Mental Health Issues in College Athlete Students

When young college athletes begin their academic career, most have a foot firmly planted in the security of their home and family while attempting to place a foot into the unexplored world of adulthood. For some, the jump from being dependent on your family to taking that step to be independent and accountable to only yourself is an easy move but for others the shift can be sudden and all too drastic, leaving them stuck between two worlds which leads to a state of confusion, uncertainty, bewilderment and almost certainly anxiety. Left by itself, this helplessness can grow and fester into harmful symptoms such as, depression, sleep disorders, substance abuse, eating disorders, impulsive behavior and finally suicide. It is a world of permanent solutions to temporary problems but one that you never think will happen to your family.

In early January 2018, the day started like any other for Tyler Hilinski, the soon to be starting quarterback for the Washington State Cougars. He played Fortnight with his friends, texted his teammates about a workout, spoke to his parents about moving into a new apartment and learned how to shoot a gun at the range the day before. None of these people could know that Tyler would suddenly end his life with the very weapon that he had just learned to use. (www.si.com, 2018)

Four years earlier, in January 2014, Madison Holleran, a freshman track star at the University of Pennsylvania, woke up after spending the evening watching movies with her best friends. She went to class and stopped by the bookstore to buy gifts for her friends and family. She went about her day like any other normal college student except this day would end with Madison jumping from the ninth floor of the parking garage after she left her gifts and a suicide note for the family. (www.espn.com, 2015)

Jordan Hankins, a star guard for the Northwestern Wildcats, spoke to younger brother almost every day and anyone you talked to would consider her a compassionate, talented and outgoing young woman but no one knew the inner turmoil until they found her dead inside her dorm room in early January 2017. ( (USA Today, 2017)

Who would know after seeing these three beautiful faces that by the end of the day all three of these up and coming NCAA college athletes would take their own lives and leave behind so many questions of why and require those close to them to search out those answers?

Every student, at one point for another, feels stressed out and it is normal to feel down or upset on occasion, but it is when those feelings become a consistent part of the daily routine that any situation could lead to the development of mental illness in young people and even more so, for college athletes. With an overabundance of stressors, including academics, team performance, family obligations, etc., the pressure to perform at the top of their game sometimes can be too much.

Recently, the National Collegiate Athletic Association (NCAA) made a push to investigate and put a spotlight on the gradual increase of mental health issues that were occurring in student-athletes across the United States. (Asif, Rao, Drezner, Toresdahl, & Harmon, 2015) It seems logical that athletic departments have become more aware of the specific needs of their student-athletes regarding their overall mental health. This is very much in contrast to the past when the specific needs of the department and its administrators were centralized in the areas of athletic performance, academic completion and the social demands from media, family, and donors. There is evidence of college athletes being at greater risk for developmental and psychological distress than the regular collegiate student walking on campuses today. (Asif, Rao, Drezner, Toresdahl, & Harmon, 2015)

When reading the stories about Madison, Tyler, and Jordan, it felt like they seemed to be orchestrating their own juggling act of life, so to speak. With the demands of long practices, trips, and sometimes separate housing areas, all of this can add up to feelings of isolation and restriction while often sensing the pressure to maintain the image of being the campus star. Some student-athletes can master the delicate balancing act but why were Tyler, Madison, and Jordan not able to do the same? What made them different? What made them choose the ultimate ending?

One fact that was prominent in some articles that I read was that depression was the most common emotional issue amongst female while male tended to abuse drugs and alcohol more than anything else. The 2017 Mental Health Disparities reported that while women may have attempted suicide more often, men were four times more likely to die. (World Health Organization, 2017) But it is also common for most of the athletes to not want to seek out help due to the stigma that is associated with mental health illnesses. They would rather suffer alone, which can compound the issue all the while increasing their desire for isolation.

It was a meeting in early January 2016, at the NCAA conference meeting, Chief Medical officer Brian Hainline stated: “Concussions may be the elephant in the room but mental health is going to be the game changer for the NCAA.” (Inside Higher Ed, 2016) While at the national convention, the NCAA’s Sports Science Institute released new guidelines for institutions across the United States providing guidance on the mental health issues with their student-athletes. At the convention, they released the “four best practices” for treating mental health issues in college athletes. According to the NCAA Sport Science Institute website, the four best practices are as follows: (NCAA Sport Science Institute, 2018)

• Schools are encouraged to ensure that the mental health care of college athletes is provided by licensed, qualified mental health services.
• Athletic departments are encouraged to work with qualified sports medicine and campus mental health professionals to develop written protocol covering emergency and non-emergency action plans for student-athletes facing a mental health challenge.
• Schools are encouraged to develop and apply mental health screening tools as well as a referral plan for testing student-athletes before they even enter the college athletic forum.
• Athletic departments are encouraged to educate student-athletes, coaches, faculty, and staff in creating a culture of openness to seeking mental health care when it is needed and having the support in doing so.

