BATON ROUGE - As a former collegiate gymnast, Lauren Li, found comfort at LSU after experiencing emotional distress at Penn State.

“Anxiety, depression, eating disorders: It was tough just talking about it because being used to suppressing those emotions, I had to like learn how to be comfortable talking about it and seeking help for it if I wanted to help myself,” said Li, who was on LSU’s highly ranked team over the last three seasons.

It is no secret that expectations are high for athletes at universities across the country. These pressures take a toll, emotionally and physically, on athletes in all sports. And there has long been a stigma that discourages many of them from seeking mental and psychological help. 

But now schools in Louisiana and elsewhere are doing more to address the problem, thanks in part to guidelines that the National Collegiate Athletic Association created in 2016 to encourage them to address the problem.

LSU has done the most in Louisiana and now has three mental health counselors working in its athletic department.

 “We have several support groups.” said LSU head football coach Ed Orgeron. “We have a lot of counseling for our guys, and anything that happens we put them in counseling.”

Tulane’s athletic department has hired its own mental health specialist. But most Louisiana schools still refer athletes to counseling centers that treat all students. Some of these schools-- like Louisiana Tech, University of Louisiana Monroe and Northwestern State University--bring in speakers on mental health issues, give athletes surveys with questions designed to flag emotional problems or teach their coaches to spot signs of distress.

“It’s been a major shift,” said Greg Burke, Northwestern State’s athletic director. “There was a definite stigma.” But with greater transparency, “the awareness level can’t be high enough right now.”

Still, Gerald Jordan, the assistant athletic director for sports medicine at Louisiana Tech, cautioned that “it’s hard to compare the big and small schools just because the resources are typically so drastically different."

“What we can do here is probably not what Grambling can do five miles down the road versus what we can do here is probably not in comparison to what LSU can do,” Jordan said.

It can still be hard for many athletes to get past the stigma themselves as well.

“When you think of most athletes, whether they’re at the collegiate level or beyond, they’ve been playing their sport for their entire lives,” said LaKeitha Poole, LSU’s director of sport psychology and counseling. “That’s a major part of their identity.”

“Any form of help-seeking, which in their terms would be seen as a weakness, definitely isn’t appealing initially,” she said.

Hannah Blackford, a freshman softball player at Southeastern Louisiana University in Hammond, said she suffered from anxiety after moving 950 miles from her home in Iowa. The transition to mounting schoolwork, rigorous softball practices and being away from her family led to constant struggles, she said.

At first, Blackford was caught up in the stigma, too. “Yeah, when my coach referred me to the counselor, I thought I could figure things out for myself,” she said.

Blackford said she was shaking before her first meeting with the counselor and thought it was just going to cover “stupid stuff I already know.”

“It opened me up and opened my eyes to reality,” Blackford said.

Now she visits the counselor every week or two.

Anxiety is not the only issue that athletes face. Depression can also be a factor but might not show.

A survey of 257 college athletes by researchers at the University of Iowa in 2006 suggested that 21 percent of them were experiencing symptoms of depression. Other researchers have estimated that 10 to 15 percent of college athletes have mental health issues that warrant counseling.

Pressure from coaches, the physicality of most sports and difficulties in balancing time demands all can influence the mental health of student-athletes. Athletes also often have an elevated status and are expected to uphold their school’s image.

 Awareness of mental health issues in sports was boosted by research on concussions and the resulting brain injuries and by Will Smith’s movie “Concussion” in 2015. 

The NCAA guidelines, passed in 2016, are voluntary and lay out the best practices for colleges to follow in four areas: identifying mental health care professionals for athletes, setting out routine and emergency practices for referring athletes to the counselors, developing preseason mental health screening questionnaires to identify potential areas of concern and promoting environments that support well-being and resilience.

Surveys also have shown that athletes are more likely to seek help if services are provided in familiar places, like athletic training centers. 

LSU can afford to have three mental-health counselors in its athletic department because it is the only Louisiana school whose sports programs earn a profit.

Having mental-health specialists at athletic facilities “would be wonderful if the revenue was available,” said Jim Murphy, the head trainer at McNeese State University in Lake Charles.

“If you look at higher education in the state of Louisiana, there’s not much money, and in fact, they keep taking money away from it,” he said.

Murphy said that if the university’s student health center cannot see an athlete quickly enough, he will call mental-health professionals in Lake Charles and ask them to help out.

Louisiana Tech and UL Monroe both invite a mental-health counselor from HealthPoint Center in Monroe to speak to their athletes. 

Louisiana Tech also gives athletes preseason surveys that include three “red flag” questions related to their sense of hope, everyday emotions and whether they have any thoughts of harming themselves or anyone else. If their answers raise concern, they see a counselor within a day or two. 

Lauren Miller, the mental health specialist for the Tulane athletics department, said requests for counseling are evenly split now between male and female athletes despite the stereotype that women are more likely to open up than men.
 
Regardless of where student-athletes receive counseling, the emphasis placed on mental health issues is easing the stigma.

Li, the former LSU gymnast, said she thinks "we’re on the rise to turning that stigma around.”

“But I think it’s 50/50 right now,” she said, “because there are some people I know that are in denial about their mental health and some people that want to be open about it and want to seek help for it.”

When she was originally recruited, Penn State promised Li that the environment surrounding her would be a supportive, safe one. But reality contrasted with this vision. 

“There was a lack of acknowledgment of our hard work and just really no positive encouragement or positive words said,” Li said. “We’re drilled into our head that we represent the university, that everything we do, we’re like the face of the university. You can’t be yourself basically. I know I felt like that a lot. Even after coming here, I felt like it was my responsibility to be someone else.”

“If I had any advice for student athletes struggling with mental health... It’s just they’re not alone, and there’s help all around you. You just have to reach out to one person to get it started, and you'll get better. Just keep at it," she said.