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The widow of former Germany goalkeeper Robert Enke, who took his life in 2009, says "perceptions have changed" since his death. "Depression is no longer a taboo topic," Teresa Enke told BBC Sport's Alex South. "A lot has happened in the way that people deal with the sickness. People are more open with it."

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The suicide of Robert Enke (German goalkeeper) and Gary Speed (Welsh defender and national team manager) were two tragic events that emphasized the existing stigma around the mental health of athletes in general. Professor Gino Kerkhoffs (Chair of the Orthopaedic Surgery department of the Amsterdam University Medical Centers) started an international research program aiming to explore the occurrence of mental health symptoms among active and former professional athletes across sports and to identify the stressors contributing to these conditions.

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The Federal Department of Health and Human Services has reported a higher prevalence rate of depression among young adults, with college athletes facing unique risk factors. Women, in general, have a higher rate of depression than men. Studies have found that women college athletes reported more depressive symptoms than male college athletes. Furthermore, the NCAA has reported that student-athletes have faced increased mental health concerns during the coronavirus pandemic.

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(iStock/The Washington Post)

It was January 2015 when the Xavier University Athletic Department called a mandatory event for all student-athletes. Sitting in our athletic center, we all migrated to our respective teams. None of us were told why we were there; on the stage stood a lone lectern and microphone.

Finally, a man took the stage and started speaking. He was a former Division I football player on the fast track to the NFL until he got hurt. Throughout college, he said, he battled severe depression.

Parents can make a plan to decrease suicide risk in their teens. Here's how.

At the time, I was a sophomore cross-country and track runner. I was struggling to keep my spot on the varsity roster and simultaneously fighting anemia and post-traumatic stress disorder from sexual assault - a situation I kept private except for close friends.

But in that moment, I thought I couldn't relate to what the speaker was saying. I wasn't part of a revenue-making sports team nor even close to becoming a professional athlete. I only wanted to represent my school and be the best runner I could be during college.

The speaker eventually opened up the discussion to my fellow athletes - one even spoke to the entire audience, saying they contemplated suicide after a bad season. But their words didn't stick with me after we left the athletic center. Because once I entered the reality we called a campus, my mind reverted back to the pressures I was facing - romantic crushes, the beginning of winter track season. Everything clouded what I later learned to be my depression.

Increasingly, more former and current student-athletes like Harry Miller and Elijah Wade are speaking out about the intersections of mental health and their sports. Unfortunately, the recent deaths by suicide of female student-athletes - including Katie Meyer, Sarah Shulze and Lauren Bernett - have raised more urgent questions. Mostly, why? Is the pressure to perform too extreme? Is there insufficient access to mental health resources for student-athletes?

It could be many factors, if not all of them, according to Josie Nicholson, a sports psychologist and counselor at the University of Mississippi.

"Student-athletes on campuses are hit with more pressure to perform and excel," Nicholson told me. "They live such hectic schedules with so many expectations. ... There's not really much time to stop and process anything."

According to the federal Department of Health and Human Services, there's a higher depression prevalence rate among young adults, and college athletes face unique risk factors. In general, the depression rate for women is higher than men, and studies have found that women college athletes reported more depressive symptoms than male college athletes. And as the NCAA reports, student-athletes have faced increased mental health concerns during the coronavirus pandemic.

For Nicholson, another salient factor is that student-athletes are in their fundamental years of growing into adulthood. Most NCAA athletes are 18 to 23 - and figuring out their identities.

Many have grown up with dreams and talent, Nicholson said, and others around them "stop talking about who they are and emphasize what they do. Their world becomes about taking that dream and living up to those expectations." In college, that one aspect of their identity becomes overemphasized, she added.

As teen suicides rock local sports communities, concerns grow over athletes' mental health

Julie Amato, a sports psychologist at Elite Mindset Sports and Princeton University, says that women athletes, in particular, struggle with perfectionism. "In my experience working with both male and female college athletes, female athletes are more preoccupied with comparing themselves to others and are more fearful of judgment and disapproval by others," she said. "They tend to magnify their mistakes and shortcomings, and feel relieved instead of joyful when they succeed."

Indeed, there are many layers to my own story, but the overarching constant in the chaos of my trauma was my identity as a student-athlete and, ultimately, a runner. Other traumas, including my assault, compounded, and I developed an eating disorder, anxiety and depression.

The athletic center where I practiced was no longer a place of relief but a stomping ground I feared. It was a reminder of the trauma I couldn't process.

By my junior year, I left the cross-country and track team. Months later, I was hospitalized and on suicide watch, and eventually diagnosed with bipolar depression. Luckily, my school had resources in place to accommodate my schoolwork. Professors and administrators checked in on me weekly, and I had access to on-campus counseling. But not every school has what mine did. And not every athletic program has access to a sports psychologist - a professional I (and many) needed the moment I came to campus as a student-athlete.

Back then, I didn't know how to ask for help; I didn't want to let people down. But I was suffering so much that the expectation to compete at an elite level was insurmountable. I'm thankful people knew to provide me with help. "Recognizing that you can stop, you can reach out" is the first step to coming out on the other side, according to Nicholson.

