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Preventing Suicide and Promoting Mental Health Among Student-Athletes From Diverse Backgrounds

Karrie L. Hamstra-Wright, John E. Coumbe-Lilley, and Eduardo E. Bustamante

Suicide and contributing mental health conditions in athletes are shared concerns within health care and society at large. This commentary focuses on suicide risk among athletes and the role of sports medicine professionals in preventing suicide and promoting mental health. In this commentary, we draw on the scientific literature and our clinical experiences to pose and answer these questions: Does suicide risk among athletes vary by sociodemographic factors (eg, sex, gender, race/ethnicity, family income, sexual orientation) or if injured? Do sociodemographic differences influence access to and benefits from services among athletes? How do I know my athletes are at risk for suicide? What do I do if one of my athletes shares with me that they have considered suicide? Within our commentary, we review the current literature and clinical practices regarding these questions and close with actionable suggestions and recommendations for future directions.

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The Relationship Between Eating Disorders, Disordered Eating, and Injury in Athletes: A Critically Appraised Topic

Karrie L. Hamstra-Wright, Kellie C. Huxel Bliven, John E. Coumbe-Lilley, Eddin Djelovic, and Jahnvi Patel

Clinical Scenario: Eating disorders (EDs) and disordered eating (DE) result in numerous physical and psychological complications for female and male athletes. Besides bone-related injury, little research exists investigating what injuries EDs and/or DE contribute to. Clinical Question: Are EDs and/or DE a risk factor for injury incidence in athletes? Summary of Key Findings: We searched for prospective studies assessing EDs or DE as a risk factor for injury in female or male athletes high school age and older. Our search returned 5 studies. One study found Eds, or DE were not a risk for any type of injury in female cross-country and track-and-field athletes. Two studies found a possible relationship between EDs or DE, as one contributing factor of others, in the incidence of bone stress injuries (BSIs) in female athletes who compete in various sports. One study found female, but not male, cross-country and track-and-field athletes with a history of EDs were more at risk for stress fractures than those without a history. One study found Eds, or DE were not a risk for BSI in female runners and triathletes. Clinical Bottom Line: Large and important gaps in the literature exist investigating injuries related to EDs or DE outside of BSIs. There is low–moderate evidence that EDs and/or DE are either a sole, or contributing, risk factor for BSIs in female athletes. Strength of Recommendation: Grade B evidence exists to support the idea that EDs and/or DE are a risk factor for a specific type of injury (BSI) in female athletes only.