Coaching with care: Recognizing and supporting athlete mental health
Coaches spend a lot of time with their athletes.
They see them practice. They see them compete. They see how they respond to a bad performance, how they handle pressure, and how they interact with their teammates.
Because of that, coaches are often in a good position to notice when something has changed.
Maybe an athlete who is usually energetic suddenly seems withdrawn. Maybe they're having trouble concentrating. Maybe they're getting unusually irritable. Maybe they're exhausted all the time. Or maybe they're still performing well, but they don't seem to be enjoying their sport anymore.
That last one can be easy to miss.
We talk a lot about athletes performing at their highest level. But one of the things that often gets forgotten about sport psychology is the other part of the equation: enjoying your sport. The goal isn't just to help athletes perform better. We also want them to actually enjoy what they're doing.
And sometimes, helping an athlete enjoy their sport again means paying attention to what's happening with their mental health.
In this episode of The Mentally Fit Athlete, Lidia Garcia, MSW, and I talk about how coaches and athletic trainers can recognize when an athlete might need additional support, how to make a referral without making the athlete feel like they're being pushed away, and why coaches don't need to become therapists to be an important part of an athlete's mental health support system.
Coaches don't have to be therapists
Let's start with something that I think can make this whole conversation a little less overwhelming.
It's not the coach's job to be the athlete's therapist.
Coaches can be supportive. They can listen. They can ask questions. They can notice when something isn't right. They can encourage an athlete to get help.
But there's a difference between supporting someone and treating a mental health problem.
We talked about physical injuries during the episode. If an athlete has a significant physical injury, a coach might listen to them, walk them to the athletic training room, or help them get connected with a doctor.
The coach doesn't try to treat the injury themselves.
Mental health can work in much the same way.
You can care about an athlete without trying to solve everything for them.
In fact, sometimes the most helpful thing a coach can say is:
“I don't know how to help with this, but I know someone who can.”
There's no shame in that.
Start by paying attention
The first step is awareness.
Athletes are often very good at pushing through discomfort. That's part of what makes them successful. They learn to tolerate physical discomfort, fatigue, frustration, and sometimes fear in order to reach their goals.
But that can also make it harder for them to notice when something is going on with their mental health.
Athletes may minimize what they're experiencing. They may think they should be able to handle it themselves. They may worry that telling their coach they're anxious or struggling will make them look weak.
And sometimes they may not even realize how much something is affecting them.
So coaches don't necessarily need to look for a particular diagnosis.
Instead, pay attention to changes.
Is this athlete behaving differently than usual?
Are they sleeping?
Are they eating enough?
Are they recovering?
Are they taking any time away from their sport?
Are they suddenly more irritable or withdrawn?
Are they having trouble concentrating?
Are they losing motivation?
Those questions aren't necessarily about mental illness. Sometimes an athlete is simply exhausted.
And that's important to recognize, too.
Sometimes the basics really are the basics
One of the things Lidia brought up during our conversation was what her coach calls “nailing the basics.”
Are you getting enough sleep?
Are you eating enough?
Are you recovering?
Are you giving yourself enough rest?
It's easy to overlook these things when we're focused on performance.
An athlete who is overtrained or exhausted can have low energy, reduced motivation, and even a lower mood. Some of those things can look similar to depression.
If an athlete gets some rest and feels significantly better, that gives you some useful information.
If the problems continue even after they've had an opportunity to recover, that's another reason to look more closely at what's happening.
The point isn't for the coach to figure out whether an athlete is fatigued or depressed.
The point is to notice that something may need attention.
When is it time to refer?
This is where things get a little more complicated.
Athletes are going to be anxious before competitions. They're going to be disappointed after a bad performance. They're going to have arguments with teammates and coaches. They're going to have relationship problems, school problems, family problems, and bad days.
Not every difficult experience means someone needs therapy.
One question that can be helpful is:
Is what's happening interfering with the athlete's ability to function?
Is it affecting their ability to participate in their sport?
Is it affecting school or work?
Is it affecting their relationships?
Is it affecting their everyday life?
If the answer is yes, that's a good reason to consider connecting the athlete with a mental health professional.
There's another question that coaches can ask themselves:
Is this becoming more than I can reasonably handle as a coach?
Coaches have responsibilities to their entire team. You may care deeply about one particular athlete, but you still have a roster to coach.
Recognizing that your capacity has been reached isn't abandoning the athlete.
It's recognizing that they may need more support than you can provide.
A referral doesn't have to mean “go find a therapist”
This is something I think we could do better with.
If a coach tells an athlete, “You should probably see a therapist,” and leaves it at that, the athlete may not know what to do next.
Especially if they're young.
A 15-year-old or 16-year-old athlete may have no idea how to find a therapist. Even a college athlete might not know where to start.
That's why a coach can be helpful in scaffolding the process.
You might walk the athlete over to the counseling center.
You might help them find the right phone number.
You might sit with them while they send an email.
You might give them the name of a therapist or sport psychologist you trust.
You don't have to make the appointment for them or take responsibility for their treatment.
But you can make the first step a little easier.
And sometimes that little bit of help is exactly what someone needs to actually follow through.
Build your mental health Rolodex
One of the things we talked about in the episode was the idea that coaches should have a list of mental health resources available to them.
Athletic programs already tend to have relationships with other professionals.
You may know a physical therapist.
You may know an athletic trainer.
You may have a team physician, nutritionist, or strength and conditioning coach.
It makes sense to also have a few mental health professionals you know and trust.
That doesn't mean you need a referral for every possible mental health issue.
It just means you know where to start.
It can also be helpful for mental health professionals to build relationships with teams and athletic programs. A therapist or sport psychologist who has already met the coaching staff and provided a presentation or workshop is a much more familiar resource than a random name pulled from Google.
