Why Sports Leadership Is Measuring the Wrong Things About Mental Health

Dec 26

A new landscape: more professionals, new rules, but still a gap

At The Zone, we spend our days with athletic departments, coaches, trainers and athletes at every level. In just a few years the landscape has changed dramatically. Once it was unusual to find a single mental‑health professional inside a sports organization. Today the conversation has shifted.

Professional leagues have formalized mental‑health support. The NFL and NFL Players Association standardised behavioural health care in 2019; each team now employs a licensed behavioural health clinician who spends 8–12 hours a week at the facility, teaching players and coaches about mental health and creating action plans for crises. The NBA adopted rules requiring every team to add at least one full‑time licensed mental health professional and retain a psychiatrist, and the MLB Players Association recently launched an independentmental health and wellness program to supplement club‑provided services; even though each MLB team already has mental‑health professionals, the union wants a network where players can seek help outside the club. These policies didn’t exist a decade ago.
College athletics is catching up. The NCAA’s 2024 Mental Health Best Practices require schools to provide annual psychological‑distress screenings, develop action plans and ensure that student‑athletes receive care from licensed mental‑health providers. New guidance tells institutions to form plans with a licensed provider, identify at‑risk athletes using validated screening tools and ensure care is delivered by qualified professionals. To comply, universities across the country are creating positions such as Assistant Athletic Director for Mental Health, sport psychologists and mental‑health counselors. This surge is welcome, but we are starting from a low baseline: less than 26 % of Division I athletic departments had any mental‑health practitioner on staff, and those that did often had only one or two providers serving hundreds of athletes. Compare that with the International Accreditation of Counseling Services’ guideline of one mental‑health professional per 1 000–1 500 students; most athletic departments aren’t close to meeting it.
Awareness doesn’t equal comfort. The NCAA’s 2021 Student‑Athlete Well‑Being Study found that two‑thirds of athletes know where to go on campus for mental‑health concerns, yet fewer than half (47 %) feel comfortable seeking support from a campus provider, and only 53 % believe their coaches take mental‑health concerns seriously. These numbers underscore that simply adding services does not guarantee trust or utilization.
Why athletes leave and what it costs. In the same NCAA survey, the most cited reasons for transfers were academics, mental health, conflict with coaches or teammates and playing time. When an athlete transfers unexpectedly, the cost isn’t just the scholarship; it is the sunk development time, the recruiting reset, the NIL ramifications and the disruption to roster stability. In practice, we’ve seen a single transfer cost $75 000–$100 000 once those factors are included.

Professional leagues, college regulators and even player unions are doing more than ever to hire clinicians and update policies. But there remains a large gap between policy and practice. Awareness is not the problem. Execution is.

Patterns we see every day and the true cost of being late

Early in The Zone’s work, mental‑wellness support was usually reactive. Help arrived only after an athlete spoke up, a coach noticed a change or performance had already declined. Across sports and levels the same patterns repeat:

Hidden disengagement. Athletes often disengage quietly months before anyone intervenes. The NCAA study shows that only half of student‑athletes believe mental health is a priority in their athletics department. When trust is low, athletes don’t ask for help; they transfer or burn out.
Injuries stall for mental reasons. Medical and performance staff tell us that anxiety, stress and personal strain routinely affect return‑to‑play timelines. Even a two‑ to three‑week delay can alter a season; yet mental readiness is often addressed only after physical rehab stalls.
Transfers blindside staff. Transfer portal data confirm that mental health and conflict with coaches are among the top reasons athletes leave. Each time an athlete transfers, the true cost easily exceeds $75 000 when lost development, recruiting resets and NIL consequences are considered.
Staff operate in triage mode. Athletic trainers and coaches now juggle academic stress, personal crises, NIL pressure and social‑media scrutiny – responsibilities far beyond physical preparation. Division III leaders note that more than 80 % of coaches are spending more time addressing mental‑health concerns than before the pandemic, with many identifying mental health as the top issue their teams face. Meanwhile counselor‑to‑athlete ratios remain far below recommended levels.

