Hoops Help Shape Mental Health

July 16, 2013

One simple addition, basketball, is doing more for health and mental health in this community than months or years of therapy or any number of medications or office visits with me.

Growing up, I happened to play a lot of sports. Except for football and hockey, I probably tried them all at some point or another. I was gifted toward some, like baseball, and in others I couldn’t seem to get it together.

Basketball was like this for me. I didn’t have any kind of vertical ability, and the coordination required to simultaneously dribble and look up from the ball was too much. In a team setting, I was the pick guy, trying not to trip on my own feet. Also, I didn’t like to foul very much. It felt bad.

But the cool thing about basketball is that just about anyone can pick up a ball and shoot it at a hoop suspended some distance in the air. I always found this alluring. In a way, basketball is the Western version of the ubiquitous soccer field. It’s open and available to all skill levels, for pick-up or throw-down 2 on 2’s or 3 on 3’s, or simply a game of H-O-R-S-E, the same way that kids in the middle of Africa put together a ball and two sticks and make a field for an afternoon. Watching some of the NBA finals reminded me that basketball can appeal to a wide range of skill levels.

I recently witnessed this instant appeal firsthand. Some enterprising staff at our local community mental health center procured a used portable basketball hoop. It’s the kind that is a little rusted, and it has a large base made of black plastic that’s filled with water or sand or something, and it usually sits on a curb in some cul-de-sac. The backboard was fiberglass and a little worn, but the basic black square could be seen slightly faded on a gray background. There was no net and no concern that it may not be exactly 10 feet off the ground.

It was perfect. Perfect, because in a funny twist of events, the nearby subsidized housing complex where many clients of the mental health center resided had just gone smoke-free. That same housing complex had a curb in front, where that basketball goal now stands, perfectly placed. Perfectly timed.

The uptake was rapid and immediate. It was as if this goal was fulfilling an innate human need to connect and move that had been suppressed. The topic came up over lunch one day when a staff noted how many clients were out enjoying the beginning of summer in Seattle shooting some hoops. I observed that they needed a net-nets always help spruce up a basketball hoop. And not a chain net either. In a day, they had one, though in retrospect I doubt that a net had much to do with community participation.

I saw this net and the accompanying hoop up close the next week visiting a patient in his apartment with his psychiatrist. I asked her what she thought of the basketball hoop, since it was right outside his apartment.

“It’s great,” she said. “People that I never thought would leave their couch are actually getting up and doing something. We’ve even been able to reduce some people’s meds because they’re focusing on something else. They’re burning off this energy, and it’s amazing.”

Reconciling all the factors contributing to this rapid change, one could easily conclude it was the weather-the Seattle winter is notoriously gloomy, summer is a welcome reprieve. Or, perhaps, the no-smoking policy. But, although people were smoking more outside at a designated smoke-hole, nobody was smoking while they were playing b-ball. That seems about flat out impossible, H-O-R-S-E or no H-O-R-S-E.

In the end, I think it was the built environment that was to blame for their activity patterns. Overcoming it was as simple as getting a used piece of equipment off craigslist or the classifieds. Yet, that simple addition is doing more for health and mental health in this community than months or years of therapy or any number of medications or office visits with me. Not to mention the effect it might have on reducing smoking.

I wonder what other interventions could go just as far. Some dumbbells? An exercise bike? A tetherball? But then I think of the simplicity and the infectiousness of the basketball goal, and it’s hard to beat. In any case, it’s a great start. I aim to go early to my next clinic to see if I can pick up a game-it’s catching, you know.

RELATED ARTICLESWhat Clinical Medicine Can Learn from GeologyLesson No. 1 For Physicians: The Customer is Always RightDon't Worry, Be Healthy