The mental health challenges and stress players endured in 2020 reminded OL Reign CEO Bill Predmore that clubs often take too narrow a view when preparing players to be “ready” for a game. That’s why, ahead of the 2021 season, OL Reign brought on new staff members to provide a holistic approach to player wellness — one that focuses on an individual’s physical, emotional, and psychological health.

Former Reign player and now Dr. Mariah Bullock joins the team as a sports psychologist and mental health counselor. She’ll work closely with the director of rehabilitation, Dr. Nicole Surdyka, who joined the club in December 2020 and is passionate about giving Reign players all the tools they need to do their jobs successfully.

Having these kinds of resources on staff is a unique approach within the league. In fact, it’s still pretty rare in any professional sports environment. To learn why it matters and look at how the club got to this point, we have to return to 2020, when the NWSL became the first professional league to return to play after the onset of the Covid-19 pandemic.

The challenge of the Challenge Cup

Enormous TV viewership growth. New sponsors. The first league in the U.S. to return to competition. The 2020 NWSL Challenge Cup was a success in so many ways, but it also came with a price for many players. And OL Reign’s Bethany Balcer helped draw attention to the mental health tolls of the tournament.

Fans grew concerned about Balcer when she left OL Reign’s match against the Portland Thorns in the 40th minute and had trouble breathing on the sideline. After the game, she took to social media to let everyone know that while she was OK, she had suffered an anxiety-induced panic attack.

“Soccer is much more than a physical sport,” Balcer said in a message she shared on Twitter. “Mental illness plays directly into it. Keep all the players in your thoughts, cuz it’s really, really tough to stay mentally sharp and healthy in an environment like this one.”

Being the first league to attempt a safe return to play alongside the beginning of a racial justice reckoning is a lot for any player to handle. On top of that, in the NWSL bubble environment, the furthest a player could venture was the parking lot. Forget interactions with friends on other teams — that was strictly forbidden.

“It’s constantly suppressing fear and anxiety,” Sky Blue midfielder McCall Zerboni said to ESPN on life in the bubble. “There’s not a lot of space to sort of escape. So it just takes a mental strength where you just can’t let any negativity seep in. It can be a very slippery slope and you start going down a rabbit hole of everything that is going on.”

While it was a new situation for many players, Balcer’s openness about the tournament's mental pressure serves as an important reminder for all of us. Despite the pedestals we put them on, the idols we follow on the pitch are not so different from any of us. In the words of Balcer, “We’re human beings too, and we struggle the same as everyone else.”

A familiar face returns

While Predmore had seen anecdotal evidence that players are facing an increase in mental health challenges, the pandemic amplified those concerns. “This is an area where there hasn’t been as much focus as would have been ideal — to really take care of the players at the level we want. I think we did a better job last year, but we don’t feel like it’s good enough,” Predmore shared in a conversation with Ride of the Valkyries.

Most clubs, including the Reign, had psychologists and mental health resources they could direct players to when needed. In fact, the league provided counselors during the Challenge Cup. But these experts weren’t connected to OL Reign’s training staff and couldn’t truly assess how much had changed day-to-day for a player.

“We wanted to more deeply integrate the mental health side into the fabric of how we’re trying to take care of and support the players. Rather than having someone from the outside, we wanted someone fully integrated into the staff,” Predmore shared.

Enter Dr. Bullock, who played for the Reign during their two best seasons — 2014 and 2015 — before retiring from the professional game to go to graduate school. She went on to earn a Ph.D. in clinical psychology in 2020. Balcer’s tweet during the Challenge Cup felt game-changing to Bullock. “I think players speaking up has been the primary catalyst to the destigmatization of mental health, especially in sport.”

Balcer’s openness inspired Bullock, and she shared a tweet that thanked the OL Reign forward for speaking up and encouraged NWSL clubs to invest in sports psychology. “You know where to find me,” she noted.

OL Reign owner Teresa Predmore saw the tweet and reached out to Bullock — noting that the club had been thinking about this for some time. The conversation took off from there and resulted in Bullock’s role with OL Reign today. While getting a job opportunity via Twitter might be unusual, returning to a familiar club that she loves is exciting.

“When I was playing for the Reign, something that I thought that they did better than a lot of the other clubs in the league is just how much they care about their players — and the extent that they would go to make us feel like we were professional athletes. I have a lot of respect for Bill and Teresa, and when this opportunity came up, I jumped on it because I completely respect how they run their organization,” Bullock shared.

