As a clinician working in sport and performance psychology, I routinely hear leadership say, “We take mental health seriously.” I believe that many mean it. Awareness campaigns are everywhere. Elite athletes are speaking out more openly than ever. Athletic organizations are hiring mental health providers at increasing rates.
And yet, athletes at every level of sport continue to die by suicide.
It matters to say this clearly and carefully before going any further: death by suicide is complex, deeply personal, and never the result of a single cause, provider, or system. Suicide reflects unbearable psychological pain shaped by biological, psychological, social, cultural, and situational forces. No single policy, person, or program can fully prevent every tragedy.
And yet…
Systems shape risk for suicide, and environments shape safety from it. When suicide occurs within sport, it calls us not to assign blame, but to examine honestly how our systems may either buffer distress or quietly amplify it.
What the Athlete Suicide Data Actually Shows
Recent surveillance of U.S. collegiate athlete deaths found that suicide is now the second leading cause of death among NCAA athletes, surpassed only by unintentional injury (Whelan et al., 2024).
While athletes overall demonstrate similar or sometimes lower rates of suicidal ideation, attempts, and death compared with non-athletes (Gill et al., 2024; Pichler, 2024), averages conceal the conditions under which athlete risk escalates.
Elevated vulnerability for suicide emerges during specific sport-related experiences, including:
These periods are reliably associated with higher rates of depression, anxiety, and psychological distress, all established risk factors for suicidal behavior (Rice et al., 2016; Gill et al., 2024).
Therefore, while sport participation does not universally increase suicide risk, certain sport environments and transitions clearly magnify vulnerability.
Racialized and Gendered Risk Remains Understudied
The athlete suicide literature remains overwhelmingly skewed toward white, male, Western samples. This limits definitive conclusions about racialized and gender-diverse athletes. That said, several important patterns remain visible:
Women athletes report higher rates of suicidal ideation and attempts, particularly following injury, abuse, coercion, and career transition (Rice et al., 2016).
Athletes from racially minoritized backgrounds face compounded stress exposure, including racism, isolation within predominantly white sport systems, and barriers to culturally responsive care (Kroshus et al., 2023).
LGBTQ+ athletes consistently report higher depression, anxiety, and suicide attempt risk than heterosexual and cisgender peers, particularly in unsupportive team climates (Gorczynski et al., 2022).
The absence of robust athlete suicide surveillance across race, gender identity, sexual orientation, and other understudied identities (e.g., neurodiverse and para athletes) does not indicate an absence of risk. It reflects a systemic failure of data collection that continues to obscure who is most vulnerable and why.
Yet, many sport systems continue to rely on race-neutral, gender-neutral, and sexuality-blind mental health frameworks that ignore how identity shapes risk, access, and care. These same systems often assume that hiring a single provider will meet the needs of increasingly diverse athlete populations, despite clear evidence that one-size-fits-all models consistently fail.
Individual Choice and Systemic Influence
It cannot be said enough that suicide is ultimately a personal act made in moments of overwhelming psychological distress. Athletes who die by suicide are human beings facing suffering that felt unlivable in that moment.
At the same time, high-performance sport continues to reward pain tolerance, emotional suppression, overidentification with performance, and self-sacrifice in the name of winning.
Many athletes are also exposed to experiences that fundamentally violate trust, safety, and core moral expectations within sport institutions.
Together, these forces create a landscape that actively promotes suicide vulnerability, including:
Pain tolerance and normalization of suffering
Emotional suppression
Overidentification with performance
Self-sacrifice in the name of winning
Institutional silencing following abuse reports
Racial, gender-based, and sexuality-based harassment
Coerced return from injury
Retaliation following whistleblowing
Across multiple sport cohorts, rates of depression and anxiety during injury, deselection, and retirement equal or exceed those observed in non-athlete populations (Rice et al., 2016; Gill et al., 2024). Athletes become exceptionally skilled at both physical and emotional endurance, but are far less supported in emotional processing. The result is a population trained to suppress distress until it becomes unbearable.
While clinicians treat the aftermath of these conditions, sport institutions control the environments and conditions under which athletes operate. Administrators of those systems ultimately make decisions about to what extent athlete mental health and well being will be prioritized.
Access Does Not Equal Psychological Safety
Mental health service availability in sport has objectively expanded over the past decade (Reardon et al., 2019). Utilization, however, continues to lag behind availability.
Help-seeking research among athletes consistently identifies perceived career and performance consequences as among the strongest barriers to care (Gulliver et al., 2012; Kaier et al., 2015). Other athletes describe fear of coaches finding out, losing playing time, and being labeled as weak or unreliable.
Access to clinicians, no matter how qualified, cannot override systems that quietly punish vulnerability.
Accordingly, organizations must adopt flexible pathways grounded in a no-wrong-door philosophy, including:
Flexible, integrated care options that include a mix of athletics-embedded services, general on-campus providers, and trusted external community resources.
Access to clinicians with expertise in suicide-linked risk domains such as eating disorders, substance use, and trauma.
Meaningful choice in providers based on identity-relevant factors, including race and ethnicity, LGBTQ+ identity, and religion or spirituality.
Without privacy and choice, expanded availability alone will continue to fall short of true access.
What Sport Administrators Must Do
Too many suicide prevention efforts still over-invest in teaching individual coping strategies while leaving structural risk untouched. Motivational talks do not erase chronic burnout. Breathing exercises do not neutralize exploitation. Mindfulness does not correct power abuse.
The strongest prevention efforts are structural rather than individual: organizational mental health policy reform, confidential care protections, trauma-informed reporting systems, and stable, independent clinician roles embedded within organizations (Reardon et al., 2019; Gill et al., 2024; Whelan et al., 2024).
And when systems are discussed, they must be understood as extending beyond individual universities and athletic departments. Conferences shape enforcement and accountability. The NCAA sets health and safety standards. Legislators have the power to fund comprehensive, enforceable mental health protections.
If prevention is genuinely the goal, sport systems must:
Fund mental health positions as core infrastructure,
Protect clinician independence and confidentiality contractually
Extend care beyond eligibility, season, and injury status
Include mental health professionals in administrative decision-making
Integrate race-, gender-, and sexuality-informed care
Hiring top sport and performance clinicians alone will not fix environments where they are structurally blocked from making real change. Even the best clinicians become little more than symbolic hires without seats at decision-making tables.
The Hard Truth
In the end, athletes do not die by suicide because a provider failed to do their job, a hotline was not called at the right time, or a single policy did not offer perfect protection. They die because suicide is complex, personal, painful, and shaped by layers of invisible suffering.
At the same time, let us not deny that they also die within systems that too often:
Reward silence
Punish vulnerability
Collapse identity into performance
Treat mental health as expendable
We can respect the autonomy and complexity of suicide while still demanding better systems of protection, accountability, and care for all athletes.
While athlete mental health providers continue to treat the suffering they meet in their offices, sport institutions must now commit to preventing as much suffering as possible through true investment in comprehensive, athlete-centered mental health services.
Instead of saying, “We take mental health seriously,” perhaps leaders should say (and mean): We will not put a price tag on an athlete’s life.
This article was written to honor the lives of athletes lost to suicide and to acknowledge the profound ripple effects carried by the families, teammates, coaches, and universities who loved them. May we never stop searching for ways to do better by our athletes, not only in words, but in sustainable actions. We will continue to say the hard things until those in positions of power listen.