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Student Athlete Mental Health Part II: What do we do at UP?

Two weeks ago I wrote a bit here on the TL blog about whether there is anything particular about student-athletes with mental health concerns compared with other students. The short answer is yes and no; student-athletes may feel particular pressures to ‘tough out’ mental health challenges due to sports culture, but a proportion will always experience the same types of mental health concerns all our students can sometimes experience.

So should faculty and academic staff treat the student-athletes we come across in academic contexts any differently when we suspect mental health concerns? Again, the short answer is probably yes and no. The NCAA nationally has developed extensive resources specific to working with college student-athlete mental health concerns (see the NCAA resource hub). And it is true that student-athletes may have different social networks than other students, including intensive relationships with coaches and athletic department staff who closely track their well-being. Because of concerns about access and stigma in sports culture, there have been points when the UP athletic department sets up counseling and consultation opportunities specifically for student-athletes.

For the most part, however, the athletic department works in the same mental health support structure as the rest of the University. That means that when faculty and academic staff have concerns about a student-athlete, it often makes most sense to start with using the general Early Alert system. Early Alert can then work with the athletic department, along with other campus resources, to plan what are most appropriate next steps – should, for example, coaches be involved or would that have the potential to unnecessarily complicate matters? Alison Knoedler, the Director of Academic and Student Athlete Development at UP, is notified of any early alert for a student athlete and works collaboratively to identify best steps for each particular situation.

The athletic department at UP is also actively making efforts to connect with other campus services: they invite UP’s professional counselors from the Health and Counseling Center to attend a staff meeting once a year, to introduce themselves to the athletic department’s compliance team, to speak with the HPE 108: Life Skills for Student Athletes (required) course each Fall, and to meet incoming student athletes in the summer to talk to new first year athletes and transfers about services on campus.

In addition, the athletic department has a ‘sports performance’ staff that primarily attends to student athlete’s physical health – but through that work also has natural access to a broader sense of student-athlete well-being. This type of work is tricky anywhere with athletes because the application of psychology in sports settings takes two very different forms: one is often termed ‘mental coaching’ and is focused largely on using psychological tools towards performance enhancement; the other is more conventional counseling psychology for athletes dealing with personal issues distinct from their athletic performance.

Sometimes these two areas overlap – student athletes can have performance issues that relate closely to personal issues. But often they are distinct – performance issues such as a lack of athletic motivation or sport-specific concentration are different from personal issues such as anxiety and depression. Each particular case might require a distinct type of intervention, and a distinct type of professional help – most ‘mental coaches’ are not trained in counseling psychology, and most counseling psychologists are not trained in mental coaching.

Ultimately, however, these should all work collaboratively: the UP athletic department tries to create a network of support and referral that works closely with the Health and Counseling Center. Coaches, assistant coaches, trainers, sports performance staff, academic support staff, and administrators in the athletic department all work to identify and refer student athletes. Ideally, and for the good of all our students – athletes or not, we faculty and academic staff outside the athletic department can best serve as an additional complimentary and supplementary layer in that network of support and referral.

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Student Athlete Mental Health: Are Sports Special?

a basketball hoop seen from below and behindDo student-athletes tend to have more mental health problems than the general student population, fewer mental health problems, or similar mental health problems? Last Spring, when introducing a speaker talking to UP student-athletes about the particular dynamics of mental health for athletes, I asked a version of this question to our UP varsity athletes. The question is one I also discuss in my PSY/SOC 453 class on ‘Psychosocial Aspects of Sport and Physical Activity’ and it turns out to be surprisingly difficult to answer with research.

Most basic data finds athletes report fewer mental health concerns than comparable non-athlete populations, but researchers generally assume that athletes underreport mental health concerns because of sports culture – high-level athletes are often socialized to be tough, competitive, and averse to admitting what could be perceived as a ‘weakness.’ Though sport culture is changing some, we are still much more likely to hear about famous athletes taking time off for physical injuries than for psychological ones.

So I was both surprised, and somewhat impressed, when a large proportion of the UP student-athletes I surveyed by show of hands last Spring thought athletes were more likely to experience mental health concerns than the general population. I was impressed because our athletes were willing to admit that the pressures and cultures of sport are not always as healthy as we might hope – and that the path of athletic excellence can indeed involve significant mental health challenges.

I was reminded of this experience recently while reading a 2017 book by ESPN journalist Kate Fagan titled What Made Maddy Run: The Secret Struggles and Tragic Death of an All-American Teen. The book tells that story of Madison Holleran – a student-athlete at the University of Pennsylvania who tragically took her life as a 19 year old first-year college student despite many external appearances of ‘having it all.’ The book, and a thoughtful long-form article on the ESPN web-site titled ‘Split Image’, discuss ways Holleran devoted so much of herself to excellence in athletics, academics, and with friends (at least partially through a carefully cultivated social media presence) that when she achieved her dream of becoming an Ivy League athlete she decompensated in isolation. She made tentative efforts to reach out to friends, family, counseling services, and coaches – but mostly she started to feel as though her inner turmoil and despair were unredeemable failures. To an outsider it seemed she was good at almost everything she did, but inside she didn’t feel good enough.

