Bigger Than Basketball: How Mental Health in the NBA Is Being Addressed

by • May 23, 2019

The players spoke, and the National Basketball Players Association (NBPA) listened. Now, everyone who plays the game and watches the game is benefitting. In recent seasons, several NBA stars have begun privately and publicly discussing their experiences with mental illness, highlighting their struggles and urging others to seek care when needed.

In response, the NBPA launched its Mental Health and Wellness Program in May 2018. Leaders Dr. William Parham and former player Keyon Dooling have established a network of psychologists working in every NBA city. They’ve created a players-only informational website and a hotline, and they’re developing a newsletter, a podcast and an app to provide players with access to mental health resources and several entry points to confidential treatment and support.

SLAM spoke with Dr. Parham and Dooling separately about their groundbreaking work, the need to treat players as people before performers and the impact players are having on broader discussions of mental health in America.

THE DOCTOR: Dr. William D. Parham, Ph.D, ABPP, Director of Mental Health and Wellness, NBPA

SLAM: How did you get involved in the NBA and where did the specific idea for this position come from?

WP: When this position came up, I had been doing some ongoing consulting with the NBA and the NBPA. And simultaneous to that, in the last number of years there have been a number of marquee basketball players who have come out with their struggles. Kevin Love, DeMar DeRozan, Kelly Oubre, a couple of coaches. There are probably in this current crop about 15 athletes. But the mental health and wellness alarm has been sounding for many, many years.

And for me, in my observation, it’s no accident that all of these disclosures are coming out at the time of what I would call identity reclamation movements. In other words, when you look at #MeToo, when you look at Black Lives Matter, just as two examples, those are movements where people are basically saying, “I’ve had enough, I’m not going to take this anymore. We need to reclaim our identity and who we are as people.”

These players finally came out and said enough is enough, here is what I need to have happen in order for me to do better as a baller and as a man. And I want to go on record as saying that the NBPA listened to the voice of the players. What we are doing is a player initiative. And it is really is responding to current and longtime calls for assistance and support. 

SLAM: Can you walk me through the logistics of how a player gets help if they contact you?

WP: I or Keyon might have an initial outreach. We certainly would refer them to one of our identified resource persons. And depending on what the complexity of their story is, we would come up with a series of interventions that long-term could really help the person recalibrate themselves back to where he needs to be.

We certainly want to be the go-to resource both for players who have significant struggles with their mental health and wellness, but also want to add here that you have to look at mental health wellness not as a dichotomous experience. It’s not like you either have it or you don’t. Mental health and wellness really needs to be viewed on a continuum.

On either end of that continuum, understanding and awareness, support, encouragement are all necessary. And our goal is to meet players where they’re at, anywhere on that continuum, and be able to provide some sort of meaningful address to them. 

SLAM: Do you think there needs to be a shift in how teams handle problematic behavior from players? Because a player missing practice or showing up late or using drugs might be indicative of a larger mental health issue that’s going untreated, and simply punishing him or fining him might not accomplish anything. We see this in the criminal justice world where there’s a growing understanding that treating certain offenses as public health problems rather than criminal problems is beneficial. Do you think you’re seeing a similar shift like that in the NBA?

WP: I don’t see the shift happening yet. I do believe, as a psychologist, in the notion that I’ve promoted before, which is that of a smoke detector. If you went back to your home right now and opened your door, and your smoke alarm was going off, I doubt that you or anybody would go get a stool, step on it, take the smoke detector down, and go get it fixed. The fact that it went off is that it’s working, not that it’s not working. And not only is it working, but it’s calling your attention that there’s likely something else that needs to be fixed.  

When I see what might be termed as aberrant behavior, all of that is smoke detector behavior…It is an indication that additional investigation needs to happen. Additional questions need to be asked. Because there’s something else fueling this behavior that is now being expressed. And so punishment isn’t always the first thing that should be considered. 

SLAM: Your mantra is addressing the player before the performer, but those two are linked, right? Treating mental illness and trauma should lead to better performance on the court, shouldn’t it?

WP: Everybody in the world has baggage. So there are only two questions on the proverbial table: What’s packed inside and how many pieces of luggage are you carrying? With that aside, if in fact these ballers are carrying around some significant baggage—some of them who are playing at Hall of Fame levels of talent on a consistent basis—what would happen if you were to provide a place and a space for them to drop some of that baggage, and to begin healing? They would then in fact have increased success.

Being a man, being a celebrity, being African-American, being poor, being whatever, you are incentivized to say nothing and just play ball. But again, there’s a point at which the human part needs a break.

[Traumatic] experiences that happen at single digit age, that are very emotionally laden, what people—both men and women—develop with those early traumas, is akin to what I now call the invisible tattoos of trauma. Many people are walking around with invisible tattoos, incentivized to keep it hidden, but nonetheless it’s something that they need to integrate into their life’s journey as they negotiate their trajectory.

SLAM: And when you have Keyon and Kevin Love and DeMar DeRozan making those tattoos visible, they make it clear that other people can do the same and be supported and still exist in the League.

