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Black Football Student-Athletes' Perceived Barriers to Seeking Mental Health Services
Abstract and Figures
Black male student-athletes have endured frequent stereotyping on college campuses (Hawkins, 2010). Additionally, Black student-athletes have experienced educational, campus, and athletic stressors (Miller & Hoffman, 2009). Many student-athletes do not seek mental health services because of their status on campus (Watson, 2005). The general population has experienced common barriers in seeking mental health services including low socioeconomic status (Hurd, Stoddard, & Zimmerman, 2013) and negative stigmas related to metal illness (Wang et al., 2005). While it is reasonable to assume similar challenges exist for Black student-athletes, it must be investigated empirically. As such, the purpose of this study was to examine the perceived barriers Black Division I football student-athletes face in seeking professional mental health services. Using phenomenological methodology, semi-structured interviews were conducted with nine Black football student-athletes. The data revealed two themes: weakness and silence. The results of this study will allow stakeholders to better assist this population in seeking mental health treatment and eliminating the barriers associated with seeking mental health services.
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... The result is year-round training, at least a 40-hour weekly workload for team members during most of the year, and additional hours spent recovering from exhausting practices, long road trips during the season, and injuries sustained during participation. As a result, both the greediness of sport and the role engulfment that accompanies it have increased to a point that challenges the mental health of athletes (Peter, 2020;Wilkerson et al., 2020). ...
... These skills, combined with the ability to critically self-reflect, are especially important for Black athletes because they face challenges that differ from those faced by white athletes during their college years and throughout post-college careers (Bernhard, 2014;Bimper, 2015;Carter-Francique, 2020;Comeaux & Grummert, 2020;Griffith et al., 2019;Harper, 2018;Njororai, 2012;Simien et al., 2019;Wilkerson et al., 2020). ...
Omitted in discussions of college athletes’ use of Name, Image, and Likeness (NIL) opportunities is a focus on equity, educational issues, and transition into post-college careers. We frequently hear National Collegiate Athletic Association (NCAA) declarations stating that nearly all college athletes ‘will go pro in something other than sports,’ but little is said about the challenges faced by Black athletes as they deal with coursework and the transition into post-college careers. In this paper, we summarize how the changing contexts of collegiate sports and race relations in higher education have intensified those challenges for Black athletes. We discuss how NIL opportunities can be used by Black athletes to expand identities, create and nurture relationships with mentors from Black-owned businesses, and develop programs in Black communities and organizations that promote social justice and racial equity. We assert that NIL can be combined with Happenstance Learning Theory (HLT) to develop skills for using unanticipated NIL-related opportunities in meeting challenges in courses and the transition into post-college lives. Lessons learned from support programs for Black athletes serve as a basis for recommending that universities fund the formation of a NIL Alliance of Black Athletes on campuses and provide career counselors to guide athletes as they meet people in connection with NIL deals that involve a combination of financial and personal development benefits relevant to education and future careers.
... Research examining the mental health of athletes has pointed to low or limited MHL as a barrier to effective mental health care. Specifically, research suggests that athletes' lack of knowledge of coping skills, lack of knowledge of common diagnoses, not knowing who to go to for help, and the inability to decrease mental health stigma are all barriers to receiving appropriate mental health services (Beasley & Hoffman, 2023;Gulliver et al., 2012;Wilkerson et al., 2020). ...
Mental health is an emerging area of interest in sport, but there is a paucity of educational initiatives in sport management curricula to train the next generation of sport managers to address the mental health needs of athletes, a type of knowledge that the mental health literature operationalizes as mental health literacy. One goal of accrediting bodies such as the Commission on Sport Management Accreditation is for excellence in sport management education; thus, due to the changing landscape of sport, sport management curricula should incorporate mental health literacy competencies. This educational research review provides justification for the inclusion of mental health literacy competencies in sport management curricula and accreditation standards, as well as pedagogical strategies for implementation.
... 15,16 Other research shows that treatment-seeking barriers may vary with race/ethnicity. 17 Additional factors including age, year in school, sexuality, and institutional traits can impact stigma and its relationships to seeking diagnoses and treatment. [18][19][20][21][22][23][24] Thus, not every individual athlete has the same level of risk for impaired mental health. ...
