The winners of 2023′s Miss USA and Miss Teen USA competitions abruptly announced their resignations this week, thrusting the Miss USA Organization and its officials into the center of conversations about mental health and the treatment of pageant participants.

UmaSofia Srivastava said she was stepping down as Miss Teen USA on Wednesday, writing on social media that her “personal values no longer fully align with the direction of the organization.” She told People that resigning “definitely was not my first choice.”

This came after Noelia Voigt announced that she was relinquishing her Miss USA crown Monday, citing mental health as a reason. But in a resignation letter, Voigt reportedly pointed to a “toxic” working environment and alleged that an incident of sexual harassment was brushed off by Miss USA Organization leadership.

“There is a toxic work environment within the Miss USA organization that, at best, is poor management and, at worst, is bullying and harassment,” her letter read, according to NBC News and ABC News. “This started soon after winning the title of Miss USA 2023.”

The resignations shocked the pageant community, which was still reeling after Cheslie Kryst, the winner of 2019′s Miss USA contest, died by suicide in 2022 following a long struggle with mental health issues. Now, just two years later, a pair of pageant winners have stepped down, with one of them citing her own mental health concerns.

In her resignation letter, Voigt reportedly said that Miss USA Organization CEO Laylah Rose was “cold and unnecessarily aggressive” as a manager and that she was dismissive when Voigt needed care.

Voigt said that at a Christmas event in Florida, she was left alone in a car with a man who “made several inappropriate statements” about “his desire to enter into a relationship” with her. Voigt said that Rose told her, “We cannot prevent people saying things to you at public appearances, it is, unfortunately, part of the role you’re in as a public figure.” Voigt also said that Rose threatened to take away her salary as a disciplinary action.

Voigt suggested that her interactions with Rose and the organization led to anxiety. She said she’s experienced “heart palpitations, full body shakes, loss of appetite, unintentional weight loss, loss of sleep, loss of hair, and more.”

Voigt’s experience appears to have prompted others in the Miss USA Organization to come forward as well.

Just days before Voigt stepped down, the organization’s social media director, Claudia Michelle, announced her own resignation. Michelle wrote that she had personally seen Voigt’s mental health decline, and added that Srivastava and her family were disrespected.

On social media, state titleholders who competed in Miss USA 2023 rallied around Voigt, sharing a statement that asked the Miss USA Organization to release Voigt from a nondisclosure agreement so she could “speak on her experiences and time as Miss USA.”

Multiple requests for comment from the Miss USA Organization — including a request for a response from Rose — weren’t immediately returned.

This is not the first time that a mental health crisis has rocked the organization. Following Kryst’s suicide, mother April Simpkins made headlines when she said the 2019 Miss USA winner had “high-functioning depression.”

Kryst had written at length about her struggles, and Simpkins has now published those writings in a book co-authored with her daughter, titled “By the Time You Read This: The Space Between Cheslie’s Smile and Mental Illness—Her Story in Her Own Words.”

Reacting to the news of the Miss USA resignations this week, Simpkins told HuffPost that she was proud of Voigt for stepping down.

“If Noelia felt that her mental health was being compromised, good for her for taking a bold and I’m sure difficult step to safeguard or maintain her mental health,” Simpkins said.

“I hope that her doing that will send word not just through the pageant community, but, you know, Miss USA as an employer … that there needs to be a point at which you value your mental health. Overall, I just think that’s so noble of her not just to do it, but to say the words out loud with regard to her reason.”

Simpkins said that “there were likely stressors that Cheslie didn’t have that perhaps Noelia did have.”

In “By the Time You Read This,” Kryst wrote about her time as Miss USA. Waking up and not knowing what time zone she was in, or what she would be doing that day until she got her itinerary, weighed on Kryst, Simpkins said.

The mother noted that Kryst had support, however. During her tenure as Miss USA, Kryst lived with the Miss Universe titleholder.

“Cheslie wasn’t alone,” Simpkins said. “She had someone to talk to. So if parts of the pageant, like the shifting schedule and other things, weighed on her, there was someone who had a same lived experience right there with her that she could talk to.

“And so, you know, [she] definitely had a different kind of support than is there now with Noelia. So I can’t speak to the comparisons. I just know what Cheslie’s experience was like.”

Nia Sanchez, Miss USA 2014, told HuffPost that she, too, experienced depression while she was the titleholder. The Miss USA Organization got her a psychiatrist immediately, Sanchez said, and she leaned into her faith.

“It’s just a time that is a lot on a young woman’s mental space, and there’s so much that’s required of you,” Sanchez said. “You are on call 24/7. Sometimes you are in different cities or states every single day, multiple days a week. So it really is taxing and can take a toll, especially because when I was Miss USA, you move immediately to New York City. And I’m from the West Coast, so I had no friends or contacts anywhere near.”

It was the first time that Sanchez had dealt with any kind of mental health struggle, she said. Now she’s starring on Bravo’s “The Valley,” where she speaks openly about her experience with postpartum depression after giving birth to twins.

Before this week, there had never been a resignation in Miss USA’s 72-year history. A similar but separate pageant, Miss America, has only ever seen one resignation, when in 1984 titleholder Vanessa Williams was forced to step down due to a magazine publishing nude photos of her without her consent.

The Miss Universe Organization, which operates the Miss Universe pageant as well as Miss USA and Miss Teen USA, has faced changes in ownership and leadership within the past few years. In 2015, Donald Trump sold the Miss Universe Organization after he made racist remarks about migrants crossing the U.S.-Mexico border. Crystle Stewart, a former Miss USA titleholder became the pageant’s national director in 2020 but was suspended in 2022 amid accusations of favoritism. Since August, Rose has been president and CEO of Miss USA and Miss Teen USA.

Sanchez said she was shocked to see Voigt and Srivastava resign.

“While I don’t know a lot about the organization, I hope that this is like a trigger to create change, where the titleholders are supported in a better way because this has never happened before,” she said.

Two other former titleholders told HuffPost that their time as Miss USA wasn’t the same as Voigt’s tenure. Kandace Matthews, Miss USA 2001, said that “things must be pretty bad” for Voigt and Srivastava to step down.

“It is such an honor to hold those titles, so I can only imagine what the situation must have been for them to reach that decision,” Matthews said.

Erin Colagiovanni, who was crowned Miss USA 2013 as Erin Brady, told HuffPost in an email that her time as the titleholder was under different ownership and that “even as stressful as things could be,” she “always felt heard.”

Hilary Levey Friedman, author of “Here She Is: The Complicated Reign of the Beauty Pageant in America,” told HuffPost that the “physical, emotional, mental demands” on a Miss USA winner can contribute to declining mental health.

Michelle, the former social media director, told NBC News that the Miss USA Organization’s management was unprofessional.

“Leaders in women’s empowerment organizations need to be held accountable,” Michelle said. “How do you not take the mental health of the face of your brand seriously?”

Need help with substance use disorder or mental health issues? In the U.S., call 800-662-HELP (4357) for the SAMHSA National Helpline.

Call or text 988 or chat 988lifeline.org for mental health support. Additionally, you can find local mental health and crisis resources at dontcallthepolice.com. Outside of the U.S., please visit the International Association for Suicide Prevention.