The Threat of Suicide Among High-Functioning Clients;

Why success does not mean free from struggles and what we can do to help.

By now many of you have heard the tragic news about Stanford University soccer captain Katie Meyer’s passing from suicide. When I read about her untimely and tragic death, I immediately had a gut-wrenching feeling in my stomach. As a mental health provider who specializes in working with athletes on clinical and sport-related issues, suicidality is a topic I deal with daily. Behind closed doors, athletes discuss suicidal ideation more often than people realize.

A 2015 study by Cox and colleagues found that 33% of Division I college athletes met the criteria for clinical depression. They found that many athletes also struggle with eating disorders, substance abuse, and suicidal ideation. Many of these issues start developing in adolescence, and what this study does not capture is the rate of clinical depression among other divisions and former college-aged athletes. In addition, depression is not the only contributing factor to dying from suicide.

I see many athletes who fit Katie’s profile in my line of work. These individuals are high achieving and high performing, so they seem to be incredibly high functioning despite the challenges they face each day. They have “ideal” lives which look outwardly successful. The truth is that high functioning does not equal okay. For example, high performers excel at hiding their struggles and pushing through their daily routine. They are taught to be “mentally tough” and endure an endless amount of pressure and stress on the surface. But when the doors to my office are closed, they open up about how hard it is to continue the image they have made for themselves. They feel like no matter what they achieve; it is never good enough. I see people at the top of their sport still striving for perfection and training relentlessly while suffering from mental health issues that they have quietly learned to manage. Sadly, Katie is not the only successful athlete to die by suicide. Unfortunately, she won’t be the last, especially if changes are not made.

I beg parents, coaches, and educators to observe and take note of thereality of what we are doing to our young people. The high-pressure, high-stake sports are no longer the outlet they used to be for relieving stress. High-stakes play, early sport specialization, parental pressure, and significant financial investments for the hope of a full ride to college are some of the reasons why our young people are suffering. The once positive place for stress relief has contributed to an endless loop of stress with no end in sight! I have had so many young people discuss how they wanted to end their lives for making a mistake or never achieving the unrealistic expectations set for them.

In my opinion, kids are pressured to perform in all the wrong ways. We place adult-like expectations on our children then wonder why they feel pressure and stress. It’s common during sporting events to see parents yell from the stands as if they were watching professional athletes. We fill our children’s schedules and overcoach them; then wonder why they lack confidence and life skills. We need to get back to a time when sports were an outlet rather than the cause of additional pressure. Until we fix many of the problems with sport and academic pressure, my private practice will continue to be filled with clients whose mental health concerns may have been preventable.

Tip: Give your child a piece of paper that says, “If you give me this piece of paper, or take a picture and text it to me, I will know you need to tell me something difficult to talk about. I promise I will not get mad or upset, and I will just listen. We will then work together to help make it better no matter what is going on. I love you, and I never want you to feel like we can’t work through something together. I am always here for you. Please let me help.”

This tip is also great for coaches and teachers. Often people suffering will over magnify situations where they might get in trouble, or they feel the image they have worked hard to portray will be tarnished. They might suffer in silence or make an impulsive decision to end their life while they are experiencing an intense emotion and feel like there is no way out. Many of my private clients have brought that note to their parents, and it started a conversation that they otherwise would have kept to themselves, including needing an emergency session with me to discuss suicidality.

If you have a child who struggles but manages to keep up, please guide them to a professional that can help them learn effective coping skills. I can’t tell you how many athletes suffered for years before getting help. Taking the leap to find a professional may be intimidating, but mental health is as important as your physical health. If you were to break a bone, you wouldn’t set it without the help of a doctor, would you? Mental health check-ins should be equal to physicals.

Find a qualified person that is licensed in your state. CMPC certification with a clinical license is ideal for athletes with mental health concerns. However, always choose a licensed professional for clinical concerns

How to find help:

  • Call the back on your insurance card for providers that accept insurance in your area.
  • Contact your primary care physician or pediatrician for referrals.
  • Look for a licensed and certified individual through AASP:
  • National Suicide Prevention Lifeline 800-273-8255

Author: Dr. Chrissy Semler, LMHC/CMPC,


Cox, C., Ross-Stewart, L., & Foltz, B. (2017). Investigating the Prevalence and Risk Factors of Depression Symptoms among NCAA Division I Collegiate Athletes Journal of Sports Science, 5.

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