Doctors hope Jarren Duran’s brave admission sparks mental health conversation

• Part 2: What can teams and leagues do to better impact the mental health of their athletes?

Members of the psychology and psychiatry community, most who have never met Jarren Duran, shared the Red Sox outfielder’s hopes this week.

On Wednesday, the documentary “The Clubhouse: A Year with the Red Sox” was released on Netflix. In the fourth episode, Duran, who has talked about his mental health struggles in the past, admitted he’d previously attempted suicide in 2022.

“I got to the point where I was sitting in my room, I had my rifle, and I had a bullet, and I pulled the trigger and the gun clicked, but nothing happened,” Duran said. “To this day, I think God just didn’t let me take my own life because I seriously don’t know why it didn’t go off. But I took it as a sign of like, ‘All right, I might have to be here for a reason.’ So that’s when I started looking myself in the mirror, after the gun didn’t go off. I was like, ‘All right, do I want to be here or do I not want to be here?’”

When speaking about that admission this week, Duran said he hoped it would help other people, especially kids, who were battling the same feeling and mental health issues that he was.

His revelation was national news. Around the country, in addition to appreciating Duran’s bravery for coming forward, doctors hoped what he said would spark important conversations about mental health among athletes. His admission created an organic opportunity to increase awareness.

“It’s a huge thing for him to come out and say this for a couple reasons. First, over the past 20 years, we’ve actually seen the suicide rate among athletes and student athletes double,” Dr. Mena Mirhom said. “We’re very proactive about not missing an injury physically in so many ways, but we really need to be much more proactive about not missing an injury on a mental health standpoint.”

Mirhom, a sports psychiatrist and assistant professor of psychology at Columbia University, is the Chief Well-Being Officer for Athletes for Hope.

Founded in 2006 by a collection of former athletes including Muhammad Ali, Warrick Dunn, Mia Hamm, Jackie Joyner-Kersee, Jeff Gordon, Andre Agassi, and Alonzo Mourning, Athletes for Hope was created to help athletes and former pro athletes.

In addition to philanthropy and charitable efforts, it’s become a place where athletes can find valuable mental health resources.

“How do we help athletes understand their own mental health, and how do we help teams better understand how to support an athlete?” Mirhom said.

Dr. Tim Wilens is the chief of child and adolescent psychology at Mass General Hospital. He’s the former medical director of MGH’s sports psychology program and has treated NFL players. He thought kids especially would benefit from Duran’s revelation.

“Any time, a role model, somebody that you see on TV, who’s at that level, opens up about something that resonates with you, in this case, depression,” he said. “It really destigmatizes it and helps you feel more likely to get to reach out for assistance, to talk to other people about it, and to see it as more normal human experience as opposed to something that’s inherently flawed in you that there’s no help for.”

Still battling perceptions

Fostering awareness and debunking misconceptions is critical.

Awareness has come a long way even in just the last 10 years. Since then, elite athletes across many sports —Serena Williams, Kevin Love, Michael Phelps, Simone Biles, Brandon Marshall — have revealed their personal struggles.

Duran’s revelation has rekindled the conversation.

The challenge for doctors, especially those who work in athletics, has been breaking down long-held misconceptions and pushing through the ethos of certain sports.

Athletes are as likely to battle mental health issues — and in some cases more likely — than anyone else.

Dr. Eugene Hong is the chief medical officer for Clemson athletics and the chief physician executive at MUSC Health in South Carolina. He’s worked as a team physician with college teams for over 25 years.

In 2015, he and two other doctors published a paper in the journal “Current Sports Medicine Reports” titled “Depression in Athletes” focused on the prevalence and risk factors. The article and others like it helped debunk the idea that because they exercised, athletes were less prone to suffering mental health issues.

“Even though there’s much more awareness than there was when I started out,” Hong said, “in my experience and my belief, we’re still battling that perception that because someone’s an athlete, no way could they be depressed, no way could they have thought about suicidal ideation, and that’s simply not the case.

“It’s not true, but there’s this perception that still to this day exists,” he continued. “So that’s one of the big parts of the value of something like Jarren Duran and the Netflix documentary.”

