The full range of mental health issues found in the general young population can also be found in the life of a teen athlete. The mental health of a college student is challenged by any number of factors of student life, and participation in competition doesn’t provide the athlete with immunity from mental health issues.
The unique stressors of intercollegiate athletic participation include the physical demands of training and competition, the time commitment to their sport, sustaining a time-loss, chronic or season-/career-ending injury, having difficulty interacting with teammates and coaches, and struggling with poor sports performance.
Coaches, athletic trainers, team physicians, strength and conditioning staff, academic support staff, equipment managers and administrators are in position to observe and interact with student-athletes on a daily basis. In most cases, coaches have the trust of the athlete and are someone that the athlete turns to in difficult times or personal crisis. In some cases, the athlete will confide in a teammate or a roommate.
There are some athletes who will not be aware of/ or inform anyone of their developing mental or emotional health issue, but will act out in nonverbal ways to let on that something is bothering them.
In addition, some athletes will demonstrate behaviors that have at their root mental health issues. For example, someone who gets in fights when drinking and shows up late all the time may actually be struggling with depression.
Behaviours to monitor:
- changes in eating and sleeping habits;
- unexplained weight loss;
- drug and/or alcohol abuse;
- gambling issues;
- withdrawing from social contact;
- problems concentrating, focusing or remembering;
- decreased interest in activities that have been enjoyable, or taking up risky behavior;
- talking about death, dying or “going away”;
- loss of emotion, or sudden changes of emotion within a short period of time;
- frequent complaints of fatigue, illness or being injured that prevent participation;
- becoming more irritable or problems managing anger.
In our country, club owners don’t understand they have to hire licensed, clinical psychologists to work with athletes on issues ranging from mental preparation for competition and relaxation to clinical depression and eating disorders.
Mental & Health professionals can enhance the medical care for student-athletes by:
- providing mental health screening and prevention education;
- conducting pre-participation evaluation screenings;
- providing continuing care for concussion management;
- managing eating disorders;
- providing counseling on challenges and stresses related to being a student-athlete;
- resolving conflicts (between athlete and coach, athlete and athlete, athlete and parent, etc.);
- serving as a key member of the team department catastrophic-incident team.
Encouraging student-athletes, or “giving them permission,” to seek help from mental health providers that will help them gain insight into their situation, and encouraging athletes that seeking counseling is a sign of strength, not weakness, can be very useful.
There are events that may serve to trigger or exacerbate a mental or emotional health concern with an athlete – examples:
- poor performance;
- conflicts with coaches or teammates;
- a debilitating injury or illness, resulting in a loss of playing time or surgery;
- lack of playing time.;
- family and relationship issues;
- changes in importance of sport, expectations by self/parents, role of sport in life;
- violence — being assaulted, a victim of domestic violence, automobile accidents, or merely witnessing a personal injury or assault on a family member, friend or teammate;
- history of physical or sexual abuse;
- adapting to college life;
- alcohol or drug abuse;
- significant dieting or weight loss;
- gambling issues;
- post-traumatic stress disorder (PTSD).
It is recommended that a relationship be developed with the counseling services and any community mental health care professionals in order to facilitate referrals.
Confidentiality – the athlete’s privacy must be respected unless he/ she is at risk for self-harm or harm to others. The athlete may be encouraged to inform others about his/ her care as appropriate.
Create a Supportive Environment:
Coaches and sports medicine staff members should follow the following guidelines in order to help enhance athlete compliance with mental health referrals:
- express confidence in the mental health professional;
- be concrete about what counseling is and how it could help;
- focus on similarities between the athlete and the mental health professional;
- offer to accompany the athlete to the initial appointment;
- offer to make the appointment while in your office;
- emphasize the confidentiality of medical care and the referral process.
The following self-help strategies may improve mild depression symptoms:
- reduce or eliminate the use of alcohol and drugs;
- break large tasks into smaller ones – set realistic goals;
- engage in regular, mild exercise;
- eat regular and nutritious meals;
- participate in activities that typically make you feel better;
- let family, friends and coaches help you;
- increase positive or optimistic thinking;
- engage in regular and adequate sleep habits.
As with physical injuries, mental health problems may, by their severity, affect athletic performance and limit or even preclude training and competition until successfully managed and treated. Some examples include:
- Suicidal Ideation.
- Panic Attacks.
- General Anxiety.
- Eating Disorders and Disordered Eating.
- Obsessive Compulsive Disorder.
- Substance Abuse Disorders.
Depression – is important to assess among student-athletes because it impacts overall personal well-being, sports performance, academic performance and injury healing. No two people experience depressed feelings in exactly the same way. However, with the proper treatment, 80% of those who seek help and 50% of those who are clinically depressed get better, and many people begin to feel better in just a few weeks.
Athletes may experience depression because of genetic predisposition, developmental challenges of college transitions, academic stress, financial pressures, interpersonal difficulties and grief over loss/ failure.
Team dynamics also may be a factor. Problems often are kept “in the family,” and it is common for teams to try to solve problems by themselves, often ignoring signs or symptoms of more serious issues. Depression affects lots of athletes – the symptoms first appear before or during college.
Approaching the athlete with a potential mental health issue:
Approaching anyone with a concern over mental well-being can be an uncomfortable experience. Consider questions that are open ended and encouraging for the student-athlete to talk about his or her issue:
- “How are things going for you?”
- “Tell me what is going on.”
- “Your behavior has me concerned for you. Can you tell me what is going on, or is there something I need to understand or know why this incident happened?”
- “Tell me more (about the incident).”
- “How do you feel about this (the incident or the facts presented?”
- “Tell me how those cuts (or other wounds) got there.”
- “Perhaps you would like to talk to someone about this issue?”
- “I want to help you, but this type of issue is beyond my scope but I know how to refer you to someone who can help.”
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