Student Athlete Mental Health: Behind the Applause

Packed schedules. Intense workouts. Pressure from coaches, teammates and fans. Those are three of the many stressors that college athletes experience on top of the pressures facing traditional students. And all of those stressors raise the risk of mental health concerns.

“When you’re a college athlete, you kind of lose the experience of just being a normal student,” says Mazella Fuller, PhD, MSW, LCSW, CEDS (she/her/hers), a social worker at Duke University’s Counseling and Psychological Services. “Sometimes athletes just want to not have to get up at 4 or 5 a.m., go to practice and take care of all the things they have to do.”

Student Athlete Mental Health Statistics

Unfortunately, the stressors for college athletes have only multiplied in recent years.

• One study indicates that 30% of cisgender female and 25% of cisgender male athletes report having anxiety.[1]
• A National Collegiate Athletic Association (NCAA) study conducted from November to December 2021 showed that reports of mental health concerns among college athletes were one-and-a-half to two times higher than historically reported by NCAA athletes prior to 2020.[2]
• Although two-thirds of student athletes surveyed by the NCAA say they know where to go on campus to seek mental health services, fewer than half (47%) say they would be comfortable seeking support.

The statistics above show why it’s important for providers, administrators and athletic departments to send a clear message: Mental health is just as important as physical health.

“A recent rise in the number of mental health advocacy groups for college athletes has helped reduce the stigma associated with mental health,” says Amy Gooding, PsyD (she/her/hers), clinical psychologist at Eating Recovery Center and Pathlight Mood & Anxiety Center (ERC Pathlight). “But it’s unfortunate that less than half of athletes say they feel comfortable seeking support on campus.”

“Seeking treatment is a sign of strength, not weakness,” adds Wendy Foulds Mathes, PhD (she/her/hers), director of academic programs and continuing education at ERC Pathlight. “When athletes seek care, they’re standing up for themselves, their team and their community.”

Prioritizing Mental Health of Student Athletes

While an athlete with a physical injury would seldom refuse medical care, the same isn’t true for seeking mental health care.

“Athletes believe they’re supposed to be mentally tough, self-confident and strong. Some fear that if they seek mental health care, they may be perceived as vulnerable or weak in some way,” Dr. Gooding says.

Athletes also face other barriers to care, both perceived and systemic. Some fear that members of their community—their coaches and teammates—will view their choice to seek care negatively. They also worry about getting less playing time or about how treatment may affect their sports performance.

Know the Signs to Watch For

The first step to helping athletes overcome these barriers is to identify when they need help.

“The signs of anxiety, depression and eating disorders aren’t much different in athletes than other students, but they present themselves in a different context because of the environment that student athletes live in,” Dr. Foulds Mathes says.

Signs of possible mental health disorders and eating disorders include:

• A decline in an athlete’s sports or academic performance
• Behaviors that isolate athletes from their teams
• Rigid food rules
• Increased exercise
• Not eating with the team

It’s important to be aware that certain events can increase an athlete’s risk for mental health disorders, including a physical injury or a change in their standing on the team. During midterm and final exam periods, athletes face intensified pressure that also raises risk.

Mental Health Treatment for College Athletes

Providing appropriate care and resources for college athletes starts by understanding their unique identity. “Many student athletes are goal-directed and solution-focused,” Dr. Foulds Mathes says. “A savvy therapist will understand this and approach their mental health care from that point instead of taking a general approach.”

A great first step is to equate an athlete’s mental health with their physical health. “A lot of times, mental health issues will require individuals to take time away from their sport, so putting mental health and physical health issues on the same playing field is important,” Dr. Gooding says.

Once an athlete is identified as needing help, motivational interviewing techniques can help them open up—especially athletes who are ambivalent about approaching treatment. “It’s a method of asking open-ended questions—How has this impacted your life? How do you hope things will be different next season?—that helps the athlete explain in their own words why they want to get help,” says Dr. Gooding.

Virtual mental health treatment, such as Eating Recovery and Pathlight At Home, a proven virtual intensive outpatient program (IOP), can make it easier for student athletes to accept care and stay in school. “With telehealth programs, athletes can get the help they need by just logging onto a computer or phone, no matter how busy their schedule is,” Dr. Gooding says. Another benefit: There’s more privacy around seeking care when you don’t have to visit an on-campus mental health services location for weekly therapy or IOP.

Reducing Mental Health Stigma

Providers, counselors, athletic directors and school administrators all can play a role in reducing the stigma surrounding mental health among college athletes. For example, when schools have mental health professionals on staff, it’s important for those providers to “show up in spaces where students are,” Dr. Fuller says. “Students should be able to see them in the hallways and visit them in their offices during drop-in hours.”

Student-led groups can also help increase awareness of mental health disorders. For instance, the student-run Duke Body group at Duke University focuses on body image and athletes. “It’s a liberating space for athletes to be their full selves, and we’re there for them,” says Chantal Gil, PsyD (she/her/hers), clinical psychologist and assistant professor in the Department of Psychiatry and Behavioral Sciences at Duke University School of Medicine.

The sooner adults who interact with student athletes recognize possible mental health issues, the better the outcome.

“If we identify and treat symptoms at a subclinical level, we can prevent the progression to a more severe disorder,” Dr. Gooding says, “allowing college athletes to receive the support they need to improve their overall well-being, get back to their sport quicker and change their life for the better.”

Become an Eating Disorder Informed Professional

The Eating Disorder Informed Professional course helps coaches, athletic departments, school counselors, professors and more develop tools to support college students at risk for developing eating disorders.

Partner Spotlight: Mental Health Advocates for College Athletes

Morgan’s Message honors the memory of Morgan Rodgers, a Division I NCAA lacrosse athlete who battled anxiety and depression before dying by suicide at age 22. Morgan’s parents and friends founded Morgan’s Message to equalize the treatment of physical and mental health in athletics. The organization’s goal is to normalize difficult conversations, empower those who suffer in silence and support individuals who feel alone in their struggles. Learn more: www.morgansmessage.org

The Hidden Opponent was founded by Victoria Garrick Browne, a former Division I women’s volleyball player and PAC-12 champion. The organization’s name comes from Garrick Browne’s 2017 TEDxTalk, which detailed her personal battle with depression and anxiety. Endorsed and supported by the late Kobe Bryant, The Hidden Opponent seeks to eradicate the stigma of mental health in sports culture. Learn more: www.thehiddenopponent.org.

Support for College Athletes

Eating Recovery and Pathlight At Home, our virtual IOP, was recognized as a best online therapy service by Health, Parents, People magazine and others. This leading program allows students to remain in school and active in athletics while they get the support they need. Learn more about virtual mental health care here.

Sources

1. The American College of Sports Medicine Statement on Mental Health Challenges for Athletes (Aug. 9, 2021)

2. NCAA Student-Athlete Well-Being Study, Fall 2021 (May 2022)