When Demmar Hamlin suffered cardiac arrest at the Buffalo Bills unscathed and collapsed on the field in the middle of a “Monday Night Football” game in Cincinnati on Jan. 2, Carrie Hastings, half a continent away, understood what she had to do — and right away.
“I had a few guys that I kind of immediately knew I had to check out,” said Hastings, a sports psychologist and mental health physician for the Los Angeles Rams. “A couple and significant others, too.”
Hastings’ familiarity with the Rams personnel, which players can experience trauma after witnessing Hamlin’s traumatic medical emergency, was a product of her having spent six seasons with the club – getting to know the athletes, getting to know the rookies when they first arrived, and making herself a regular presence at the Rams facility .
Across the NFL, there is no such continuity of sponsorship. The league is working its way toward a type of mental health support for players, coaches and staff where a range of counseling is standard and easily accessible.
Just over three years ago, in 2019, the NFL implemented official programme To manage the mental health needs of its employees. This came as part of a new collective bargaining agreement, after the NFL Players Association lobbied hard for its creation. Among other things, the agreement requires that each team have a licensed behavioral health physician.
But individual franchises still have a lot of freedom in implementing this directive. Some have full-time sports psychologists; Others hire doctors part-time, Hastings said, while a few contract outside providers and make them available to players. Doctors are not required to have any sports background, which some sports psychologists consider a critical shortcoming.
“This is a very specialized area,” said Sam Manyar, a psychologist who counsels the Cleveland Browns and previously served as the team’s full-time physician. “The athletics environment, especially at the highest level, is something that requires specialization, and not every doctor brought into the NFL has that.”
A sprinter and hurdler in her college years at Notre Dame, Hastings has deep professional experience with athletes and is listed on the US Olympic and Paralympic Committee’s registry for Sport Psychology and Mental Training. She maintains her own practice a short drive from the Rams’ training facility in Agoura Hills, northwest of Los Angeles, and though she technically works part-time, Hastings said she’s at the facility three or four times a week “and mainly under Demand 24/7 during the season.”
In this capacity, Hastings has worked to build a foundation of trust with elite athletes who often think of a sports psychologist only in terms of getting them ready for competition.
“Often the player comes up with something related to performance, and that opens the door to conversations in other areas of mental health,” she said. “The relationship is deepening.”
This kind of ingrained presence with teams, doctors say, is crucial, especially as some athletes have begun to talk more openly about the mental and emotional challenges they face and indirectly encourage their peers to be more open for help.
Tennis sensation Naomi OsakaOlympic gold medalists Simone Biles and Michael Phelps, are also NBA stars Kevin Love and DeMar DeRozan have all publicly discussed the mental health challenges they face over the past decade, and several have led campaigns to raise awareness. Outside of his relationship with Brown, said Manyar, who runs a sports performance center in Ohio and works with college and high school football teams.
The NFL is a difficult arena for such conversations. Players in the league are accustomed to working through practically all kinds of pain and injury as a job requirement, and for as long as the league has existed, athletes have been primarily trained to show no weaknesses.
Implementation of a comprehensive programme, while an important milestone, has not drastically accelerated the pace of change. “I think the NFL is still a dinosaur in that regard,” the Green Bay Packers quarterback said said Aaron Rodgers The New York Times two seasons ago. “There’s a stigma around talking about feelings and conflicts and dealing with stress. There’s a lot of slang that refers to vulnerability.”
The players’ association has become more aggressive in addressing the issue. “NFL players are often viewed as the pinnacle of masculinity, and because concern for our mental well-being and seeking support have not historically been associated with masculinity, many of us do not prioritize this aspect of our health,” says NFL President JC Tretter, an NFL veteran. American football for eight years, wrote in a 2021 blog post For players, urging them to take advantage of the available resources.
Hastings said that Hamlin’s unusual emergency, in which he required CPR on the field before being transported to a hospital from Cincinnati Stadium where the Bills and Bengals were playing, “concerned some players, worried others.” In addition to contacting several players individually, she sent a message through the Rams organization to remind the athletes, coaches, and staff that she was available to speak.
“A lot of them were responsive,” Hastings said. “The elephant in the room is death. The players know they can get injured, and they’ve all dealt with injuries, but this included an element they have no control over.”
The players from the Bills and Cincinnati Bengals stood in stunned silence as Hamlin lay on the field. Days later, the Buffalo players are still struggling to express their feelings. “The scene plays out in your head,” quarterback Josh Allen said during a press conference. “It’s hard to describe what I felt and how my team-mates felt in that moment. It’s something we’ll never forget.”
Hamlin’s subsequent progress, including being released from hospital care to recover at home, “will help alleviate some of the trauma players are going through,” said Dr. Joshua Norman, an Ohio State University sports psychologist who often works with athletes in processing emotions. . . “But even though they’ve tried to break things down, these players have seen a serious injury. Some of them will have a strong reaction.”
Dr. Claudia Reardon, a psychiatrist at the University of Wisconsin, said the term “vicarial trauma” applies in this case. “The original traumatic event did not happen to you personally, but it is painful to have witnessed or learned about,” Reardon said. She said reactions range from fear and helplessness to nightmares and flashbacks, and some athletes will try to avoid “people, places, or things that remind them of the trauma they witnessed.”
“I wouldn’t be surprised to see some players retire early,” Maniar said. “The big concern is for a player to go out and play with hesitation or fear. That’s a sure way to get hurt in a sport like football, and this is a league where contracts aren’t guaranteed. You’ve heard the saying, ‘The NFL isn’t for long.’ Players feel that pressure.”
Doctors say the NFL’s best chance of making strides in its coverage of mental health may stem from the simple fact that it is constantly drafting and developing new talent. “The younger generation is more sophisticated in terms of mental health, period,” Norman said. “They come to campus often after they’ve already established some connection to their mental health needs, through counseling or other means. They’re more open to the idea of dealing with their mental health.”
Within the franchise complexes, work continues. Both Hastings and Maniar were hired by their NFL teams years before the league made doctors mandatory, and both made sure to keep an office away from the training facility for those players who weren’t comfortable seeing them in action. But Hastings said that, too, has been changing recently.
“Players talk about these types of issues with each other often, and they do so very publicly,” she said. “In many ways, we’ve built our mental health protocol since I started working in 2017.” In the NFL, it proves to be a slow turn.