Breaking Stigma Around Athlete Mental Health

Mental health. That phrase SO many people are reluctant to discuss. Add "athlete" to that phrase, and it gets even more quiet. Yet, do a quick google search, and you will find dozens of articles discussing mental health difficulties in athletes of all levels, ages, and abilities. 

Unfortunately, in the sports world, there's historically been stigma surrounding athlete mental health (although it's changing...YAY!!). On one hand, given mental health is still battling stigma in non-athlete populations, I can understand it. On the other hand, it is TIME for us to stop being weird about athlete mental health; we are all responsible for breaking that stigma. It's time for us to have real, honest discussions about it, and all work together toward helping student-athletes seek mental health treatment.

As you may already know, athlete mental health is one of my passions. I'm a practicing clinical + sport psychologist, so I work with many college student-athletes who are dealing with mental health issues. I'm incredibly comfortable discussing mental health and often encourage people to seek services in my professional AND personal life. Seeking mental health treatment IS NOT a weakness. Would you consider it weak to get an MRI and surgery for your knee? Nope. Mental health is no different.

One of the biggest barriers to student-athletes seeking mental health services is stigma (Wahto, Swift, & Whipple, 2016; Watson, 2005). This may take the form of student-athletes fearing how others will perceive them seeking treatment. It may also include their own negative biases about treatment, including believing that it's not helpful. Given we know mental health treatment can be incredibly effective in reducing difficulties and improving outcomes, what can be done to reduce stigma for student-athletes seeking mental health services?

1. Encourage those who are struggling to seek help.

Mental health difficulties can be incredibly scary and lonely. I cannot tell you how many student-athletes have asked me if they are the only ones who I've worked with dealing with mental health issues. (The answer is a resounding NO, by the way.) Mental health difficulties impact our thoughts and emotions to the point that it can be incredibly isolating. Unfortunately, when that's the case student-athletes may be reluctant to talk about what's really going on.

Don't be afraid to ask a student-athlete how he or she is doing. If you come at it from a place of genuine care and concern, it will be meaningful. Tell them what you've noticed and why you're wondering if they're struggling. Let them know you're there for them and can help them find resources to feel better. If you're not sure how to find these resources, ask someone you trust (a coach, team physician, ATC, teammate, parent, etc.) to help you or the student-athlete find them. 

If you're seeking mental health services, make sure you're working with a LICENSED mental health provider, such as a psychologist (LP), social worker (LICSW), or counselor (LPCC). That "mental toughness" expert working with your team may not have appropriate training to effectively help you manage mental health issues. Ideally, the licensed provider with whom you're working will also have sport psychology training, too, because there are a number of unique factors in the student-athlete world that complicate things. 

The American Psychological Association (APA) has a psychologist locator that you can use to find a psychologist in your area. You can also search the Association for Applied Sport Psychology Certified Consultant database. Just make sure the certified consultant you choose is also licensed in a mental health discipline. Other places to find providers include your college counseling center, local mental health agencies, or state psychological associations. 

It's also important to note that there are MANY different therapeutic approaches. Unfortunately, movies perpetuate a stigma that therapy means laying on a couch, talking endlessly about feelings related to your mom, while the therapist is drawing on a notepad and not listening. THIS IS NOT TRUE! Well, I do have a couch and we will talk about feelings, but the other points aren't true. The only time I take notes is during the first session, just so I can remember all the new info!

One of the most common, evidence-based, and effective approaches is cognitive behavioral therapy (CBT). I touched on CBT in my previous blog post about "shoulds." It's ideal for athletes, as it's action-oriented. Granted, there will be some discussion about feelings (they're good things!) but not like it's portrayed in the movies. There are also other evidence-based approaches that are helpful that your therapist will discuss at the outset of treatment if they're right for you.

2. Create a climate of mental health acceptance.

Although mental health difficulties are common, not everyone has experienced them. As humans, we are vulnerable to judging what we don't understand. We may not even intend to come across as judgmental, but trust me, others notice and experience even subtle judgement harshly. Take a moment to notice how you talk about mental health. Are you weird about it? Do you whisper when you mention depression? Do you avoid talking about it all together? Do you dismiss mental health as something "in your head"?

If you talk about mental health in a stigmatized manner it's not going to help those you care about open up to you. If you don't understand mental health difficulties, APA has many resources available to help you understand them better. (There's also a great article on that page about how to choose the right psychologist.)

I find being matter of fact (yet supportive) about mental health to be a good approach. Allow others to acknowledge their difficulties, and direct them toward getting help if they haven't already. Ask how they want you to be helpful in this process. If you're not able to help in the manner they desire, offer something you CAN do. For example, maybe you're not one to have long conversations about emotional topics, but you'll invite them over to play with your dog. It's still being supportive, just in a different way!

There are also a number of great organizations that promote student-athlete mental health. Two of my favorites are the University of Michigan's Athletes Connected and the Student-Athlete Mental Health Initiative. These resources can be a good starting point for the discussion around student-athlete mental health.

3. Be patient.

Some mental health difficulties can be resolved relatively quickly, whereas others take time. Or maybe you'll feel better and then encounter a road bump that increases mental health symptoms. That's okay! It's like rehab for a physical injury: sometimes we know the course of recovery, sometimes we don't. Most of the time recovery isn't entirely linear and has some setbacks. Stay the course and keep working on it. You WILL feel better! 

If someone you care about is dealing with mental health difficulties, remind them of this path. Athletes are used to pushing hard and getting results! Managing mental health concerns sometimes means pushing hard, whereas other time it means being patient. (What a great time to work on those patience skills, huh?).

I'm a strong proponent of student-athletes seeking mental health services. You're managing MANY different roles at any given moment, and at the very least, keeping it all in balance can be stressful. The reality is that life also happens while you're working on all of these accomplishments. You don't always know when you'll be thrown a curve ball, and it may not always be at the best time.

Talking with a therapist does NOT mean you're "crazy." Nearly all the people with whom I work are typical people that most wouldn't even know experienced mental health difficulties. Chances are they are just like you. 

Dr. Erin Haugen is a licensed clinical psychologist and sport/performance psychologist located in Grand Forks, ND. She specializes in helping college student-athletes excel in sports and in life. She is a former basketball player, current triathlete, and LOVES dogs.


Disclaimer: You should consult an appropriate professional for specific advice tailored to your situation. If you are experiencing a life-threatening emergency, you should call 911 or go to your nearest emergency room.