Suicide in National Collegiate Athletic Association athletes: a 20-year analysis

To determine the incidence rate of suicide from 2002 to 2022 among athletes from the National Collegiate Athletic Association (NCAA) and assess for potential differences by, sex, race, division and sport.

NCAA athlete deaths over a 20-year period from 2002 to 2022 were identified. Poisson regression models were built to assess changes in incidence rates over time. Linear and quadratic fits between year and suicide incidence for males and females were evaluated.

Of 1102 total deaths, 128 (11.6%) deaths by suicide were reported (male n=98, female n=30). The overall incidence was 1:71 145 athlete-years (AYs). Over the last decade, suicide was the second most common cause of death after accidents. The proportion of deaths by suicide doubled from the first 10 years (7.6%) to the second 10 years (15.3%). The suicide incidence rate for males increased linearly (5-year incidence rate ratio 1.32 (95% CI 1.14 to 1.53)), whereas a quadratic association was identified among female athletes (p=0.002), with the incidence rate reaching its lowest point in females in 2010-2011 and increasing thereafter. Male cross-country athletes had the highest suicide incidence rate (1:29 815 AYs) and Division I and II athletes had a higher suicide incidence rate than Division III athletes. No significant differences in suicide incidence rates by sex, race or sport were identified.

Deaths by suicide among NCAA athletes increased in both males and females throughout the 20-year study period, and suicide is now the second most common cause of death in this population. Greater suicide prevention efforts geared towards NCAA athletes are warranted.