The Baltimore Orioles' Mental Health Program

First, I want to say kudos to Jake Arrieta for speaking openly about his anxiety issues. The Associated Press article about Jake's demotion carries several mentions of his mental state:

• "Jake Arrieta couldn't get his mind right on the mound …"
• "[Buck Showalter and I] talked about high anxiety situations and he pretty much asked me, 'Why do you have high anxiety in any situation with the stuff you have?' " Arrieta said. "Basically, I told him that I just want to be what my team needs me to be. Sometimes I create the anxiety for myself. So I just need to limit that."
• "I let previous instances creep up in my thought process sometimes," [Arrieta] said. "I think that's where things go awry and that's where the walks come in."
• Showalter said, "The thing [Jake's] got to solve is the mental side of it."

Struggling to throw strikes on the mound in front of 35,000 screaming fans can't be easy, especially when nothing is visibly wrong with you. And although some high-profile players (Zack Greinke, Joey Votto, John Smoltz, etc.) have dealt with anxiety and depression in full public view, we are still a long way from a culture in which ballplayers feel as comfortable discussing their mental struggles as they do their swing mechanics or strength conditioning routines.

Why not? Well, there are a variety of reasons. But the main one is that baseball players are male. Speaking as a guy, we all know we're not the most forthcoming with our thoughts and feelings. Since we were young, many of us have been socialized to believe not only that talking about our feelings is a feminine characteristic, but also that femininity is equivalent to physical weakness. No man, especially not competitive ballplayers, wants to be accused of being weak.

Votto implies as much when talking about his struggles:

[My biggest hesitation was] coming out and letting people know, letting my teammates know [about my depression]. We're supposed to be known as mentally tough and able to withstand any type of adversity.

Former major-leaguer Bob Tewksbury, now a sports psychologist, might agree:

Anytime someone says 'psychology,' [players] say 'Oh my God. I can't talk to him because it's sign of weakness!' That's permeated our culture a little bit, particularly with males in our world.

Even some teams avoid talking about the mental health aspects of their staff. For example, the O's list the team orthopedist and dentist on their web page, but not anyone associated with their mental health program.

Yet we know that they have such a program. In early 2012, Dan Duquette hired Seth Kaplan as their Director of Mental Training. Kaplan has an M.Ed. in Counseling Psychology with a specialization in Sports Psychology. He works for Elite Performance Coaching (actually, its web site hints that he may be EPC) and helps the Orioles' pitchers with "mental toughness" training. As Duquette said at the time of the hiring:

The idea is to help [our pitchers] prepare mentally to prepare physically. It's a key component.

Some more research turns up the name David McDuff, M.D., who is the Team Psychiatrist for the Baltimore Orioles (and the Ravens). He's written several books that you can find online, but there's a paper on his website that distills his philosophies. It's a mental toughness training (there's those words again!) manual for baseball players. It talks about thinking like a winner, setting goals (like hitting 10 more home runs or walking one fewer batter per game), establishing a routine, regulating your intensity, and building a team.

(Side note: notice how the talk of sports psychology is couched in terms of mental "toughess." Votto, Kaplan, and McDuff all use that phrase.)

I can only speculate as to whether Arrieta used Kaplan's or McDuff's services. He hasn't gone on the DL for anxiety issues, but we know that he spoke with at least one sports psychologist (former major-league pitcher Don Carman) in August 2012, when he was last in AAA.

It's simplistic to conclude that because Jake is still struggling, something is wrong with either him or the mental health professional(s) he has seen. That's not the entire picture. His teammates (and manager) bear some responsibility for creating a clubhouse culture that Jake feels comfortable discussing his struggles in. Baseball as a whole bears some responsibility for spreading this kind of culture to other teams. The fans and the media also bear aspects of this responsibility.

I'm not saying we need to baby him. Jake needs to be held accountable for performing his chosen job well, as do we all. But you'd be surprised what benefits a culture of open communication can have. Sometimes simply feeling like you can talk about your struggles openly is a key to making the struggles disappear. It seems the Orioles acknowledge the need for mental health professionals on staff, which is a great start.

Further Reading