Although she has withdrawn from the French Open, tennis star Naomi Osaka this week scored a victory that athletes and advocates say will have an enduring impact by putting athletes’ mental health in the global spotlight — and sending a warning shot to the sports industry that it cannot disregard the well-being of those who play the games.

With her back-to-back rejections of tennis tradition — refusing to participate in mandatory news conferences, then pulling out after the tournament fined her and threatened disqualification — Osaka also became the latest high-profile athlete to challenge the rules and traditions of a powerful sports organization they believe does them harm.

She follows star Olympic gymnast Simone Biles, who in 2018 refused to return to USA Gymnastics’ training center at the Karolyi Ranch, where she and numerous other young athletes had been sexually assaulted by a team doctor, prompting the organization to close the facility. More recently, at the height of the pandemic in the United States, roughly 500 Pac-12 Conference football players dictated health and safety protocols under which they would agree to compete.

Former Women’s Sports Foundation president Julie Foudy, a two-time Olympic champion and ex-captain of the U.S. women’s national soccer team, said Tuesday that Osaka’s actions mark a potential paradigm shift, forcing sports governing bodies to help safeguard athletes’ mental health.

Naomi Osaka, on May 31, withdrew from the French Open out of concern for her mental well-being. (The Washington Post)

“It sparked a discussion that’s long overdue,” Foudy said. “I think most organizations, leagues and team owners do a terrible job of addressing this, even though you have athletes who are speaking up more and more and having the courage to say, ‘I have some things I’m dealing with and need help.’ Organizations can’t just keep sweeping [it under the rug] or threatening.”

It is a cause that Nancy Hogshead-Makar, a three-Olympic gold medalist in swimming, has championed for years through her work as a civil rights lawyer and athlete advocate.

“I don’t think most people thought about a female athlete’s mental health in that interview room until now,” Hogshead-Makar said. “It was obvious Naomi Osaka didn’t like news conferences, but few appreciated that she is just 23 and that she found them torturous. She was expected to deliver substantive responses that many tenured professors would have struggled to provide. It is embarrassing that we are only now recognizing the humanity of our athletes.”

Osaka’s actions are a “wake-up call” to athletes, too, said Ramogi Huma, executive director of the National College Players Association, an athlete-advocacy group founded in 2001.

“Her taking that stance is a signal to athletes everywhere that it’s up to them to ultimately look out for their own well-being,” Huma said. “It is also a wake-up call for governing bodies; you wouldn’t require an athlete with a broken leg to do sprints. For the same reason, you shouldn’t require an athlete struggling with mental health to do interviews against her will.”

Ultimately, Huma believes, the controversy speaks to a profit motive. “When you make athletes available, it increases the visibility of the sport; it can enhance viewership and help maximize media rights deals,” he said. “But at what cost?”

Pushing back on press

A four-time major winner, Osaka announced last week she would skip the French Open’s mandatory news conferences, citing their impact on her mental health. She was castigated online by sports fans who viewed her stance as the complaint of an entitled millionaire athlete shirking her contractual responsibilities. And after Osaka skipped her first news conference Sunday, the French Open, joined by the heads of the three other Grand Slams, fined her $15,000 and noted that she faced potential disqualification if she persisted.

It wasn’t until Monday, when she withdrew from the event, that Osaka disclosed that she had battled “long bouts of depression” since her 2018 U.S. Open victory — an emotional win over fan-favorite Serena Williams — and suffered anxiety over the prospect of fielding questions from the media.

On Tuesday, the French Open issued another statement, striking a more compassionate tone: “On behalf of the Grand Slams, we wish to offer Naomi Osaka our support and assistance in any way possible as she takes time away from the court. She is an exceptional athlete and we look forward to her return as soon as she deems appropriate.”

The Women’s Tennis Association created a mental health and wellness team more than 20 years ago, according to a spokesperson, and has a health-care provider available to its athletes at all tournaments, including Grand Slams. It is unclear whether Osaka sought help from or took advantage of the program.

