On 31 May 2021, Naomi Osaka — the reigning US Open champion and world number two — withdrew from the French Open at Roland Garros following a controversy over her decision to skip post-match press conferences. The stated reason was her mental health: Osaka disclosed that she had been suffering from depression since 2018 and that the obligation to conduct press conferences caused significant anxiety. The announcement prompted global conversation about athlete mental health and the responsibilities of sporting organisations toward the wellbeing of the athletes who compete under their regulations. It also exposed, in real time, the inadequacy of health insurance provision for professional athletes' mental health needs.
What Osaka's Withdrawal Revealed About Tennis's Insurance Gaps
The WTA Tour — under which Osaka was competing — provides its member players with certain health provisions, but mental health support and coverage is not a prominently featured element. The ATP and WTA player health programmes have historically focused on physical injury and illness: medical treatment during tournaments, access to physiotherapists, and basic health screenings. The mental health provisions — particularly for the specific pressures of being a top-ten professional tennis player navigating the global media environment — were minimal.
When Osaka announced her withdrawal, the WTA's response was to threaten fines and potential disqualification from subsequent Grand Slams — a regulatory framework designed for physical withdrawal from competition, applied awkwardly to a mental health situation. The response illustrated precisely why mental health coverage and support for professional athletes operates in a different — and inadequately designed — space compared to physical health provision.
For insurance purposes, Osaka's situation raised a specific question: does an athlete's personal health insurance cover income loss and competition withdrawal costs arising from mental health conditions? In most standard athlete health policies, the answer in 2021 was: inadequately, at best.
The Financial Consequences of Osaka's Withdrawal
Osaka was fined $15,000 by Roland Garros officials for missing a press conference before her withdrawal. Following her full withdrawal, she was not subject to further Grand Slam sanctions — but the financial impact extended beyond the fine. She forfeited potential prize money from the tournament. More significantly, the extensive media coverage — and the polarised public reaction to her decision — had implications for her commercial portfolio, which at the time was generating an estimated $55 million per year, making her the world's highest-earning female athlete.
Several of Osaka's sponsors — including a number of Japanese brands with cultural sensitivities around public duty — required careful relationship management in the aftermath of the Roland Garros situation. The potential commercial impact of sponsor reactions to a mental health withdrawal — which Osaka ultimately navigated successfully with support from her management team — illustrates why reputational and commercial insurance provisions are relevant to mental health situations, not just physical ones.
How Professional Tennis Responded to the Mental Health Crisis
Osaka's disclosure accelerated a shift that was already underway. Following the Roland Garros controversy, both the ATP and WTA invested significantly in player mental health support programmes. The Grand Slam organisations commissioned reviews of their media obligation structures. Sports psychologists became more prominently integrated into tour support services.
From an insurance perspective, the most significant development has been the gradual expansion of athlete health insurance policies to include more robust mental health coverage. Several specialist sports insurers now offer dedicated mental health provisions within athlete health programmes — covering psychological treatment, psychiatric care, and in-patient mental health treatment, with none of the session limits that typically restrict mental health provision in standard health policies.
Simone Biles, Marcus Rashford, and the Mental Health Insurance Moment
Osaka was not alone. Simone Biles withdrew from multiple events at the Tokyo 2020 Olympics in July 2021, citing mental health concerns and the specific condition of "the twists" — a dangerous loss of spatial awareness during gymnastic performance. Marcus Rashford has spoken about mental health challenges during his career. Tyson Fury has been extraordinarily open about his battles with depression and substance dependency during his career.
Each of these cases demonstrates the same underlying point: mental health conditions are as capable of interrupting professional athletic careers — and creating income loss — as physical injuries. The insurance infrastructure that protects athletes must treat mental health with the same financial seriousness as physical health. As of 2026, the market is moving in this direction — but the gap between provision and need remains significant for many professional athletes.
What Athletes Must Demand From Their Health Insurance in 2026
- No session limits on psychological therapy: Standard policies that cap at 10 or 20 sessions per year are inadequate for serious mental health needs. Demand unlimited or high-limit mental health access.
- Coverage for sport-specific psychological conditions: Performance anxiety, depression related to injury or career pressure, and conditions like Biles's "the twists" — directly performance-related mental health conditions — must be explicitly covered.
- Income protection triggered by mental health conditions: If a mental health condition prevents you from competing, income protection should activate just as it would for a physical injury.
- Confidentiality provisions: Mental health treatment information must be protected from disclosure to clubs, federations, or commercial partners. Confirm this in your policy terms.
Naomi Osaka changed the conversation about athlete mental health in 2021. The insurance industry is catching up — but athletes must actively seek out the coverage that reflects the true scope of their health needs, not just the physical element of them.
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