One of the clearest lessons we’ve learned is how expensive being late really is. The longer an athlete struggles without support, the harder (and costlier) it becomes to repair the damage. We’ve seen mental‑health crises evolve into compliance, legal or reputational emergencies that cost hundreds of thousands of dollars in investigations, legal fees, settlements and donor confidence. These costs rarely appear on a budget line, but every administrator recognizes them when they happen.

Stop measuring the wrong things engagement is episodic

When The Zone first deployed digital mental‑wellness tools, we assumed that if access existed athletes would use it constantly. We were wrong. Research on mental‑health apps shows that engagement is generally abysmal: about 4 % of users continue using a mental‑health app after 15 days, and only 3 % stay after 30 days. Most mental‑health apps for depression and anxiety have zero or near‑zero active users. Across programs using digital mental‑wellness tools, typical monthly engagement sits in the low single digits often between two and five percent.

At The Zone we see a different pattern. Our monthly engagement typically ranges between 10 % and 15 % roughly three to five times higher than industry norms. This is not because our athletes use the platform every day; it’s because our system acts like infrastructure, not programming. Engagement clusters around injury, performance stress, transitions and personal disruption.

Importantly, small numbers do not mean small impact. If a school has 400 athletes and 40 of them use a digital mental‑health product in a given month, those 40 are often the athletes closest to the edge they may be dealing with injuries, contemplating a transfer or quietly struggling. Catching those 40 early is far more valuable than forcing all 400 to log in daily. In our experience, the athletes who engage with a digital tool during stress spikes frequently include the ones at risk of transferring; intervening for even a handful of such athletes can save tens of thousands of dollars and preserve roster stability.

Episodic usage is not a failure; it is how mental wellness actually works. When we measure success by constant logins or total minutes, we incentivize the wrong behaviour and ignore the fact that the most important interactions happen when pressure peaks. Instead, the metric that matters is whether the system catches pressure spikes early enough to prevent crises and whether it reaches the individuals who might otherwise slip through the cracks.

Low clinical‑escalation rates are another misunderstood metric. Across our work, less than one percent of athletes are escalated into clinical care a figure some administrators interpret as low adoption. In reality, it reflects proper triage. A responsible system shouldn’t funnel large percentages of athletes into therapy. It should identify the right athletes early, provide appropriate support and keep them from reaching crisis.

The workforce problem ratios, costs and why coaches can’t do this alone

Hiring good mental‑health professionals is expensive. But so is not hiring them. Remember, the recommended counseling‑center ratio is one mental‑health professional per 1000–1500 students; yet fewer than 26 % of Division I athletic departments have any mental‑health practitioner on staff. Those that do usually have only one or two providers serving hundreds of athletes, far below the recommended ratio. When we under‑staff, waiting lists grow, crises go unnoticed and liability risks increase. Universities that follow the guidelines see fewer crises and higher retention because athletes get timely support.

Meanwhile, coaches and trainers are feeling the strain. The NCAA’s Coach Well‑Being Study highlighted that more than 80 % of coaches have increased the time they spend addressing mental‑health concerns. Yet the National Coach Survey found that only 18 % of coaches feel highly confident linking athletes to mental‑health resources, 19 % feel confident identifying off‑field stressors and 20 % feel confident reducing performance anxiety. Coaches are experts in X’s and O’s, but they are not trained clinicians. Expecting them to shoulder mental‑health responsibilities without support is unfair and unsustainable. In addition, a survey of athletic directors reported that nine out of ten institutions failed to provide sufficient mental‑health training for coaches.

The pressure to “do more with less” has financial consequences. We have watched programs delay hiring a psychologist to save $80 000, only to lose $100 000 when a key athlete transfers because his mental‑health needs weren’t met. Or pay six figures in legal and reputational costs after a crisis escalated. Investing in early mental‑health support isn’t altruism; it’s risk management.

