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Safety in Sports Includes Mental Health Care

Medical professionals agree that about 20% of high school athletes and 30% of college athletes have or will have a serious anxiety or diagnosable mental health disorder that causes some degree of impairment in their sport performance and, more importantly, in their daily life. This is true at every level, high school, college and professional, and for whatever gender the athlete identifies with. We also know from the courageous testimony of athletes in every sport such as Simone Biles, Naomi Osaka, Michael Phelps and Kenley Jansen, the problem only becomes more prevalent and acute for elite athletes.

The reasons for the universality of the mental health crisis are easy to understand. The stressors and triggers for athletes include time demands, overtraining, injuries, pressure leading up to the game and performance in the game, over-emphasis on winning, interpersonal relationships with coaches and teammates, issues with social relationships generally, self-image, self-esteem, intensive parenting and other issues at home. These factors can lead to loss of sleep, poor appetite and self-destructive coping behaviors such as using tobacco, drugs, alcohol, stimulants and PEDs, sexual promiscuity, eating and obsessive compulsive disorders and suicidal ideation.

With this issue more than any other coaches must remember the basic coaching tenet of, “we coach people, not sports.” Coaches must know and recognize the signs and symptoms of the person’s struggles and must take active measures to help the self-care of all of their athletes without crossing the line of diagnosing the specific issues or attempting any resolution of the problems. In short, with regard to specific athletes, a coach’s job is to recognize and refer, not to solve.

Mental health issues have become so prevalent today and the consequences so serious that coaches at the high school level and above should be required to obtain a certification for understanding mental health issues similar to those currently required for First Aid/CPR, concussions and heat stroke. The necessity of coaches being proactive is illustrated by the fact that while as many as 1 in 3 college athletes suffer from a mental health issue, only 10% of them will seek help on their own. A high school athlete is still struggling with basic issues of self-identity so they may be even less likely to reach out to parents or medical professionals for help.

The NFHS has an excellent workshop on this subject and it or its equivalent should be a requirement for all high school and college coaches.

With regard to general team health care, here are some principles I recommend coaches follow:

  1. Never assume mental stability from athletic ability.
  2. Consequences of practice competitions should be positive for the winning person or team rather than negative for the losing person or team.
  3. Give praise publicly and criticism privately.
  4. Always make criticism about the behavior never about the person.
  5. Never breach a player or team confidence. What is said between you and them stays between you and them.
  6. Make sure your positive comments outweigh your negative comments 99 to 1.
  7. Give your negative comments at an emotionally neutral time, e.g., not immediately after a game.
  8. Keep the consequences for inappropriate behavior reasonable and consistent with the infraction and the needs of the person.
  9. Have a witness to every serious conversation and document in writing the action, reaction, conversation and professional referral in your file and the school’s file.
  10. When things do not go well, look first in the mirror with honest intent.
  11. A ritual I highly recommend that has helped build the self-esteem of everyone involved on our teams is called the Heartfelt Handshake. It is based on the fact that if two people each take one of their hands and press them together firmly for ten seconds or more and then very slowly pull them apart, they will still feel like their hands are together.

At the end of each practice and game, instead of a handshake or cheer, have the team divide into pairs. Have each person in the pair take one of their hands and press them together firmly and have them hold them together until each person has said something positive from their heart to the other person. The comments can be about how the person performed that day in practice or just something inspirational about the way that person acts outside of the sport. Time will only allow for one pairing each day, but be sure you change the pairings every day and that coaches are paired with players, as well as, other coaches.

After each person has said something to the other from their heart, have the two people slowly pull their hands apart. Then each person takes their hand and makes a fist with it symbolizing that they will hold on to what the other person said. Lastly, the person puts their fist over their heart symbolizing that they will put what was said into their heart to nurture themself and to be used to help others.

Try it. It’s powerful!

Coaches should know the members of their team well enough as people to distinguish between normal growth mindset issues and more serious mental health issues. Many coaches at every level have learned that the ‘win’ for their willingness to do so was saving a person’s life not just a game.

Peace and be well to you and your team.