Suicide Intervention in Sport Spaces
Suicide has been and continues to be a public health concern within the general population. Alarmingly, suicide rates increased by 36% from 2001 to 2021 (Centers for Disease Control and Prevention, 2023). Further, suicide is the second leading cause of death among adolescents (ages 15-19) and college-aged students (ages 18-24; Dodd et al., 2021; National Center for Injury Prevention and Control, 2019). Athletic participation and exercise can be a protective factor against mental health concerns leading to suicide (Rao, 2021); however, athletes also face unique stressors as they function within a sport system valuing toughness and a “win at all costs” mentality creating a culture rife with suicide risks for athletes. Therefore, it is important for those operating within the sport system (e.g., coaches, support staff, administrators, parents, etc.) to be informed about suicide causes, intervention strategies, and risk factors specific to athletes.
Joiner (2007) developed a conceptual model to better understand the factors leading to suicide attempts and/or completion. The model (as seen below) demonstrates that suicidal ideation and desire are cultivated when an individual experiences thwarted belongingness and perceived burdensomeness. Therefore, individuals who do not feel as though they belong to or have a community, as well as those who feel as if they are a burden to others (i.e., emotionally, mentally, physically, financially), are at greater risk for suicidal ideation and desire. Further, individuals who experience both thwarted belongingness combined with perceived burdensomeness as well as have the means/capability for suicide (e.g., access to a gun, chemicals, etc.) are more likely to attempt and/or complete suicide.
Risk factors specific to athletes fall within these overarching umbrellas of thwarted belongingness and perceived burdensomeness. For example, athletes experiencing injury may feel both thwarted belongingness (e.g., no longer practicing/traveling with the team) and perceived burdensomeness (e.g., relying on an athletic trainer for treatment/help, not producing results for the team but still using team resources). Other athlete-specific risk factors include transition (e.g., into/out of sport, to a new position, etc.), identity (e.g., historically marginalized identity such as LGBTQ+, transitioning out of sport and losing athlete identity), concussions/head trauma, overtraining, and social media/social pressure. These experiences can lead to both feelings and behaviors that can serve as signals to those around the athlete that they may be at a heightened risk for suicidal ideation or attempt.
Examples of high-risk feelings include:
No reason for living
No sense of purpose
Hopelessness
Anxiousness/agitation
Feeling trapped
Examples of high-risk behaviors include:
Increase substance abuse
Withdrawal from family, friends, society
Rage, anger, and revenge-seeking behavior
Risky decision-making (e.g, driving significantly above the speed limit, drinking and driving, spending large amounts of money without care, mixing medications)
Unable to sleep or sleeping all the time
If you notice an athlete experiencing these feelings or demonstrating these behaviors, it is important to check in and ask directly if they are having thoughts of suicide (intent), have a plan to complete suicide (plan), and/or have the means to complete suicide (means).
Although coaches, parents, support staff, etc., may not be directly trained in mental health and suicide intervention, it is important to understand the risk factors and warning signs to refer athletes to the care they need. The most important step is often intervening with questions, care, and concern and then making the correct referral to a licensed mental health professional for continued assessment and care. An athlete in passive suicidal ideation (has intent but no plans and/or means) may not be in immediate danger; however, they should be referred to a therapist and/or counseling center for care and monitoring. An athlete in active suicidal ideation (intent, plans, and means) may be in immediate danger, and this should be treated as an emergency. In this case, it is important to call emergency personnel (i.e., 911, 988, or in-patient behavioral care).
Athletes may seem superhuman in some instances, but they are human beings with emotional and mental health needs. When working in sport spaces, particular attention should be paid to the feelings and behaviors of athletes to intervene when needed. Athletes are trained to be tough, self-sufficient, and seek perfection; thus, they may not directly admit when they need help. Sport leaders need to be observational and directly ask about suicidal ideation.
If you or someone you know is having suicidal thoughts, call 988.
***To register for a more in-depth overview of suicide intervention training, you can register for a free-webinar here.***
References
Center for Disease Prevention and Control (2023, August 10). Suicide data and statistics. https://www.cdc.gov/suicide/suicide-data-statistics.html
Joiner, T. (2007). Why people die by suicide (1st ed.). Harvard University Press.
National Center for Injury Prevention and Control. (2019). Leading causes of death reports, 1981—2019. Centers for Disease Control and Prevention. https://www.cdc.gov/injury/wisqars/index.html
Rao, A. L. (2021). Suicide among athletes. In M. Lang (Ed.) Routledge handbook of athlete welfare. (pp. 153-162). Routledge. https://doi.org/10.4324/9780429201745
