Credit...Mitch Blunt

Pushed by Players, the N.F.L. Works to Embrace Mental Health

N.F.L. teams have standardized support for mental wellness as their players fight social stigmas and the league’s “just play through it” ethos.

Defensive lineman Solomon Thomas remembers sitting at lunch one day during his rookie season in San Francisco in 2016 and pointing out the 49ers’ team therapist at an adjacent table. “Oh no, we can’t go over there,” he said a teammate told him. “Otherwise, we look like we’re crazy.”

Thomas was surprised. He had played college football at Stanford, where he considered the team very attentive to mental health. But as he experienced his first N.F.L. practices and orientation meetings, he noticed that the issue was not so big a focus.

Players might have talked about stressful situations, he said, but there was little mention of sadness, anxiety or general check-ins about well-being, and players stayed quiet while trying to succeed in a profession of constant evaluation.

“It’s like you are being judged for everything you do,” said Thomas, now with the Las Vegas Raiders. “Guys are cut, traded and signed every day. As much as you want to say it should be different, it’s hard, because you might open up to someone one day, and they’re gone the next day.”

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In 2020, Solomon Thomas, now a Las Vegas Raiders defensive lineman, and his family started a nonprofit organization called The Defensive Line, which is aimed at suicide prevention, particularly among young people of color.Credit...Saeed Rahbaran for The New York Times

Thomas’s rookie impression in San Francisco was hardly unique. While some teams had introduced some type of mental health support system, back then there wasn’t a leaguewide protocol to help players deal with the N.F.L.’s next-man-up, just-play-through-it ethos.

In May 2019, the N.F.L. Players Association and the N.F.L. agreed to form the Comprehensive Mental Health and Wellness Committee, a panel of doctors appointed by both groups, which mandated that each team employ a behavioral health team clinician.

Seven teams now have a full-time clinician, and the rest of the clubs employ someone in the role for at least eight hours each week. As a result, more players have taken advantage, and have been more open about doing so.

Their outspokenness is part of a larger trend among athletes who are publicly emphasizing that mental health should be prioritized alongside physical care. In October, with the Atlanta Falcons’ support, receiver Calvin Ridley stepped away from football to “focus on my mental well-being.”

That week, Philadelphia Eagles tackle Lane Johnson disclosed that he had been absent from the team for three games while managing anxiety and depression.

Simone Biles, Naomi Osaka and other major stars have withdrawn from competitions after saying they didn’t feel mentally fit to compete. And for the past several years, N.B.A. players like Kevin Love and DeMar DeRozan have talked openly about mental health challenges.

But N.F.L. players said the shift within football had been more gradual. The mandated measures are new enough, and the league’s machismo culture entrenched enough, that some players, including Green Bay Packers quarterback Aaron Rodgers, argue that pro football lags other sports when it comes to fostering mental health practices and encouraging players to lean into that support.

“I think the N.F.L. is a dinosaur in that respect,” Rodgers said in a September telephone interview. “There’s a stigma around talking about feelings, struggles and dealing with stress. There’s a lot of vernacular that seems to tag it as weakness.”

Ravens defensive end Calais Campbell said that he did not feel comfortable talking about mental health when he entered the league in 2008 — “it was something you were afraid to even mention” — but that over his 13-year career he had come to see it as a key to his longevity. “This is a very stressful job full of changes,” Campbell said. “You have to be able to work through that. You need someone to talk to.”

He said having a full-time expert inside the team’s facility makes those conversations easier. Team clinicians offer players a wide range of wellness practices, from holding one-on-one meetings to offering sports performance exercises, meditation sessions and reading material. Sometimes, Campbell said, it’s as simple as a check-in about how the day is going.

“You don’t want there to be this idea that ‘I can’t talk about my mental health unless there’s a crisis,’” said Nyaka NiiLampti, the N.F.L.’s vice president of wellness and clinical services. “I want to be able to talk about my mental health in a way that’s from a healthy perspective.”

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“I think especially in the Black communities, even still in my family, people feel when you talk to someone it’s a sign of weakness,” said Calais Campbell, a Baltimore Ravens defensive end. “That’s something we’re still trying to break.”Credit...Jeffrey Phelps/Associated Press

“I don’t separate mental training from mental health,” said Christopher Carr, the Packers’ director of sports psychology and behavioral technician. Carr, who consulted for the team several years before being hired in a full-time role in 2020, said offering a 360-degree approach to players’ needs is vital. Carr teaches courses on mental performance, consults with players’ position groups and meets with them individually, recommends educational programming for players’ iPads and coordinates external resources.

Carr stands with the team on the sidelines at games, and he’s in the Packers’ facility every day that the team is. “There’s all kinds of touch points,” he said. “Being in the culture creates open doors to be integrated and helps develop trust.”

