ITHACA, N.Y.--- It was another training morning for Gianna Salzbrunn at 7 a.m. But when she woke up, she could feel the difference that would happen in that morning's practice. She tugged along to practice feeling sluggish from the new lifting cycle. That, on top of the stress of classes and being reasonably tired in the morning, swarmed Gianna like a wave, causing her to feel overwhelmed.
After making it to the track, Gianna prepared herself for what was to come. Her coach explained the details of the workout. After he explained it, he talked about the plans for racing the upcoming weekend.
"He said: 'I'm thinking you two will run the 600 at Grand Valley and then G I'm gonna have you run the 4x4 also'" Gianna said.
In that moment she looked at her coach and felt her emotions hit her like another wave. She did not cry but she did tear up. The tears did not have a chance to leave her eyes because as quickly as she noticed it happening is as quickly as she shut it back down. She had to be mentally tough.
The workout came and went. It was an average workout for Gianna and her training partner Elle.
When the practice was over, Gianna's coach pulled her aside and scolded her for the previous slip up of emotions she had. As an athlete, she is expected to be able to hold back any emotions that could potentially stop her from succeeding.
"I was able to pull myself back together which shows a certain degree of mental toughness," Gianna said.
But her coach did not approve at all. For him, she should not have even been feeling that way.
It was in that moment that Gianna began to question why she was even there. Why she chose to put herself through early morning training, through regular training, through lift, and through heavy workloads. It was in that moment, Gianna genuinely considered quitting the team. She called home and told her parents that she did not want to do this anymore.
In the United States, there are over 400,000 NCAA student-athletes across 23 sports. In the past 10 years, 477 of those athletes have taken their lives making suicide the third leading cause of student-athlete deaths. In a nine-year analysis of NCAA, suicide represented 7.3% of mortality causes among student-athletes. In 2017, the American Foundation for Suicide Prevention found that people between the ages of 15 to 24 had a suicide rate of 14.46.
Gianna is still running at Eastern Michigan University today and is currently a junior. Although Gianna was strong enough to fight through her stress, there were many who have not been able to. Madison Holleran was a track and field athlete at the University of Pennsylvania but committed suicide in 2014. Not too much later in that same year, Ohio State football player and wrestler Kosta Karageorge took his own life as well.
Mental health is a topic that is slowly coming into the light of today's world. 10 years ago, mental health did not get nearly as much coverage as it does now. But now with all the coverage, shouldn't there be fewer cases like Madison's and Kosta's?
Mental toughness. The ability to perform your best while not losing focus due to outside forces or stress. Being mentally tough is being able to block out anything that stops you from achieving your goal. Mental toughness is a lot easier said than done.
This is something every athlete is taught on and off the field. It is something that Gianna Salzbrunn encounters every time she steps foot on the track.
During the end of her freshman year outdoor track season, her grandfather became ill, passing not too long after the diagnosis. Two weeks later she had to put down her dog.
"I carried a lot of resentment for the sport of track and field because when my grandfather first got sick, I asked my coach to go home and she said no," Gianna said.
She did not resist and stayed on campus and attended practice as usual. But there was something different about Gianna. She was not the happy girl that she was when she first began running at Eastern Michigan. At this point, she was angry.
"It definitely impacted my performance," Gianna said. "It made the entire sport unenjoyable for me which sucked because I love track, I love running."
The next track season was difficult for her. She didn't begin to feel relief from her pain until the beginning of her outdoor season sophomore year. How? Through the help of training partners and friends.
Gianna is a multi-event athlete meaning she does multiple events as one event. The pentathlon and the heptathlon are examples. In order to succeed in the running events, she trains with runners in that event. Her training partner, Elle, during the time helped her more than ever.
"She was always there to listen, to talk to and cry to about the workouts," Gianna said. "She definitely made a world of difference for me."
Gianna was fortunate enough to have friends, family, and teammates to help her along through her process when she wasn't utilizing her other resources.
When athletes are not using their friends, family, or teammates, they can use a sports psychologist.
Sports psychology is an interdisciplinary science that draws on knowledge from biomechanics, physiology, kinesiology, and psychology. It ties all these factors together to interpret and anticipate how they will affect an athlete's performance.
Eric Goldstein, the Sports Psychologist at the University of Miami, says that one in four college athletes have some sort of mental health problem.
"One of the things we see with college athletes is the higher level of stress because they have so much more they are trying to balance," Goldstein said.
