In a recent video, AthleticDirectorU talked with former student-athletes about the identity question they and their peers faced as they transitioned away from competition. The question – “Can you differentiate between who you are and what you do?” – presents a dilemma to many athletes when it is time to retire from their respective sport.
As the focus on mental health has become wider throughout the United States, more attention has also been give to mental health of student-athletes on high school and college campuses. Recently, that focus has become even more pronounced as the need for mental health services for former student-athletes is also discussed. In this Experts’ Roundtable, two schools that provide structured mental health services programs for former student-athletes share insight into how their respective programs coordinate care.
The Experts:
Shelly Mullenix – Sr. Associate AD for Health & Wellness at LSU
Dr. Molly McQueary – Director of Student-Athlete Wellness at Michigan State
Additional assistance from MSU’s Shayna Bruno and Doron Willis
- How prominent is the need for mental health care for former student-athletes?
MULLENIX: We think it may be high. The fact that too few institutions or other sources track this issue complicates how we address the problem. Getting good baseline data will be important moving forward, but acting now—on the fair assumption that a problem exists—is just common sense.
It’s important to remember that student-athletes are just a subset of college students, who are universally experiencing high levels of anxiety, depression, substance use, and sleep deprivation. The American College Health Association’s Spring 2023 national survey estimated that up to 76% of undergrads have been experiencing moderate to serious psychological distress. While athletics can be a protective factor, student-athletes still experience all the same stressors of their campus cohorts plus more from training and competing at elite levels in sport.
Many of us in collegiate athletics recognize the importance of supporting the biopsychosocial needs of our student-athletes. This support is often made available to student-athletes by embedding clinical mental health care within the athletics department, utilizing mental health counseling services at campus student health centers, or referring to psychological care from within the community. Unfortunately, as students graduate, some are not prepared for the transition from student-athlete to “real-life.” They may experience a loss of self-worth and a loss of self-identity having not prepared for life outside of their sport.
MCQUEARY: The need for mental health care among former student-athletes is not just increasingly prominent, it’s becoming recognized as essential within the sports community. Transitioning out of the structured environment of collegiate athletics poses numerous challenges, including loss of identity and adapting to life after sports, often compounded by the pressures of career transitions. Research underscores that former athletes may face elevated rates of depression, anxiety, and other mental health issues compared to the general population, stemming from factors such as injuries and the abrupt end of their athletic careers.
In response to these challenges, universities, athletic departments, and sports organizations are implementing programs and initiatives to support the mental health and well-being of former student-athletes. These efforts encompass providing access to mental health resources, offering transition assistance, and nurturing alumni networks for ongoing support. Mental health services offer crucial safe spaces for addressing a spectrum of issues, whether new, past, current, or ongoing, facilitating individual and community growth.
Addressing the unique mental health needs of former student-athletes is paramount, ensuring they have access to comprehensive support services beyond their athletic careers. This recognition underscores the importance of prioritizing mental health care within the sports community and beyond.
- Has the issue of mental health care for former student-athletes ever been (or currently being) discussed amongst mental health and college athletics professionals?
MCQUEARY: The issue of mental health care for former student-athletes has never been as actively addressed as it is today. Historically, there was a significant level of secrecy surrounding mental health, particularly within athletics and among males. However, a new era of transparency has emerged, bringing this important issue to the forefront. Ongoing conversations are taking place within the NCAA and universities that provide mental health services. These discussions extend to the community level and, importantly, involve peer-to-peer and student-athlete-to-student-athlete interactions. This comprehensive dialogue marks a pivotal shift towards prioritizing the mental well-being of former student-athletes.
MULLENIX: Absolutely. Like other schools, LSU enjoys strong ties with many former student athletes, and we partner with them and organizations they support on several initiatives that speak to this issue specifically. Mental health across the lifespan is a special interest of mine, having worked more than 35 years with student athletes and watched, literally, generations of them grow up and continue their lives beyond their athletic careers.
While mental health concerns for student-athletes have been on the radar for years, the abrupt ending of sports and subsequent isolation experienced during COVID-19 saw a considerable increase in levels of stress and fatigue in this population. Added pressures associated with remote learning environments, the expectations around NIL (Name, ‘Image and Likeness), and over-scheduling seem to have added gasoline on a low-burning fire.
- Was there a specific event or situation that served as the catalyst for your school to provide post career mental health benefits for student-athletes?
MULLENIX: There have been inflection points. We have seen tragic evidence of self-harm, for example, and other ways of acting out. Larger social issues and events also affect students on campus. But this movement has been building for some time.
As a former Athletic Trainer, I was fortunate enough to have gained the trust and respect of thousands of student-athletes during my time embedded with teams. What I already knew was that student-athletes continued to reach out for guidance and support years after they left campus. Knowing that these athletes were more than just their sport, it seemed unfair to make them fend for themselves with inadequate resources, facing barriers to adequate healthcare, or having limited trust in systems. LSU wanted to find a way to provide the care and support for a smoother transition.
