How a Michigan program is focusing on athletes' mental health

Courtesy Michigan Athletics

After narrowly missing a spot at the Olympic trials, Kally Fayhee learned the importance of having an identity beyond being a swimmer.

Kally Fayhee was 6 when the water became her safe place.

After her family moved to its suburban Chicago home, Fayhee's parents could hardly keep her out of the pool at the neighborhood YMCA. It was, after all, a great place for the new kid in town to meet new friends. As she grew older, Fayhee found the water had the opposite effect, the outside world melting away when she slid into the pool. She pushed herself physically, but it was the kind of exhaustion that exhilarated her.

It wasn't long before Fayhee discovered that the water, beyond being a haven, could morph into a stage. Folks applauded her performances. Once she moved onto high school and club programs, big-name colleges came calling.

Then, as with other things that consume a life the way swimming consumed Fayhee's, the sport started to sour. In 2008, when she was still in high school, Fayhee came one-tenth of one second away from the Olympic trials -- a dream washed away in less time than it took to blink.

Vowing to try harder, Fayhee moved to Ann Arbor, Michigan, to start her college swimming career at the University of Michigan. But the pressure she put on herself, the anxiety of always trying to be better than a broken dream, mounted. With that ".1" monopolizing her mind, and with the next chance at Olympic trials around the corner in 2012, Fayhee struggled with race anxiety. She needed an edge, she thought.

So she turned to food restriction.

"I needed to lose weight to be faster in the water," she said, explaining the reasoning that seemed logical to her at the time. "I started paying attention to what I was putting in my body, which isn't a bad thing until you become obsessive."

But the obsession began. Fayhee started purging -- a word that still makes her skittish to this day. If she ate something she deemed unworthy, she would "take care of it." She couldn't sleep without the constant worry, couldn't eat without the constant guilt.

"It just kind of snowballed," she said. "I was using it to control anxiety, when at the end of the day, it was controlling me."

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Courtesy Michigan

Will Heininger, who suffered from depression when he played football for Michigan, thinks one of Athletes Connected's most important missions is destigmatizing mental illness.

Fayhee's story is hardly unique across college athletics. In fact, it is now told over and over again at the University of Michigan as part of its Athletes Connected program -- a groundbreaking research, treatment and educational project dedicated to promoting mental health in student-athletes. The program, originally funded by a 2014 NCAA Innovations in Research and Practice Grant and now 100 percent philanthropy-based, has become a model for other schools.

Mental illness has permeated college campuses in the same way it has permeated the country. Millions suffer, from all walks of life. According to a study led by Drexel University and published in the February edition of the British Journal of Sports Medicine, nearly a quarter of student-athletes studied (enrolled in liberal-arts colleges on the East Coast) suffered from depressive symptoms. Female athletes were nearly twice as likely as male athletes to display symptoms. On top of that, Athletes Connected research found only about one-third of college students suffering from mental illness seeks help. When it comes to student-athletes who are suffering, though, that number drops to one in 10.

Athletes Connected uses short, educational videos -- including one chronicling Fayhee's story -- information sessions for all coaches and students in the athletic program, and drop-in support groups run by a clinical social worker to help provide treatment and prevent stigma.

If you had a torn ACL, you wouldn't hide it from people. You'd be forced to get treatment for it. It should be the same with your mental health. That culture of toughness, in a way, is especially challenging for student-athletes.
Trish Meyer, outreach coordinator for Michigan's Depression Center

The university employs three full-time counselors within its athletic department. Many schools partner with a sports psychologist, but it's rare that an athletic department itself houses counselors.

One of those at Michigan, Barb Hansen, is the person Fayhee finally went to for help. For months, the swimmer had wrestled with the idea that people would think she was weak if she admitted she was suffering from acute anxiety and a quickly spiraling eating disorder. She was up for a captain's position her senior year. How would her teammates consider her a leader?

"I think sometimes they think, 'How will this affect my playing time?'" Hansen said. "'If my coach knows, they're gonna think I'm not tough enough to be on the field, or in the pool.' They're a little leery with people knowing they're struggling."

As the nation's attention turns to the Final Four, we'll celebrate as the best college basketball players go for glory. But beyond that, it also stands to reason that many students playing in similar spotlights will be struggling -- often in silence -- with varying degrees of mental illness.

"It's not that you have a mental illness or not; it's that you have a continuum of mental health, with one side being very high-functioning, peak performance, and the other is a severe clinical issue," said Will Heininger, a former Michigan football player who suffered from depression during his playing days and now serves as program coordinator for Athletes Connected.

"I've been at both ends of that continuum, so we want to meet anybody where they are," he said. "It's about the destigmatization and education about mental illness, and treating it like a physical injury."

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Courtesy Michigan

Former Michigan football player Will Heininger speaks at Michigan's "Mock Rock." Money raised at the 2016 show will be donated to Athletes Connected.

For many college athletes, their sport is as much a part of their identity as the other labels they take on: student, daughter, brother, friend. Most have been swimming, playing baseball or swinging a tennis racket their entire lives. They've come to college after starring in high school; they've grown up with lofty expectations of success and, often, perfection. Their identity becomes inextricably tied to their sport, and eventually, their performance.

Adam Kern -- now a study coordinator for the "Health Minds Network" national survey that Michigan administers -- knows that feeling all too well. He came to Michigan in 2010 as a cross-country runner, but quickly began to struggle with the increased demands. Running, where every practice felt like a race as he fought for his roster spot, became a fear, not a passion.

