MENTAL HEALTH AND COLLEGE ATHLETES BEHIND THE APPLAUSE:

Facing unique pressure and stressors, athletes require specific approaches to care

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 pressure 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.”

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 What’s more, 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. That’s 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.”

Understanding the Stigma

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.

Seeing the Warning Signs

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.

A decline in an athlete’s sports or academic performance is a potential red flag, as are behaviors that isolate athletes from their teams. In addition, athletes who introduce rigid food rules, increase their exercise output or stop eating with the