While she’s still a full-time athletic psychologist for the University of Nebraska, Bullock will be working remotely with Reign players on various things. That includes mental health counseling and treatment for clinical depression, anxiety, eating disorders, or substance abuse disorders. She’ll also work closely with Dr. Nicole Surdyka on sports performance work — advising on performance anxiety, returning from injury, confidence and motivation.

Working in this role is a dream come true for Bullock. “I still really love soccer. Being able to work with professional soccer players — and having gone through my program and seeing how much that could have helped my game — I’m really excited to come back and look at all these other things that can help you improve if you so choose.”

A focus on holistic health

Surdyka welcomes Bullock with open arms. “I think Bill deserves a lot of credit for recognizing the importance of this and being willing to bring someone in,” the new rehab director shared. “It’s so much better to have someone in-house who you can have daily communications with.”

“We’re trying to look at this in a holistic way,” Predmore said. “We had a lot of silos previously in our roles. We wanted something where we were able to look at the player holistically — every aspect of their wellness.”

With this vision in mind, Surdyka thinks about each player through a pie-chart lens. Imagine each pie chart represents an individual athlete. There’s the physical component of the game — one slice of the pie — but there’s also the psychological component, along with the technical skills and tactical awareness a player needs to succeed.

“Each individual athlete will have different ratios of these pieces. Sometimes, maybe there’s somebody who is really great technically and physically, but nobody ever addresses the mental side or the psychological side. Maybe we can get to a next level of performance by unlocking the psychological component a bit.”

It’s all about context

While the pandemic hasn’t changed her philosophy, it has reminded Surdyka to put everything the players do in context.

“There are a lot of athletes who haven’t seen their families in the last year. You know, there’s a lot of contextual factors to consider all the time, but I think it’s a little more in the forefront of all of our minds now.”

Bullock agrees, pointing to the Challenge Cup and other bubble experiences that were incredibly stressful for players last year. “I think during the pandemic, the general public was just so hungry for sports to watch that there was pressure for athletes to be competing, which put them in a really sticky situation that wasn’t necessarily the best for their physical and mental health. It pushed athletes to be playing under less than ideal situations.”

That’s why the health and performance team has a daily morning and afternoon meeting. Among other things, they talk about the context around each athlete — discussing why an athlete might be sore or acknowledging another that has extra stressors in their lives.

“We’re always considering it and talking about this extra context, and that’s why it’s so nice to have Dr. Bullock on board with us and engaging in these conversations. She can tell us — ‘It’s good to know what they have that going on. Here is some advice and some tips on how you can best help this athlete.’”

Help players focus on soccer

Balcer’s Challenge Cup didn’t end with that panic attack on the sideline. The team’s next game — a quarterfinal match against the Chicago Red Stars — came down to penalty kicks. Balcer stepped up and confidently buried her kick into the left corner, and you could see the relief fall across her face the instant it was over.

“I heard a teammate say ‘only take one if you are CONFIDENT.’ Last game, my anxiety got the best of me. Before this game, I drew a pic of me & wrote ‘confident’ above it. I knew in this moment I could choose to overcome that anxiety and I did,” Balcer tweeted after the match.

While her team ultimately fell in penalties, Balcer got the better of her anxiety in that moment. And that might be the most consequential thing that came from the Challenge Cup, as it reinforced how important it was for the club’s leadership to invest in holistic supports for player wellness.

As Predmore concluded, “All of these things are tied together in terms of determining a player’s ability to perform. We’ve spent a lot of time thinking about that, putting plans together to address that, and now we’re executing on that.”

Just three months into the job, Surdyka is already grateful for the investment. “This is by far the most fulfilling role I’ve had in my professional career so far. It’s so nice to be able to have the support from the club to build up a team that I think can really help our athletes achieve the performance that they’re looking to achieve on the field. We want to provide an environment where all the athletes have to do is step onto the field and worry about soccer.”

While Bullock might be returning to a team with a slightly different name and location, she still believes the club has the same ambitions they did when she played for the Reign.

“I hope that, at some point, every team has a full-time me with them. That’s something that excites me. The Reign have always tried to be at the forefront of what the league is doing. And I think this is another example of what we’re going to trail blaze, what it means to give professional women’s soccer players the resources that they deserve.”