Jade Carey will replace Biles in the competition on Thursday, USA Gymnastics said in a statement. Biles' withdrawal from the all-around, where she is the defending Olympic gold medalist, comes a day after she pulled out of the team final after one event on Tuesday.

USA Gymnastics said Biles will not compete so she can focus on her mental health and would continue to be evaluated to determine whether or not she would compete in event finals next week.

Biles withdrew from the team competition Tuesday night after vault, the Americans’ first event. She had bailed on an Amanar in warmups, and did the same when it came time to compete. The 2½-twisting somersault is one of the most difficult vaults being done, but is so second-nature to Biles she could probably do it five minutes after getting out of bed.

She looked close to tears as she walked off the podium, and coach Cecile Landi immediately went and put an arm around her shoulders. Biles could be seen talking with team physician Dr. Marcia Faustin for several minutes before the two left the competition floor.

Biles returned several minutes later. After hugging her teammates, she took off her grips – signaling she would not be doing uneven bars – and put on her warmup pants. USA Gymnastics announced shortly after that she was withdrawing.

“I'm still struggling with some things,” Biles said afterward. “It just sucks when you're fighting with your own head.”

Biles stayed on the floor to cheer on the rest of the Americans as they finished the competition. The U.S. won the silver medal, the first time since the 2010 world championships that they failed to win gold at a worlds or an Olympics.

Biles qualified for all four event finals, and would be favored to win gold on three of them. Vault, where she is the reigning Olympic and world champion, and uneven bars are Sunday. Floor, where she is also the reigning Olympic and world champion and has two skills named after her, are Monday. Balance beam, where she is the world champion and the 2016 bronze medalist, is Tuesday.

Biles has been increasingly open about her struggles with mental health. She has said she, too, was sexually abused by Larry Nassar, and continues to deal with the trauma from that. She also has expressed discomfort with being the biggest star of the Tokyo Olympics now that Michael Phelps and Usain Bolt are retired.

“I'm also not having as much fun,” Biles said, beginning to cry. “This Olympic Games, I wanted it to be for myself. I came in and felt I was still doing it for other people. So that just hurts my heart that doing what I love has been kind of taken away from me, to please other people.”