‘Relatability is Key’: Athletes Are Taking Control of the Business of Mental Health

As a basketball player at Missouri State University, Nafis Ricks was where he wanted to be. He’d achieved his goal of earning a scholarship, and he was playing the game he loved. But he was carrying the trauma of his brother being killed a few years earlier, and at college, the pressures of being a Division I student-athlete started to mount. He had a mental health breakdown and asked his coach for help, which led to an appointment with a psychologist.

“It helped me in a dramatic way, not just in sports, but in my life,” he says. “What I got out of therapy is I got to dig deep inside myself, and look myself in the mirror and understand that I’m not the only one going through struggles. It’s OK not to be OK sometimes.”

Today, Ricks has a master’s in psychology and is working toward his doctorate in counseling psychology. He created Collaboration Management, which provides mental health services to athletes. It serves as a mental health coaching hub, providing one-on-one and group coaching as well as other resources. Ricks hosts online seminars and workshops, sometimes bringing in a therapist or psychologist. “It creates a safe space for athletes to talk about the things that they’re going through,” he says.

As mental health has become a larger focus among athletes, many former collegiate and pro athletes like Ricks have made it their profession, launching startups to better connect athletes with mental health resources and treatment.

National Basketball Association champion Kevin Love started the Kevin Love Fund to prioritize mental wellness and established the Kevin Love Fund Chair in UCLA’s psychology department to help diagnose, prevent, treat, and destigmatize anxiety and depression. Love is also an investor in the mental health startup Coa. Other high-profile athletes have invested in mental health startups, including soccer gold medalist Megan Rapinoe backing Real and two-time National Football League champion Richard Sherman investing in Nurosene. Across the growing athlete mental health industry, athletes themselves are increasingly the ones taking support and access to treatment into their own hands.

An Urgent Problem

Christina Hagner VandenBerg is CEO and co-founder of the mental health startup MyHuddle. She was also driven by her experience in college. She played soccer at Harvard University and struggled when she got injured. “I realized that the mental side was something that I overlooked in terms of my overall health, well-being, and performance,” she says. When athletes are injured, she adds, they often “realize that they’re missing some of those mental skills and strategies and support to persevere through that injury recovery.”

VandenBerg says that if she’d had access to a mental health clinician or a sports psychology professional “to proactively work on my well-being, I think I would have maybe performed even better in my sport and then also felt better off the field.”

Athletes are struggling with mental health at all levels from youth to pros. The mental burden that athletes carry can be heavy, and it can be exacerbated for certain demographics – and by stressors such as the COVID-19 pandemic and racial and social injustice.

At the collegiate level, the problem is stark. In March and April alone, four National Collegiate Athletic Association athletes died by suicide: Stanford University soccer player Katie Meyer, Binghamton University lacrosse player Robert Martin, University of Wisconsin runner Sarah Shulze, and James Madison University softball player Lauren Bernett.

The NCAA’s 2019 GOALS study found that nearly 30 percent of female student-athletes and 25 percent of male student-athletes felt difficulties piling up so high that they could not overcome them in the month before they took the survey.

Many universities have boosted their mental health offerings, but the resources that are readily available to athletes can vary widely. Athletes may lack access to mental health professionals or resources, not know how to access them, or not recognize that they could benefit from getting help. Coaches may not be well equipped to help.

The GOALS study found that fewer female than male student-athletes felt comfortable talking with coaches about mental health issues – 49 percent female vs. 62 percent male. Thirty-seven percent of female student-athletes said they were very satisfied with the mental health care they received from team or college medical personnel, while 46% of male student-athletes said so.

Some on-campus mental health professionals serve the general student population, without any particular focus on athletes. VandenBerg had a bad experience when one of her college teammates needed help. “The solution, when this teammate went to see the mental health clinician on campus, was: ‘Well, why don’t you just quit your sport?’” she recalls. “And it’s not that simple. Your sport is everything to you at that point. It’s so much of your identity.”

This experience taught VandenBerg how important it is for a mental health professional to understand the sports experience. “That’s what we try to do at MyHuddle – bring on specialists who understand the mental side but also understand the sport side,” she says.

