State of Mind

How College Sports Can Better Protect Athletes’ Mental Health

A basketball.
Photo illustration by Slate. Photo by Getty Images Plus.

A version of this piece first appeared in Global Sport Matters.

A few months ago, someone asked me, “Have you always been this open about your mental health?” I laughed nervously and shook my head. No. Then they asked, “Have you ever felt the fear of being judged or misunderstood?” Great question.

As a college athlete, one of the worst things you can buy into is the noise—the underlying hum of opinions shared in the news and on social media. However, when the word is out that you struggle with mental health, it’s a different story. The noise finds you.

Advertisement

For the better part of my life, I’ve lived alongside depression and obsessive-compulsive disorder. They shadowed me throughout high school and followed me out West to sunny California, becoming bolder and more palpable. I wasn’t formally diagnosed with both conditions until my freshman year at Stanford, home to one of the strongest women’s basketball programs in the country. I was the first Canadian to ever play for Cardinal, and fresh off of a silver medal with Team Canada at the FIBA Americas Championship.

Advertisement
Advertisement
Advertisement

Then in February 2017, I was hospitalized on a 5150 hold for suicide.

The hospital cleaved my spirit, as my teammates saw each time they visited. I had meager energy between lengthy, harsh therapy sessions and bouts of robust suicidal thoughts. In loneliness, I was left mindlessly scrolling through social media, articles, and message boards that only wore me down more.

Advertisement
Advertisement

I came across speculations about where I could have been when I wasn’t on the Stanford bench for a prolonged time. Many were negative: “She wasn’t good enough.” “She was kicked off of the team.” “She got into drugs and alcohol.” “She was pregnant.” Ironically, this ended up being productive scrolling—I recognized a problem that I could address.

My time away from the court didn’t prompt fans, the pubic, or news outlets to ask, “Gosh, I wonder if she’s struggling with her mental health?” Perhaps that was because of the stereotype that college athletes are unbreakable. The skills and abilities of athletes are undeniably inspiring and motivating, but still, we’re not suited for Mount Olympus—we have the same brains and physiology as everyone else.

Advertisement

College athletes know the value of trying again, maybe better than anyone—a crooked jump shot or loose running form isn’t an indication of failure, but a need to rework something. A growth mindset for training, competition, and physical performance is embedded into the culture of sports.

Advertisement

But the fabric of that culture leaves out a critical thread: Mental health is rigidly and fatally misunderstood, especially in college athletics. College live in an environment that makes their struggles unique.

To address those struggles, we need more and better resources: well-organized mental health care models; access to care; significantly lower ratios of athletes to mental health care providers; and diverse, culturally competent, sport-specific staff. We also need to remove the greatest barrier to help-seeking right now: stigma.

Advertisement
Advertisement
Advertisement
Advertisement

When we lost Stanford soccer player Katie Meyer recently, the anger I felt broke my heart. Our stories and experiences are not the same. But I do know what that moment of crisis and panic feels like.

Rooted in my own experiences, here are four things that universities and everyone else who works in college athletics need to do to support student-athletes.

1. Understand performance pressure and athletic identity foreclosure.

Athletes train to perform, compete, and thrive under pressure. This pressure doesn’t go away outside of training and competition. In non-sport environments, the ability to perform under pressure mutates into an internal pressure to perform all the time. Because identity and self-worth are so powerfully influenced by performance, what follows is strong athletic identity, and “athletic identity foreclosure”—associating your worth and identity solely with performance in sport and the athlete role.

Advertisement
Advertisement
Advertisement

When performance—in life and sport—isn’t where we’d like it to be, we have no other identity to turn to. We get caught confusing not achieving enough with not being enough.

Anyone working alongside college athletes should consider these nuances in the way identity, pressure, performance, and mental health concerns are intertwined. Take a step back and examine the standards, expectations, and procedures that you hold your athletes to. Are there any messages that shape these nuances or make them more complicated? Does your community’s culture value performance above being human? Do you remind athletes, and yourself, that mental health—alongside physical health—should be the primary standard and expectation, above all else? Are you training young humans to be great athletes, or young athletes to not be human?

2. Redefine and expand the shared symbol of mental toughness.

Mental toughness is one of the most treasured mindsets in athletics. Right now, it is defined as the ability to get through pain and discomfort at any cost. There needs to be a clear boundary between where we can expect student-athletes to push through, and where we can expect them to ask for help.