According to Jeffrey A. Lieberman, chairman of psychiatry at Columbia University’s College of Physicians and Surgeons, part of the challenge in understanding the gravity of mental illness is that terms such as “depression” and “anxiety” are frequently used in a casual sense, describing a mood or state that can be weathered with sufficient will.

“Clinical depression is a completely different animal,” Lieberman said. “It is excruciating to the point of not just being emotional but physical.”

Although elite athletes are exceedingly disciplined and determined, he noted, that doesn’t mean they are immune from mental illness. Moreover, ignoring the illness, or being rebuffed in seeking help, can lead to detrimental or even disastrous consequences. He cited the suicide of Hall of Fame NFL linebacker Junior Seau, who was found to have a degenerative brain disease, and the shortened career of top-10 tennis player Mardy Fish, who retired in peak form because of a panic disorder.

“The question becomes: How does [a tournament or sports organization] accommodate that in terms of a policy?” Lieberman said.

Hogshead-Makar believes the obligatory postgame news conference may be due for an overhaul.

“[Why] have older, more experienced, mostly White men critique Naomi Osaka on the court and then again in that room, when she has ready-access to the public about her performance through her social media?” Hogshead-Makar said. “She is available to the press lots of other times besides that post-competition grilling.”

‘Not everyone is the same’

Osaka, who was born in Japan to a Japanese mother and a Haitian father and moved to United States at 3, has long described herself as shy. At 20, she confessed in a news conference she didn’t know how to start a conversation with someone she was meeting for the first time.

Nonetheless, she displays freshness and candor in her often-expansive replies at news conferences. So it wasn’t clear, at least to many outside her immediate circle, that she experienced deep anxiety over the mere prospect of fielding journalists’ questions. She explained as much in her statement Monday announcing she was withdrawing from the French Open and taking an indefinite break from competition.

Osaka vaulted into public eye in March 2018 upon winning her first WTA tournament at Indian Wells in California. In her mind, the victory was overshadowed by her struggles in delivering her on-court acceptance speech, which she concluded by saying, “This is probably going to be the worst acceptance speech of all time.”

In the news conference that followed, she elaborated.

“I knew what I was going to say in which order,” she said. “But then when he called me, I freaked out. And then I just started saying whatever came into my mind first, which is why I think I kept, like, stopping halfway through my sentences, because I just remembered something else I had to say.”

Six months later, she won her first Grand Slam title by toppling Williams in the 2018 U.S. Open final. But what should have been a shining, indelible moment was marred by the torrent of boos the raucous New York crowd unleashed on the umpire, who had docked Williams a point and then a game for successive violations of the sport’s Code of Conduct.

Osaka later called the tearful victory “a little bittersweet.”

Now, Osaka, the world’s highest-compensated female athlete, is scheduled to embark on a three-month stretch in which the media glare will be more intense than ever, with Wimbledon following the French Open and the Tokyo Olympics just weeks after that.

When she returns, she’ll have the support of athletes from multiple sports, many of whom criticized French Open officials for not supporting the world No. 2.

“I feel for Naomi,” Serena Williams told reporters Monday after her first-round win. “I feel like I wish I could give her a hug because I know what it’s like. We have different personalities, and people are different. Not everyone is the same. I’m thick. Other people are thin. Everyone is different, and everyone handles things differently.”

Three-time WNBA MVP Lisa Leslie posted on Twitter: “It’s so sad that we are in a time that when a young person tells you they need help or a break, people respond with anger and a lack of support! I stand with you @naomiosaka. Your mental health is just as important as your physical health.”

Wrote Golden State point guard Stephen Curry: “You shouldn’t ever have to make a decision like this-but so damn impressive taking the high road when the powers that be dont protect their own. major respect @naomiosaka.”

Fish, 39, the former tennis pro and current U.S. Davis Cup captain who battled anxiety, wrote on social media: “Mental health is nothing to criticize. Nothing to joke about. [Please] take your mental health seriously. Without my support system, I truly believe I would not be here today. Here for you @naomiosaka.”