What Coaches and Athletic Trainers Can Do About Student-Athlete Mental Health

By Jason von Stietz, PhD (originally from www.cbtsocal.com)

Why Mental Health Matters

Mental health is not separate from physical health. Medical problems can often lead to mental health issues. Mental health issues, such as substance abuse and eating disorders, can result in medical problems. Furthermore, psychological stress from daily life can leave athletes vulnerable to injuries.

Student-athletes are at special risk for mental health conditions because:

  • College is a time of many transitions (leaving home, ending relationships, increase in academic expectations/workload, establishing place on a new team, responding to new coaches, etc.)
  • Adolescence/ early adulthood is a time when some mental health issues are more prevalent (substance abuse, eating disorders); most mental health symptoms arise by age 24.
  • Some mental health issues can be exacerbated by pressure. Many student-athletes feel significant sport-related/ performance stress. Overtime this leads to physical/emotional exhaustion.

Why coaches and trainers are important in identifying mental health issues:

  • Coaches and trainers often spend a significant amount of quality time with student-athletes. They notice behaviors that may be overlooked by staff, faculty or even parents.
  • Coaches and trainers have significant influence that can help student athletes receive timely and effective mental health treatment. The negative consequences of mental health issues can be minimized by continued follow-up by coaches and trainers’ interactions with athletes.

What to Look For ("Signs and Symptoms")

  • Behavioral: Disruption of daily activities, social withdrawal, agitation/fighting, difficulty with authority, decrease in academic and athletic performance, and increase in substance use.
  • Cognitive: Difficulty concentrating, poor memory, impaired decision-making, obsessive thoughts, negative self-talk and suicidal thoughts.
  • Emotional: Irritability, excessive worry, feeling out of control, mood swings, and apathy.
  • Physical/Medical: Difficulty sleeping, changes in appetite or weight, fatigue/low energy, headaches, and overuse injuries.


Selected Statistics:

      • Anxiety: In the US, nearly 1 in 3 adolescents suffer from an anxiety disorder. According to NCAA, 85% of athletic trainers believe anxiety disorders are affecting their athletes.
      • Depression: 15-20% of the population will suffer from depression once in their lifetime. The average age of onset of depression is 22 years old.
      • Substance abuse: Recent research indicates that 30% of student athletes reported they drank alcohol to the point of “blacking out.” 25% of student-athletes have missed class and 16% have performed poorly on a test due to alcohol use. Student-athletes who have used marijuana in the last 30 days fail classes at 3 times the rate of students who do not use.
      • Suicidality: Suicide is the second leading cause of death among college students. 10% of college students have attempted or considered attempting suicide.

What You Can Do

  • Recognize mental health issues and refer the student-athlete to a mental health professional.
  • Remember that issues such as anxiety and depression are mental health issues that need treatment. Mental health issues are not “choices.” Ask the hard questions.
  • Validate their emotional experience. Be a sounding board. Be a safe space. Model making good choices for mental health.
  • Check-in with one student-athlete a day about how their personal life is going. This builds trust and a healthy relationship.

Some things that are likely to be less helpful, and thus should be avoided, include:

  • Shaming the student-athlete or judging them as “weak” due to emotional issues.
  • Minimizing the problem. The problem is likely larger than the student-athlete is acknowledging.


Remember to Take Care of Yourself!

Avoid allowing a student-athlete’s mental health issues to weigh on you too heavily by knowing your limits. Be aware of what you can reasonably expect from yourself. Your responsibility is to recognize and refer. Consult with the Counseling Center staff or a mental health professional at the first sign of risk indicators.

Black male runner about to start a race.
Thomas Smalley Stretching an Athlete
Soccer players kicking a ball