Anonymous Screening Increases Self Reported Symptoms Of Mental Health In College Athletes

Abstract

PURPOSE: To identify the effect of anonymous vs identified screening for depression, anxiety and eating disorders in college student athletes. METHODS: NCAA student athletes were electronically screened for mental health disorders using the PHQ-9 (depression), GAD-7 (anxiety) and SCOFF (eating disorder) questionnaires. A positive result correlated with a score of 10 or more on the PHQ-9 and GAD-7, and 2 or more on the SCOFF. The screening tests were completed between the 2020 and 2021 academic years by students attending major universities in the Greenville, South Carolina area. Both surveys were completed from the same collegiate population via the same online platform with or without collection of names and demographic info as part of preparticipation paperwork and history taking. The results by both groups were collected in each of the 3 categories (Table 1) and reported as a percentage of the total number of athletes in the group. The percentage of positive screens in each category was compared between the identified and anonymous groups and the Chi-squared test was used for determination of statistical significance. RESULTS: 949 athletes participated. Two-thirds were male and 502 were identified while 447 reported anonymously. Positive screening captures were reduced in each category in the identified group compared to the anonymous screening. Percent positive screens dropped from 11.3% to 1.4% (p < 0.0001) on the PHQ-9, from 15.3% to 2.2% (p < 0.00001) on the GAD-7, and from 6.4% to 2.4% (p = 0.01) on the SCOFF. Overall, positive screening on any of the tools dropped from 22.6% to 4.4% (p < 0.00001). CONCLUSION: The prevalence of positive mental health screening in student athletes is dramatically lower when athletes are identified compared to anonymous screening. Considering the high prevalence of mental health disorders in athletes, it is important to identify athletes at risk accurately on screening to intervene appropriately.