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Challenges of Mental-health Issues in High School Athletics

By Cari Wood, ATC, and Kevin Bryant, CMAA on February 05, 2019 hst Print

Editor’s Note: This is the first in a series of two articles addressing the challenges of mental-health issues in high school athletics. This article presents an example of how a single high school addressed these challenges. Next month, High School Today will explore a statewide approach to this important and difficult subject.

“The two most important days of your life are the day you are born, and the day you find out why.” –Mark Twain

High school athletics can be a conduit to helping students prepare for life. Passion around a chosen activity, connection to caring adults, striving for personal goals and meeting high expectations are ingredients for great triumphs or stumbling blocks which, all too often, can provoke anxiety and depression.

The relationship between coaches and athletes can be complex. Coaches may feel pressured to base their interactions around techniques and tactics of the sport in order to “win now.” Ideally, coaches will have the desire and administrative support to have a lifelong impact on their athletes, helping them develop into caring, competent and productive adults.

In turn, many student-athletes, relishing the positive feedback, rewards of immediate success and attention of a coach may feel pressured to stay in the athletic-performance focused part of the coach-athlete relationship, hiding the ways in which they are struggling and in need of emotional and mental support.

There are more high school students using anti-anxiety medications and dealing with depression than ever before.

  • An estimated 31.9 percent of adolescents have some form of an anxiety disorder.
  • Of adolescents with any anxiety disorder, an estimated 8.3 percent have a severe impairment.
  • The prevalence of any anxiety disorder among adolescents is higher for females (38%) than for males (26.1%).
  • Depression and anxiety disorders are different, but people with depression often experience symptoms similar to those of an anxiety disorder, such as nervousness, irritability and problems sleeping and concentrating.
  • Each disorder has its own causes and its own emotional and behavioral symptoms.
  • Many people who develop depression have a history of an anxiety disorder earlier in life.
  • There is no evidence one disorder causes the other, but there is clear evidence that many people suffer from both disorders.

Participation in athletics can lend to a culture that emphasizes the need to “just play through it” when injured, stressed or in pain. “No pain, no gain.” Student-athletes can quickly allow their athletic accomplishments (or failures) to become their identity and source of self worth. This emphasis on athletics can cause significant stress and challenges in their lives.

Athletics may also represent an avenue of “escape” for students. However, if they never learn how to cope with stress on or off the playing field, they are at risk for a mental-health crisis. Students can use any number of ways to numb the pain of family issues, divorce, abuse, disappointment, dating relationship breakups, academic failure, cyberbullying and physical injury.

When our coaching staff last year was asked how many had athletes who were showing signs of anxiety and depression, every coach’s hand in the room was raised. These behaviors can often be masked or put off by the use of drugs, alcohol, tobacco and thoughts of suicide looking for relief from pressure, anxiety and family issues.

In the athletic program at Redmond (Oregon) High School, we received a huge wake-up call a year ago with the suicide of one of our three-sport athletes. We are now committed to do our best to avoid that ever happening again. A video was developed by the parents of our fallen student, which has registered more than 3.4 million hits on Facebook.

This past year, several prominent professional athletes have addressed their own mental and emotional health including NBA players Kevin Love and DeMar DeRozan sharing their struggles with anxiety and depression. Love stated that “Everyone is going through something.” A panic attack at a game last year led him to seek professional counseling help. He said he had to “confront the fact he needed help.” By doing so, Love pushed back on the unwritten rules about “being a man,” asking for help and taking his story public. He also wanted to help decrease the stigma associated with emotional and mental challenges many have endured.

Michael Phelps, the winner of 28 Olympic medals, shared his own challenges with anxiety and depression recently, admitting he had considered suicide. Breaking his first world record at age 15, Phelps described living a life of dedication, high expectations, challenging physical workouts and dealing with disappointment associated with the pursuit of big goals. Caught up in the world of “real men” do not talk about their problems, Phelps finally became convinced that “it is OK to not be OK.”

During the past year, the Redmond School District coaching staff has become more attuned to athletes’ moods, attitudes, family challenges and potential substance-abuse issues following our athlete’s suicide. Recently, one of our coaches sought help for a student- athlete who he knew was struggling at home and the coach wanted to help. Shortly thereafter, another coach asked us to meet with an athlete who was exhibiting suicidal ideation through photos and other communication online.

This school year, our school district hired two mental-health counselors who are working inside both of the high schools in our district, giving us access to trained expertise in this challenging area. Still, with the number of athletes in our program, we cannot meet or know the extent or challenges facing every student.

In an attempt to bridge the gap, the Redmond High School athletic training staff designed a “Google form” consisting of four questions that is distributed to every fall athlete on a weekly basis. This “Wellness Check” allows our athletes to respond to inquiries regarding sleep, diet, injury issues and mental health. The athletic training staff then follows up on the information personally if there are any concerning responses, and then decides who else needs to be notified.

Discussion at the Redmond School District’s monthly coaches meetings has focused on Student-Athlete Development (SAD) in specific ways related to overall health in four key areas:

  1. Mental Skills Training (emotion management, visualization, positive self-talk and goal setting)
  2. Emotional/Mental Health
  3. Physical Improvement (strength, speed and agility)
  4. Academic Responsibility and Success

Recently, we were guests on a live Facebook event focused on the mental and emotional health of our athletes, which took place on National Mental Health Day with the NATA. We discussed some of the specifics of our program and were able to connect with people from around the United States with similar concerns and challenges. In April, we will be presenting a workshop at the annual Oregon Athletic Directors Association (OADA) state conference focused on student-athlete mental and emotional health.

Ultimately, everyone who works with athletes wants to do whatever possible to help them succeed athletically and academically; however, the most important goal is to help build strong and resilient young men and women who will be ready for all of the challenges of life during and after high school. We do not want to lose another student to suicide because the signs were not recognized, or no one knew where to turn for help. Often, we do not possess the expertise to assist our athletes in these areas of concern; we need to find community resources available to make sure no athlete falls through the cracks.