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'The helper of the players': Former tennis player teams with US Open to take on mental health

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NEW YORK — Mardy Fish can still pinpoint the moment, just about nine years ago, when his anxiety crossed through the thick white lines. It was the type of scenario that most tennis players dream of — primetime at the U.S. Open, headlining a match at Arthur Ashe Stadium — but by the end of it, Fish didn’t feel relief or joy. He defeated his opponent, Gilles Simon, 6-1, 5-7, 7-6, 6-3, earning a date with Roger Federer in the fourth round, and he felt agony.

It started in the fourth set. Fish was up two sets to one, and he saw it was after midnight. The set was at 3-2, and instead of thinking about how to close it out, he was thinking about what was to come: the press conference, the massage, the meal, the ice bath. He added all of that time up, and realized he might not go to sleep until 4 a.m. And then he thought about the next day, and how it would feel, probably like a hangover, even though he hadn’t had a drop of alcohol. And then he thought about his mind, and how it would run then, just as it was running now.

“I was already thinking about the anxiety that I was going to have,” he said. “I was getting anxiety thinking about the anxiety.”

Until that evening, Sept. 1, 2012, Fish could count on a 78-foot long, 27-foot wide rectangle to give him space from the voices in his head. Now, he felt like his last safe haven had been ripped away. On Sept. 3, Fish withdrew from his match against Federer — arguably the most important match of his career — after having multiple anxiety attacks on his way to the court.

He says he was lucky. The match against Simon had ended so late that there were few reporters at his post-match press conference. If Fish had played in the afternoon, it likely would have been a different situation.

Naomi Osaka returns to a Grand Slam as she plans to play in the U.S. Open, which she won in 2018 and '20.
Naomi Osaka returns to a Grand Slam as she plans to play in the U.S. Open, which she won in 2018 and '20.

“I imagine it would have taken me a long time to try to gather up the mental energy to go and answer questions,” he said. “Maybe I would have tried to get out of it and gotten fined, or maybe I would have tried to push through. I don’t know.”

This is a dilemma that has been expressed by more and more athletes across the sports landscape in recent days, months and years, one that U.S. Open leadership has taken note of.

Stacey Allaster, tournament director of the U.S. Open, said she started rethinking the U.S. Tennis Association’s (USTA) approach to mental health as early as last year’s U.S. Open, while she observed the impact of the pandemic on players. Then, in May, Naomi Osaka pulled out of the French Open, after a bitter back-and-forth over media obligations between herself and tournament officials, explaining in an Instagram post that she was struggling with depression and anxiety.

“The Naomi situation at Roland Garros was a piece of the puzzle,” Allaster said. “And I think for me personally, during the Olympic Games, just seeing how athletes’ mental health really rose to the spotlight, just gave me this personal catalyst to say, we've really to look at this.”

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One of Allaster’s first calls was to Fish, who has become somewhat of an ambassador for players struggling with mental health. (He says that since he opened up publicly about his own struggles a few years ago, he has been contacted by dozens of athletes.)

In collaboration with Dr. Claudia Reardon, a professor at the University of Wisconsin, and Dr. Brian Hainline, the USTA’s first vice president and NCAA’s chief medical officer, they devised a six-part plan, dubbed the “USTA Mental Health Initiative.” Reardon will serve as a mental health consultant throughout the Open, while Fish, the current U.S. Davis Cup captain, will be an “athlete mental health ambassador,” or, as he puts it, “the helper of the players.”

Entering this year’s U.S. Open, which starts Monday, players will have access to licensed mental health providers, who will be available 24 hours a day, seven days a week. In previous years, this type of support has only been provided upon request. Quiet rooms and recovery services will be available at hotels and on site at Flushing Meadows. Reardon, an expert in sports psychiatry, will continue to consult with USTA officials, to make sure that their processes and procedures keep mental health in mind.

But the most dramatic change, in light of Osaka’s actions over the past few months, might be in handling media availability.

While the USTA maintains that there will be no rule changes regarding post-match press conferences, it concedes that more options for the athletes will be considered. The current rule states that unless an athlete is “injured and physically unable to appear, a player or team must attend the post-match media conference organized immediately or within 30 minutes after the conclusion of each match,” adding that a violation will incur a $20,000 fine.

At the U.S. Open, athletes can undergo a post-match mental health evaluation, if they request it, or if someone around them notices that they are struggling. Reardon and Allaster said they intend to treat an athlete’s mental health just like they would any other injury. If the U.S. Open medical team determines that it wouldn’t benefit an athlete to do a post-game press conference — whether it’s because of an ankle sprain or a something anxiety-related, for example — that player will be excused from the obligation. If the player does not receive clearance from the medical team, and declines to do the post-game press conference, the tournament referee will decide whether to issue a fine.

“Historically, I think people saw this artificial divide between physical and mental health,” said Reardon. “I think that now, when we talk about the health of an athlete, it's understood that, of course, we mean the brain, of course we mean mental health. So when we're thinking about what it means for an athlete to be able to safely meet with the media in a way that's not going to exacerbate an acute medical problem, that means that we also consider what mental health condition could be worsened in that circumstance.”

It won’t always come down to whether an athlete will meet with the media or not — other possibilities include pushing back media sessions by a few hours or passing along questions through a tour communications official — and Fish says that they’re still in the process of hammering out logistics. Identifying who needs help, when dealing with a mental illness that doesn’t manifest itself physically, could be difficult, and tennis doesn’t lend itself to emotional vulnerability.

“It’s such a one-on-one sport, and so we’re trained to never show negative thoughts,” Fish said. “‘Don’t throw your racket, don’t show them that you’re upset, don’t show the other player that you’re tired or hurting, or something like that. Any other injury to the body, you can see it — you have a cast on your arm, you’re limping — but you can’t see that someone’s suffering with their mental health. So that’s what makes it so difficult to talk about. I’m trying to show people that it’s okay to show fear and discomfort. I think that’s actually showing strength.”

Another concern is that players will attempt to use the increased flexibility as a way to skirt media obligations, without incurring a fine. But Fish hopes that players will respect an empathy-based approach, and understand that the USTA is implementing it for their benefit.

“When Mardy was talking about his experience in the locker room (after his match on Sept. 1, 2012), he didn't know he could raise his hand, that he didn't have to do press, because of his mental health,” Allaster said. “He didn’t feel comfortable telling people he had an issue. We're now trying to open up that conversation. There was a 'tough it out, come on,’ kind of mentality, and it should just be, “okay.” That's where we need to get it.”

This article originally appeared on USA TODAY: US Open aims to take on mental health as tennis tournament begins