MCQUEARY: The catalyst for our school to provide post-career mental health benefits for student-athletes stemmed from concerns raised by former student-athletes and their families about mental health. Some of these instances being life threatening and others being baseline mental health concerns. We have a few standout cases that solidified our need for this initiative, but we really care about their confidentiality. Many former student athletes faced challenges in accessing adequate mental health care or had limited resources.
Dr. Sally Nogle, a steadfast advocate for mental health initiatives, played a pivotal role in advancing this cause. Her experiences and persistent advocacy were instrumental in pushing this initiative forward, ensuring that former student-athletes receive the mental health support they need.
- What is the program that the school has put in place to serve former student-athletes? Who are the partner organizations that help make the program available and how is the partnership structured? Is there a cost to the former student-athlete?
MCQUEARY: The program that the school has put in place to serve former student-athletes is called Alumni STATE of Mind. MSU Athletics partnered with The Hope Desk and Skywood Recovery (Fund Recovery) to provide a 24/7 concierge call line to give former student-athletes immediate support and access to a network of vetted mental health providers and substance use programs nationwide.
The partnership is structured as Skywood Recovery being the official sponsor of the program, and The Hope Desk serving as the call center to help former student-athletes and their family members streamline the process of finding the right mental health support.
There is no cost for former student-athletes to call The Hope Desk to find appropriate mental health support. However, a chosen provider or program may require a payment, which will be given at a discounted price as a participant in the program. If former student athletes aren’t equipped to cover the cost of care, there are avenues we can take to support them in that.
We have had an unwavering level of support from the Montgomery family throughout this journey as well.
Key Features of the Alumni STATE of Mind Program include:
- Dedicated Concierge Call Line: A 24/7 dedicated concierge call line, reachable at(855) 2-SPARTY, (855-277-2789), providing personalized assistance and immediate crisis support. Non-crisis communication is also available.
- Preferred Access to Clinical Programs: Alumni and their families will have preferred access to select clinical programs tailored to meet their specific mental health needs.
- Nationwide Network of Providers: The program grants access to a nationwide list of vetted and accredited mental health providers, ensuring MSU alumni have a broad range of options for receiving quality care.
- Discounted Provider Pricing: Participants in the program benefit from discounted pricing on mental health services, ensuring affordability and accessibility for all.
MULLENIX: Great questions! Our newest partnership is with Tiger Legacy Care (TLC), a mental health support program offered by the National L-Club (Student-Athlete Alumni Association) to any former LSU student-athlete and their immediate family. The program is sponsored in partnership with Our Lady of the Lake Health, with mental health concierge services provided by the Hope Desk.
Tiger Legacy Care provides a dedicated concierge call line specifically for former LSU student-athletes to receive personalized and confidential guidance to help navigate various mental health resources, including talk or telehealth therapy, substance use treatment, or psychiatric care. The TLC program has mental health providers available in all 50 states, Canada, and parts of Europe. All calls are completely confidential, and professional mental health team members will help connect alumni with the most appropriate healthcare services in their respective geographic location. There is no cost to the former student-athletes to utilize this service.
The initial start-up cost of the TLC program was leveraged with our Championship Healthcare partner Our Lady of the Lake Health. This is a large health system within Louisiana. Covering the costs associated with the actual delivery of mental health services can be obtained a few different ways.
If the former student-athlete has health insurance, Hope Desk will assist in finding a provider that accepts their particular insurance. In this scenario, TLC has served as a facilitator to get them connected.
If our alumni find themselves in a place in time where they can’t cover the cost of care, TLC would work with Hope Desk in developing strategic ways to fund the care needed. This is done through fund raising efforts with an organization called Fund Recovery- directed by Ryan Cain. In some scenarios, crowd sourcing becomes an avenue for funding support. It is a very creative way to solve a critical problem associated with mental health access.
Concierge Line (Non-Emergency) 866-LSU-9989 or 866-578-9989 or email LSU@HopeDesk.co
- Are there any limitations to providing this service?
MULLENIX: We’re proud of the service we provide with the help of our partners, but of course we would love to expand it! Limitations are always a concern with any program, whether they be in budget, staffing, communications, competing responsibilities, etc. But no progress would be possible without so many dedicated people agreeing to work through these limitations toward whatever more can be achieved on behalf of our former student-athletes.
MCQUEARY: While we’re proud of the services we offer with our partners, expanding can be a challenge due to various limitations. However, our progress is driven by so many amazing people at the Fund Recovery and The Hope Desk. Specific challenges may include the lack of knowledge about vetted providers in the program, however we trust our partnership and know they have chosen highly equipped clinicians to provide care to our former student athletes. Additionally, we can assume the stigma surrounding mental health may prevent some former student-athletes from seeking help. Despite these challenges, we’re committed to supporting our student-athletes’ mental health and overall well-being, both during their time at MSU and beyond.
- How do you communicate the benefits of continuity of care to former student-athletes who may not have received services from your department in years, or possibly never?
