For Student-Athletes’ Mental Health: A More Educated Approach
This article was originally published by the NCAA in the New York Times.
Pressures can quickly accumulate for young people as they transition from home and high school to life as college students.
New academic and personal challenges often coincide with separation from friends and family. And in that time of change — one that many parents might assume is defined by discovery and optimism — an unexpected obstacle can emerge, often unnoticed: an issue with mental health. It can reveal itself in the form of intense anxiety before a test or competition, changes in eating habits that can morph into an eating disorder, or feelings of depression that can hamper young people’s ability to manage the day-to-day responsibilities of their new world.
It’s now recognized as a common challenge: An estimated one in five adults will face a mental health condition each year, and the majority of those conditions develop by age 24. But while students and student-athletes are affected equally, the competitive nature of sports also has engendered an attitude that can spur some to hide their problem. Seeking help in an athlete’s world might be considered a sign of weakness. Rather than speaking with someone or seeking help, some athletes believe they should simply tough it out.
The stories of just a few real-life challenges faced by three student-athletes at California State University, Monterey Bay, make the reality clear: unexpected panic attacks, a best friend overdosing on drugs, two knee surgeries. In their words:
“It was almost like the walls were closing in on me, and I couldn’t breathe, couldn’t think clearly.”
“I never knew what anxiety was. I never thought I’d have it, but I for sure had it.”
“It felt like my heart was breaking in two. Literally for hours, I cried myself to sleep.”
As students, they face the daily rigors of classes, homework and exams. As athletes, they add regular practices, workouts and travel for games. All of it comes with the constant strain to succeed, not only for the future — “can I make it pro?” — but for the past sacrifices parents and coaches made along the way and the present pressures of living up to expectations.
In recent years, coaches and athletic staff have begun recognizing the importance of understanding and supporting student-athlete mental wellness. Guided by new resources, such as Mental Health Best Practices, a guide published by the NCAA’s Sport Science Institute in 2016, schools are devoting more education and resources to mental health well-being. Rather than hide from stigma, students and student-athletes are speaking up, seeking help and taking advantage of ever-stronger support systems on campus.
Keeping Above Water
Kally Fayhee knows firsthand how seeking help can make a difference.
She started swimming competitively by age 6, and her years in middle school and high school became defined by the single goal of earning a swimming scholarship. She accomplished that goal, enrolled at the University of Michigan and set her sights even higher: She wanted to be an Olympian. As she rose to team captain, the pursuit of her dream came with mounting pressures. She felt she had to live up to what she perceived as her parents’ and her coaches’ expectations, as well as a desire to be a role model as captain of her team. Eventually, those burdens overwhelmed her.
“I started having anxiety of living up to the expectations,” says Fayhee, who graduated in 2013 and now works in marketing. “Because I didn’t have a lot of balance and because I truthfully didn’t know how to mentally process all of it, the anxiety started to kind of spiral, and I wasn’t able to cope.”
Searching for a sense of control, Fayhee began closely monitoring everything she ate, obsessively counting calories. What started with a goal of optimizing her swimming performance devolved into an eating disorder. Fayhee realized she was struggling with bulimia, but she didn’t know where to turn for help. The shame she felt, combined with her stress and anxiety, led to sleep deprivation. A routine trip to get ice cream with a teammate was a turning point.
“We were driving back to the house, and she was like, ‘Are you OK?’ ” Fayhee recalls. “I just lost it. I started bawling and told her everything.”
Her friend told her to see University of Michigan athletics counselor Barb Hansen. “She said, ‘Either you go talk to Barb, or I’ll tell the coaches.’ ”
But Fayhee wasn’t focused on getting help. “Well, Barb is legally obligated not to tell anybody,” she remembers thinking. “The coaches aren’t, so I’ll go to Barb.”
Even with help, recovery wasn’t easy. Counseling helped her manage the pressure she felt as a student and an athlete, but progress was undermined when Fayhee missed qualifying for the Olympic trials by just a millisecond. It took more counseling, and more support from friends and family, to prevent her eating disorder from resurfacing.
Hansen says she often sees students who are used to being self-sufficient suddenly struggle when thrust into new environments with new pressures. Sometimes in those instances, their established coping mechanisms might not work and can lead to negative cycles of excessive self-criticism and distorted thinking. These exaggerated or irrational thought patterns reinforce negative self-talk.
Hansen’s work lies in getting students to step back and examine their own thoughts. Often these thoughts may be misguided, favor unrealistic extremes or overgeneralize.
“Are they magnifying problems? Are they trying to tell their own fortunes and jumping to conclusions? Because none of those distorted thoughts are based in fact and truth,” she says.
With time and counseling, Hansen says student-athletes can begin to recognize those patterns and develop skills for effectively coping. In that way, their internal struggles can be managed in the same manner that they might recognize a recurring physical injury and seek help from their trainer.
