Baseball as Therapy

Baseball’s therapeutic qualities are undeniable, despite being a maddening game at times. (via Chris Yarzab)

The history of treatment for various mental illnesses throughout human history is fraught with ignorance, confusion, and often outright abuse of human liberties. Certainly, herbal concoctions and various forms of “therapy” have been used for millennia to assist those most stricken by psychosis or severe “melancholia” with little-to-no effect. Medications deliberately created for treatment of different types of psychosis have  been around only since the mid-20th century.

Basic but effective therapies such as cognitive behavioral therapy (CBT), what is often called “talk therapy” but which involves providing coping mechanisms and problem-solving for the mental illness, has been around in its current form for even less time. But in the midst of the naiveté of the mid-19th century’s efforts at managing severe mental illness, one new treatment was thrown against the wall to see how well it would stick—baseball.

The rise of asylums in the mid-19th century seemed to represent the most convenient solution at the time for managing those with a mental illness—containment of the afflicted. If no available treatment is effective, the thinking went, institutionalizing those with psychoses and delusions, oftentimes placing them in shackles or near-constant restraints, must be in everyone’s best interest. Some progressive (and typically private instead of public) asylums would allow the residents to engage in outdoor activities of some type, often including playing baseball.

As we know now, participating in exercise while getting sunshine and developing the camaraderie inherent in team sports can be very beneficial for one’s mental health. Other recreational activities, such as “lunatic balls” with dancing and socializing, were also popular. However, the superintendent of the Middletown State Homeopathic Asylum, Selden Talcott, reported in 1889 that a hospital-sponsored baseball team was implemented a year earlier for the sake of watching the game, as opposed to playing in it. Thus was born the Asylum Base Ball club, the first of many asylum-sponsored clubs across the U.S. In less than 20 years, multiple teams were formed from New York to Oregon.

Dr. Talcott’s 1889 Annual Report of the institution included his justification for sponsoring the club: 

“The beneficial effect of the national game upon those whose minds have been depressed or disturbed is very marked. The patients in whom it had hitherto been impossible to arouse a healthy interest in anything, seemed to awaken and become brighter at the crack of the sharp base hit. Even demented patients were eager watchers of the game. No game has ever excited such universal interest on the part of the inmates of the asylum. Even those who were very sick would insist upon being propped up by pillows so that they could look out the windows and watch a game while it was in progress.”

A few years later in his 1892 report, he added:

“After several years of experiment, our medical superintendent claims that baseball as a craze displaces other crazes and helps to relieve the mind of its troubles and delusions. There is ample evidence for this belief, and any one at all acquainted with the insane has only to attend a ball game on the asylum grounds, or go through the wards on the day of a game to feel its full force……On the day of a ball game everybody is astir. A thrill of absorbing attention of what is going on, all due to the healthy stimulus and the fascinating character of the national pastime….”

Of course, his observations were mere anecdote. This does not qualify as any meaningful scientific research, but his point is valid. The team was primarily staffed by hospital employees. Future Hall of Famer Jack Chesbro was recruited to work at the hospital in order to play on the club, and many others went on to play in the major leagues.

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Today, one in five Americans lives with a mental illness. Thankfully, the vast majority are not institutionalized, and many are able to live productive lives. I am one who has suffered from clinical depression and anxiety for many years, but thankfully I have found a treatment regimen that works well for me. There are multiple treatment options, including many lifestyle habits such as a healthy diet, exercise, and finding activities to help cope with the illness and symptoms that support our body’s ability to manage the illness. For many, baseball falls into that category. 

At first blush, it may seem silly to consider spectating baseball as a treatment for mental illness. Obviously, any reader of this site is interested in baseball and thus finds some element of solace, excitement, or identity with rooting for a particular team or player. Even those gluttons for punishment who stick with a losing team no matter what do it for some kind of benefit, though there certainly are times when it can have the opposite effect.  