Athletes, especially at successful Division I institutions, travel frequently. On top of traveling, there is the stress of school, social life, and the 20-hour a week practices. Athletes are not typical students. Balancing all of these things is extremely stressful. When stress is not handled well, it can develop into serious problems.
Chronic levels of stress increase the risk of developing depression and anxiety. When the brain perceives a "stressor", neurotransmitters are released while shortly after stress hormones are released. Stress hormones can affect areas of the brain that are used for memory and regulating emotions. Having constant triggers in those areas of the brain can have the brain stop doing its job correctly.
Goldstein says that athletes tend to have distorted thinking. This does not mean they are crazy but it simply means they do not understand the whole picture.
Imagine a track and field athlete who is extremely frustrated because they cannot seem to improve their performance. They rack their brain of everything they could have possibly done wrong between now and their last personal record. Because they cannot seem to figure it out, they become frustrated and angry. Their performance gets worse and the cycle continues. After days of being fed up, the athlete sits down with their coach to vent about the recent frustration. The coach begins to explain some of the things that the athlete is getting wrong. "You need a faster heel recovery coming out of the blocks". "You don't open your arms wide enough on the last 100-meters of the race". "You don't run the turns tight enough". Suddenly this athlete feels a relief of stress. They finally understand the full picture and can figure out how to tackle it. Now, they will be doing the same race, only with less stress.
In a perfect world, this athlete will never experience stress again but this is not a perfect world and this is not a perfect athlete. In fact, no athlete is perfect. They still have a chance of experiencing these feelings again.
The numbers are high and the effects are real but there's a bigger problem at play: seeking help. It took days for the hypothetical athlete to finally seek answers. For some, it may take weeks. Some may never do it. The question is why.
According to USA Today, Daniel Eisenberg, an associate professor at the University of Michigan, found that only 10% of college athletes seek help.
There is a huge stigma surrounding mental health and especially mental health around college athletes. While this stigma is currently being tackled, athletes know that it is still there.
"Can you imagine the star quarterback walks over to the counseling center, his picture or something is going to end up on Twitter," Ashley Harmon, Assistant Director of Clinical Behavioral Health at the University of Texas, said.
The last place an athlete wants to be noticed is in the counseling department. Harmon suggests an in-house approach to athletes struggling with mental health. She does all of her sessions in the stadium. Additionally, it is in a familiar space with faces they see all the time.
"It all feels really private," says Harmon. "It's really convenient. I'm in the stadium which is where all their study hall is, it's where all their treatment is, where their weights are so it's right there next to everything."
For Harmon, this works best for athletes because they will not have to go too far to seek help since their schedules are so busy.
Another reason for choosing not to seek help is because of their image. Athletes are supposed to be picture perfect with no flaws.
"A lot of athletes are afraid to come out and talk about these things because they feel like it makes them weak and it makes them vulnerable," says Rachel Hickey, a student-athlete at Illinois State University who also struggles with mental health. "There's a stigma around athletes that they have to be mentally tough all the time and mentally tougher than their classmates."
There are even studies that show athletes should have better mental health and be able to manage stress better. The lack of privacy and the stigma that surrounds athletes and mental health inhibits a lot of athletes from seeking help.
Athletes may not even know where they can seek help. At their perspective schools. Harmon and Goldstein do athlete outreach to try to get more people to come out and so that they know someone is willing to help them. They also do workshops that provide education for teams and coaches.
"One thing that we have done at the University of Miami is that we have created a whole mental health ambassador program," says Goldstein. "We have some of our athletes who are mental health ambassadors go out to all the teams and giving the message."
"Coaches and teams can request, essentially, whatever they want and I can accommodate that," says Harmon. "This past fall I put on a workshop for coaches on how to work with stressed athletes."
It is important to note that not all schools are like Miami and Texas. Some colleges and universities offer different resources who may work the same way or have limitations to their position.
At Ithaca College, the graduate students in the exercise and sports sciences program who concentrate in mental performance consulting help athletes through the season as a part of their training.
"We work with students on things such as stress, pre-performance, anxiety and things of that sort in order to ultimately improve the athlete's performance." Said Khee Nance, a mental performance consultant and graduate student in exercise and sports sciences program at Ithaca College.
Student-athletes can come to people like Khee to seek out help if they feel their performance is not improving. Mental performance consultants will try to pinpoint and tackle the problem through group or individual sessions. They use a holistic approach so they can get a better understanding of what other factors may be affecting the athlete's performance. A misconception about these consultants is that they are a sports psychologist. In order to be a sports psychologist, you must obtain a Ph.D. If an athlete comes to Khee and they express that they have severe mental health problems, she will have to refer them to someone else. However, this is not the immediate course of action. There are many steps taken before going straight to a referral.
