When you or someone you understand could also be experiencing a mental health crisis, contact the 988 Suicide & Crisis Lifeline by dialing “988,” or the Crisis Text Line by texting “HOME” to 741741.

Within the weeks after Stanford University soccer goalie Katie Meyer, 22, died by suicide last March, her grieving teammates were inseparable even when not training.

Coaches adjusted practices to offer the athletes time and space to make sense of losing their friend and team captain. They offered to cancel the spring season, however the players declined, said Melissa Charloe, who began as a Stanford assistant women’s soccer coach the day Meyer died.

“It’s hard because there is no playbook on learn how to do that,” Charloe said.

No playbook exists because, until recently, it was relatively unusual for student-athletes to die by suicide. But no less than five NCAA athletes, including Meyer, ended their lives in a two-month period last 12 months. And a 2021 NCAA poll released in May found that student-athletes say they’re experiencing more mental health concerns, anxiety, and depression than they reported in surveys conducted before the covid-19 pandemic took hold in 2020.

Suicide is the second-leading reason for death on college campuses. And despite the general rise in mental health concerns there, universities have been caught off guard when student-athletes have died by suicide. Traditionally, sports psychologists focused on mental health because it related to performance on the sector. Their goal was to assist athletes improve physically — jump higher, run faster — not navigate mental health crises, largely due to a misperception that college athletes were less at risk of mental health concerns.

What little research exists about student athletes and mental health is inconsistent and inconclusive. But many experts thought athletes were insulated from risk aspects reminiscent of depression and social isolation, partially because physical activity is sweet for mental health and athletes have a gradual stream of individuals around them, including coaches, trainers, and teammates, said Kim Gorman, director of counseling and psychological services at Western Carolina University.

“They’re form of used to pain — it isn’t so foreign to them,” added organizational psychologist Matt Mishkind, deputy director of the Helen and Arthur E. Johnson Depression Center on the University of Colorado’s Anschutz Medical Campus.

Still, athletes face pressures that their peers in the overall student population don’t, reminiscent of balancing sports, schoolwork, fears of career-ending injuries, and mistakes that may result in ridicule that gets amplified on social media. With suicide rates in the overall population on the rise and the consequences of the pandemic continuing to threaten well-being, high-profile suicides highlight learn how to cope with the unthinkable — and learn how to try to forestall it from happening again.

Within the wake of such suicides, schools are reevaluating the form of mental health support they supply. Making a protected space to discuss grief with someone who understands suicide is a critical first step, said psychologist Doreen Marshall, a vp on the American Foundation for Suicide Prevention.

“Many professionals are good with grief, but suicide grief might be just a little different,” she said, because it often involves guilt and questions on why someone would end their life.

Gina Meyer, Katie’s mother, and her husband, Steve, have developed an initiative, Katie’s Save, to be sure that all students have a trusted advocate to show to in times of trouble. “We all know that the bravest thing you’ll be able to do is ask for help,” she said.

The Meyers filed a wrongful death lawsuit against Stanford in November alleging that their daughter ended her life after receiving an email from the university about disciplinary motion against her. Stanford University spokesperson Dee Mostofi didn’t answer questions on the case, but Stanford posted an announcement on its website saying the Meyers’ suit comprises misleading information and the college disagrees with their allegations that it’s accountable for Katie’s death.

“Like other colleges and universities across the country, Stanford has seen a pointy increase in demand for mental health counseling and other well-being resources during the last two years,” Mostofi said. “Mental health stays not only an ongoing challenge but our most urgent priority.”

After Meyer died, Stanford provided mental health counselors and a sports psychologist to her teammates, however the players said they lobbied the university to pay for Zoom sessions with a specialist, Kimberly O’Brien, a clinical social employee within the Sports Medicine Division’s Female Athlete Program at Boston Kid’s Hospital.

O’Brien has skilled and private experience coping with sports and suicide: She was an ice hockey player at Harvard in 1998 when considered one of the athletes in her university house died. “I wasn’t even extremely near her, however it affected me profoundly,” she said. “There have been no resources to cope with it.”

That is changing. Colleges try to rent more mental health therapists to satisfy increasing and varied needs. Some, including Stanford and Washington State University, are working with The Jed Foundation, which provides suicide prevention programming for prime school and college students. And crisis support doesn’t occur just in the scholar health center: Colleges are establishing campus-wide “postvention” programs to forestall suicide contagion.

Before cross-country runner Sarah Shulze, 21, died by suicide on the University of Wisconsin-Madison in April 2022, the athletics department was expanding its skilled mental health support from two staffers to 6 to assist the college’s roughly 800 student-athletes, said David Lacocque, the department’s director of mental health and sport psychology. The department, known until eight months ago as “clinical & sport psychology,” modified its name partially because student-athletes were asking for mental health support.

Along with scheduled appointments, the sports liaisons attend practices, team meetings, training sessions, and competitions to assist normalize mental health concerns.

“Gone are the times after we sit in our office and wait for people to knock on the door and confer with us,” Lacocque said.

Student-athletes may also seek free help from the university’s mental health professionals or providers in the neighborhood under contract with the University of Wisconsin athletics department. And a few women’s cross-country athletes at the college now keep watch over their teammates when coaches aren’t around, letting the team’s liaison know in the event that they’re concerned about someone’s mental health.

“We don’t desire anyone slipping between the cracks,” said teammate Maddie Mooney. “It’s a tough time for everyone, and everybody grieves at different paces and processes things otherwise.”

Teammate Victoria Heiligenthal, who shared a house with Shulze, said she avoided talking to campus counselors for months after her close friend died. “I only desired to be alone or be with my friends who really understood the situation,” she said.

Heiligenthal couldn’t bear to remain in the house where she and Shulze had lived, so the university put her and Mooney up in a hotel for per week, after which she stayed awhile at Mooney’s apartment. Once back in her own place, teammates, coaches, training staff, and psychologists checked in on her and Mooney.

But the actual game changer for the 2 was connecting last spring with Stanford soccer players Sierra Enge and Naomi Girma (who now plays professionally). Enge reached out after seeing something Mooney posted on Instagram. Since then, the 4 have met via Zoom. They’ve also talked with O’Brien and can join her on a mental health panel at a conference in Boston in June to discuss their experiences of losing a teammate to suicide.

“It was powerful hearing the parallels,” Heiligenthal said. “It made you realize Maddie and I weren’t alone; there have been others who were experiencing similar things to us.”

On the University of Wisconsin-Madison and Stanford, athletes honored their late teammates last fall by raising mental health awareness. At a significant meet in October, the Wisconsin runners painted green ribbons on the course, put ribbons in race packets, and contributed to a video. At Stanford’s game against UCLA in November, spectators wore green ribbons to spotlight the importance of addressing mental health issues.

Stanford won the sport, handing UCLA its first lack of the season. The victory was bittersweet. A 12 months earlier, Meyer had spearheaded the team’s first mental health awareness game.