Researchers voice concerns over rising suicide rates affecting young athletes in USA
Researchers have found that the number of suicides among US college student athletes has doubled over the past 20 years.
In an article published today (5 April) in the British Journal of Sports Medicine, Bridget Whelan, who works in Family Medicine at the University of Washington in Seattle, and her co-writers outline an analysis of data gathered from the National Collegiate Athletic Association (NCAA).
They found that suicide is now the second most common cause of death – after accidents – in this group of young people.
The highest suicide rate is occurring among cross-country competitors, the researchers note. US suicide rates rose by around 36 per cent across all age groups between 2001 and 2021, Dr Whelan and her colleagues state. But the evidence around athletes’ vulnerability to suicide, particularly young athletes, is contradictory, they suggest.
To better inform policy and suicide prevention efforts, they analysed suicide rates from 1 July 2002 to 30 June 2022 among NCAA athletes to see if there were any discernible differences or trends in incidence by age, sex, race, division, sport, time of year and day of the week. Athletes were defined as those competing in at least one varsity sport at NCAA Division I, II or III institutions.
Rising death toll from suicide in recent decades
The cause of each athlete’s death, as well as details of age, race, and sporting discipline, were ascertained through online media reports and obituaries and reviews of post mortem examinations and other official documents.
Deaths were broadly categorised as accident, murder, suicide, unintentional drug/alcohol overdose or medical cause. From 2001 to 2021, 1,102 athletes died, 128 (11.5 per cent+) of whom took their own lives: males 98 (77 per cent); females 30. Their average age was 20, with ages ranging from 17 to 24. More than half (59 per cent; 91) were White.
The yearly incidence rate of suicide for males increased throughout the study period while that for females increased from 2010–11 onwards. This was in sharp contrast to the incidence rate of other deaths, which fell between 2002 and 2022. Male suicides increased from 31 in the first 10 years to 67 in the second 10 years; similarly, female suicides increased from nine to 21.
Only accidents given as reason for more deaths
Overall, the proportion of suicide deaths doubled from the first 10 years (just over 7.5 per cent) to the second 10 years (just over 15 per cent), so that by the second decade, suicide became the second most common cause of death after accidents among NCAA athletes.
The highest number of suicides was among male cross-country athletes, and among division I and II athletes compared with division III athletes. But there were no significant differences in rates when analysed by sex, race, or sporting discipline.
Overall, the researchers calculated that there were nine deaths every two years in male athletes; three deaths every two years in female athletes; and two deaths every five years in cross-country athletes.
The most suicide deaths occurred at the age of 20 (33; 26 per cent). This is when a college student athlete would be in the middle of their career if they started as a freshman at age 17 or 18, Whelan and her colleagues note.
The pressures [on athletes] of school, internal and external performance expectations, time demands, injury, athletic identity and physical fatigue can lead to depression, mental health problems and suicide [Bridget Whelan et al]
Most deaths occurred on Mondays and Tuesdays
There also seemed to be temporal and seasonal differences in incidence. Most suicides occurred on Mondays (25; 20 per cent) and Tuesdays (26; 20 per cent).
And while the average number of suicides during the summer months of June–August was 6.7/month, during the rest of the year the average number was 12/month over the entire 20-year period.
Study limitations
The researchers acknowledge various limitations to their findings, including that the study relied on third party reports in the absence of any mandatory reporting system for athlete deaths, so the true incidence may have been underestimated.
Nor was there any information on potentially triggering underlying mental health issues, such as depression and anxiety, among the athletes who died by suicide.
Staff need extra training
Dr Whelan and colleagues point out: 'Athletes are generally thought of as one of the healthiest populations in our society, yet the pressures of school, internal and external performance expectations, time demands, injury, athletic identity and physical fatigue can lead to depression, mental health problems and suicide.’
They add: ‘Athletes may also experience harassment and abuse within their sport, including psychological abuse, physical abuse, sexual abuse, hazing and cyberbullying from the public and members of their team including peer athletes, coaches and members of the entourage.'
Additional mental health resources to help raise awareness, screening for early risk identification, training coaches and support staff on how to identify athletes at risk, and providing access to mental health providers trained in sport psychology could all help prevent suicide in this group, they suggest.
To access the full version of the article by Dr Whelan and colleague titled – Suicide in National Collegiate Athletic Association athletes: a 20-year analysis doi: 10.1136/bjsports-2023-107509 – click
Author: I A McMillan
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