Each N.F.L. team works with its clinician to determine what might work best for that organization, deciding whether to hire separate employees for performance-focused training and mental wellness or to have a clinician like Carr serve in an all-encompassing role.

But the league’s power dynamics, in which treatment is provided through an employer with the power to cut, trade or not start a player, can create another barrier. “There’s an element of a trust factor,” said Ali Marpet, an offensive lineman with the Tampa Bay Buccaneers. “I think that’s some of the battle that our clinicians face if they’re employed by the club: These meetings stay here and everything that happens stays here.”

Other stigmas holding players back from treatment have roots beyond the N.F.L., in long-held social standards of masculinity.

“The masculine part of it is difficult, because there’s this idea that we grew up with about what it means to be a man,” Rodgers said. “This idealism that a man doesn’t cry, show weakness, talk about feelings. Until that kind of breaks down in society and we embrace that side of our personality and encourage those conversations, I think the stigma around asking someone for help is going to still be there.”

Roughly 70 percent of N.F.L. players are Black, and according to a report by the Substance Abuse and Mental Health Services Administration in 2019, non-Hispanic Black adults are half as likely as their white peers to receive treatment. In addition, the American Psychiatric Association this year apologized for racial inequities in care and research.

“I think especially in the Black communities, even still in my family, people feel when you talk to someone it’s a sign of weakness,” Campbell said. “That’s something we’re still trying to break. It starts with educating our youth and empowering them, so it’s a social norm. I’ve seen other players like Dak doing similar things — it has to be a collective process for all of us.”

Like Thomas, Dallas Cowboys quarterback Dak Prescott learned the value of talking to a mental health professional while he was in college. During Mississippi State’s spring semester of 2014, the year after his mother, Peggy, died of cancer, the university recommended that Prescott see a psychologist.

Initially, he viewed it as a punishment, saying to the therapist: “I don’t have a problem.” Still, his mother had always been the first person he turned to when he wanted to talk. As Prescott sat in the psychologist’s office, he realized that it helped to open up.

Before the 2016 N.F.L. draft, Prescott was arrested on suspicion of driving under the influence (he was later acquitted in the case). The Cowboys chose him in the fourth round, and that September the N.F.L. mandated that he see a psychologist unaffiliated with the league once a week, as part of the league’s drug and alcohol program.

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Dallas Cowboys quarterback Dak Prescott has been vocal about the importance of mental health, writing “Ask4Help” on his game-day wristband to promote suicide prevention.Credit...Cooper Neill for The New York Times

“I didn’t realize what it was doing for me then,” said Prescott, who helped lead Dallas to a 13-3 record in his rookie season. “But looking back, that’s why I was able to do what I did.”

Prescott said that he is in regular contact with the Cowboys’ mental health and wellness consultant, Yolanda Bruce Brooks, as well as the team’s mental conditioning coach, Chad Bohling, and that he realized that talking to a therapist on both good days and bad helped him be consistent on and off the field.

His brother Jace died by suicide in April 2020, and Prescott has said he dealt with anxiety and depression that year, in part brought on by a contract negotiation and his recovery from season-ending ankle operations. He has publicly stressed the importance of mental health, writing “Ask4Help” on his game-day wristband to promote suicide prevention and starting FaithFightFinish, a foundation that, among other things, encourages prioritizing mental health.

N.F.L. players face the same traumas, disorders and conditions that affect the rest of the population, but they may also seek treatment or support because of challenges specific to their careers.

Thomas’s sister, Ella, died by suicide in 2018, and he was depressed for months afterward. In February 2020, he tore the labrum in one of his shoulders, and, a month later, he had surgery for a bone spur in his ankle. He recovered in time for the season, but in only his second game, tore the anterior cruciate ligament in his left knee. Recognizing the onset of depression after another season-ending injury, Thomas began talking to a therapist and established his own mental wellness routines, which he has maintained.

During training camp, Thomas wrote in a journal every morning. Teammates would see and ask him about it, and he’d explain his daily affirmations and talk about his mindfulness practices, encouraging them to find their own routines and rhythms. In 2020, he and his family started a nonprofit organization called The Defensive Line, which is aimed at suicide prevention, particularly among young people of color.

He is hopeful about the cultural shift he said he had witnessed within the N.F.L. “I’ve seen how sensitive locker rooms can be now, in a loving and compassionate way — guys being such good teammates and being there for each other’s families,” Thomas said. “It’s definitely more open now.”

A correction was made on 
Nov. 29, 2021

An earlier version of a picture caption with this article misidentified an N.F.L. player. He is Solomon Thomas, not Calais Campbell.


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A version of this article appears in print on  , Section A, Page 31 of the New York edition with the headline: In a Sport Built on Machismo, Players Start to Open Up. Order Reprints | Today’s Paper | Subscribe

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