“Anyone who has played sports understands that it can bring its own unique set of pressures and demands, especially at certain competitive levels,” including recruiting, injury and recovery, and pressure from parents, VandenBerg says. A professional who’s familiar with these pressures is more approachable for athletes, she says.

Ricks agreed. “Relatability is key,” he says, and athletes are more likely to relate to someone in their sport or who has had similar experiences. “Having people who look like the athlete that you’re serving, and who have had similar experiences,” can help, he says.

This relatability made Collaboration Management click, Ricks says. “Once I shared my story and kind of opened up the doors, that was what made me lean more into it, because I understand the rigors of being an athlete,” he says. “I’ve been in different dynamics and been on the coaching side, as well, to see what’s really going on.” Ricks also played basketball professionally overseas.

When Ricks was struggling in college, he felt like he was going to let himself down, as well as disappoint his family and others who supported him. “I didn’t want to be a failure,” he says. He knew his chances of making it to the NBA were slim, but he wanted to give himself the best possible chance, so he decided he wanted to get help. He reached out to his coach, who then connected him to the help he needed.

An Enduring Stigma

Athletes often think mental health care is only for sick people, VandenBerg says. “Mental health is just like physical health. There is a continuum. And your mental health is actually trainable. You can work on mental skills and strategies in the same way that you work on your physical skills.”

Athletes may be used to sayin g, “Hmm, I’m not running as fast as I usually can. Let me go work with a strength and conditioning coach,” VandenBerg says. But when it comes to mental health, they’re less likely to seek out a therapist or counselor if they’re not feeling great. “We wait,” she says. “Unfortunately, our culture has been to wait until a crisis moment.”

Seeking help for mental health can be seen as a sign of weakness, says Phillip Wells, a therapist based in Fort Lauderdale who ran track at Winthrop University. “I think that it kind of goes back to how athletes play through injuries. … It’s the same with mental health,” he says.

Ricks agreed. “I think the world sees us as superhuman, and we feel like we cannot express ourselves because we’re supposed to be tough,” he says.

Ricks’s work is aimed specifically at Black boys and men. “I think in some of the Black community and in certain households, mental health is not a real thing, and they tell you to pray about it,” he says. “It compelled me to really tackle that demographic and open up the space, because a lot of athletes out there – Black young men or boys – they’re struggling with learning how to express themselves.”

Therapist Eugene Garmon, who works with athletes and grew up playing basketball, points out that after the pandemic forced therapists to go virtual, those options are more plentiful now. As a result, athletes may be more likely “to adapt to the virtual side of things versus the traditional,” he says.

If the session is virtual, the athlete doesn’t have to worry about walking to the office and being seen. “If I have a session, I can talk to this man or this woman in the privacy of my bedroom, on my phone or my laptop, and nobody will know that I’m working with a therapist until I decide I’m ready to say, ‘I got a therapist. Maybe you should talk to him or her,’” says Garmon, who is a clinical therapist with Center Street Center in Allentown, Pa., and has also worked as an assistant basketball coach.

The conversation about mental health seems to be shifting, Wells says. “I think the older generation is having a tough time understanding, but the younger generations … I think they’re doing a better job making it less of a stigma.”

Improving Access

People have been working to make mental health care more accessible in many ways, from simply having more clinicians available to athletes, to opening up conversations about mental health and creating safe spaces, to incorporating mindfulness or mental health training into daily life.

For youth, schools and teams often lack the staff and funding to provide access to mental health professionals. MyHuddle works with high schools and club teams to provide mental training workshops and one-on-one counseling through an online platform, matching each athlete to a specialist.

Mental training sessions focus on topics such as overcoming fear of failure, managing high expectations, and confidence issues, and MyHuddle works with the coach to understand the team culture while designing sessions. “If you can help equip high-schoolers with those mental skills and strategies earlier on, then once they get to college and life beyond, they’ll be better equipped,” VandenBerg says.

Startups are looking well beyond the athlete’s performance. “I want to see healthy people, or people striving to become healthy, not in their respective sport, but just on a personal level,” Ricks says.

Ricks would like to see people get mental health training across different career paths, such as “a course to teach teachers, doctors, and lawyers to learn how to deal with some of the issues, or be preventative,” he says. Then, people could be more aware of signs to look for, he says, “so we can prevent some of these things that happen to people, and so people can stop suffering in silence.”

