MLB officials happy with new system to address mental health

The 2023 MLB season ought to be remembered for the inception of the pitch clock, banning of the shift and the speeding up of the game.

And one other thing: it’s the year the MLB saw more players speak up about mental health struggles and utilize the injured list to deal with issues related to anxiety.

Three players this year have already spent time on the IL for anxiety: A’s reliever Trevor May, who spent more than a month on the IL before returning to the A’s in late May, Rockies reliever Daniel Bard, who started the year on the IL but returned in April, and Tigers outfielder Austin Meadows, who went on the IL after six games and has yet to return.

It represents progress from two years ago, when Sports Illustrated reported there were more than a dozen players on the restricted list while batting mental health struggles. The difference? Players on the restricted list often go without pay and access to health services; players on the injured list continue receiving the same benefits as an active player.

“We’ve had the option for mental health IL placements for a few seasons now, but we have in the last year or two seen an uptick,” said Jon Coyles, MLB’s vice president of drug, health and safety programs. “It’s been at least five or six years we’ve had this option available. We’re just seeing it used more now.”

Dr. Larry Westreich, a practicing psychiatrist in New York who also serves as MLB’s consultant on behavioral health and addiction, has been assisting MLB for two decades. He was originally hired to help players combat the use of steroids and other drugs.

“It’s become well known that we treat mental health injuries the same way we treat physical injuries,” he said. “I think all the major sports are putting mental health in the foreground and society in general is doing that. COVID brought it to the floor… It normalized it for everybody.”

Each team is now required to have at least one mental health specialist on staff, although many teams have added multiple clinicians.

When a player is struggling, they’ll have confidential access to the team’s clinician. And if an injury list placement is required, Westreich must sign off on the decision.

“We look for a clear diagnosis, a clear treatment plan and a prospective return to work,” he said. “Obviously that third thing is not something you can necessarily tell when guys walk into the door.”

Westreich made it clear that there’s a difference between players who are nervous to perform on a one-off basis — a regular feeling for just about every athlete at some point — and a diagnosis from an ongoing issue.

“Usually people have serious mental health problems that are being dealt with that are not allowing a person to function the way he wants to,” Westreich said.

In May’s case, the A’s were aware of the his struggles with anxiety well before the injury list placement. The 33-year-old relief pitcher said the league has created a smooth process for players who are struggling.

“It’s not that tough,” he said last month. “Every team has a psychologist on staff or someone who is trained in that bucket and usually it’s a conversation with them. It’ll never be a situation where they’re like, ‘nah, he’s fine.’ That probably will never happen.

“For the most part it was painless. Everyone was on board. Everyone is supportive.”

The only difficult part for May was the embarrassment.

“You never want to say, ‘hey, I can’t go play a kid’s game because of circumstances I’m not going to fully get into,’” said May, who has a 1.50 ERA in five outings since returning to the A’s. “There’s a little bit of that. I’m big on honoring commitments. I don’t want to leave these guys hanging… but I think I am on the up and up. And hopefully have a nice toolbox full of stuff I can use to feel better.”

Shana Alexander, a sports psychologist and the director of mental health and wellness for the Giants, said she’s seen MLB evolve quickly in the level of attention it’s paying towards players’ mental health.

“I think one thing I’ve noticed is several key players have spoken to the media about their individual therapy and named me in their work and talked about how it’s made such an impact on their performance and mental health,” she said. “To me, that represents a huge stride because before they didn’t even want to disclose they were talking to a therapist, much less talking about it with the media.

“It helps so much with the destigmatization of mental health, not only for other baseball players but for the general population. Younger athletes or anyone in general who follows baseball and idolizes some of these players. They’re so open and vulnerable about their journeys.”

Alexander would like to see a mental health specialist in the dugout traveling with the teams. And a regularly scheduled mental health training session added to every players’ daily schedule, just as they do with stretching, weight-lifting, throwing and hitting.

“It could be a variety of techniques: meditation, talking, visualization, all those sorts of things,” she said.

The most common issue players deal with? Imposter syndrome, in which players can doubt their abilities and sometimes feel like their success has been fraudulent.