So why baseball? Why not basketball or football or soccer or hockey or other recreational pursuit? All the elements of baseball support known research for things that contribute to positive mental health—being outside, feeling sunshine, a serene and beautiful setting, a relatively calm activity. It also allows for various levels of attention and understanding of the events within the game. If you want to dive into strategy and numbers while watching, you can; or if you prefer to relax and simply watch the action, you can. One of the main reasons for watching sports—namely to see very strong athletic performances—has also been shown to increase spectator excitement and decrease anxiety. The pace of baseball also allows for time to process and think, which can contribute to understanding what is going on in the game or also to get lost in your own thoughts. Very few other sports or activities allow for this constellation of factors, making baseball uniquely suited to positive mental health.

In the context of living in a 19th century asylum, other options for baseball’s positive impact are likely. It may simply have provided something to do, a break in the monotony and potential boredom of being restricted to the enclosed property of the institution. As this was before the days of popularity for many of our most prominent sports now—such as basketball and football—baseball may have provided a connection to the larger national culture and society, a bond that could help one identify with those outside of their immediate confines. It likely did provide a certain kinship with others living in the asylum, a chance to have a combined rooting interest or common goal. Even in loss, there is a special connection with other fans of the same team. Or maybe baseball fandom simply requires an element of psychosis.

Baseball, You Make It Hard to Love You
Again, a scandal puts fans on the defensive about their game.

While some historians have explored this baseball-as-treatment phenomenon of the late 19th and early 20th century baseball teams at “insane” asylums, very little research has been done since then to further the notion of baseball as therapy. However, in recent years a team of researchers in Japan located just north of Tokyo near the Seibu Lions professional team have been looking at the impact of baseball on the mental health of elderly individuals. To be clear, the methods of the studies are very limited for multiple reasons, and we could argue how applicable the findings truly are, but the point is that the idea of baseball as therapeutic is a topic that is once again emerging.

The research team in Japan (full disclosure: it included support from the Seibu Lions organization) has published two studies since 2017 along these lines. Among elderly of both sexes without a history of depression or dementia, who do not identify as a big fan of any particular baseball team and who rarely see games in person, were found to have an increase in happiness after the game (regardless of game outcome). An increase in calmness was seen but narrowly missed statistical significance.

A randomized controlled trial was later performed by the research team. This included 58 participants (compared to 16 in the first study) that were randomized to attend baseball games versus the control group who would “maintain their daily routines.” The exposure group (to see games in person) were required to go to at least two games per month for two months, but could go to as many of the 21 scheduled games as desired. The researchers looked at resultant cognitive function, health-related quality of life, symptoms of depression, subjective happiness, and physical activity. Despite no difference in depressive symptoms at baseline, the intervention group going to ball games showed a statistically significant decrease in depression and some improvement in cognition.

Again, these studies are less than ideal and are limited in their scope. The research focused on the elderly in Japan, they did not have depression at baseline, they received free tickets to the games, it covered a fairly short period of time, and one may worry about bias from the Seibu Lions in supporting this research. But they still demonstrate some improvement in mood by attending baseball games, something which we can all attest to. 

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Dr. Talcott started a trend of spectating baseball as a form of therapy for those with a severe mental illness in 1888 which quickly spread across the country. A team of Japanese researchers have taken up the exploration of this old but still novel concept of the impact of baseball on mood. A positive impact is not lost on many of us. But whether it provides a real or sustainable improvement in mood symptoms is unknown. When I first encountered this idea, I approached it more tongue in cheek. It remains partly that, but not completely.


Kyle Jones is a husband, father, Twins fan, and physician, in that order. He practices as a family physician and teaches at the University of Utah School of Medicine. He is the author of Fallible: a memoir of a young physician’s struggle with mental illness, and he thinks the 1991 World Series may be the pinnacle of all existence. Visit his website and follow him on Twitter @kbjones11.

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