Context
Increased attention continues to be placed on best practices for assisting studentathletes who show symptoms of a mental health illness. One of the most common mental health issues for student-athletes is feeling overwhelmed or anxious. Early recognition of these symptoms can assist the student-athlete in finding early intervention.
Objective
To elucidate specific attributes associated with increased likelihood of anxiety symptoms and treatment avoidance, to help practitioners (i.e. athletic trainers) better-identify and assist high-risk individuals.
Design
Cross-sectional study.
Setting
United States colleges and universities.
Patients of Other Participants
Varsity athletes (n=51,882) who completed the National College Health Assessment (NCHA) between 2011 and 2019.
Main Outcome Measures
Survey responses (self-report) to questions related to anxiety symptoms and disorders cross-sectioned into eight predictors: year in school, gender, sexual orientation, race/ethnicity, school type, international student, history of mental health illness anxiety of impending academic performance.
Results
Over three-fourths the of student-athletes reported an overwhelming feeling with all that they had to do in their daily activities, while only half of the student-athletes reported overwhelming anxiety as a symptom. Gender, sexual orientation, and race/ethnicity had a large effect on these two symptoms. However, of the student-athletes who reported overwhelming anxiety as a symptom only one-fourth of those student-athletes reported receiving a diagnosis for anxiety and/or received treatment for anxiety.
Conclusions
Factors like year in school and availability of mental health information appeared to have little impact. Others including gender, sexual orientation, race/ethnicity, school type, and prior mental health treatment had important effects on the experience of anxiety-related symptoms and the propensity to seek treatment. The present study provides additional evidence that the stresses Online First 2 placed on college student-athletes frequently lead to feelings of being overwhelmed and, eventually, anxiety disorder diagnoses. However, most student-athletes experiencing anxietyrelated symptoms still do not seek diagnosis/treatment.
... 3 Barriers to seeking treatment included not only limited time and a lack of services but also social and selfimposed stigmas for seeking treatment originating from family, community, teammates, and cultural contexts. 4 Such stigmas exist in the broader society but may be exacerbated among athletes, for whom concepts such as "mental toughness" contribute to a reluctance to address mental health conditions. These impediments to seeking the appropriate diagnosis and treatment can have detrimental effects on wellbeing and quality of life, as well as on athletic and academic performance. ...
Context:
Recently, the athletic training community has paid increased attention to collegiate student-athlete mental health, mental health treatment-seeking behavior, and the effects of mental health factors on athletic and academic performance. Ongoing efforts to better educate and equip athletic trainers to help student-athletes in this regard should result in improved mental health-related outcomes.
Objective:
To examine changes in the mental health of student-athletes over the past decade compared with that of nonathlete students.
Design:
Cross-sectional study.
Setting:
Colleges and universities in the United States.
Patients or other participants:
Varsity athletes (athletes; n = 54 479) and nonathlete students (nonathletes; n = 448 301) who completed the National College Health Assessment between 2011 and 2019.
Main outcome measure(s):
Surveys included responses (self-reported) to questions in 5 mental health-related categories: recent mental health symptoms, recent mental health diagnosis, mental health treatment-seeking behavior, receiving mental health information from the institution, and the recent effect of mental health factors on academic performance.
Results:
Athletes consistently described lower symptom and diagnosis rates compared with nonathletes, except for attempted suicide, substance abuse, and eating disorders. Rates of diagnosis increased over time in both groups but remained lower in athletes. Treatment-seeking behavior and openness to future treatment increased over time in both groups but remained lower in athletes. Athletes received more information on stress reduction, substance abuse, eating disorders, and handling distress or violence compared with nonathletes. Both groups received information more frequently over time. Athletes reported fewer academic effects, especially for depression and anxiety, but these effects grew over time in both groups. The effects of injuries and extracurricular activities on academic performance were greater in athletes than in nonathletes.