In addition to other life factors that can affect mental health, athletes’ struggles are more public, which was portrayed clearly in Duran’s case. When athletes fail, people see it and often scrutinize it. Duran talked extensively in the Netflix documentary about those challenges. Because being an athlete is so closely tied to identity, the criticisms aren’t just of how they played but who they are.

“Many athletes at different levels, college, certainly and professional, their self-identity is wrapped up in them being an athlete,” Hong said.

So when a player isn’t playing well or is injured, that impacts how a player perceives themselves and how they believe people perceive them.

Resources to address those issues vary from team to team and league to league. Some teams have psychiatrists and/or psychologists as part of their staff. Others provide a directory — often through the players’ associations — the athletes can access when they need care.

High-functioning, silent suffering

For teams, the value goes beyond helping someone through a challenging time. There are clear, tangible benefits. An athlete’s performance is likely to improve with their mental health.

“Athletes, by definition, are high-functioning and prone to silent suffering. In the data we see, sometimes up to 40 percent of athletes could be experiencing significant anxiety symptoms that they’ve learned to work with and worth through,” Mirhom said. “It feels like game jitters or performance pressure. That kind of stuff. But when you unpack that a little bit, it could be up to 1-in-4 athletes are dealing with something that’s diagnosable that we can treat.”

But even players who aren’t experiencing a medical condition can benefit from mental health professionals.

“Even if you’re not dealing with something diagnosable, 100 percent of the people on the field or on the court are looking for strategies and more effective ways to sleep and more effective ways to manage their emotional and psychological injury after a loss or not playing well,” Mirhom said. “These peak performance life skills apply to everybody. You don’t have to have a diagnosis of insomnia to learn more about how to optimize your sleep. You don’t have to have a diagnosis of anxiety to learn better ways to control your heart rate in a moment of difficulty.”

Hong said drawing the link between improved mental health and improved performance can help convince skeptical coaches about the value of having psychiatrists and psychologists involved with an organization.

“These mental health conditions if they go undiagnosed, can impact performance,” he said. “Why aren’t we paying more attention to this because ultimately the athlete wants to perform as well as they can on the field or the court and the coach wants them to do that too. So it’s a kind of missed opportunity, if that makes sense, and we don’t talk about that enough in my opinion.”

A player who is addressing their mental health issues properly is also less likely to turn to substance abuse as a method of coping. Athletes are uniquely vulnerable to substance issues because they’re often prescribed painkillers to help both manage pain and get back into action.

Being injured can produce not just physical pain but mental health issues related to identity when the ability to play is compromised. The temptation to overuse painkillers to address both issues can be a concern.

Incidents of domestic violence among athletes are likely to decrease when the athletes are addressing the root causes of their frustration and anger in a healthier fashion.

“This could be a game-changer. When you leave something unaddressed, it’s something that’s building up, that’s stacking one after the other, where it winds up manifesting, is at home, with a partner, with a family member,” Mirhom said.

Things are improving. Society’s collective understanding of mental health issues has expanded. Sports are following a similar path.

“We are moving in the right direction,” Hong said. “Just as sports medicine doc, I want us to move a little faster in terms of providing mental health care.”

Mirhom was encouraged by the progress and hoped it would continue.

“On one hand, this is much better than it was 10 years ago because the conversation wasn’t really happening. Pro athletes, baseball or otherwise, we weren’t talking about mental health or mental injury at all. The progress is good. The advocacy is there. The conversation is there.

“But for some teams it’s kind of a check box. It’s not substantial enough that it makes a difference. It’s more of being able to say, ‘Hey we do it too. We care.’ The degree to which a team puts their resources behind it still varies a lot. On an ideal team, when you’re caring about the whole person and making sure that they’re not just doing well as a player, but doing well as a person. You want the psychologist or psychiatrist to pick up trauma, to pick up susceptibility to substance use, to pick up the possibility where there could be suicide involved or major illness.”

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If you or someone you know is thinking about suicide, you are not alone.

Samaritans Statewide Hotline: Call or Text: 1-877-870-HOPE (4673)

National Suicide Prevention Lifeline: 988 or 1-800-273-TALK (8255) Press # 1 if you are a Veteran

The Trevor Helpline: 866-4-U-TREVOR (488-7386) Support designed for lesbian, gay, bisexual and transgender youth and young adults