“Youth mental health is in crisis,” says pediatrician and adolescent medicine specialist Sara Chrisman, MD, MPH.

Today’s adolescents, she says, have many stressors, including school, relationships, current events, their developing identities and the social isolation of the pandemic.

That’s why Chrisman and her colleagues at The Sports Institute at UW Medicine have worked to develop Mentally Strong, a mental health program for high school athletes. The program, created with a generous philanthropic gift from the Prentice Family and supported by the Garvey Institute for Brain Health Solutions, is designed to support coaches in teaching student-athletes coping skills to manage stress, with an ultimate goal of providing youth coping strategies that will prevent emotional crises. With additional donor support, Chrisman hopes to expand the program to help young athletes at all levels nationwide.

Sports offers community and support

During the pandemic, 1 in 4 youth reported depressive symptoms, and 1 in 5 experienced anxiety. In 2021, the American Academy of Pediatrics declared a national emergency in children’s mental health, out of concern that there was an inadequate number of providers to care for the many youth in crisis.

Chrisman, an associate professor of pediatrics at UW Medicine and a physician at Seattle Children’s Hospital, has seen firsthand the impact of physical activity and sports in her young patients’ lives. A sports enthusiast herself, she realized that focusing on high school athletes might be a way to help address the youth mental health crisis.

“Sports can be a stressor, but they can also be a profound source of structure, support, mentorship and purpose,” says Chrisman.

Participating in sports particularly offers emotional support to youth through connections with coaches and teammates, helping youth develop a sense of community and decreasing anxiety.

However, sports can also create stress. The pressure to compete, and the challenges of managing failure and injury, can negatively impact youth development and emotional health. Sports culture has traditionally made it challenging to seek help for mental health issues. Professional athletes like tennis player Naomi Osaka, swimmer Michael Phelps and gymnast Simone Biles are trying to change this by speaking openly about their mental health struggles.

Chrisman and her colleagues at The Sports Institute saw an opportunity to equip coaches to provide mental health support for high school student-athletes.

“We’re excited by the idea of working upstream to support coaches and teens to learn healthy ways of managing stress,” says Chrisman.

Tools to help coaches

“Many collegiate and professional coaches have recognized that mental health is important and tapped into programs to support athlete coping skills, but those resources do not exist for high school athletes,” says Chrisman. “Knowing how to manage your emotional responses is key not only to preventing mental health crises, but also to sport performance.”

“We have developed an evidence-based educational program for coaches to help youth athletes learn positive coping strategies to promote mental strength and catalyze success, both on and off the field.” 

Dr. Chrisman and The Sports Institute at UW Medicine have been working on the Mentally Strong program for a few years now, and in spring 2024, they were excited to pilot a beta version of the program with teams at Ballard High School. 

“This partnership provided tremendous information about the program, inspiring us to build out an ‘athlete champion’ role to support implementation and develop a new athlete platform,” says Chrisman.   

Dr. Chrisman and her team also worked to improve the structure of the Mentally Strong program so it could fit seamlessly into a busy athletic program, with more clearly outlined activities and new videos filmed with former professional athletes. They are now developing another spring pilot, this time with Seattle’s Ingraham and Garfield High Schools, and are excited to see how these teams will respond to the new athlete champion role and engage with the program in a deeper way.  

“A few weeks ago, we visited Ingraham and Garfield to jumpstart the program, engaging a room full of high school athletes in breathing exercises and mindfulness activities. It was amazing to be a part of,” says Chrisman.   

They are also partnering with Nichole Sams —  a PhD student at the department of Human Centered Design & Engineering, part of the College of Engineering — who will be leading the youth advisory board later this spring. The data Chrisman and her team are collecting will lay the groundwork for local and national advocacy and potentially lead to the creation of new approaches and guidelines for supporting youth in the sports setting.  

“The time to act is now”

The Mentally Strong program was established with a gift from the Prentice family, who are dedicated supporters of The Sports Institute. Julie Prentice has been passionate about mental health issues throughout her career. A former therapist and crisis line volunteer, she’s now part of a group of philanthropists seeking to leverage their impact on mental health.

“One silver lining of COVID-19 is that there’s more awareness and destigmatizing of people needing support in mental health and well-being,” says Julie. “Until recently, there’s been this approach that mental health is a separate silo, but it’s not. So how can we meet kids where they’re already congregating?”

To Julie, the answer was clear: youth sports. “We have three kids who played sports in high school and college,” she says. “You learn so much — teamwork, how to give your personal best, how to handle challenges, how to pick yourself up and go on. And the coach is an integral part of that experience.”

Julie’s father-in-law, Arnie, agrees. “Mental health issues are one of the major challenges we have in this country, and a lot of it starts at the youth level,” he says. “It’s important that we’ve got coaches being aware of that and helping kids work their way through it.”

Additional support would allow Chrisman and her team to accelerate the development of the toolkit and deploy it in a local pilot program targeted at multiple types of sports. It would also enable them to partner with a coalition of collegiate, Olympic and professional athletes to launch an awareness campaign about the importance of mental health in sports.

“The time to act is now,” says Julie. “We want others to join us, so this can start serving kids.”

Written by Stephanie Perry