When the Surgeon General issued an advisory on the state of youth mental health in the United States in 2021, we were already several years into what we can reasonably call a youth mental health crisis: that’s why, over the past several years, people directly involved in the lives of youth and adolescents embarked on a mission to learn what helps youth mental health, what harms youth mental health, and what activities – such as organized youth sports – can protect mental health from youth through adulthood.
It’s well known that when talking about mental health disorders, there are risk factors and protective factors that play a role in whether an individual develops a mental health disorder or not. Risk factors are things associated with poor mental health, including adverse childhood experiences (ACEs), which we write about in this article on our blog:
Adverse Childhood Experiences (ACEs) and Long-Term Mental Health
That piece describes risk factors such as experiencing neglect or abuse and witnessing violence, as well as risk factors such as living with a family member with a substance use disorder or a mental health disorder, or experiencing the death of a close family member.
On the other hand, protective factors, i.e. things that promote positive mental health, include a supportive, stable home environment, a safe neighborhood, a robust and positive social network, quality schools, and participation in non-academic activities either at or outside of school, including clubs, the arts, individual or team sports, and hobbies.
In this article, we’ll review the results of a study published recently on how participating in youth sports can have an effect on mental health during adulthood. Spoiler alert: the study includes novel findings that can help us help adolescents as they navigate the challenges of growing up.
Patterns of Participation: Organized Youth Sports and Long-Term Mental Health
In the peer-reviewed study “Better to Have Played Than Not Played? Childhood Sport Participation, Dropout Frequencies and Reasons, and Mental Health in Adulthood” researchers explore how participating in organized sports before age 18 affects mental health. In establishing the necessity of conducting research on the topic, the research team notes two important facts:
- Half of all mental health disorder appear before age 14
- Participation in sports can protect against the development of mental health disorders
Previous research published in several meta-analyses on the topic – read them here, here, and here – show that young people who played organized sports, compared to those who didn’t, report the following:
- Lower symptoms of anxiety
- Lower symptoms of depression
- Higher health-related quality of life scores into young adulthood
- Lower rates of psychological difficulties
- Greater social functioning
Based on this data, the research team designed a study to examine the following:
“The impact of youth sport participation patterns on mental health, specifically, the impact organized youth sport participation patterns have mental health implications into adulthood.”
To conduct the study, the research team used data from close to 4,000 people who took part in the National Sports and Society Survey conducted by Ohio State University. Here’s what they looked for in the survey results:
- Participation in organized sports: did youth stay engaged until age 18, or drop out?
- Reasons for dropping out: why did youth stop participating in organized sports?
- Association of participation in organized sports with symptoms of depression and anxiety: how did participating impact mental health during adulthood?
- Association of participating, then dropping out of organized sports, with symptoms of depression and anxiety: how did this impact mental health during adulthood?
- Impact of not participating in organized sports on symptoms of depression and anxiety: Compared to youth who did participate, what impact did not participating have?
- Association of reasons for dropping out and symptoms of depression and anxiety during adulthood: was there any connection between why youth dropped out and adult mental health?
Let’s take a look at what they found.
The Outcomes, Part One: Participation and Dropping Out
We should point something out that will become important later in this article: although organized youth sports are a positive experience for most people who play them, not every young person who participates in organized youth sports enjoys the experience. In fact, for some youth, it’s a negative experience, and may be associated with stress, anxiety, burnout, and in some cases, abuse by coaches.
That explains why, in the sample set of 4,000 people, close to 40 percent of survey participants reported dropping out before age 18. Previous research on this topic identifies the most common reasons for dropping out of organized youth sports:
- No longer fun/were never fun
- Anxiety caused by pressure from parents
- Anxiety caused by negative coaches
- Maltreatment from negative coaches, including physical or emotional abuse
- General stress and anxiety related to performance
- Injuries/burnout
- Poor peer relationships
- Time/cost
- Grades
Researchers divided these reasons into two categories: interpersonal and structural. Here’s the percentage of participants in the sample set who dropped out for each reason.
Why Drop Out of Organized Sports Before Age 18?
Interpersonal Reasons
- Not having fun: 45%
- Did not get along with coach: 11%
- Issue with team members 15%
- Abused by a coach 8%
Structural Reasons
- Focus on grades: 16%
- Health problem or injury: 16%
- Other clubs and activities: 14%
- Not a good enough player: 31%
- Parents worries about injury: 3%
- Lacked equipment: 4%
- Problem traveling to practice: 5%
- Parents would not let play: 4%
- Not enough money: 16%
- No sport liked: 4%
- Had a job: 11%
- Had to care for a family member: 5%
Keep these reasons in mind as we move to the next section of this article, where we share the results of participation on mental health, and explore the impact of specific reasons for dropping out on long-term mental health.
The Outcomes, Part Two: Participation, Dropping Out, and Long-Term Mental Health
To recap.