WP: They are members of an elite fraternity of ballers who distinguish themselves, whose vulnerability mirrors how much stronger they actually are, not how weak they are.

THE PLAYER: Keyon Dooling, NBA (2000-2013), Player Wellness Counselor, NBPA

SLAM: Do you encourage players to tell their stories?

KD: I don’t encourage anyone to tell their stories. I encourage people to get help. And in that healing process, you’ll be empowered enough to tell what you’ve experienced. Or share it. Or not. It’s totally a personal choice. I don’t think everyone has to share their experience, but I do want them to heal from what they’ve had to endure and what they go through on a daily basis.

SLAM: But people talking about it helps normalize it, right? And makes it easier for others to get help?

KD: Yeah it does. If we tear an MCL or an ACL or if we go down with a physical injury, people are very sympathetic toward it. But if you go through something mentally or emotionally, you know, in the past historically there’ve been some very negative stigmas associated with that. I think we’ve gotten past that. I think we’re more aware about our mental and emotional health nowadays.

SLAM: Speaking to stigma—a lot of that, especially in sports, is around masculinity, right? You’re working in these hyper-masculine environments that typically tell men not to talk about these things. How much does that affect your work?

KD: It’s a sport of a lot of machismo, a sport with a lot of ego and competition, so obviously there’s going to be some masculine energy there. But I don’t think it starts in sports. Though I think, you know in the past, sports-related mental or emotional problems were weakness, and so I think a lot of people mask their pain in silence. But I also think it’s a society problem. As a man, we’re told to shut up. Don’t cry. Suck it up. Be tough. What it does is it programs us to internalize things. And then what will happen as we get older, those things will start changing in us…and we start acting out and masking our pain or our behaviors or our anger, whatever the case may be. Whatever the vice may be. I just think that nowadays we’re just fighting those tall stigmas. And I think there are a lot of brave people who are speaking about that.

SLAM: Another stigma is the race aspect. Because in African-American communities, mental health stigma tends to be stronger, and the League is mostly black. Does that shape how you approach players?

KD: Yeah, I do think you have to consider the cultural connections around mental health. Look, for the African-American experience, it’s been varied generationally. The resources around mental health aren’t in a lot of these communities, the awareness. And I think now it’s just starting to really catch up. But I don’t want to make mental health unique to the African-American community. I live in the suburbs now and I see mental health challenges everywhere. But I do think there is a specific connection with our players from the inner cities and some of the things they had to see. And then there’s a lot of healing opportunity if they can actually do their work.

SLAM: And they can then model mental health discussions for people who are living in those communities who are fans of the game.

KD: Right, right. That whole routine around your mental and emotional health is very important. But the first step is knowing that you’re not crazy because you’re going through something. You might just be traumatized. You might be grappling with grief. You might be hurting from your past. You might be nervous about your performance. So it’s not all in one brush.

SLAM: Dr. Parham described it as treating the person, not the performer. 

KD: Right. Yeah, Dr. P’s got some bars, dog. He’s got some bars. 

SLAM: You played for 13 years and now you’re doing this work. That’s a long time to be associated with the League. What kind of shift have you seen over that time span in the attitudes toward mental health in the NBA?

KD: Night and day. Night and day. There was a lack of empathy and sympathy for people who were going through challenges emotionally. A lot of times, I think the lack of diversity within staff would make it abnormal if somebody was acting out. But I think we’ve done a great job of diversity and inclusion in our league. And putting people from communities who can understand some of the experiences of guys and help them cope and get through.

And so I just think the whole game has changed. I would say that with [NBA Commissioner] Adam Silver and [NBPA Executive VP] Michele Roberts, since their tenure, they have put a big emphasis on mental and emotional health. And I think everybody knows how important it is now, and so it’s just a good time to heal. 

SLAM: One difficult instance that comes to mind is the Royce White situation. He was critical of the way the league responded when he spoke out about his mental health. And he still says it’s part of the reason he’s not in the league. Does his experience factor into how you shape the program? 

KD: Well obviously you think about everybody’s experience around mental and emotional health. I know Royce’s issues are totally different from Ron Artest, totally different from me or Chamique Holdsclaw. And sometimes with mental health, they all get lumped together. And it’s really unfair to lump everybody’s issues together. Royce has done a great job sharing his experience. And if he would have come around during this era where we are more mentally aware, maybe it could have been a different story.

SLAM: The goal of the program is to serve players. That’s the priority. If there are players reading this, what would your message be to them about how to approach their mental health?

KD: I would say the biggest room in your life, the biggest room in the world, is the room for improvement. No matter what you’re weak at, no matter what you’re going through, healing is possible, getting better is possible. And the same way we can work on our handles and our jump shots is the same way we can work on our emotions and our behaviors.

SLAM: And that applies even to non-players. Even to the fans watching.

KD: That goes for everybody. It is not unique to players. This is universal.


Vinay Krishnan is an attorney and a writer living in Brooklyn. Follow him @vinayrkrishnan.

Photos courtesy of the NBPA.