Dr. Erin Haugen, a sports psychologist in Grand Forks, likes to joke that you can give an athlete any date – say, Aug. 23 – and the athlete can tell you exactly what they're doing that day.
The athlete knows what time they're waking up, what medical treatment they might receive, what workout to attend, what practice to participate in or what film session to view. That routine has been completely upended, however, as many local sports schedules have been canceled, postponed or altered.
"Right now there's so much uncertainty ... the starting and stopping," Haugen said. "Something that is usually really familiar with their sport is unpredictable, at best. That's kind of overwhelming."
Despite the coronavirus pandemic, high school sports in North Dakota are underway, albeit with practices and schedules altered to help athletes adhere to social distancing standards. In many other states, including Minnesota, fall sports have been postponed until spring. Many colleges, too, have called off sports this fall.
The uncertainty has been unsettling for many athletes.
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That's one of the many reasons Grand Forks' athletic medical leaders are saying they're seeing a surge in caseload for mental health during the pandemic.
An international study of youth sport during the coronavirus pandemic has shown that young people have been hit by a lack of exercise and competition, with results showing a decrease in their social, mental and physical well-being in the absence of sport, according to research carried out by Birmingham City University in the United Kingdom, Michigan State, Illinois State and Queen's University in Canada.
In the study, 78% of parents reported a decrease in their children's social health and well-being. In addition, 75% of youth sport coaches reported feeling that the removal of organized sport had decreased their own social well-being.
"All of us are dealing with more mental health issues," said Steve Westereng, the department chair for the UND Department of Sports Medicine. "Their athletic identity is such a big part of them. They're losing that, but more they're losing the structure. They're used to 'do this, do this, go to bed.' You lose that structure when you're not having to show up to workouts and class. Athletes are structured people for the most part. The time sitting around and thinking is now more of an issue."
In late June, Dr. Tim McGuine of the University of Wisconsin announced a research study of Wisconsin prep athletes impacted by the school closures and sports shutdowns resulting from the pandemic.
The study consisted of an online survey of 3,243 teen athletes in Wisconsin regarding their feelings, emotions and responses to the sport shutdown.
The findings show significant mental health, anxiety and depression issues in the high school-aged population. Of the more than 3,000 participants, 65% reported anxiety symptoms, with 25% suffering moderate or severe anxiety.
Using historical data obtained from past research studies, the group determined that the rate of mild to severe depression increased from 31% to 68%.
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"Another thing we're seeing is athletes concerned about the disruption of performance," said Haugen, the only licensed sports psychologist in the state. "Will I get back to pre-COVID ability? Are my skills as refined as I want them to be? Is there motivation for training? Am I even going to be competing? Will I have to stop abruptly?"
The NCAA also conducted a similar study of college athletes. More than 37,000 athletes responded to the survey, including those from all three divisions, as well as all sports and conferences.
The NCAA study found "high rates of mental distress since the outset of the pandemic." More than a third reported experiencing sleep difficulties, more than a quarter reported feeling sadness and a sense of loss, and 1 in 12 reported feeling so depressed it has been difficult to function "constantly" or "most every day."
If parents or athletes are concerned about themselves or others, Haugen has a few tips for spotting mental health concerns among family, friends or teammates.
"One of the things to look at is sleep," Haugen said. "Sleep is a modifiable risk factor for a variety of mental health concerns. Disruption in sleep would be something that would grab my attention. That could be sleeping more or taking more naps. Another thing to look for is are they more or less engaged with the family? Do they have a shift in motivation? And as always, do they want to harm self or others? Any concern of hopelessness or suicide, we encourage to reach out to a mental health professional."
At UND, Westereng said UND athletic director Bill Chaves, who started in Grand Forks in March of 2018, has made a big push to address athlete mental health.
Chaves asked Westereng to oversee a sports medicine advisory board, which includes trainers, physicians, strength coaches, mental health workers and registered dietitians. The group leans heavily on Haugen and Tom Solem, director of the university counseling center.
The group has come up with handouts for tips and resources to common issues, and Chaves has held athlete-wide Zoom video meetings in which Haugen has provided tips and explained the resources available.
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"We're lucky to have the access to resources we do," Westereng said.
There's been a shift in awareness over the past few years when it comes to mental health, Haugen said, and the pandemic has potentially brought the topic even further into the spotlight.
"Teammates are now seeing these signs and saying go see so and so," Haugen said. "It's weird to use the phrase benefit of a pandemic, but it's brought mental health to the forefront."
