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For an Inclusive Approach to Mental Health in Tennis 

On May 31, 2021, tennis star Naomi Osaka tweeted her decision to withdraw from the then ongoing French Open. She revealed her struggle with mental health. A few weeks later, she pulled out of the upcoming Wimbledon championship too. The public statement from her team read: ‘She is taking some personal time with friends and family.’ Osaka’s performance at the2018 US open final stunned Serena Williams, who was chasing Margaret Court’s record of 24 Grand Slam singles titles, to become the first Japanese person to win the Grand Slam. She continued her success with three more Grand Slam titles over the following years. Her decision to pull out of the French open and the Wimbledon raised the importance of self-care for protecting mental health at the highest level of competitive tennis and beyond.

Following the inclusion of mental health in the Sustainable Development Goal, the World Health Organisation advocated for mental health and human wellbeing by promoting health-informed education and diet as well as encouraging exercise and outdoor activities.1 When the Lancet Commission on global mental health and sustainable development was set up, experts argued that ‘mental health problems are not simply a clinical or health-system concern: they are a central concern to a just society’.2 One of the key messages here is to acknowledge the non-clinical factors contributing to the making of mental health beyond physical health and how a rights-based approach is a sustainable way to help address the invisible struggles in mental health.3 As of 26th June 2021, Osaka’s tweet about her withdrawal from the French Open was retweeted 59K times, got 24.6K quote tweets and 410.5K likes. While some followers tweeted their support, others criticised Osaka’s decision to stay away from the tournaments. A number of comments considered the reason of mental health as an excuse. The scale of responses towards her decision shows how important and challenging it is to think bigger than sports and commercial interests. Cliff Richey4, Mardy Fish5, Petra Kvitova6, Victoria Azarenka7, and Rebecca Marino8 are a few tennis players who faced different mental health issues. These players remind us that mental health should not be taken-for-granted at any cost.

Evidence suggests that there is not only a high-prevalence of issues like anxiety and depression among sports persons in comparison with the public but also the future of mental health in sports needs to account for both competitive and non-competitive spheres.9 This is similar to the Lancet Commission’s approach to mental health and human development. Recently, the International Olympic Committee (IOC) developed tools to help anticipate, assess and deal with the mental health and wellbeing of athletes and their social network10.

The mental health of an athlete needs equal attention as the treatment of physical injuries especially when Covid-19 amplifies the mental health struggles across the world. The champion as the figure who overcomes every physical barrier to be successful should encompass the analytics of mental health. This would mean more agencies to each player irrespective of their career stage, identity, records and fan following. Sports administrators and policy makers can listen to these players while developing a humane and sensible treatment towards successful and struggling athletes for an inclusive, global mental health.


1Europe, WHO. 2018. ‘Fact sheets on sustainable development goals: health targets’,, Accessed June 21, 2021

2Patel, et al. 2016. ‘Sustainable development and global mental health—a Lancet Commission’, Lancet, 387: 1143-45.

3Patel, et al. 2018. ‘The Lancet Commission on global mental health and sustainable development’, Lancet 392: 1553–98.

4ESPN, May 5, 2010. ‘Cliff Richey’s path to peace’,, Accessed June 20, 2021

5Los Angels Times, June 1, 2021. ‘Mardy Fish offers support to Naomi Osaka. He’s been on his own mental health journey’,, Accessed June 22, 2021. 

6ESPN, August 7, 2015. ‘Mental illness a growing concern on tennis tours’,, Accessed June 20, 2021.

7Firstpost, January 16, 2015, ‘Victoria Azarenka talks about depression, says she turned to art for therapy’,, Accessed June 20, 2021.

8CBC, January 28, 2021, ‘Canada’s Rebecca Marino ‘feels like different person’ ahead of 1st major in 8 years’,, Accessed June 27, 2021. 

9Rice, et al. 2016. ‘The Mental Health of Elite Athletes: A Narrative Systematic Review’,Sports Medicine, 46(9): 1333–53

10Gouttebarge, et al. 2021. ‘International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes’ mental health’, British Journal of Sports Medicine, 55(1): 30–37.

Views expressed by the author are personal and need not reflect or represent the views of Centre for Public Policy Research.

Abin Thomas
Abin Thomas
Dr Abin Thomas is Research Fellow (Global Health) at CPPR. He is a medical anthropologist whose research focuses on global health, biomedicine, and ethics. Before joining the Global Academy of Agriculture and Food Security at University of Edinburgh, Abin studied at the Hyderabad Central University, the Delhi University, and obtained his PhD at the King’s College London.

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