To build trust with athletes, mental health professionals need to be not only accessible but also present, Garmon says. “We’ve got to be there at practices. We’ve got to be there at games,” he says. “That doesn’t mean that the therapists are going to be out there calling plays, … but we have to have a face. We have to be around.”

Supporting Coaches

Similarly, coaches can’t double as mental health professionals. But if coaches have some knowledge about mental health issues, they’ll be more likely to understand when an athlete is off their game or behaving differently. Many of the mental health solutions that athletes have devised focus on making coaches more helpful.

“Coaches have a lot on their shoulders and often are on the front lines of supporting these young athletes,” VandenBerg says. “We can’t make them a mental health counselor overnight, and that shouldn’t be another added expectation for coaches, but how can we give them tools and resources to help them be successful in their job, too?”

A mental health professional can help a coach understand warning signs for depression, self-harm, suicidal ideation, and substance addiction, Garmon says. “And knowing that, they can then funnel them to the right resources.”

Coaches who embrace mental health training signal to athletes that it’s normal and valued. VandenBerg said MyHuddle’s mental training sessions help athletes see not only that their peers share these issues but also that these issues matter to the coach. “As a high-schooler, you look up to your coach, and to have your coach carve out time for that in your season, and then hear from that senior that you look up to on a team, saying, ‘Yeah, when I messed up, I was really worried what all of you would think about me,’ that’s powerful,” she says.

“The coaches that we’ve had the opportunity to work with are also grateful that they now have a sports psychology professional in their pocket, that they can get advice from and bring onto their team and be part of imparting those lessons to their athletes,” VandenBerg says.

“Just knowing that there’s someone there who represents the culture to come in and be that intermediary for these kids” can be helpful to coaches, says Garmon, the Pennsylvania therapist.

Mental health professionals can help coaches talk to athletes in difficult situations, such as not making the team and feeling like they want to leave the sport. “You may have 100 kids come and try out for a 12-man basketball team. What’s going to happen with the 88 that won’t make it?” Garmon says.

The Bigger Picture

Garmon played organized basketball as a kid and was doing well in leagues, but then he started to lose interest and wasn’t sure what to do next. “And that’s something that I’ve seen professionally, where adolescents come to a point where sport drop-off happens,” he says. As a therapist, he talks to the athlete about their sport identity, “recognizing and understanding what identity is” and what happens if sport is no longer a factor in their lives.

“There may be kids in middle school that won’t make the high school team, may be kids in high school that won’t make the college team, may be that those kids made it to college but they aren’t going pro,” Garmon says. “So you really have to start saying: ‘All right, how do I build you up outside of the identity that sport gave you?’ And that’s up to the coaches, athletic directors, everybody involved.”

Wells, the Winthrop track athlete turned therapist, encourages his clients to find out what their values are. “Those values help them get through those really tough days. Whether it’s the value of hard work, supportiveness, teamwork, the value of confidence – those are the things that are more important than the sport in and of itself,” he says.

“All those things, they have a due date – the day that you graduate or retire from a professional sport – and we want to make sure that after those things are gone, they have something that’s still meaningful to them.”

After playing sports in high school, Wells wasn’t sure whether he wanted to go to college until his school counselor, Mr. Padgett, asked him about it. When Wells decided he did want to go to college, Padgett sat with him every day to help with applications. “I actually said, ‘You know what? That's what I want to do. I want to be Mr. Padgett,’” Wells recalls. So he went to school, got a degree in social work, then a master’s in school counseling, and started working as a school counselor.

Later, he decided to become a therapist, “because I wanted to be more hands-on. I wanted to go more in depth,” he says. Now, he works one-on-one with adults who are struggling in their careers or their personal lives and who lack confidence, including athletes. “Their whole thing is getting out of their own way.”

Ricks says his own story of transitioning from athlete to mental health professional – which he shares on the Collaboration Management platform – has been about not being afraid to step out of his comfort zone. “Knowing that you have transferable skills from playing your respective sport, you can venture off … and you can make a career out of who you are as a person. You don’t have to try to be somebody you’re not,” he says.

Please see our list of Mental Health Resources if you are seeking information or assistance regarding mental health.