TOKYO (KXAN) — Four-time Olympic gold medalist Simone Biles pulled out of the gymnastics team competition Tuesday and sparked a new conversation on mental health.

Biles withdrew after a wayward vault in the early stages of competition. USA Gymnastics said Biles exited due to a “medical issue.” After Russia Olympic Committee won gold and the U.S. finished with silver, Biles explained she needed to focus on her mental health.

“I say put mental health first, because if you don’t then you’re not going to enjoy your sport, and you’re not going to succeed as much as you want to,” she said. “So it’s OK sometimes to even sit out the big competitions to focus on yourself, because it shows how strong of a competitor and person that you really are.”

Biles’ candid conversation about her health has elicited support from fellow Olympians worldwide.

Michael Phelps, who owns the all-time record for gold medals, has previously opened up about his struggles with depression. Phelps said Biles’ struggles Tuesday “broke his heart.”

“We carry a lot of weight on our shoulders, and it is challenging especially when the lights are on us,” Phelps told NBC’s Mike Tirico during Tuesday’s primetime Olympic coverage.

Biles will try to defend her all-around title Thursday.

2016 U.S. teammate Aly Raisman was outspoken in her support of Biles Tuesday, tweeting “Love you” after the team final.

Kerri Strug, whose iconic one-legged vault spurred the U.S. to the 1996 team gold medal, said — “sending love to you @Simone_Biles. UNITED States of America.”

First Lady Michelle Obama wrote: “Am I good enough? Yes, I am. The mantra I practice daily. @Simone_Biles, we are proud of you and we are rooting for you. Congratulations on the silver medal, Team USA.

Jamaican gymnast Danusia Francis — “Don’t know about you but I think @Simone_Biles just empowered everyone to put their mental well-being above everything else. WHAT A QUEEN. GOAT in more ways than one.