The questions leaders are asking and our answers

Over the last two years, the questions we hear from athletic directors and coaches have changed. It’s no longer “Does mental health matter?” It’s:

How do we identify risk earlier without labeling athletes?
Early identification doesn’t require labels or diagnoses. It requires signals. At The Zone we do not monitor individual behaviour in a way that invades privacy; instead, we analyse multiple team‑level data points self‑reported stress and engagement patterns to detect when an athlete’s pressure is spiking. These metrics are collected and reported as aggregated data sets, so no single athlete’s responses are exposed. Private, anonymous check‑ins allow athletes to flag concerns without fear, and because engagement is episodic we look for changes rather than raw volume. A normally engaged athlete who suddenly stops checking in is a more important signal than someone who never used the app. This aggregated approach protects confidentiality while still giving the head of wellness early warning signals so they can proactively check in with teams/athletes who may be struggling. Building trust with athletes and letting them know their data will only ever be used in aggregate is essential to making this work.
How do we offer access without stigma or fear of consequences?
Start by making support confidential and separate from performance evaluation, and commit to it as a core part of the organization, not a box to tick. Professional leagues have shown the value of independent options; the MLBPA created a network of independent mental‑health professionals precisely because some players prefer to seek help outside their team. In college, ensure that digital tools are password‑protected, data are aggregated and that only qualified professionals not coaches see individual responses. But confidentiality alone isn’t enough; how you introduce the program whether you frame it as integral to performance and wellbeing or merely a compliance exercise determines whether athletes and staff will buy in. Educate athletes that low clinical‑escalation rates (<1 %) signal effective triage, not neglect.
How do we support athletes who will never walk into an office?
Meet them where they are. Digital platforms allow athletes to seek help privately at 2 a.m. Our data show that engagement spikes when stress does. Providing asynchronous resources (e.g., guided cognitive‑behavioural modules, mindfulness exercises) lets athletes access support when they need it. For those who prefer face‑to‑face, integrate counselors into team settings—much like the NFL’s on‑site clinicians who spend 8–12 hours per week with the team.
How do we do this without adding headcount we can’t sustain?
Leverage technology as force multiplier. A single psychologist can oversee a digital platform that serves hundreds of athletes, triaging those who need in‑person care. Use the NCAA’s mandate for annual screenings to catch issues early; digital screening tools like CCAPS‑Screen meet NCAA requirements and are inexpensive. Programs that invest in early detection and targeted interventions reduce crises, which in turn reduces the need for large clinical staffs and the cost of late interventions.
How do we get coaches to buy in?
Coaches play a pivotal role because athletes trust them, but they need training and clarity. Division III is currently offering fully funded Mental Health First Aid training for coaches and athletic trainers. The program teaches participants to recognise signs of mental‑health challenges, use the five‑step MHFA action plan (ALGEE), interact with someone in crisis and connect athletes with professional help. Feedback from participants shows that the training reduces stigma and empowers coaches to approach athletes with concerns. Data from the National Coach Survey underscore the need: only 18 % of coaches feel highly confident linking athletes to mental‑health resources. To improve buy‑in, educate coaches on how mental wellness directly impacts performance their jobs depend on wins, and the science is clear that mentally healthy athletes perform better. Providing structured training, clear referral pathways and a culture where mental‑health discussions don’t threaten playing time will improve buy‑in. You wouldn’t let a coach design a strength program without certification; why would you expect them to manage mental health without training?

These questions and their answers illustrate that mental wellness behaves more like infrastructure than programming. It’s about building systems that quietly catch problems early, respect privacy and extend the capacity of the limited professionals we have.

From awareness to accountability

We’ve spent years building awareness. Professional leagues now have mental‑health staff on payroll, the NCAA mandates licensed providers and annual screenings, and universities are hiring sport psychologists at unprecedented rates. Yet athletes still leave because they don’t feel supported, coaches are stretched beyond their expertise and leadership often measures success by the wrong metrics.

Leadership today isn’t about perfect systems or eliminating every risk. It’s about reducing how much depends on chance. It’s about shifting from reactive support to earlier points of access, understanding that mental wellness is already embedded in performance, availability, retention and institutional risk whether we acknowledge it or not. The organizations that remain stable won’t be those that tweet the most about mental health. They’ll be the ones that quietly build structures that protect athletes before the cost of being late becomes irreversible.

We’ve done the work of awareness. The next step is accountability. That is, ultimately, a leadership decision.

We close with an invitation. At The Zone, we remain committed to helping athletic departments, teams and leagues build effective mental‑wellness and performance systems. Whether you’re wondering how to take step one or how to scale a mental‑wellness program across an entire organization, we are always open to answering questions and sharing what we’ve learned. The path ahead is about accountability start by reaching out.