Olivia Lubarsky showed up to Towson University her freshman year in 2017 shouldering the weight of high-functioning depression stemming from an immobilizing fear of failure. Acknowledging it, she said, made her feel as if she were finding a way to justify her shortcomings as a college gymnast.
Her sport became her outlet — a way to ignore her worsening mental health.
Days before Lubarsky’s college sports debut, she ruptured her Achilles tendon. Athletic trainers laid out a step-by-step recovery plan before the day was over, but one part of her recuperation would be neglected.
“I noticed a glaring disconnect between the support and treatment that I received for my battles with depression and my Achilles injury,” she said.
A Maryland House bill questions why mental health doesn’t receive the same priority. House Bill 375, if passed into law, would make Maryland the first state to mandate that all public high school and college institutions provide training for coaches to recognize indicators of mental illness and behavioral distress in students, including depression, trauma, violence, youth suicide and substance abuse. The bill was amended from its original version that specified “mental health first-aid training.”
Thursday the bill passed through the appropriation and ways and means committee favorably with the amendment.
The bill was brought before the House Appropriations Committee on March 9 by its sponsor, Del. Dalya Attar, a Democrat from Baltimore City, who talked about its importance and fiscal impact.
Marcus Alston spoke next. The mental health advocate shared his experience, contending his own athletic trajectory might have been different had he received help in high school rather than after college. Alston additionally noted that the Johns Hopkins University, “the golden standard for health care in our country,” had several coaches and athletics staff take the eight-hour National Council for Mental Wellbeing’s course in the fall.
Alston, who founded the mental health care organization Alston for Athletes in 2019, initially proposed the idea for the bill to delegates in June. He’s a graduate of Mount Saint Joseph, where he played football and basketball before getting his bachelor’s at Saint Francis University in Loretto, Pennsylvania.
St. Vincent Pallotti boys basketball coach Kyle Harmon said 1 in 6 youths 6 to 17 years old in the United States experience a mental health disorder each year. “It’s not our kids that are broken,” he said. “We’re just not giving them the tools that they need to cope.”
The bill calls for training in recognizing and responding to indicators of mental illness and behavioral distress while briefing coaches on identifying professional resources to help students in crisis. Still open to amendments, it was introduced Jan. 26 and, if enacted, would take effect July 1.
Harmon, a coach for nearly two decades, took the 40-hour mental health training course needed to certify others in 2017. He said he has used the training in “hundreds of incidents” since then but predicts some coaches will push back.
“I don’t think you’re going to get everybody on board, unfortunately. You have people who are set in their ways,” Harmon said. “They have a process that’s worked for them for an extended period of time. But I do think since the pandemic, it has brought about a lot of the mental health struggles that we’re all dealing with. Our mental health issues are so much on the rise that we can’t ignore it anymore. We have to do something about it.”
A 2022 study by the Aspen Institute surveying more than 10,000 coaches found that 18% of youth coaches feel highly confident in their ability to link athletes to mental health resources and 67% want more education on the subject. Similarly, more than 80% of NCAA coaches across all three divisions recently reported spending more time discussing mental health since the coronavirus pandemic began.
Under Maryland law, all members of a coaching staff are required to receive training in emergency action plans, seizure plans and the operation of automatic external defibrillators. Harmon said that while those are all crucial skills, the mental health first-aid training outlined in the bill would be used far more frequently.
Students raising awareness
Glenelg junior soccer and basketball player Maria Garbis knows firsthand the taxing nature of being a student-athlete. She reached out to Gladiators softball coach and Mt. Hebron girls soccer assistant coach Anna Pallozzi in the fall looking to start a local chapter of “Morgan’s Message.”
The national nonprofit is based on the story of Duke lacrosse player Morgan Rodgers, who took her life in July 2019 after a two-year battle with anxiety and depression. Her struggles were amplified by a serious knee injury that led to feelings of isolation and stress as she suffered in silence.
“It’s just nice to know that your coach is understanding of what’s going on,” Garbis said. “Whether it’s about you, yourself or your playing. If they have more resources to do so, it would definitely make a significant impact on every high school and college athlete.”
Pallozzi said she feels she has a unique connection with her players as a younger women’s coach. Many of her players are comfortable confiding when they’re feeling overwhelmed, she said. Pallozzi argues that the bill could help build a bridge for other coaches to achieve similar results.
The Morgan’s Message group at Glenelg is similar to an initiative Lubarsky started in 2019 called “Own Your Roar,” urging student-athletes to “own their inner voice and teach that mental illness is just as valid and just as detrimental to performance as physical injury.” The idea came to her the night she underwent Achilles surgery.