Conclusions:
Athletes described overall lower levels of mental health symptoms, diagnoses, and academic effects compared with nonathletes. Whereas the rates in nonathletes climbed over the past decade, the rates in athletes broadly remained flat or climbed less rapidly. Increasingly positive attitudes toward treatment were encouraging, but the deficit in athletes relative to nonathletes persisted. Ongoing efforts of athletic trainers to educate athletes and guide them to mental health resources are needed to continue, or better yet to accelerate, the observed positive trends in information dissemination and treatment-seeking behavior.
... When properly balanced, these roles can enhance one another (Graham & Dixon, 2014). However, athletic expectations lead college athletes to devote considerable time to their sport (Wilkerson et al., 2020). For example, the Pac-12 Conference (2015) found that college athletes spend closer to 50 hr/week on athletic demand requirements (e.g., voluntary workouts/meetings, injury treatments, practices, and competition travel). ...
The revered tradition of amateurism has transformed due to legal and legislative challenges initiated by the name, image, and likeness landscape. In contrast to the traditional National Collegiate Athletic Association model, college athletes have now gained the opportunity to benefit financially from their notoriety by adopting an influencer role. The purpose of this manuscript was to explore the conceptual and theoretical shifts resulting from the introduction of the influencer role, considering the existing literature on athlete–student role theory. By achieving harmony between the athlete, student, and influencer roles, athletes should produce the most significant gains in each area, including academic performance, athletic achievement, and monetary benefit. However, greater psychological and sociological consequences may emerge for athletes if the influencer role further complicates the conflict between their athlete and student roles.
... Studentathletes appear to experience mental health symptoms and disorders in similar proportion to the general population, yet mental health treatment-seeking behaviors among student-athletes is low (Castaldelli-Maia et. al., 2019) Recent discussions suggest that this may be particularly so for student-athletes of color (Wilkerson, Stokowski, Fridley, Dittmore & Bell, 2020). A recent survey conducted by the National Collegiate Athletic Association (NCAA) indicates that African American athletes are disproportionately and negatively affected by mental health issues (Peter, 2020). ...
The current discussion reviews the extant literature on student-athlete mental and advocates for a social work perspective in addressing the needs of this uniquely at-risk, and vulnerable population. Sports social work practitioners focus on the personal and contextual influences that potentially affect athlete mental health and well-being. In this way, social work is uniquely qualified to address challenges of the athletic experience and provide athletes with the resources and support needed both on and off the field to thrive in all areas of life.
... For that reason, future research should include non-graduates in order to uncover potential sub-population trends. Moreover, given potential racial disparities in the mental health experiences of African-American student-athletes (Wilkerson et al., 2020), future study designs would benefit from comparing the experiences of former athletes by race/ethnicity. For study variables that were significantly different across former athlete versus non-athletes sampled, the more positive response was endorsed by the former athlete sample suggesting potential benefits of the collegiate athlete experience on lifespan health and well-being. ...
American collegiate sport participation has been linked with psychosocial and career-related benefits as well as with mental and physical health risks, with extant research on this topic revealing mixed results. The study purpose was, informed by the Health through Sport Conceptual Model, to describe and compare associations among health related quality of life and psychosocial measures of former U.S. collegiate athletes and non-athletes from four university graduation cohorts. Results suggest on aggregate former collegiate athletes report more positive measures than their non-athlete peers. Study findings were, in some instances, mitigated/reversed when participants endorsed concussion, career ending injury or revenue sport participation histories or were female. Though limited by a cross-sectional design and a potential health worker effect, results provide some support for protective associations of collegiate athletics participation. This study also provides a theoretical bridge from intercollegiate athletics participation to broader sport promotion literatures.
Objective
Health disparities are widely prevalent; however, little has been done to examine and address their causes and effects in sports and exercise medicine (SEM). We aimed to summarise the focus areas and methodology used for existing North American health disparity research in SEM and to identify gaps in the evidence base.
Design
Scoping review.
Data sources
Systematic literature search of PubMed, Scopus, SPORTDiscus, CINAHL Plus with Full Text, Web of Science Core Collection and Cochrane Central Register of Controlled Trials.
Eligibility criteria
Full-text, peer-reviewed manuscripts of primary research, conducted in North America; published in the year 2000 or after, in English; and focusing on organised sports were included.
