Stigma, attitudes, and intentions to seek mental health services in college students-athletes.

Hillard RC, Watson JC 2nd, and Zizzi SJ. J Am Coll Health. 2020 Sep 2:1-10. doi: 10.1080/07448481.2020.1806851. [Epub Ahead of Print].

Take-Home Message

To encourage student-athletes to use mental health services, we may want programs to address stigma and improve attitudes.


College student-athletes have highly regimented schedules and increased pressures to perform both athletically and academically. Almost 1 in 4 collegiate athletes report clinically meaningful levels of depression. While there are often additional support services available for athletes, athletes underutilize mental health services. One reason for not seeking mental health services is stigma, which is a belief or perception of beliefs that seeking these services are undesirable and individuals who seek help are socially unacceptable. However, to encourage student-athletes to receive needed services we need to understand how willingness to seek counseling relates to stigma, attitudes, and intentions to seek counseling. Hillard and colleagues surveyed college athletes to study the relationship between public stigma, social network stigma, self-stigma, attitudes, and intentions to seek mental health counseling. A total of 312 student-athletes from 3 NCAA Division II or III universities (224 males) completed the survey. The survey had several tools to collect data on demographics, stigma, and attitudes towards using mental health support: The Perceptions of Stigmatization by Others for Seeking help scale (PSOSH), The Stigma Scale for Receiving Psychological Help (SSRPH), the Self-Stigma of Seeking Help Scale (SSOSH), the Attitudes Toward Seeking Professional Psychological Help-Short Form (ATSPPH-SF), and The Mental Help-Seeking Intention Scale (MHSIS). The authors found 1) public stigma (reflecting a belief in what society thinks) related to self-stigma (personal beliefs), 2) self-stigma related to attitudes towards using mental health support, and 3) these attitudes related to intentions to seek mental health support. They also found that participants who previously received mental health support were more likely to have better attitudes toward mental health support. Finally, student-athletes reported being most likely to seek help for drug problems, depression, and excessive alcohol. In contrast, they were least likely to seek help for sexuality, difficulty with friends, and body image.


Overall, this study provides clinicians with information on factors to address when developing programs to increase the use of mental health services among college student-athletes. While the investigators did not evaluate a specific strategy to increase the use of these services, it may be impactful if clinicians develop educational strategies to de-stigmatize mental health services and improve attitudes. This study’s findings may suggest that prior positive interactions with mental health services can improve an athlete’s attitudes towards these services. While effective programs need to be developed and tested, clinicians should educate and discuss mental health services with athletes in ways that de-stigmatize them.

Questions for Discussion

What mental health services do you have available to you in your current setting? How have you worked with these offices or individuals to help de-stigmatize the seeking of mental health services?

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

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