Nicholson also says that truly helping student-athletes requires "athletes hearing from coaches, everybody, what the resources are and encouraging them to use those resources, while genuinely checking in with each other."

Amato agrees that detecting signs early leads to saving lives. "Working to de-stigmatize seeking help within athletics culture is also a critical step," she said. "Too often we hear there were no signs - which tells me the person was likely struggling internally but did not know how to talk about it, or what to do about it."

But most of all, Amato says, people need to treat student-athletes as "humans first and foremost": "We need to ask about their life outside of sport, show that you care about them and are invested in them regardless of how they perform athletically."

Walking away from a sport that I truly loved was, and still is, heartbreaking. But more heartbreaking for me now are the stories of current student-athletes' suffering. I eventually turned to advocacy work as a way to empower myself and others, and I learned that many more were struggling with situations similar to mine.

At Xavier, our saying was, "All for one and one for all." To achieve true change for athletes, it will take all of us - the NCAA, universities and other students - to help one another. Because every individual is worth saving.
If you or someone you know needs help, call the National Suicide Prevention Lifeline at 800-273-TALK (8255). You can also text a crisis counselor at 741741. Devi Jags is a co-founder of Sambar Kitchen and an MFA creative writing candidate at Sarah Lawrence College.
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Perspective | There's a mental health crisis in college sports. I know it firsthand.

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It was January 2015 when the Xavier University Athletic Department called a mandatory event for all student-athletes. Sitting in our athletic center, we all migrated to our respective teams. None of us were told why we were there; on the stage stood a lone lectern and microphone.

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Foundation named in honor of late Conner Taylor inspires others while educating about mental illness

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Keep his memory, legacy alive': Change 4 Conner Foundation positively impacting young adults

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Keep his memory, legacy alive': Change 4 Conner Foundation positively impacting young adults

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Conner Taylor was a college baseball player at Coffeyville Community College. He was a young man with a future, but little did others know he was fighting many demons. After committing suicide his parents developed the Change 4 Conner Foundation. Marcy Taylor has made it a mission to get the topic of mental health brought up in the college baseball arena. Through the work of his foundation they are able to support other baseball programs and players through scholarships. His legacy will live on just as the topic of mental health does.

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NBA star Kevin Love on finding success while struggling with mental health: ‘You can’t achieve yourself out of depression’

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NBA star Kevin Love on finding success while struggling with mental health: ‘You can’t achieve yourself out of depression’

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The best way to protect your time and stress is to train, refuel, recover, and repeat. It feels good to sweat — and for me, it’s like killing two birds with one stone because it’s helping me play basketball.

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A call for change.

Updated July 5, 2023 | Reviewed by Vanessa Lancaster

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College Student-Athletes Are Dying in Mental Health Crisis

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College Student-Athletes Are Dying in Mental Health Crisis

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Creating a mentally healthy environment where athletes feel safe is also vital. For example, providing curCreating a mentally healthy environment for athletes, where they feel safe, is crucial. It is not sufficient to provide only cursory "check-ins" with athletes. Coaches and staff must go beyond that and create an atmosphere where athletes feel safe enough to be open and honest about how they are doing, even when they are struggling. "Check-ins" with athletes are not enough. Coaches and staff must create an environment where athletes feel safe to be honest about how they are doing, even when it is not well.

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Key points

College student-athlete suicide is at a record high.

College athletes are mirrors for the environments created by coaches/staff.

An athletics culture change is needed to keep athletes safe.

College athletes have always had distinct mental health needs. Student-athletes are likely to struggle with depression, anxiety, eating disorders, and substance abuse-but they often do not seek help. This sets up a huge problem where athletes are expected to perform at a high level but mentally suffer in silence.

In 2022, at least four college student-athletes died by suicide. All were high-achieving, high-performing student-athletes who seemed to be doing well to the knowledge of everyone around them. Their deaths left communities wondering, "Why?"

One answer is clear, which is that athletics departments (ADs) and affiliated staff have a responsibility to foster cultures of mental wellness rather than athletic excellence alone.

Attempts at Change

Athletics departments have come a long way over the past decade. Many ADs have sports psychologists on staff or affiliated therapists in counseling centers. These mental health professionals work with dietitians, physicians, strength coaches, physical therapists, and athletic trainers to provide comprehensive care to student-athletes. Undoubtedly, the athletic staff is working hard to increase mental health awareness and keep athletes safe. But it's not enough.

The institutional structure of athletics itself is not built for wellness. Athletes who want to play at the college level are often asked to commit to institutions as early as age 14. Once in college, athletes are put through rigorous training and travel schedules while adjusting to classes and new relationships with peers, coaches, professors, and staff. Institutions profit off athlete effort in exchange for a diploma-a diploma representative of a college education with diminishing value. The pressure to achieve profits and wins outweighs any efforts for well-rounded health.

