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An introduction to Mind, Body and Sport

The NCAA's chief medical officer weighs in on the Sport Science Institute's new guide to student-athlete mental health

By Dr. Brian Hainline

When I began my tenure as NCAA Chief Medical Officer in January 2013, my first task was to connect with NCAA stakeholders and constituents to understand their concerns. I have since met with hundreds of student-athletes and dozens of student-athlete groups to ask them their primary challenges from a health and safety standpoint. Almost to a person, the No. 1 response is student-athlete mental health and wellness.

That may surprise people whose only contact with student-athletes is from watching them compete on television. It's just a game, after all – what could be so hard about that?

But those of you in the trenches working with student-athletes on a daily basis know the challenges they face – and you know that while student-athletes may play games, being a student-athlete isn't a game at all.

Student-athletes are college students, with all the challenges and opportunities presented to emerging adults, and with an additional role – as sports performer and in many cases campus celebrities, wearing the colors of their school and representing hopes and expectations of their campus and community.

College students in general represent a healthy cohort among same-aged peers, and student-athletes an even healthier subpopulation, buttressed by a discipline, commitment and attention to exercise and nutrition required to meet the demands of their sport. As such, and rightly so, athletics departments have developed sports medicine services that increasingly engage a multitude of resources and expertise to address student-athletes' injuries and illnesses to ensure they are in the best condition to compete. 

But there's more to being a student-athlete than just physical preparation and performance. As more media coverage, commentary and public scrutiny are devoted to what student-athletes do off the field, along with the accompanying pressures to perform (and win games) on the field, student-athletes are inundated with factors that may affect their mental health and wellness. And the “culture” of athletics may inhibit student-athletes from seeking help to address issues such as anxiety, depression, the stress associated with the expectations of their sport, and the everyday stress of dealing with relationships, academic demands, and adjusting to life away from home.

Student-athletes themselves have begun to speak out about issues and resource needs. Consider the insightful words from former Notre Dame football player Aaron Taylor. Aaron completed his undergraduate degree in three and a half years, was a two-time All-American, won the esteemed Lombardi Trophy as college football's top lineman, and was a first-round NFL draft pick.

As Aaron says, his was the classic story of the quintessential overachiever whose success was the result of equal amounts of talent and hard work. But in his words, his experience wasn't as rosy as it appeared. Hidden just behind the accolades, trophies and championships was a young man suffering from anxiety and depression.

Here's what he told us:

“I later discovered that many of my issues stemmed from the internal pressure I placed on myself to reach some unattainable level of greatness as a way to mitigate the effects of an early childhood divorce and a variety of other challenges. I brought these issues with me to campus, but no one was the wiser, as my ‘game face' helped hide my condition with relative ease…even from myself.

“Beginning in college and throughout my professional career, I battled depression with the same regularity as blitzing defenses, but the external opponents were much easier to deal with than the internal ones. Due to fear of looking weak or being judged, I hid my condition from those closest to me, including my coaches and teammates. Even though I lived my life in the spotlight, I was suffering in silence.”

Aaron is not alone, which is why we have developed this resource to present a comprehensive look at the student-athlete experience from a mental health perspective – from the relationships with faculty, peers, administrators, coaches and fans to the struggles student-athletes may face in their sport. Some struggles are immense, including pain and injury that preclude competition; criticism and blame for poor sport outcomes; and prevailing attitudes that asking for help demonstrates weakness of spirit and drive.

We've selected Aaron's story to lead off the publication as a first-person account of the inner life underneath the toughness that student-athletes are conditioned to show on the surface. We've also sought advice from dozens of experts in the field. In all, this publication is designed to help athletics departments, campus mental health providers, and all sport stakeholders promote and develop effective strategies to understand and support student-athlete mental wellness. The chapters address:

  • Stressors specific to student-athlete identify, such as transition, performance, injury, academic stress and coach relations
  • Overview of clinical diagnoses, including depression, anxiety, eating disorders, substance abuse and gambling
  • Key components in developing best practices for constructing mental health services for student-athletes
  • The role and perspective of sports medicine staff in identification and referral
  • Cultural pressures and impacts on minority groups
  • How sexual assault, hazing and bullying affect mental health

This publication is the most comprehensive overview to date of college student-athlete mental health, and we hope this becomes a springboard for addressing mental health in the continuum from youth sport to intercollegiate sport and beyond. NCAA member institutions have committed to supporting student-athlete health and safety and ensuring that athletics departments are an integral part of the institutional mission for more than 100 years. But only recently have we begun to fully understand the mental health component of being a student-athlete.

I hope that you join us in our journey of understanding and supporting student-athlete mental wellness, and that you'll benefit from the best practices our experts provide in the following chapters. The contributing authors suggest dozens of recommendations for institutions to consider based on the individual circumstances and needs of the campus.

Our intent is for this publication to become a living and breathing document  through social networks and online discussions that help break down the topics – and the barriers – to providing student-athletes the help they need. Remember that the student-athletes have spoken: Mental health is their No. 1 concern – and it is our responsibility to provide the services and care to help each student-athlete reach his or her full potential.


Download the Mind, Body and Sport handbook

Chapter 1 – First-Person Perspective
Chapter 2 – Positioning the Experts
Chapter 3 – Dissecting the Disorders
Chapter 4 – The Big Injury (And Small Ones, Too)
Chapter 5 – Social and Environmental Risk Factors
Chapter 6 – What Do You Do Now?

Need help?

In the U.S., call 1-800-273-8255

National Suicide Prevention Lifeline

Campus tools