Madison’s Holleran’s story is not just about sports, but it does say important things about the relationship between sports culture and mental health. Student-athletes often invest massive amounts of their selves and their identities in being good at sports. Those who succeed get many benefits from that investment, but they also experience costs – they often feel a constant pressure to get better and be the best, they sometimes lack the autonomy to make their own decisions and change directions in their lives, and they don’t always have opportunities to explore identities outside of sports that might actually balance their development into healthy adults.

Over the last few years at UP I’ve learned about several ways our athletic department tries to care for the mental health of student athletes who may have concerns; I hope to discuss some of those ways in a follow-up post soon. For now, however, it is worth emphasizing to UP faculty and academic staff who interact with student athletes that mental health concerns can affect even those who seem the strongest. Student athletes often have to fight against the stigma in sports culture against openly acknowledging mental health concerns, but many should and do take up that fight.

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Best Practices in College Student Mental Health: What The Jed Foundation Might Offer

the quad at UP, students walking across campusIn the midst of growing national attention to mental health several organizations have started providing resources and programming specific to the target demographic most relevant to our work as UP faculty: college students. One particularly prominent organization in this realm is The Jed Foundation, started in 2000 by a philanthropist couple who lost their son (Jed) to suicide during his sophomore year of college.

Some of us at UP have become familiar with The Jed Foundation in the last few years after the 2015-2016 President’s Panel on Mental Health recommended working with the Jed “Campus Program” which they describe as “A nationwide initiative designed to guide schools through a collaborative process of developing comprehensive systems, programs and policies with customized support to build upon existing student mental health, substance abuse and suicide prevention efforts.” This program involves a multi-year consultation towards improving mental health on college campuses, and UP has begun some of the initial steps in working with Jed on our campus. They estimate that over 150 colleges are participating in the program, including schools such as Notre Dame, the University of Washington, Princeton, and Georgetown, so we are in good company!

There may be points where this work directly intersects with faculty work, though much of it will involve a broader group of campus offices that work with students – ranging from the Health and Counseling Center to Public Safety. But there are also ways that The Jed Foundation might be of more direct interest to faculty and academic staff, including both specific information about “What to do if…I’m worried about someone” (such as one of our students) and their model for “a comprehensive, public health approach to promoting emotional well-being and preventing suicide and serious substance abuse.”

Their specific information about “What to do if…I’m worried about someone” includes informational resources that might help faculty and academic staff think about what to do with students of concern. How can we know when students are just bored and disengaged, or when those traits may actually be symptoms of more serious psychological distress? The short answer is that there is no easy way to know – and at UP any student that might raise those types of questions in your mind is likely worth first submitting an early alert through our own on-campus system. But it might also be helpful to know some of what The Jed Foundation identifies as “Common signs of suicidal thoughts and behaviors”:

  • Talking about wanting to end it all; in person, via text or on social media
  • Expressing guilt (e.g., “I’m a terrible person”) or hopelessness (e.g., “What’s the point, things will never get better”)
  • Withdrawal from everyday life (e.g., no longer spending time with friends or engaging in previously enjoyable hobbies/school activities)
  • Asking about or actively seeking access to means to self-harm (e.g., weapons, pills, etc.)
  • Giving away personal possessions
  • Changes in use of substances (alcohol and/or drug use)

Or what they identify as “additional warning signs that might indicate that a young person is suicidal”:

  • Change in eating and sleeping habits
  • Violent or unusually rebellious behavior; running away
  • Drug or alcohol use
  • Neglecting their appearance, change in their usual grooming habits
  • Persistent boredom
  • Change in physical health. Persistent complaints about ailments such as headaches and stomach aches
  • Not tolerating praise or reward

The Jed Foundation has many other related informational resources, and links to other related resources such as relevant web-pages for the American Association of Suicidology and the National Suicide Prevention Lifeline. Though it is worth remembering that faculty and academic staff’s main job with students of concern is to get them connected to the professional resources they need, we can also keep ourselves informed.

And it may also be helpful for faculty and academic staff to remember that promoting students well-being really does require what Jed calls a “comprehensive approach” (also see their strategic planning diagram below). Their model for colleges and universities includes components for helping students develop life skills; promoting social connectedness; identifying students at risk early; increasing help-seeking behavior; providing adequate mental health and substance abuse services; following appropriate crisis management procedures; and reducing access to potentially lethal means.

Faculty and academic staff are only one small part of this larger whole – but for the sake of our students, and for our own sake when we confront challenges in the classroom, we can take advantage of our academic brains to learn about and understand what national organizations such as The Jed Foundation already know.