The negative effects of disclosing a history of mental illness and the need for mental health services are well documented in the professional literature (Corrigan, 2005). Being labeled as "mentally ill" can lead to negative stereotypes placed on the individual that lead to prejudice and discrimination (Corrigan, 2004). These negative effects of disclosing psychological disturbances have led to some individuals being hesitant to seek help, even if the individuals or those close to them feel it is needed (Thornicroft, 2006). College students are a vulnerable population due to the likelihood that they will experience their first psychological disturbance during their college years (Eisenberg, Golberstein, & Gollust, 2007), making access to mental health care crucial. College student-athletes may be even more at-risk for certain psychological disturbances, based on their unique demands and environmental stressors they face (Pinkerton, Hintz, & Barrow, 1989). College student-athletes appear to be underutilizing the mental health services available to them on college campuses (Watson & Kissinger, 2007). Prior studies have shown that college student-athletes are less likely to seek out mental health treatment than other college students (Watson, 2005). The purpose of this study was to see whether or not college student-athletes would exhibit more negative attitudes than student-nonathletes towards mental illness. This study also compared the attitudes toward seeking psychological help between athletes and non-athletes (using a measure developed for use with student-athletes and student-nonathletes by Watson, 2005). Scales that measure social distance, perceived devaluation and discrimination towards mental illness were used to operationalize stigma towards mental illness. The scales this study used to measure social distance (Martin et al., 2000) and perceived discrimination towards mental illness (Link, 1987) had never been used before in a student-athlete population. The potential roles that athletic identity, race, and gender play in treatment-seeking comfort were also examined.

Introduction: Adolescents and young adults experience a high level of mental health conditions.These disorders appear to be increasing in number and severity. The prevalence rate for 18-25-years-olds is 8.7% in 12 months. Mental health conditions are treatable, yet many people do not seek professional help. Seeking help from a professional source is particularly important for preventing, early detection, treatment, and recovery from mental health conditions. Purpose: The purpose of this mixed-methods study is to demonstrate the prevalence of depression, explore student-athletes attitudes towards seeking mental health help, understand what factors may influence help-seeking behaviors, and explore the athlete's perceptions of the role that athletic trainers play in the assessment and referral process. Methods: An exploratory, concurrent mixed methods design was used. Survey data from the ATSPPH-SF and PHQ-9 were collected from collegiate student-athletes. A phenomenological approach will guide the qualitative research process. Semi-structured interviews will be audiotaped, transcribed, and analyzed using an interpretive thematic analytical approach. Study Participants: National Collegiate Athletic Association (NCAA) student-athletes participating at the Divsion III (DIII) level. Results: The prevalence of depression was almost 42% in the study population. There was no relationship between PHQ-9 scores and sex. Attitudes towards seeking help were generally positive. Females tend to have more favorable attitudes than males, but this finding was not statistically significant. There was no relationhship between PHQ-9 scores and ATSPPH-SF scores. Barriers to help-seeking included perceived seriousness, stigma, lack of time, accessibility, prefer to handle issues on own, and cost. Facilitators to help-seeking included perceived and nee-problems that were serious enough to warrant help and a supportive network. Clinical Importance: As we continue to address the mental health crisis, it is imperative to understand what prevents student-athletes from seeking professional psychological help and develop supportive programs to help them overcome these barriers. Certified athletic trainers, coaches, and other athletic personel need to understand the seriousness of untreated mental health conditions and be educated to recognize when an athlete may be struggling with issues beyond their control. Knowing when to refer a student-athlete to a professional is essential in preventing potential unnecessary and irreversible consequences.

"Student-athletes encounter a series of unique stressors associated with their athletic status that can compromise their well-being (Beauchemin, 2012; Brown et al., 2014; Parham, 1993; Valentine & Taub, 1999). There is evidence to suggest that demands on student-athletes' increase their risk for experiencing certain mental and physical distress (e.g., eating disorders, anxiety, depression) (Brown et al., 2014; Etzel et al., 2006; Rice et al., 2016). Further, student-athletes are less likely to seek help from mental health professionals than their non-athlete peers (Watson, 2005). The purpose of this study was to understand the role that communication plays in socializing student-athletes, and how communication influences their perceptions of seeking mental health services. The research questions in this study were the following: 1) What are the memorable messages student-athletes receive that inform their perceptions of seeking mental health services? 2) Which sources who deliver the memorable messages have the greatest impact on student-athletes' attitudes and perceptions of seeking mental health services? This study utilized Consensual Qualitative Research (CQR) to conduct and analyze in-depth interviews about Division I student-athletes' experiences and context surrounding the memorable messages received, with the intention of identifying themes that capture the impact the messages have had on their help-seeking attitudes and behaviors. The current body of research provides evidence that memorable messages student-athletes received have positively and negatively influenced their attitudes and behaviors towards seeking professional help. Findings from this current study revealed that, across the two domains that directly answered the research questions, there were five general categories and seven typical categories indicating there were commonalities in the memorable messages received and significant sources who communicated them. All participants identified and recalled specific memorable messages, both positive and negative, regarding seeking mental health services; however, overall student-athletes received a higher frequency of positive messages. The common theme around the positive messages student-athletes received were some variation of "It's ok to not be ok" while the theme around the negative messages received were rooted in sport culture norms such as "Athletes are supposed to be tough" and "You're weak if you need help." The significant sources who most influenced student-athletes' perceptions of seeking mental health services were coaches and family (parents, dad, mom, sister, and uncle)."--Abstract from author supplied metadata