On top of sports psychologist and mental performance consultants, there are social workers in sports as well. They can help athletes with mental health disorders such as depression, eating disorders and anxiety. Social workers try to bring the more human side into athletics by acknowledging their vulnerability. They acknowledge that the outside world could be a huge factor in decreased performance. Like sports psychologist and mental performance consultants, they can have sessions where they try different methods to help with the athlete's mental health. If it may be something family related, the social worker will find resources that best fit their situation.
While these are great resources to have, many institutions only have one sports psychologist for every sport on campus. However, in general, it is unknown how many schools in the country have what amount of each of these resources
Eastern Michigan is home to 16 sports teams almost 300 athletes but they only have one sports psychologist.
"When I was seeing her my sophomore year I'd send her a text or an email and she'd say 'oh yeah, you can come in in like four days'" Gianna said. Her instant thought was "what if I need you right now".
There is not much public information on how much schools spend on mental health resources. Schools like Illinois State and Eastern Michigan do not have this information disclosed in their budget reports. Harmon believes that money for universities is not lacking in this area. It is more of a prioritization problem.
"They spend millions and billions of dollars on creating facilities and locker rooms," says Harmon. "So now they need to spend money on behavioral health."
At the University of Texas, athletes who come in to see Harmon do not have to wait or have a time limit. They have seven therapists who are specifically used for the athletes which stop the "what if I need you right now" problem.
Even the schools who do provide services, they are done through the schoolwide counseling department. Student-athletes "see themselves as different" Goldstein explained. They will probably not use these resources because they know it will take a while to get an appointment and when they do get one, they may not feel understood by the counselor they get.
Although the number of behavioral health staff at universities is perceived to be pretty low, both Goldstein and Harmon believe that the demand has increased immensely over the years.
"I think the more that it's being talked about, specifically with all the pro athletes coming out, I think that's making it okay for some of the younger students to come out," Harmon said.
According to the Bureau for Labor Statistics, the job outlook for all psychologist will increase by 14% between 2016 and 2026. They note that this is faster than average and the percentage may vary depending on the type of psychologist. For their data based on 2012 to 2022, "other" psychologist demand will increase by 11%.
We will have to wait to see if these estimations prove true. If they are, we can expect to see great changes in athlete mental health. This is not to say every athlete will never have a mental health problem again, but that when the problems do arise there will be a place for them. Hopefully, as they begin to come out, their teammates will feel confident enough to do the same.
Athletes must also understand who can help them with what situations. Finding what kind of resources the school provides before the season starts is a good way to avoid feeling overwhelmed when it is the end of the season and one finally realizes they may need help. If that time ever does come, they will know if that person will be best suited for your problem.
The NCAA has tried to tackle the issue of mental health by putting up a webpage about it. The webpage includes educational resources, best practices, data and research and summits and task forces. Each link covers its respective topic in great detail, making sure that anyone who reads it can understand the true nature of the issue.
In addition to their webpage, the NCAA has new legislation about access to mental health services. This proposal will require schools to make mental health services available to all student-athletes. This could be done by having a contract with the on-campus mental health center or within athletics. The Division I conferences adopting this legislation are the Atlantic Coast, Big Ten, Big 12, Pac-12 and Southeastern.
At Eastern Michigan, they have a whole week during the school year dedicated to athletes and mental health. The week is used to break the stigma of mental health around athletes and educate them on it.
A student athletic-trainer at Ithaca College mentioned how their teachers take their time teaching their students about what to do if they encounter a student-athlete with mental health problems.
Institutions hold their athletes to high standards. They are broadcasted on television, expected more of in the classroom and so many other things that would be unfathomable to a regular student. While all of these things are taking place, they are not receiving the resources needed to continue to live up to these standards. Some drown in their own silence because of the fear of being judged or misunderstood. The first step is to understand that everyone is different and not everyone can hold the weight of the world on their shoulders.
"Things could be falling apart for totally different reasons," Gianna said. "For somebody else, God knows what, they're failing their classes and they just can't focus. It's just totally different reasons and it doesn't mean any reason is more or less valid than the other."
As the stigma begins to break away around mental health in athletes, the demand for resources and education continues to increase. Like previously said, we can only wait to see if those statistics hold out. But it seems like everyone is putting their best foot forward to make sure athletes begin to get the care they deserve.