Results
103 articles met inclusion criteria. Articles were classified into five focus areas: access to and participation in sports (n=45), access to SEM care (n=28), health-related outcomes in SEM (n=24), provider representation in SEM (n=5) and methodology (n=1). Race/ethnicity (n=39), socioeconomic status (n=28) and sex (n=27) were the most studied potential causes of health disparities, whereas sexual orientation (n=5), location (rural/urban/suburban, n=5), education level (n=5), body composition (n=5), gender identity (n=4) and language (n=2) were the least studied. Most articles (n=74) were cross-sectional, conducted on youth (n=55) and originated in the USA (n=90).
Conclusion
Health disparity research relevant to SEM in North America is limited. The overall volume and breadth of research required to identify patterns in a heterogeneous sports landscape, which can then be used to inform positive change, need expansion. Intentional research focused on assessing the intersectionality, causes and consequences of health disparities in SEM is necessary.
Prevalence of mental health (MH) concerns among young adults is high and continues to increase. As a specific subset of young adults, National Collegiate Athletic Association (NCAA) athletes seem to experience these concerns at a similar or greater prevalence rate than their nonathlete, age-matched peers. Yet, how MH affects sport performance has not been robustly studied, and existing studies have not included the diversity of identities present in the collegiate athlete population. Thus, via online survey, this study explored the beliefs of 249 collegiate athletes representing diverse identities and sports regarding how MH affects sport performance. Regardless of demographic variable, 96.4%–100.0% of participants believed that MH affects sport performance. Three themes were identified: (a) collegiate athletes affirm that MH affects sport performance, (b) collegiate athletes’ perceptions of how MH affects sport performance, and (c) collegiate athletes believe that being a collegiate athlete exacerbates their MH concerns. The universality of endorsement and the themes represent novel findings that warrant further exploration of the MH–sport performance connection.
Alyssa Williams, the Student-Athlete Advisory Committee (SAAC) president at Oak Grove University (OGU), wants to meet with the assistant athletic director after conversing with the Student-Athlete Advisory Committee group dedicated to student-athlete well-being. Alyssa meets with Dr. Nora Coleman to discuss how student-athletes want more resources to support mental health conditions at Oak Grove University. Dr. Coleman agrees and asks Alyssa to readdress the Student-Athlete Advisory Committee group so they can identify the mental factors affecting them and to compare and contrast using internal and external resources. After finding this information, Alyssa will have a follow-up meeting with Dr. Coleman to make a proposal and address the university’s athletic board.
This study investigated differences in stigmatization by others, self-stigma, and attitudes (value and discomfort) toward online counseling (OC) and face-to-face counseling (F2F), and the relationships between these variables, in college student-athletes (n = 101) and non-athletes (n = 101). Results revealed no differences in levels of stigmatization by others and self-stigma between student-athletes and non-athletes. Furthermore, both groups reported higher value, and less discomfort, in F2F compared to OC, while non-athletes reported higher levels of value in F2F compared to student-athletes. A multiple group path analysis revealed no difference in the relationship of the stigma and attitudes variables between the two groups. Stigmatization by others was a significant positive predictor of self-stigma and value in OC. In addition, self-stigma was a significant negative predictor of value in F2F, and a significant positive predictor of discomfort in F2F. The current findings have implications for university counseling centers and athletic departments.
Background: While mental health among collegiate athletes is receiving increased attention, research on factors surrounding collegiate athletes' decision to seek mental health services is limited. The goal of the present review was to analyze and synthesize the current literature concerning collegiate athletes' utilization of mental health services, including the facilitators of and barriers to use of these services.
Methods: The analysis was guided and organized using a socio-ecological framework, which considered the unique context in which collegiate athletes study and perform. A total of 21 articles, published between 2005 and 2016, which concern U.S. collegiate athletes' mental health services utilization (MHSU) were selected and included for the final analysis. Conceptualizations and operationalizations of MHSU were compared and contrasted. Facilitators of and barriers to athletes MHSU were examined and summarized while appropriately considering the proximity of each factor (facilitator or barrier) to the athletes.
Results: Results showed variations in conceptualizations and operationalizations of MHSU in the articles analyzed, which made interpretation and cross comparison difficult. Collegiate athletes are willing to utilize mental health services, but gender, perceived stigma, peer norms—for athletes and coaches—plus service availability impact their MHSU.
