Review: ‘The Price She Pays’ offers solutions to mental health ‘crisis’ in women’s sports

When Katie Steele and Tiffany Brown began conducting interviews for their book, “The Price She Pays,” they expected to hear stories of athletes facing internal struggles, external pressures, mistreatment and abuse.

As licensed therapists with longstanding and direct connections to the world of sports, it was no secret to either of them that the journey for women in sports can be rife with trauma.

What Steele and Brown did not expect was the sheer volume of shared experiences, and the clarity of solutions they could offer in the book, which examines what the authors describe as a mental health “crisis” in women’s sports from the youth level up to the pros. “The Price She Pays” releases next Tuesday, with a book signing event set for 7 p.m. Thursday, June 27, at Powell’s Books in Beaverton.

The Oregonian/OregonLive received an advance copy for review.

“Part of what we are trained to do with our background and the type of therapy that we employ is looking at the whole system,” Brown told The Oregonian/OregonLive. “If you’re coming into therapy and you’re dealing with depression, we’re not just going to be focused on one or two things differently to get better with your depression. We’re also looking at what is going on around you and what is happening within all the systems around you that make that depression make sense, and what we can do differently within those systems.

“In order for there to be change in women’s sports, there has to be change within the systems women operate and compete under.”

As women’s sports continue their rapid ascent in popularity and financial viability, it is Steele and Brown’s belief that the growth of women’s sports must happen concurrently with a solutions-based approach to mental health. If women are to be properly supported in the athletic space, then parents, fans, coaches, media and institutional leaders have a responsibility to reframe how they think about both the positive and negative impacts of sport on the well-being of women and girls.

Body confidence and acceptance, creating healthy player-coach relationships, parenting with patience and emotional sensitivity, identifying mental health concerns or potential mistreatment and abuse — those are just a handful of the heavy topics “The Price She Pays” tackles.

“It’s essential,” Steele said. “We need to pull the veil back, because if we don’t know what we don’t know, then it’s hard to generate change. We needed to pull the veil back so people can have a full understanding of what is happening in women’s sports, and to create solutions. We don’t just want to name the problem. We can know there are things that aren’t working and also know other things that are, and there are athletes and programs and coaches who are celebrating women athletes and elevating them to where they deserve to be. A big piece of mental health is coexistence. It can be all of it at once.”

The book is at times not an easy read, but it shouldn’t be. What is being confronted is systemic and — for women or for those with women in their lives who play or used to play sports — validating in several heartbreaking ways.

But it’s not all doom and gloom, or a scream into the void: Steele and Brown wanted to make these problems clear and create as much if not more space in these pages for tangible, nuanced, thoughtful solutions.

“We wouldn’t have done this if we didn’t believe change was possible,” Steele said. “We wouldn’t have done this if we didn’t love sports. These sports are amazing, and the athletes partaking are incredible. We want to see all of that be elevated and believe in the possibility of that.”

Steele is a former track and field athlete at the University of Oregon and co-founder of Thrive Mental Health along with the Athletes Mental Health Foundation. Brown is a senior member of the UO faculty in the couples and family therapy graduate program and provides mental health education for coaches and staff. They co-wrote “The Price She Pays,” along with journalist Erin Strout.

The early pages include Steele’s retelling of her motivation for pursuing a career in the mental health space: her personal story of trauma during her time in the UO track program, which she said included numerous pressures that affected her body image and overall mental health along with alleged mismanagement of medications prescribed to her by a doctor.

“The Price She Pays” makes clear that all trauma — “big T and little t,” as it is referred to in the book — is valid. All of it is a reason for systemic change, be it the fourth grader who quits basketball because she doesn’t feel comfortable in her uniform or the widespread failures by teams and institutions to protect professional women’s soccer players from abuse as outlined in the Yates report in 2022.

Leagues, teams, coaches and parents can no longer operate in half-measures and pat themselves on the back when it comes to addressing mental health, Steele and Brown explain. They have to take a hard look at these problems, listen to athletes, and act on solutions that put their well-being first.

“It is a business,” Brown said. “And because of that, just like any other business, we need to look at how the ‘employees’ are being treated and what the expectations are. Unfortunately, in sports — and especially women’s sports — there’s not a lot of clear expectations in terms of how women are treated.”

Those in the world of sports will need to understand that enacting clear solutions to mental health challenges is just as important — if not more so — than winning, Steele explained. And that the two are inextricably linked.

“Most teams, most established leagues and programs, know that mental health needs to be named,” Steele said. “The NCAA just rolled out ‘best practices’ for mental health. And we’re like, best practices? We’re in 2024. These need to be mandated. There is a box that is getting checked by sports teams and leagues and institutions, when it needs to be actually integrated. We need athlete well-being to become just as important as winning, and we need to quantify that.”

“The Price She Pays” is straightforward, instructive, heartbreaking and persistently inclusive. It should be required reading for those who love, value or have a vested interest in sports. It is available for pre-order through Powell’s, Amazon, Barnes & Noble and elsewhere.

The book signing event with Steele and Brown starts at 7 p.m. Thursday, June 27, at the Beaverton location of Powell’s, 3415 SW Cedar Hills Blvd.

— Ryan Clarke covers the Oregon Ducks and Big Ten Conference for The Oregonian and co-hosts the Soccer Made in Portland and Ducks Confidential podcasts. He can be reached at [email protected] or @RyanTClarke.

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