That familiarity can make it easier for everyone when an athlete actually needs help.
Make mental health part of the team culture
One of the easiest things a coach can do is talk about mental health before there's a problem.
It doesn't have to be complicated.
A coach can tell their athletes something like:
“We take physical health seriously, and we take mental health seriously, too. If you're struggling, you can talk to me. I'll listen, and I'll help you get connected with someone who can help.”
That's a pretty simple message.
But it tells athletes something important:
You don't have to pretend everything is fine.
That can be especially important for athletes who are worried about looking weak or disappointing their coach.
If mental health is something that gets talked about openly from the beginning, an athlete may be more comfortable saying something when they actually need help.
Athletes are whole people
Another important part of this conversation is remembering that athletes don't stop being people just because they're at practice.
They have families.
They have relationships.
They have school and work.
They have financial concerns.
They may be dealing with trauma or conflict at home.
They may be worried about where their next meal is coming from.
They may be struggling with something that has absolutely nothing to do with their sport but is still affecting their ability to participate in it.
This is especially important to remember when we're talking about high-level athletes.
There's sometimes an assumption that if someone is competing at a high level, they must have everything else figured out.
That's not necessarily true.
An athlete can be incredibly talented and still be struggling financially. They can be competing internationally and still be worried about paying rent. They can be working toward an Olympic goal and still be dealing with problems at home.
Athletes have the same basic needs as everyone else.
Sometimes helping an athlete means connecting them with a therapist.
Sometimes it means helping them find other resources.
Either way, the goal is to look at the whole person rather than only looking at their performance.
Don't forget about enjoyment
This brings me back to something that I think gets overlooked in conversations about sport psychology.
Athletes are supposed to enjoy their sport.
That doesn't mean every practice needs to be fun.
It doesn't mean athletes won't experience frustration, disappointment, or hard days.
And it certainly doesn't mean that athletes should quit whenever something becomes difficult.
But if an athlete has reached the point where they're miserable all the time, that's worth paying attention to.
We've all seen athletes who are incredibly successful but don't seem to enjoy what they're doing anymore.
Sometimes the pressure to perform becomes so intense that the actual experience of participating in the sport gets pushed into the background.
Young athletes can burn out, too. Sometimes they become afraid to tell their parents that they don't love their sport anymore because they worry about disappointing them. Sometimes they've already tried to bring it up and it has become a point of conflict.
That's a problem.
The goal of sport isn't simply to produce the highest possible number of wins, scholarships, medals, or championships.
Those things can be great.
But enjoying what you're doing matters, too.
Coaches don't have to know everything
If you're a coach, athletic trainer, or administrator, learning about mental health can feel overwhelming.
There are a lot of different problems athletes can experience.
You might worry about saying the wrong thing.
You might wonder whether you're overreacting.
You might wonder whether something is serious enough to warrant a referral.
You don't have to know everything.
You can learn a little bit at a time.
You can become more comfortable talking about mental health.
You can learn some of the warning signs.
You can build relationships with professionals.
And you can have a list of resources available before you need them.
Most importantly, you don't have to carry all of this by yourself.
Sometimes your role is simply to be a sounding board.
Sometimes it's to sit with an athlete while they figure out what to do next.
Sometimes it's to say, “I think you could use some additional support,” and help them find it.
That can go a long way.
Know what you do well
I really liked an analogy Lidia came up with during our conversation.
She compared it to cutting hair.
If you ask Lydia to cut your hair, she's going to tell you that isn't what she does.
She could pick up some scissors and give it a shot, but you probably aren't going to get the haircut you wanted.
Instead, she's going to send you to someone who knows what they're doing.
Mental health is similar.
As a coach, you have an area of expertise.
You know your sport.
You know how to coach.
You know your athletes.
You may know how to motivate them, challenge them, and help them perform under pressure.
That's important.
But you don't need to know how to treat depression, OCD, an eating disorder, trauma, or every other mental health problem an athlete might experience.
That's what mental health professionals are for.
Knowing when something is outside your area of expertise doesn't make you less of a coach.
It makes you a better one.
And sometimes the best thing you can do for an athlete is help them find someone who can provide the kind of support you can't.
Just don't ask Lidia for a haircut.
Seriously.
Supporting the athlete doesn't mean carrying everything
Ultimately, I think that's the biggest takeaway from this conversation.
Coaches have an important role in supporting athletes' mental health.
But they don't have to carry the entire thing.
Notice when something has changed.
Ask how the athlete is doing.
Listen.
Take their concerns seriously.
Help them take care of the basics.
Know your own limits.
And when an athlete needs more support than you can provide, help connect them with someone who can provide it.
That's not failing the athlete.
That's part of taking care of them.
Because athletes are more than their performance.
And sometimes helping an athlete perform at their best starts with making sure they're doing okay as a person.
Looking for additional support?
If you're a coach or athletic trainer and you think an athlete could benefit from working with a mental health professional, I'm happy to talk with you about whether I might be a good fit.
I work with athletes dealing with anxiety, OCD, performance anxiety, perfectionism, burnout, confidence issues, and other concerns that can get in the way of both mental health and performance.
I provide telehealth throughout California, including Los Angeles, Long Beach, and the South Bay.
If you're in Los Angeles, you can learn more about my approach to working with athletes on my Los Angeles sport psychology page.
If you're in Long Beach, you can learn more on my [Long Beach sport psychology page].
And if you're in the South Bay, you can learn more on my South Bay sport psychology page.
If you're not sure whether working with a sport psychologist makes sense, that's okay. We can talk about what's going on and figure out whether I'm the right person to help, or whether another resource would make more sense.