Advertisement
Advertisement

When mental toughness is expected to be maintained unconditionally, it can become pathological. An expectation to do that extra chin-up when your arms burn can and should coexist with an expectation to seek help when you’re experiencing depression. Being mentally tough is also not synonymous with being shatterproof. In sports, these terms are often used interchangeably. But there are thoughts, feelings, and experiences that nutrition, hydration, and extra foam rolling can’t address.

Advertisement

Athletes recognize this. But they also fear the consequences of not exemplifying mental toughness as it’s currently understood. They fear that their coach and teammates will see them as weak, and lose confidence and trust in them. Athletes react to adverse experiences in the same ways that other people do, yet they are too often penalized for expressing stressful, fearful, and angry emotions. They are expected to be stoic. When they aren’t, they’re seen as out of control.

Advertisement

At the intersection of being mentally tough and bottling up emotions is burnout. To a coach, burnout may manifest as being out of shape, a lack of discipline, insufficient work ethic, and inadequate mental toughness. But if our definition of mental toughness is expanded to include prioritizing and allowing space for all emotions to run their course, including the tough ones, we can reduce and reverse burnout among athletes.

3. Eliminate the notion that you have to be in crisis to seek help.

Mental health, like anything, is a continuum—it constantly ebbs and flows. Athletes should be encouraged to take care of it before the point of crisis.

There is a common notion that those who are in therapy or seeking treatment already are in crisis, which isn’t true. Many people who utilize therapy do not meet the criteria for a mental illness diagnosis, just as many suicides are related to factors outside of mental illness. Mental health is profoundly shaped by the social determinants of health, such as income, employment, food, housing security, social protection, and non-discrimination, and college athletes should be encouraged to seek and engage with resources – perhaps especially when they are feeling mentally well.

Advertisement
Advertisement
Advertisement
Advertisement
Advertisement

With that said, crisis scenarios do occur. Currently, the only crisis options are checking into a hospital or calling 911. Across North America, mental health crisis response teams are being trained and implemented. In the future, sport-specific resources would likely be a comforting option for athletes. These teams would steer them away from the hospital and the police, and keep them outside of the public eye.

Within sports, a willingness to simply listen to your players, teammates, friends, and colleagues can also go a long way. Speaking through thoughts and experiences is much easier with a trusted individual who is willing to set aside the role of coach or athlete temporarily. Freeing a story from your own brain gives it—and the storyteller—breathing room. Sharing with a professional may then feel like a less scary next step. My teammates did this with me. And truthfully, it saved my life.

4. Change the narrative around continued care.

When someone accesses mental health support or is open about their struggles, we assume that they’re fixed. When we frame healing this way, we reinforce the narrative that they must always appear fixed. This firmly places us back at square one and is one of the most prominent barriers I’ve faced.

Advertisement
Advertisement

I’m open, honest, and vocal about being a mental health activist and advocate, though a prerequisite of this role is a willingness to pick my scabs to share my story and thoughts authentically. This is often painful. I also still experience deep bouts of depression and potent, convincing obsessions and compulsions.

When student-athletes choose to be open about their mental health, there cannot be an assumption that it implies that they’re fully healed. Broken bones, for the most part, fully heal, and a return to practice and competition indicates that the break is in the past. Mental health doesn’t fit the same trajectory. College athletes may return to practice and competition while simultaneously working through mental health struggles. Mental health maintenance is a lifelong process. Just because athletes speak openly about their experiences doesn’t place them on the other side of the bridge.

Advertisement
Advertisement

Looking back, my struggles hurt my relationship with basketball. I sat on the bench for most of my career at Stanford, partially because I gave up—I assumed that I wasn’t capable of competing anymore. I’ve since learned not to assume defeat. My career didn’t turn out the way I’d anticipated, not because I wasn’t capable, but because I didn’t want to be alive. I spent so much time trying to believe that I needed to stay because my absence would hurt and devastate people I cared about. The truth is, I did feel needed, valued, and loved, which made me feel more selfish and guilty each time I contemplated suicide.

College athletes are a lot like the stick-figure example passengers on airplane safety cards.
They spend considerable time putting on oxygen masks for everyone else in the sports ecosystem by reaching for lofty expectations and standards. They seldom pause to put on their own until there isn’t enough oxygen to breathe.

​​If you need to talk, or if you or someone you know is experiencing suicidal thoughts, text the Crisis Text Line at 741-741 or call the National Suicide Prevention Lifeline at 1-800-273-8255.

State of Mind is a partnership of Slate and Arizona State University that offers a practical look at our mental health system—and how to make it better.

Advertisement