With these four best practices in mind, it was Chief Medical officer Hainline who said he would like all universities to operationalize these policies and stated “the problems that regular students have with mental health are exactly the same as the ones that student-athletes do” and campus facilities need to recognize this. (USA Today, 2017)

Again, if we look back at the stigma of receiving mental health assistance, this also plays into the situation when it is athlete vs non-athlete. A current study by the NCAA recording 304 athletes representing sixteen teams within Division 1. The study results showed that athletes reported higher perceived public stigma versus personal stigma. 103 athletes reported significantly higher levels of stigma versus non-athletes and also felt that e

Athletes would benefit greatly from educational programs that would help them reduce the stigma of having to reach out to mental illness professionals. (Kaier, Cromer, Johnson, Strunk, & Davis, 2015)

 As a Student Affairs professional, it is our job to watch out for instances of mental health behaviors in both student-athletes and non-athletic students. As mentioned in our textbooks, student affairs practitioners are expected to be counselors and have the knowledge to know when students are at risk. It is vital for us to be prepared to supervise, mentor, be able to manage a crisis and to respond to students who have concerns about suicide, self-harm or any type of substance abuse. (Schuh, Jones, & Torres, 2017) But in reality, how much responsibility does a university want to take on when it comes to mental health services?                            College educators continue to dispute how much of an obligation they have to students in taking on the responsibility for their emotional wellbeing. There are those on one side who feel that colleges and universities are places of learning and helping students figure out their academic hopes and dreams and do not consider themselves a facility for mental health treatments. Then you have the other side of the argument stating that it is a colleges responsibility to help their students be emotionally healthy and to keep them in school. By being healthy, it allows them to complete their academic career and also provides a massive financial base for the university in overall retention rates when these students continue on. But we also have those in the middle who think that while we need to help students with their mental health behaviors/illnesses, there is also not an unlimited amount of money to do that with. With budgets being cut left and right, typically the health programs are sometimes the first to go, unfortunately.

 With all the mental health programs available to her, Madison Holleran’s mother, Stacy, just couldn’t understand why her daughter never sought out the help she needed. She knew that Madison was uneasy about returning to the University of Penn but nothing out of the ordinary so when she got the phone call that dreadful day, she was shocked. She began asking questions of the track coach, the Resident Director, counseling officials, anyone who would sit and listen. (espn.com, 2015) What happened and what did they miss as parents? Many said that Madison arrived at the University of Penn with pre-diagnosed mental health conditions but her parents said that was false. The questions that were asked after will never have answers that the Holleran’s want as they died with their daughter when she felt she had nowhere to turn.

So where do we go from here? One thing that is very important to remember is that the NCAA has offered many great programs that allow universities the ability to implement mental health programs for their student-athletes. One of the biggest was the creation of the NCAA Sport Science Institute which is mentioned above. It is their aim to provide administrators and athletes a one-stop shop for information on mental health which will provide the “best environment for safety, excellence and wellness through research, education, best practices, and collaboration with member schools, national governing bodies, key medical and youth sport organizations, and the public and private sectors”. (NCAA Sport Science Institute, 2018) The website is an amazing resource of information for everything from Mental Health Workshops planning kits, training videos for coaches on ways to have a meaningful conversation about the well-being of their athletes and worksheets for administrations on how to come up with comprehensive programs to support mental health awareness programs and their students.

 One of the best things I found about the Sport Science Institute was the vast “Fact Sheet” section that included information on the following: Anxiety Awareness, Depression, Eating Disorder Awareness, Risk of Suicide, Bullying, Mental Health Referral Decision Worksheet, Mental Health Campus-Wide Assessment worksheet, a Mental Health Self-Assessment and a handbook for managing Student-Athlete Mental Health issues. (NCAA Sport Science Institute, 2018) All of these items could and should be used when implementing a mental health protocol on any college campus today.

References

• https://www.si.com/college-football/2018/06/26/tyler-hilinski-suicide-washington-state-qb-cte
• http://www.espn.com/espn/feature/story/_/id/12833146/instagram-account-university-pennsylvania-runner-showed-only-part-story
• https://www.usatoday.com/story/sports/ncaaw/2017/01/09/northwestern-basketball-player-jordan-hankins-found-dead/96376536/
• https://www.insidehighered.com/news/2016/01/14/ncaa-establishes-best-practices-mental-health-college-athletes
• Textbook
• https://www.insidehighered.com/news/2016/01/14/ncaa-establishes-best-practices-mental-health-college-athletes
• https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4547116/
• Sports Health, 2015 Volume 7 (issue 5)
• Journal of Adolescent Health, 2015, issue 16, pages 325-331
• https://www.who.int/mental_health/prevention/genderwomen/en/
• http://www.ncaa.org/
• Journal of College Student Development, Volume 56, Number 7, October 2015, pages 737-739; Perceptions of Mental Illness Stigma; Comparisons of Athletes to Non-Athletes