The "win-at-all-costs" culture and rigid expectations are also felt by staff. Athletics departments are notorious for rapid staff turnover and high levels of burnout. Many positions are filled and refilled each year. By the time student-athletes build a relationship with a trusted adult, that professional could be gone the next season.

These institutional structures pose real barriers to culture change. The future is not hopeless - athletic departments can take certain action steps that emphasize athlete well-being - but it will require radical steps.

This Is How We Change the Culture

Although mental health awareness is important, awareness without substantial programming cannot be expected to make a meaningful impact on athletes' mental health. Data on the percentage of NCAA budgets dedicated to mental health-related expenses are not readily available, but it is unlikely that mental health-related spending is a top priority in current budgets.

Athletics departments must dedicate significant resources (funding, time, energy) to the mental wellness of athletes. That means multiple positions for wellness staff and adequate compensation for those positions. It also means funding for wellness programs that both directly benefit athletes and reduce/eliminate waiting times for services. These services could include individual and group therapy programs, team performance meetings, social gatherings, and small group discussions. Wellness programs should be diverse in offerings and times for ease of access.

It is also vital to create a mentally healthy environment where athletes feel safe. For example, it's not enough to provide cursory "check-ins" with athletes. Coaches and staff must create an environment where athletes feel safe to truly be honest about how they are doing, even when it is not well.

Check-in often. Let athletes know that it is okay (possible and even positive) to feel all emotions, even when emotions are unpleasant. Normalize how common it is to struggle. Validate that college, especially college athletics, is hard to navigate. Emphasize that vulnerability is a shared human experience. Making mistakes improves performance in the long run (and can even make us more likable).

Do not minimize or make fun of sickness or injury. Do not encourage athletes to push through physical or mental health concerns. Do not promote the idea that you must be "hurt enough" or "sick enough" to miss athletic functions or that you have to "earn" rest. Avoid promoting the idea that athletes "fake" or maximize injuries. It's important that you avoid not only these comments towards your athletes/staff but other athletes/staff as well. Regardless of the intended target, athletes will hear comments (even if directed at others) and internalize those messages. College athletes are mirrors of the environments that coaches and staff create.

Instead, emphasize high effort with ample time for rest and recovery (both physical and mental). Teach athletes to actively rest - i.e., actively engage in wellness activities that improve well-being, like enjoyable activities, rather than passive resting (sleep, zoning out). Make rest a vital and non-negotiable part of training and optimal performance. Amplify and encourage athletes' interests outside of sports.

A Call to Action

Student-athlete suicide rates have skyrocketed amid a national mental health crisis among adolescents and young adults. While there have been efforts to increase mental wellness in college athletics, much more must be done. Athletic departments must actively combat institutional barriers like a win-at-all-cost mentality and prioritizing profits over people. Athletes can only flourish on and off the field when these systems become dismantled. Athletes cannot afford to wait.
If you or someone you love is contemplating suicide, seek help immediately. For help 24/7, dial 988 for the National Suicide Prevention Lifeline, or reach out to the Crisis Text Line by texting TALK to 741741. To find a therapist near you, visit the Psychology Today Therapy Directory. Want more content like this? Sign up for my free newsletter.

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College Student-Athletes Are Dying in Mental Health Crisis

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Major League Baseball player Drew Robinson attempted to take his own life. After surviving for 20 hours, he chose life and called for help. His mission now is to help others as he returns to baseball.

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Ratio of Athletes to Mental Health Professionals.

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Ratio of Athletes to Mental Health Professionals.

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Effective change will require student-athletes and their parents, professional athletes and their representatives, and even coaches to raise awareness with athletic administrators and organizational executives. It’s time we think about the whole athlete, not just the body. The late, great Yankees catcher Yogi Berra wasn’t exactly a math whiz, but he did show extraordinary insight into the human psyche when he said, “Baseball (sports) is 90% mental. The other half is physical.”

In other words, athletes must be free of psychological and emotional encumbrance to perform at their peak. Thus, creating fully staffed and funded mental health initiatives is a wise investment if it's all about the wins. If an athlete’s mind is clear, they can perform better. The ratio of mental health professionals per athlete should be the same as the ratio of athletic trainers to athletes.

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Professionals struggle although they are among the top athletes in the World

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Professionals struggle although they are among the top athletes in the World

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Naomi Osaka, Serena Williams, Usain Bolt, Simone Biles, and Michael Phelps... what do these athletes all have in common? They all have struggled with mental health. Our society has push professionals towards unsustainable expectations for perfection, constant improvement, and public pressure in their performances. They have all been discussed negatively because of their desire to mend their mental health issues. They have helped shift the discussion of mental health in the sports industry from a negative topic to one that is becoming a priority among many programs.

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Tampa Bay Sports Green Mental Health Ribbon on Uniforms

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Tampa Bay Sports Green Mental Health Ribbon on Uniforms

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In May, Tampa sports ribbons for every game. While their campaign information page may not explicitly state it, indications suggest that the Rays are also supplying ribbons to opposing teams as a gesture of solidarity with Tampa.