Putting mental health in a spotlight
Attar, House Bill 375’s lone sponsor, said in an email: “It is easy to not talk about mental health issues; however, it is very prevalent and affects all types of people. Our students have many stresses that can lead to mental health concerns and our athletic students are, many times, under even more pressure than other students. We must make mental health a priority to protect our athletes.”
Alston says he believes the bill has great support.
“I’ve heard things like, ‘I’m a former coach. I can relate to something like this.’ It’s still very much a work in progress, but I think the general consensus is perceived pretty well,” he said.
A lot of that perception stems from the aftermath of Buffalo Bills safety Damar Hamlin’s cardiac arrest during a “Monday Night Football” game Jan. 2. Alston pointed to the emotional distress Hamlin’s teammates were under as putting a spotlight on athletes’ mental health.
“Athletes need to know that they are more than just an athlete. And that’s what this bill does,” former NFL player Marques Ogden said. “If you’re having a hard time, it’s OK. Don’t internalize it. Don’t hold on to it. I say this all the time: Be fulfilled as an athlete, not driven by success. Which means, create an alignment between your internal happiness and what you do on the outside. And be proud of that.”
Ogden, the brother of former Raven and Pro Football Hall of Famer Jonathan Ogden, battled several mental health issues after the loss of his father in 2006. Much of that resurfaced in 2013 when his construction company went bankrupt, he said. The five-year NFL journeyman is now a motivational speaker, podcast host and advisor to Alston’s foundation.
Michael Duffy, Carroll County’s supervisor of athletics and past Maryland Public Secondary Schools Athletic Association president, has spoken with area coaches since learning of the bill. He said some expressed hesitations.
“I’m very much in favor of the idea of supporting our students’ mental health,” Duffy said. “We just want to make sure that what we’re doing follows educational standards and is reasonable to benefit students while keeping our coaches within their skill set and within their expertise. Not placing unreasonable expectations on them that wind up backfiring against what we want.”
Columbia-based sports psychologist Dan Zimet recognized that as a common concern.
Zimet, whose clientele largely centers on college athletes but also includes high schoolers and professionals, thinks the success of the bill depends on ease of utilization.
“Coaches already have so much that they do,” Zimet said. “I think it is important for coaches to know they’re not expected to provide any treatment, they’re not expected to sit in on counseling sessions or to know what kind of doctor this person might need. … They’re supposed to understand that there are certain warning signs to look out for. And they want to be able to reach out to the athlete in a constructive way, a supportive way and hand them off to someone who can do all of those things.”
Laura Murray, a senior scientist at Johns Hopkins who has studied mental health extensively, said coaches often are initially hesitant to address the subject but become more comfortable with it.
Murray and Zimet agree that at the very least, potential training for coaches should provide a list of symptoms and resources. Zimet called it a “911 page.”
“It’s important for coaches, administrators, staff, etc., to recognize that student-athletes have a lot of demands both physically and mentally that need to be recognized and cared for,” added Towson athletic trainer Briana Galeazzi, who joined the Tigers’ staff in 2020. “Mental health in sports is going to continue to take strides in the right direction and it would be impressive to see Maryland athletics do the same.”
Starting the program
Specifics of how the state would implement mental health first-aid training are unclear. The bill says the state Department of Education, in collaboration with the Department of Health, each county board of education and the Maryland Public Secondary Schools Athletic Association would work together to develop guidelines.
Ohio and Colorado — two other known states having similar discourse — can shed light on potential resolutions.
Ohio’s proposal passed the House but died in the Senate in December. It has since been reintroduced. The bill allows for mental health training to be coupled with CPR and first-aid training, or any other required instruction.
Colorado does not have legislation pertaining to mental health training for coaches, but the Colorado High School Activities Association requires training on the subject. Coaches have the option of taking the free “Student Mental Health and Suicide Prevention” course through the National Federation of State High School Associations or taking their own district’s training.
The bill’s proponents argue costs of implementing training in Maryland are negligible.
Attar told the Maryland appropriations committee that the bill’s expenditures would have “minimal impact, if any.” The bill’s fiscal analysis reflects that.
At the college level, according to the analysis, Towson University and Frostburg State University already advise similar training that would meet the bill’s requirements. Morgan State University says the bill does not have a “significant fiscal impact on the university.” St. Mary’s College and the University of Maryland say providing training would require approximately $3,500 in additional expenses annually. Baltimore City Community College estimates less than $2,000 annually.
The fiscal report says Baltimore County estimates an annual cost of $25,000 for training and participant stipends; Montgomery County estimates roughly $24,000. Anne Arundel County foresees expenditures varying based on the selected training and cost of materials.
“The people that don’t want to get this training or prioritize their athletes’ overall well-being,” Alston said, “I personally don’t believe they should be a coach.”