Collegiate athletes experience mental health concerns at similar rates to non-athlete students, however, the student-athlete population underutilizes professional mental health help with only 10% of those in need seeking services. Criticisms of the extant research on studentathlete mental health help-seeking include studies that lack theoretical guidance, and convenience samples who are not experiencing a mental health issue. The aim of this study was to conduct a theoretically driven investigation assessing factors of help-seeking associated with the Health Belief Model and Reasoned Action Approach while sampling student-athletes who identified as currently experiencing a personal or emotional health concern. More specifically, the purpose of this study was to investigate which factors of help-seeking behavior predict the likelihood that a student-athlete will seek professional help, and to identify the differences in help-seeking factors between student-athletes with a lower likelihood of seeking help compared to those with a higher likelihood of seeking help. Participants were 269 NCAA student-athletes who completed an online survey assessing factors related to their help-seeking behavior. A multiple liner regression reveled that perceived benefits, perceived susceptibility, and perceived attitudes factors were significant predictors of the likelihood that a student-athlete would seek treatment. Results from a one-way MANOVA showed significant differences between the lower likelihood and the higher likelihood of seeking help group on the perceived seriousness, perceived susceptibility, perceived benefits, instrumental barriers, stigma-related barriers, and the perceived attitudes factors. Additional information gathered in this study suggests the most frequently reported factors which prevented student-athletes from seeking help include a belief the issues they are experiencing is not that serious, or a desire to seek help from a source other than a mental health professional. Findings from this study have implications for athletic departments, campus counseling centers, and future interventions designed to enhance mental health help-seeking.

This study explored eighteen National Collegiate Athletic Association (NCAA) Division II female student athletes’ experiences and opinions of help seeking for mental health concerns. A mixed methodological design was used. Qualitative and quantitative data was collected to gain an understanding of help seeking barriers for the participant and their beliefs about help seeking barriers for their peers. Results from the qualitative data identified several themes that assisted in understanding help seeking behaviors. Data suggest that there was a lack of motivation when it came to seek mental health services as a whole by the female student athlete population. Time, lack of understanding as to where to get counseling, as well as lack of information as a whole showed to be the most prominent barriers within the female athlete population. There was also a significant finding involving lack of information and the amount of time the participant has been at the university, showing that the longer they were at the university the less information they had about mental health services. Many themes were also collected such as fear of being misunderstood, as well as feeling there is a lack of qualified counselors and a lack of counselors of the respondents’ own gender and race.

Purpose. The purpose of this study was to assess collegiate student-athlete perception of mental health. A secondary purpose was to develop a list of attitudes and behaviors toward athletes seeking help, and university perception. Methods. Alcorn State University student-athletes were given a survey about mental health in collegiate athletics. One-hundred and ninety student athletes submitted a complete response. Results. There was no significant relationship between the number of barriers and seeking help. There was an overwhelming number of student-athletes that do not believe that Alcorn is prepared to help with a mental health crisis. There was no significant difference between male and female participants for willingness to seek help. Discussion. The number of barriers data was skewed due to the high number of responses for zero and one barrier, but questions could be used for future studies. Many of the student-athletes feel that Alcorn is not prepared and provided several qualitative responses that could benefit the athletic department. Lastly, even though there was no significance between the sexes, it shows that the gap between them is starting to decrease. Conclusion. There are a lot of improvements that could be made to the mental health crisis response. Student-athlete opinions are important and should be used to develop protocols and policies.

Student-athletes are at high risk for poor mental health. Leaders within the varsity sport environment influence athlete mental health and help-seeking. This dissertation explored the behaviors, perspectives and needs of athletes, coaches, and athletic trainers as it pertains to mental health in sport. Three studies were conducted, the first utilized the Theory of Planned Behavior to explore factors associated with coach-athlete conversations about mental health. A coach's Attitude towards having a conversation with an athlete significantly influenced their Intention to do so. Perceived Behavioral Control (PBC) significantly influenced the relationship between Social Norms and Intention. Both PBC and Social Norms had a significant relationship with the Behavior (having a conversation about mental health with an athlete). The second study applied a conceptual model from Horn's Working Model of Coach Effectiveness to explore how an athlete's perception of coach behavior impacts attitudes and help-seeking behaviors. Psychological distress levels influenced an athlete's Perception of their coach's behavior. Openness to help-seeking was significantly related to help-seeking Behaviors and influenced the relationship between personal characteristics and help-seeking. Perception of coach behaviors influenced the relationship between psychological distress and help-seeking from a coach. The last study sought to determine the acceptance of an online varsity sport-specific mental health resource. Preliminary results were promising; The PEER Network was frequently used over the study period and participants had positive and supportive feedback. Overall, results from the three studies suggest that perceived ability and social support may influence whether coach-athlete conversations about mental health occur. Due to the effects of these variables, coach mental health training should focus on improving the skills required for these conversations and normalizing mental health in sport. As an athlete's perception of coach behavior mediated the relationship between psychological distress and help-seeking, training should also focus on clear ways to show athletes that coaches are supportive of mental health. Athlete-specific training should try and improve attitudes towards help-seeking and highlight the value from seeking help. The PEER Network may be an easily accessible and context-specific way of achieving these educational goals for members of the varsity athletic community.