be evaluated before deciding if she will participate in next week's individual events.

"I have to focus on my mental health," the 24-year-old said after the event. "I just think mental health is more prevalent in sports right now.

"We have to protect our minds and our bodies, rather than just go out there and do what the world wants us to do."

Taslim Alani-Verjee, a clinical psychologist and the director and founder of the Silm Centre for Mental Health in Toronto, commended Biles on prioritizing her well-being.

"I think it's incredible that she was able to have the courage and the insight to say that she couldn't do it, or that it wasn't in her best interest to do it, and that she is allowed to come first in all of this," Alani-Verjee told CBC Sports.

The team representing the Russian Olympic Committee won gold, while Biles's U.S. teammates earned silver. Great Britain took home bronze.

Stigma can impact athletes' careers

Biles posted on social media on Monday that she felt like she has the weight of the world on her shoulders at times.

Kamkar, who is also an assistant professor in the department of psychiatry at the University of Toronto, said the amount of stressors faced by athletes, in addition to the everyday issues people contend with, often aren't appreciated by a viewing audience.

She noted that the stigma around mental health in the sports world has declined over the years due to a strong focus on education and dialogue, but there is still room for improvement.

"Of course, there is a further need for improvement, but we also know that the stigma around mental illness and health concerns remains present in the athletic world," said Kamkar, who was the medical practitioner for the 2017 Invictus Games in Toronto, where she worked closely with service members and veterans.

Alani-Verjee added that this stigma can have a tangible impact on athletes. "When a person shares their mental health struggles, stigma can affect how they're recruited, how they are coached, what opportunities they're allowed to participate in," she said.

"It will affect how the crowd perceives them, it will affect sponsorships — and unfortunately, because mental health and mental illness are still seen as vulnerabilities and weaknesses and lack of willpower, for an athlete this could make or break a career."

Participation in other events to be determined

Biles is scheduled to defend her Olympic title in the all-around final on Thursday. She also qualified for all four event finals later in the Games, but whether she will participate remains to be seen.

She told reporters she is going to "take it a day at a time" before deciding what to do.

Alani-Verjee said Biles's decision to look after her own interests first could allow other athletes to vocalize their own need to take a step back from competition if that is what's best for them.

"I think that sets an incredible precedent for how athletes ought to be thinking about themselves and their performance, as well as how we ought to be treating athletes and humanizing their experience," she said.