Barriers to and Facilitators of Collegiate Athletes Seeking Mental Health Services

Abstract

Context: Approximately 1 in 5 student-athletes experience some type of mental health concern. However, fewer than half of student-athletes who report mental health concerns seek mental health treatment (ie, psychotherapy or medication). Data concerning barriers to student-athletes seeking mental health care are limited but suggest that stigma is the primary reason. Further, whether having shared identities with their sport psychologists (eg, race and gender) encourages student-athletes to seek help has been minimally explored.

Objectives: To determine the frequency of internal and external barriers to athletes seeking mental health care and examine the importance of athletes and sport psychologists sharing identities as a facilitator of seeking help.

Design: Cross-sectional study.

Setting: Collegiate athletics.

Patients or other participants: A total of 266 student-athletes (53.8% women, 42.5% White) from a National Collegiate Athletic Association Division I university.

Main outcome measures: Student-athletes responded to 9 binary (yes or no) prompts related to internal barriers (eg, beliefs and attitudes about mental health) and 7 reflecting external barriers (ie, different stakeholders, such as the head coach). Regarding facilitators of mental health help-seeking, student-athletes rated how important it was for them to share each of 10 identities with their sport psychologist from 1 (not at all important) to 5 (extremely important). All identified barriers and facilitators were derived from existing research.

Results: Differences were found in athletes' ratings of internal and external barriers. For example, a belief in one's own reliance and not having enough time were significant barriers, as was their head coach having a negative attitude about the importance of mental health. Female student-athletes rated sharing a gender identity with their sport psychologist as more important than did male student-athletes.

Conclusions: Despite efforts by the National Collegiate Athletic Association to reduce the stigma surrounding mental health, persisting barriers within collegiate sports may keep athletes from seeking help.

Keywords: matching hypothesis; mental health stigma; psychological well-being.