The NCAA's Mental Health Crisis
Editor’s Note: This story discusses suicide. If you or someone you know is at risk of suicide, please call the Suicide and Crisis Lifeline at 988, or text HOME to 741741.
If you’ve ever played a sport, you probably know the all-too-familiar feeling of nervous energy before a big game. The pressure to perform well can be overwhelming for any athlete. Nervousness and stress are a normal part of any sport, to an extent.
But combine that with consistent travel, 30-plus hours of training per week, and the expectation of maintaining good grades, all while playing at one of the highest levels for your sport. This is the reality that many college athletes face.
And it’s one that many have begun to realize is not sustainable in terms of mental health.
This past spring, at least five NCAA student-athletes died by suicide, igniting calls for the NCAA to change the way mental health is handled and perceived in collegiate athletics. And out of around 500,000 student-athletes in NCAA sports, 477 died from suicide between 2003-2013, according to one study.
So where’s the issue?
While mental health issues have become more regularly discussed and treated in the past decade, NCAA athletes have continued to report these problems at high levels. In fact, the start of the COVID-19 pandemic saw an increase in depression, anxiety, and mental exhaustion among college athletes. In the NCAA’s fall 2020 student-athlete well-being survey, these levels were nearly two times higher than pre-pandemic levels.
Two years later, these levels remain elevated. Erin Curtin, a softball player at Trinity Christian College, shares that her mental health has been affected as a result of playing in college.
“I have struggled with my mental health during my time in college,” Curtin said. “It’s definitely impacted my relationships with my teammates and made it more difficult to enjoy playing my sport. It’s also been hard to uphold the expectations that coaches, teammates, and parents have for me performance-wise.”
Student-athletes are expected to handle as many responsibilities as their non-athlete peers in college, yet have additional stressors that create an intense environment at times. And while some athletes are fortunate enough to have adequate resources for their health, many don’t feel comfortable reaching out for support.
A number of athletes quit or transfer due to mental health as well. This may seem like a practical solution, but the reality is that playing sports can also be a major reliever of anxiety, and that the issues stem from a combination of stressors, not just the sport itself.
“Being in a bad mood and going out onto the field is like an escape from reality for a few hours that allows me time to regroup and distract myself,” said Megan McCarthy, a field hockey player at Ohio Wesleyan University. “However, sometimes it does get a lot to handle and it can be hard trying to manage everything at once during busy times.”
A 2020 NCAA GOALS Survey revealed that more than 62% of male student-athletes felt comfortable enough to talk with coaches about their mental health, while only 49% of female college athletes could say the same. In addition, only 48% of female and 46% of male athletes reported that they would be at ease seeking help for their mental health from an on-campus mental health provider.
Unfortunately, it can be hard to dissect exactly where the issue lies, as comfort levels and stigma are heavily variable, many times depending on each individual program and school itself. Some coaches may be more outspoken or approachable when it comes to mental health, and some schools may designate more funds to that area compared to others.
Soccer player at the University of Oregon, Madeline Gravante, has dealt with issues of stress and anxiety during her time at Oregon due to injury.
“I think not being able to do something you love for so long will have that effect on a person no matter if they’re an athlete or not,” Gravante said. “For me, I had a lot of anxiety and stress when thinking about returning to playing again in fear that I wouldn’t be the same as prior to my injury.”
But Gravante reports that her school has mental health resources easily available to anyone who needs them and that they helped her get through her struggles while injured.
“I really believe my coaches and staff have helped a lot in that aspect, whether it was just checking in or just reminding me of the resources we must help with the stress of coming back,” Gravante said. “I was reminded often of the resources so often that I ended up using the resources, and it has helped me so much.”
However, Curtin shares a much different experience to that of Gravante, including some neglect by the NCAA when dealing with mental health.
“I haven’t really sought out, or been directed to our school resources on campus at all,” Curtin said. “I feel as though mental health struggles that athletes face at both my personal university and the NCAA in general are just swept under the rug and either have to be dealt with on our own time or are dealt with internally within the teams.”
Under the NCAA constitution, member schools are held responsible for maintaining an environment that emphasizes physical and mental health and directing athletes to resources and discussions about their health. Currently, the NCAA has a few touchpoints for schools looking to provide this environment for their athletes.
Brian Hainline was named the Chief Medical Officer of the NCAA in 2013, which was when the organization first showed signs of taking mental health issues more seriously. Hainline then created the Mental Health Task Force, made of a group of administrators, clinicians, coaches, policy experts, team physicians, scientists, and student-athletes hired to handle mental health concerns in college athletics.
The NCAA also has the Sport Science Institute to provide educational resources, best practices, and tools that are used to demonstrate the best way to care for the mental health of student-athletes. In collaboration with the Mental Health Task Force, the SSI created the Mental Health Best Practices Guide, a document that details important information and procedures for universities, coaches, and medical staff to know in order to best treat the mental health of college athletes. All three divisions in the NCAA are required to design a plan that aligns with this guide.
As much as these groups may be exhibiting efforts to curb the number of athletes suffering from mental health issues while in college, many athletes don’t believe they are doing enough. In a survey of 400 people, 60% of which were former high school or college athletes, 49% responded that they didn’t believe the NCAA offered enough mental health services. Only 18% reported that they thought sufficient services were provided, and 33% said they had no opinion.
“The NCAA, I believe, has the resources to deal with mental health but would say they aren’t doing enough,” Gravante said. “ I think the NCAA is more vocal about events like March Madness than the mental health crisis that is so present in college athletics.”
What can be done?
The first major issue with the way mental health is currently handled is that it is education-based rather than action-based. Having a solid understanding of mental health, the resources available, and how to access them is absolutely necessary, of course. But as long as there’s a stigma surrounding mental health, education won’t be enough.
“I think the first step for the NCAA is not just providing resources for athletes, but to reach out to universities athletic programs and their athletes for check-ins and their opinions on what would benefit them both mentally and physically,” Curtin said.
Ensuring that the care athletes receive is high quality is also vital. Only 46% of male student-athletes and 37% of female student-athletes felt very satisfied with the mental health care received from team or college medical personnel, according to the 2019 GOALS Study.
This issue may stem from the fact that some schools don’t have athlete-specific mental health services. In some cases, athletes are deferred to the general mental health resources that the rest of university is recommended to use. Every university designs this system differently, with varying numbers of counselors, athletic trainers, and free sessions. While large universities may have enough funding to provide quality therapists, the demand for these therapists may also be overwhelming with the number of students at a school.
But once again, it depends on each school.
De-stigmatizing mental health is one of the only ways to have a foolproof way of providing mental healthcare. Athletes must feel like seeking help is a win-win situation, and not have any fears about what could happen to them in school or sports if they receive help.
Athletes like Simone Biles and Naomi Osaka have been leaders in the movement to prioritize health over athletics. Osaka dropped out of the French Open last year with Biles following by leaving the Olympics early, each citing mental health as their reasoning.
As the 2022 fall season is right around the corner, all eyes will be on the NCAA. Fulfilling the calls for change voiced by athletes, parents, and coaches around the country is imperative to ensuring the health and safety and student-athletes.
"If every athlete was given proper tools specific to mental health in sports and the resources to get help, I personally think that every athlete would benefit from that,” McCarthy said.