The Connection Between COVID-19 and Student Athlete Mental Health Part II: A Deeper Dive with Hanna Hall

As I reported last week, the NCAA conducted a Student-Athlete COVID-19 Well Being Survey back in May 2020, the results of which were astounding. The mental health concerns student athletes experienced during the month of May were 150% to 250% higher than historically reported. Now, the NCAA hasn’t conducted a follow up survey, but one can only guess that those numbers haven’t changed much. Seasons have been canceled, athletic related activities have been suspended indefinitely, and some universities have even sent student athletes home after outbreaks. As student athletes continue to navigate through the unexpected change and uncertainty, their mental health is (or at least should be) becoming more of a concern for those who work with them.

From A Student Athlete’s Perspective

I sat down with Hanna Hall, a senior guard on UB Women’s Basketball team, who has been extremely open and candid about her struggles and triumphs with mental health. She and her teammates were in Cleveland, OH for the MAC conference tournament when they found out that their NCAA championship run would end there. Obviously, there was initial shock and disbelief, but she said that it really took until the semester was over for it to “sink in” that the end of the season didn’t really happen. Even though it was hard, Hanna felt as though she was a little more prepared than some of her teammates and other student athletes due to her prior experience with mental health. One of the hardest things for Hanna was the “social isolation aspect” as that is exactly what she was working not to do and to get away from.

Video Credit: Antonio Garcia Tuñas

After UB rolled out its return to campus plan, it took the Women’s Basketball team about two months to get back to their “normal routine.” Initially, the team was getting tested weekly, then bi-weekly, and when I spoke with Hanna back in September, only 25% of the team was getting tested because they were “staying within their pod.” Hanna said that it was scary because “day by day [the rules] changed” and they didn’t know what would come next. The team was trying very hard to stay within their bubble, but the whole situation was tough on them. Hanna mentioned that there is a lot of responsibility because “you don’t want to be that person to test positive.” The anxiety around testing is just an added stressor to an already stressful situation.

The biggest factor in getting through this tough time was and still is Hanna’s support system, which, of course, includes her teammates and coaches. Hanna said that the coaching staff has been extremely open and encourages the team to be vulnerable and talk things through. “Connecting and being there together and not ignoring the fact that we’re in a pandemic” has allowed the team to carry on through everything. As a team, they are encouraged to talk about how they’re feeling and address all of those concerns and stressors with each other (or someone) rather than bottling it up. Having a coaching staff being this open and welcoming prevents those mental health concerns from going unnoticed and can ultimately save a student athlete. As of right now their season is still on, but there’s still so much uncertainty and things can change in a heart beat.

Athletic Identity and Mental Health

For many of these student athletes their identity is wrapped up in athletics. Athletic identity refers to the strength with which people identify with and embrace their role as an athlete and is a valued component of one’s sense of self. There are, however, risks to having this strong identity. When athletes who possess strong athletic identities are faced with an abrupt career or season end, they tend to dissociate from their athletic identity and experience an accompanying sense of loss that increases the risk of depression and other mental illness.

Photo Credit: Saraswati Hendrix (@hendrix_sw)

If you watch Hanna’s story (linked above) she mentions that she twice lost the thing she loved most, basketball. Hanna likely has a strong athletic identity to basketball, as do most student athletes competing at such a high level. Being a former Division I lacrosse player at the University at Albany, I can confidently say that my athletic identity as a lacrosse player was my whole being for a long time. That’s who I was. That’s what defined me. And when that gets taken away from you, whether abruptly or not, that accompanying sense of loss is very real.

This group of student athletes who are living through the COVID-19 pandemic, and all of its curveballs, are being tested on a daily basis. Their mental strength is being worked as would their physical strength. But not every student athlete has the ability to recognize that they are not in a good mental place. Not every student athlete has the courage to reach out when they need help, or has the knowledge to know when to reach out on a teammate’s behalf. Part of this responsibility to inform student athletes falls on the NCAA and athletic departments. This presents two questions: (1) is the NCAA doing enough? and (2) are athletic departments doing enough?

Legal Liability

Despite the potential that student athletes are being subjected to increased risks to their mental health, college student athletes are reported to utilize counseling or psychological services at rates lower than their non-athlete peers. Seeking help for mental health issues is stigmatized in the general population, but it is even more stigmatized among athletes.

NCAA

At first glance, the NCAA appears to be completely invested in student athlete mental health. The NCAA Sports Science Institute has an entire page including educational resources, best practices for campuses, data and research and more. In my last article I mentioned the NCAA Best Practices which include:

  1. Clinical Licensure of Practitioners Providing Mental Health Care;
  2. Procedures for Identification and Referral of Student-Athletes to Qualified Practitioners
  3. Pre-Participation Mental Health Screening; and
  4. Health-Promoting Environments that Support Mental Well-Being and Resilience

On a very basic level, this is sufficient to ensure that the NCAA avoids legal liability because it has provided the closest thing they can to “industry standards.” But shouldn’t it be held to a higher standard, especially with the results of the May 2020 survey? When it is crystal clear how much student athletes are struggling right now, there should be a greater push coming from the top to ensure the safety of student athletes.

Athletic Departments

We know that athletic departments at least have to meet the NCAA’s Best Practices, but the real question is, is that enough? Many universities don’t think so, especially with respect to the first best practice, which really just requires the university to have some sort of counseling program on campus. Schools such as Michigan, Ohio State, USC and others have implemented an “in-house” sports psychology programs which allows student-athletes direct access to certified sports psychology counselors.

Photo Credit: Michigan Athletics Counseling Team

However, not every school is fortunate to have the money and/or resources to pay for a full-time sports psychologist, let alone an entire team of them. The question then becomes not are they doing enough, but what happens if there is a mental health crisis, more specifically a student athlete suicide, and there is no full-time psychologist on staff?

The general rule is that third parties are not liable when another inflicts self-harm, but there are now two significant exceptions to the rule. Now, a defendant can be held liable for the suicide of another if either of these two conditions are met: 1) if it is found that the defendant caused the suicide; or 2) if it is found that the defendant had a duty to prevent the suicide from happening. The second exception arises when the defendant has a legally recognized special relationship with a suicidal individual sufficient to create a duty to prevent suicide. Universities and university employees and administrators have generally avoided suicide liability because courts have narrowly applied the concept of the special relationship to universities. So now, the question changes again — should there be a special relationship between a university’s athletic department and its student athletes?

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