We discussed the reason a study like this is important: our youth are in the midst of a mental health crisis. We discussed previously identified benefits of organized sports during youth on long term mental health: improved overall quality of life, lower symptoms of depression and anxiety, improved social function, lower overall psychological difficulty. In addition, we addressed the fact that not everyone loves organized sports, and some youth have negative experiences.
Now we’ll share the meat and potatoes of the data from this study, and then address how they can help us support youth mental health moving forward.
Here’s what they found:
Youth Participated in Organized Sport Continually Until Age 18:
- Depression: Significantly fewer depressive symptoms during adulthood
- Anxiety: Significantly fewer symptoms of anxiety during adulthood
Continuous participation until age 18 was associated with the most favorable mental health outcomes, compared not participating or participating then dropping out.
Participated and Dropped Out Before Age 18:
- Depression: Significantly more depressive symptoms during adulthood
- Anxiety: Significantly more symptoms of anxiety during adulthood
Participating and dropping out before the age of 18 was associated with elevated levels of depression/anxiety symptoms compared to participating and not dropping out or not participating.
Never Participated in Organized Sports Before Age 18:
- Depression: Significantly fewer depressive symptoms during adulthood
- Anxiety: Significantly fewer symptoms of anxiety during adulthood
Never participating in organized sports before age 18 was associated with elevated levels of depression/anxiety symptoms compared to participating but was also associated with lower levels of depression/anxiety symptoms compared to participating and dropping out before age 18.
Those results teach us something we didn’t know or anticipate: the association of participating and dropping out with the presence of elevated symptoms of depression and anxiety during adulthood. We expected participation to correlated with positive mental health, but we didn’t expect to learn that dropping out correlated with negative long-term outcomes.
We’ll explore that outcome in more detail, below.
Reasons for Dropping Out: Connection to Depression and Anxiety
Here’s the data on the relationship of the presence of mental health symptoms during adulthood with reasons people dropped out of organized sports before age 18.
Not having fun:
- Depression: More symptoms during adulthood
- Anxiety: More symptoms during adulthood
Didn’t get along with coach:
- Depression: More symptoms during adulthood
- Anxiety: More symptoms during adulthood
Problems with team peers:
- Depression: More symptoms during adulthood
- Anxiety: More symptoms during adulthood
Abused by coach:
- Depression: More symptoms during adulthood
- Anxiety: More symptoms during adulthood
Thought they weren’t good enough:
- Anxiety: More symptoms during adulthood
Dropping out of organized sports before age 18 for interpersonal reasons was associated with less favorable mental health outcomes, compared to dropping out for structural reasons.
Lacked equipment:
- Depression: More symptoms during adulthood
- Anxiety: More symptoms during adulthood
This was the only structural reason for dropping out of organized sports before age 18 significantly associated with the unfavorable mental health outcomes during adulthood.
Got a job:
- Depression: Fewer symptoms during adulthood
- Anxiety: Fewer symptoms during adulthood
Focus on grades:
- Depression: Fewer symptoms during adulthood
- Anxiety: Fewer symptoms during adulthood
Dropping out of organized sports before age 18 to get a job or focus on grades were the only two reasons significantly associated with the favorable mental health outcomes.
We’ll summarize these results here:
- Compared to people who didn’t participate in organized youth sports, people who participated continuously until age 18 reported lower symptoms of depression and anxiety in adulthood.
- People who participated then dropped out before age 18 reported higher symptoms of depression and anxiety than people who never played.
- People who dropped out for interpersonal reasons showed greater likelihood of reporting elevated symptoms of depression and anxiety during adulthood
Overall, the study shows that the longer a young person participates in organized sports, the greater the protection against psychological difficulty during adulthood. The impact appears cumulative. Researchers theorize that longer participation can lead to habits that protect mental health, such as commitment to staying active and exercising, as well as the ability to engage in the pursuit of a common goal in cooperation with others.
How This Information Helps Us Help Teens
When we began reading the study we share in this article, we thought we’d find data supporting the idea that participating in organized sports before age 18 benefits long-term mental health. We did find that data, but we found something else that may be more important: the association of dropping out with long-term mental health problems.
We know some coaches cause harm, and that’s why kids drop out of organized sports. And we know some teammates can say and do things that cause harm, too. That’s another reason kids drop out of organized sports.
But consider this. If a kid really loves soccer, for instance, as in they play almost every day from age 6 to age 14 and love, love, love, every second of it, then decide to drop out at age 15, what’s behind that? Maybe nothing. Maybe they grew out of soccer, and simply want to hang out with friends more, or perhaps pursue another hobby or sport.
However, when we see this data, we need to consider the fact that it may be something else, such as an abusive coach, bullying teammates, or an undiagnosed mental health disorder. It may be none of those things. But it may be one of them – and the chance that it might be means we need to pay close attention to kids who participate in organized sports and then drop out.
That’s our takeaway, which we can generalize to all interests that teens or youth have. if they stop doing something they love, it’s important to investigate the why. It may be something innocuous, and it may be something that requires action.
In either case, it’s important to find out, and in all cases, this maxim holds true: knowledge is power.