“I tried to white-knuckle it, but it took me being 100 percent honest with everybody about what I had gone through to even get on the road to being better,” Fayhee says. “Barb helped me figure out the best ways for me to process adversity — knowing when to push through and when to back off and ask for help. Because that’s actually going to help you push further in the end. I think that’s something we’re all still learning.”
Today, that lesson is one Fayhee is dedicated to teaching. After graduating, Fayhee became involved with Athletes Connected, a University of Michigan program that aims to reduce the stigma around mental health conditions and to provide resources for wellness. A recipient of an NCAA Innovations in Research and Practice Grant, the organization creates videos to raise awareness of mental health, develops informational presentations (at which Fayhee is a frequent speaker) and hosts support groups.
Raising A Hand
Challenges with mental health aren’t limited to athletes with Olympic goals. The pressure to compete and succeed permeates the athletics community, from a nationally recognized program like Michigan to more regionally known schools with smaller staffs and fewer resources. The culture that demands strength and toughness in adverse situations affects all athletes.
Many of the challenges Fayhee faced at Michigan are also familiar to student-athletes at Cal State Monterey Bay. To give students support, the athletics department is actively working to reduce the stigma of mental health conditions so students seek help. For the past five years, it has worked closely with its kinesiology department, which focuses on the physiology and mechanics of body movement, to provide student-athletes with a holistic approach to wellness. Through a collaborative approach with mental health care providers, the medical team, coaches and other support staff, Cal State Monterey Bay student-athletes have an opportunity to focus on a more unified approach to mental, emotional and physical wellness.
The NCAA Mental Health Best Practices provides recommendations in four main areas:
Identifying certified mental health care professionals for student-athletes.
Identifying routine and emergency referral practices for students’ mental health issues.
Developing preseason mental health screening questionnaires to help identify potential areas of concern.
Promoting environments that support mental well-being, resilience and thriving.
“What I appreciate here at CSUMB is that we treat the student-athlete as a whole person, not just as an athlete,” says professor Joanna Morrissey, who helps athletes optimize their athletic performance by focusing on the mind-body connection. “What is important for any college student is that they are able to develop themselves and grow as a person.”
As part of its mental health support strategy, Cal State Monterey Bay employed the NCAA’s Mental Health Best Practices, a resource designed to help schools of any size develop programs to support student mental wellness.
Accompanied by a morning mist rolling in from the Pacific Ocean, 270 student-athletes arrived on campus in 2016 and were asked to take a mental health pre-participation screening questionnaire regarding topics such as sleep, anxiety, depression, substance abuse and more. It was the the first year the mental health screening questionnaires were incorporated into the NCAA’s Mental Health Best Practices. They are designed to help assess whether students might benefit from additional help, says Cal State Monterey Bay Athletics Director Kirby Garry.
“To have 20 percent of your students raise their hand before we even get started and say, ‘Yeah, I’m dealing with some kind of anxiety or stress right now. I would like help,’ it gave us a better feel for where our students were mentally as they come into a new school year,” he says. This additional help first stems from a culture – actively promoted by coaches – that makes it just as normal to seek care for a mental health concern as for a sprained ankle. Awareness is the most important first step, and may lead to mental health counseling provided by a licensed professional, as described in the best practices guide.
The survey afforded Morrissey the chance to interact with student-athletes before the hectic start to the semester. One of the most common challenges students face is time management, she says. As a Division II school, scholarships for athletes are only partially funded, if at all. That means a student might be balancing a part-time job on top of a full course load and a grueling athletic schedule, piling on pressure to perform in all three areas. Teaching scheduling and time management skills can go a long way to relieving a student-athlete’s stress.
The No. 1 psychological predictor of injury susceptibility is poor stress management, Morrissey says. “If our athletes are not effective in coping and managing their stressors, it’s going to put them at greater risk of injury,” Morrissey says.
Starting a Conversation
Fayhee believes the most encouraging aspect of the measures schools like Michigan and Cal State Monterey Bay are taking is that they provide a framework to build awareness.
“It needs to start with conversation and breaking down the stigmas of help-seeking in general,” she says. “I would have been a better leader if I had been honest because my teammates would have been able to be honest with me and say, ‘Hey I’m struggling with this.’ They would have been more open to come to me, knowing that I had struggled, versus trying to be perfect. Because, truthfully, nobody is perfect.”
Morrissey believes all colleges across the country have one thing in common that can help: They encourage a sense of community and a natural support structure.
“There’s a reason why they are part of a team,” she says, referring to student-athletes. “There’s a reason why they are part of a campus community. That means taking advantage of the resources that are out there.”
It’s these resources that have made a very real difference in the lives of student-athletes at Cal State Monterey Bay. And you can hear it in their words:
“It’s helped calm me down a bit and just feel like I’m in control a little bit more.”
“Now I’m back to my old self again. No more stressing over nothing. No more unwelcome anxieties.”
“With the help of Dr. Morrissey, the support of my family and my friends, I know that I’m going to be OK.”