MCQUEARY: We disseminate this information to former student-athletes through various channels, including our social media platform @msu_athwellness, announcements at MSU home games, and interviews with local news outlets. Currently, we’re collaborating with The Mental Game Podcast to feature interviews with former MSU student-athletes discussing their mental health challenges and how Alumni STATE of Mind can offer crucial support. As athletes graduate, we ensure they receive this information as they transition out of our care. Our hope is that former student-athletes who may not have received services from the department in years or never before reaped the benefits.
MULLENIX: The conversations about mental health, as well as the availability of confidential counseling services offered to our current student-athletes, are communicated across several platforms available to active student-athletes at LSU. The LSU Sport Psychology and Counseling unit is embedded within our athletics department, which is located within the main athletic training complex in Tiger Stadium. The close proximity of physical health and mental health units is intentional and helps to minimize the stigma generally associated mental health services as well as facilitating exposure to these services.
The mental health counselors provide team building presentations, which give them direct access to the coaches and the student-athletes within their own sports environment. Student-athletes are encouraged by administrators, coaches, athletics trainers as well as academic support to utilize these counseling services.
Information about TLC is provided at the time of student-athlete recruitment, so that each recruit knows that becoming a Tiger includes services that they and their families would benefit from for a lifetime. TLC informational flyers are provided with exit physicals and when students are terminating care with their mental health counselor. Flyers are strategically placed within athletics facilities to serve as a reminder to reach out for support. Once off campus, information regarding the TLC program is disseminated through the National L-Club, at sports tailgating events, on the LSU Sports website, as well as on HealthyTiger.net, a social platform of LSU Athletics that encourages continued connections between current and former LSU student-athlete and staff.
- How do former student-athletes access the services? Has this program been utilized since its inception? If so, is there a primary demographic that you see using the services?
MULLENIX: In addition to the ways mentioned above, access to the Tiger Legacy Care program is included in the concierge line and leads to a team of trained call-center staffers prepared to provide crisis support as well as make critical connections between vetted mental health professionals and the former student-athletes.
Our partners at Hope Desk have received calls from former LSU student-athletes of all ages from the newly graduated to former athletes over 60 years of age. Demographics have included those who have identified as male and female and from locations not only in the United States, but even from our international student-athlete alumni.
MCQUEARY: Former student athletes can access these services in two ways.
- Calling 855-2SPARTY (855-277-2789)
- Emailing STATEOFMIND@HOPEDESK@.CO
Our program is still in its early stages, so we do not yet have comprehensive data on how former student-athletes access the services or the primary demographic using them. However, we hope to see widespread utilization across various demographics, with former student-athletes from diverse backgrounds and sports taking advantage of these services. Our goal is to ensure equitable access and support for all former student-athletes, regardless of their financial situation, to promote overall mental well-being and success in their post-athletic lives.
- Have you seen an uptick in utilization of mental health services for current student-athletes? Do you anticipate these services being heavily used as the current student-athletes move on to post college career athletes?
MCQUEARY: Before our unit was established, the athletes at Michigan State University received extensive support from the psychiatrists within MSU Healthcare. Their foundational work laid the groundwork and paved the way for integrating psychology into athletics at Michigan State. These psychiatrists continue to support our student-athletes today.
Since our unit’s inception, we have observed a significant increase in the number of athletes seeking our services. We have dedicated substantial efforts to breaking the stigma associated with mental health on our campus. One of the most compelling aspects of this program has been witnessing our first cohort of student-athletes transition out of our care while choosing to continue their therapeutic work. We anticipate that many of our current student-athletes will utilize this service after they graduate.
MULLENIX: We believe a few factors have led to increasing use of our in-house mental health services. As our student-athletes are more exposed to team mental health trainings, the conversations about mental health are becoming more normalized. As this happens, the stigma often associated with mental health counseling lessens.
We also feel that, generationally, today’s late adolescents are more comfortable in the “mental health space” and are specifically seeking out these counseling services as a regular part of their health care routines. Lastly, coaches themselves are experiencing higher rates of mental health distress, and some are deciding to have these conversations more openly, which helps to change the culture and stigma among teams.
- What do you want former student-athletes to know about your commitment to their mental health and well-being, after graduation?
MULLENIX: What has always been true about me and many of my colleagues is our belief that collegiate athletics is just a small part of a longer journey. We use a holistic approach to help student-athletes understand they are more than just a body. It’s important to us that they understand themselves as multidimensional and they will have different needs and expectations on any given day. This is the human side of existence. And it does not change after students leave campus.
Through Tiger Legacy Care, we can provide the continued support and access to care that was a part of their championship experience at LSU.
MCQUEARY: Our commitment to the mental health and well-being of our student-athletes extends far beyond their time on the field. We care about our athletes not just during their years at Michigan State, but throughout their lives as alumni. We strive to ensure they feel supported in all aspects of their identity. By offering continued support to both them and their families, we aim to help them become the best versions of themselves as they transition away from campus. We are truly dedicated to their lifelong success.