Conclusion: Key stakeholders, administrators, and public health officials should partner to eliminate MHSU barriers, support facilitators, and generally empower collegiate athletes to actively manage their mental health.
This study aimed to determine an overall prevalence rate for depression symptoms among National Collegiate Athletic Association (NCAA) Division I collegiate athletes while also assessing various risk factors that may increase an athlete’s vulnerability to depression. Using a sample of 950 NCAA Division I athletes, it was found that 33.2% of athletes experienced symptoms of depression, contradicting findings from previous studies that have suggested a prevalence rate lower than the general college population. Female athletes (P = 0.00), underclassmen (P = 0.01), recently injured athletes (P = 0.05), and in-season athletes (P = 0.05), were all found to experience higher rates of depression symptoms than other athletes. It was found that 25.7% of athletes did not know how or where to access mental health treatment at their university, and 44.5% had received no mental health education from their athletic department. The results from this study suggest that depression is a more significant issue in college athletics than previously thought, and they highlight the need for continued improvements to be made in both the understanding of mental health issues in college athletics and the services that are provided to athletes.
The purpose of this study was to determine the relationship between personality, the serotonin transporter (5HTT) polymorphisms and the occurrence of anxiety and depressive symptoms in elite athletes. 133 healthy participants completed the NEO Five-Factor Inventory (NEO-FFI). The mood states were assessed using the Profile of Mood States (POMS) questionnaire. The athlete's mental skills were assessed through the Sport Performance Psychological Inventory (IPPS-48). The occurrence of psychiatric and personality disorders was assessed using the Clinical Interview for DSM-IV Disorders. A polymerase chain reaction was employed to identify genotypes at the 5HTTLPR polymorphism. The 5HTTLPR s/s genotype was associated with both neuroticism (p< 0.001) and tension/anxiety symptoms according to the POMS (p<0.02), cognitive anxiety and emotional arousal control according to the IPPS-48 (p<0.01). Significant correlations were proved between neuroticism and symptoms of anxiety and depression (p<0.05). Neuroticism mediates the association between the 5HTTLPR polymorphism and symptoms of cognitive anxiety and emotional arousal control (p<0.05). These results suggest a significant interaction between the 5HTTLPR polymorphism, neuroticism and sport related stress that predict adverse mental health outcomes in athletes. Identification of homogeneous groups of athletes having predispositions to anxiety and depressive symptoms may help to implement early prevention programs.
The purpose of the current study was to examine the levels of burnout among student-athletes at two Canadian universities and to investigate whether there were significant differences related to gender, sport, year of university sport participation, academic year, and academic program. Burnout was measured by administering Raedeke and Smith’s (2001) Athlete Burnout Questionnaire to 145 student-athletes from various sports. Overall, 1.4% of the student-athletes had elevated burnout scores on all three subscales, and 17% scored high on two of the three subscales. No significant differences emerged with regards to year of varsity sport participation, academic year, or program. However, women had significantly higher levels of emotional and physical exhaustion than men. Significant differences also emerged in relation to levels of emotional and physical exhaustion, and of sport devaluation, when comparing various sports.
Research has shown that African American college students have a difficult time adjusting at predominately White institutions (PWIs) in comparison with historically Black colleges and universities (HBCUs) with regard to both general and race-related stressors (Neville, Heppner, Ji, & Thye, 2004; Prillerman, Myers, & Smedley, 1989; Sedlacek, 1999). For college student-athletes, the campus environment can challenge their capacity to ft in and adhere to academic and social expectations, perhaps especially for Black student-athletes (BSA). The current study therefore examined the sociocultural and mental health adjustment of 98 BSA based on their perceived social support, perceived campus racial climate, team cohesion, and life events using latent profle analysis (LPA). Results indicated three distinct profile groups: Low Social Support/Cohesion, High Minority Stress, and High Social Support/Cohesion. Profiles were predictive of adjustment concerns and campus setting (PWIs vs. HBCUs), highlighting within-group differences among BSA. Implications for interventions to facilitate and support healthy adjustment and success for BSA are discussed.