Kern was cut after his freshman season.

"That was basically my worst nightmare," he said. "My identity, I guess you could say, was cut away. I was not in a good place."

Kern, like Fayhee, benefited from therapy. Now he helps with Michigan's research and how stigma can be erased.

According to Hansen, who estimates she works with 25-30 Michigan student-athletes per week in one-on-one sessions, helping athletes understand their identity outside of sports is one of the most crucial parts of what Athletes Connected does.

It's what Fayhee struggled with, what Kern had a hard time accepting, and what hundreds, even thousands, of athletes throughout the country deal with.

"Look at what you are besides a student-athlete, because that can go away in a hot second," Hansen said. "You can blow out a knee, or you're unable to continue because of concussions, or whatever it is. We want to support what they want to do, because they're coming to Michigan to play their sport, and we want to support that identity. But we certainly begin to plant the seeds that that's not all there is."

Michigan's approach has inspired others. According to Heininger, dozens of colleges and universities have reached out to learn more about Athletes Connected, wondering if there are aspects of the project to institute on their own campuses. Stanford, Indiana, Northwestern, Cornell and Penn have all made the call. The Big Sky Conference invited Athletes Connected to its annual student-athlete mental health and wellness symposium to present last year.

It's not that you have a mental illness or not; it's that you have a continuum of mental health, with one side being very high-functioning, peak performance, and the other is a severe clinical issue I've been at both ends of that continuum, so we want to meet anybody where they are.
Will Heininger, former Michigan football player

Michigan's Depression Center, a partner of Athletes Connected, hosts an annual "Depression on College Campuses" conference, dedicated to finding ways to fight mental illness on campuses. The 2016 version was earlier this month, and featured sessions on everything from relationship building to suicide prevention.

It's a slow climb to the point where every person accepts mental illness as just that -- an illness, rather than a choice or character deficiency. But those at Michigan have seen the increase in student-athletes using the resources. In February, student-athletes voted for Athletes Connected to be the beneficiary of their annual talent/comedy show, "Mock Rock," the proceeds of which go to a different charity each year.

The "Healthy Minds Network" survey, which Kern helps coordinate, has been administered to more than 100 colleges and universities across the country. Once Michigan receives the results, principal researcher Daniel Eisenberg helps create individualized analyses for each school. Depending on how many students at that school are affected, the economic impact of those students not getting help can be determined. Michigan also provides advice on what kinds of programs schools can institute, based on their resources -- both for their athletes and their overall student populations.

And those at Athletes Connected still pick up the phone anytime a school calls in search of advice on how to institute a similar program. According to the project's original research, the initial success of Athletes Connected "leads our research team to believe that this pilot program has potential to become a model for replication on other campuses."

"They are by far leading the charge," Big Sky associate commissioner Jaynee Nadolski said of Athletes Connected. "They understand the importance of getting this information out, and they've been fantastic to work with. ... I think they're the gold standard, and that's what everyone should aspire to."

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Education is at the crux. For those suffering, it's education about symptoms and how to better institute self-care in their lives. And even those who aren't suffering, it's education about how to help friends, remain sympathetic and work on their own mental health.

People often don't see depression or anxiety as physically debilitating. It's all inside your head.

But Athletes Connected hopes to teach about the physical effects of mental illness -- fatigue, increased heart rates, headaches, muscle tension, stomach ailments. The sooner student-athletes, coaches and administrators understand the full reach of mental illness, the more likely they are to create a culture that promotes help-seeking.

"If you had a torn ACL, you wouldn't hide it from people," said Trish Meyer, outreach coordinator for Michigan's Depression Center. "You'd be forced to get treatment for it. It should be the same with your mental health. That culture of toughness, in a way, is especially challenging for student-athletes."

For athletes, it's about understanding their own unique place on a college campus. Being a college athlete can provide support systems other students don't have -- routine, being part of a team, coaches serving as mentors. Athletes Connected helps them understand how to better utilize those resources.

But the other side of a student-athlete's experience can perhaps lend itself to mental illness. Pressure to perform, an inner commitment to perfection and a lack of time for self-care can all cancel out those insulating factors.

"Something I think is overlooked so often is just that student-athletes are humans," Heininger said. "They deal with the same stresses in a lot of ways that others do, and then they deal with additional stresses too. ... Student-athletes start to understand, 'Yeah, it's not an indictment of me, just like it wouldn't be if I tore my ACL. It's not something I need to be embarrassed about.'"

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A swimmer can always be a swimmer. But she can also be everything else a human being is -- a daughter, a girlfriend, a person having a bad day, a person experiencing a range of emotions as deep as the pool itself.

Fayhee drove from Chicago to Ann Arbor frequently as Athletes Connected was getting started in 2014, and her video is shown to Michigan student-athletes these days. She also was invited to speak on a SXSW panel, "Mental Health in Sports: The Next Barrier to Break?," earlier this month.

Thanks at least in part to her university's mental health services, she realized how to grow outside of her sport. Fayhee hopes others will follow in her footsteps of self-discovery.

Just recently, after about a year's layoff, Fayhee got back into a pool. She didn't worry about her weight or how fast she was. She did it because the water could still be her safe place -- a piece of a full life she could enjoy at will. It didn't control her anymore.

"I remember sitting with Barb at first, and she said, 'Tell me three good things about yourself,'" Fayhee said. "I started naming off things about swimming. I had nothing. So she was like, 'OK. That's where we start.' It was learning how to live life not defining myself as a swimmer, but defining myself as Kally Fayhee."

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