Harry Miller couldn't have chosen a better setting or a better advocate for a near cataclysm. It just didn't seem that way a year ago, shortly before the 2021 college football season. The Ohio State center, who made an appointment with Ryan Day, told his coach he was thinking about killing himself.
"He kind of opened up and was honest with about where he was [mentally]," Day told CBS Sports. "A big part of it was whether he wanted to continue playing football or not. At that point, to me, it had nothing to do with football. It had everything to do with where he was [mentally]."
Miller was on the brink, a tragic mile marker for many afflicted with what has become a spreading mental health crisis in college that expects say is certainly not exclusive to athletes. A combination of rapidly converging issues -- COVID-19, politics, inflation, class disparity among them -- has brought society to its knees in recent years.
In college athletics, however, the issues, ages and consequences are different -- and possibly even more damaging. Mental health experts consulted for this story all mentioned that college is a time when minds, personalities and lives are being formed. Throw in the pressure of social media, relationships, even NIL, and the stakes are raised.
The numbers don't lie. From 2000-16, the Centers for Disease Control and Prevention report a 30% rise in death by suicide. One study, cited by the Harvard School of Public Health, showed one in four persons aged 13-34 acted on a suicide attempt after considering it for less than 5 minutes.
"This is bad right now, and it will get worse," said Dr. John Rosa, a behavioral medicine expert who served as a White House consultant on the opioid crisis across the last three presidential administrations. "Even if we shine a light and pay attention to it and understand it, it's still going to get worse."
We enter the 153rd college football season with a hidden enemy gnawing at the fabric of college sports. A mental health crisis, for sure. Some even say a suicide crisis among college athletes. At least four college athletes -- all women -- have died from suicide in the first five months of 2022.
Miller's struggle stands as one of the most significant stories of the offseason. In March, he announced his medical retirement from football in an emotional, detailed tweet. The former high school valedictorian from Georgia referenced scars on his wrists and his throat. Eleven days later, the nation witnessed his story on NBC's "Today."
"People have called me brave," Miller said that day, "but to me, it felt like not dying."
Miller remains on scholarship at Ohio State as he pursues an engineering degree. On the day Miller sought his coach's counsel, the help he received was immediate and significant. Ohio State has five full-time and two part-time sports psychologists who combine to cover athletes and staffs across all 36 sports. If that sounds ambitious, it is. Depending on funding, some schools are lucky to have one psychology professional.
Ohio State had already lost walk-on football player Kosta Karageorge, who died by self-inflicted gunshot wound in 2014.
OSU athletic director Gene Smith said the realization that more help was needed hit him within the last decade.
"That [realization is] when we started down the path," Smith said.
Miller certainly benefitted as Day immediately steered his center towards Ohio State's significant mental health resources. Day's father died of suicide when he was 8 years old. In the last year, during a series of interviews, Day discussed his eventual awakening after the tragedy.
The comprehension of his father's death didn't hit him until he was 11. As a youth, Day would get angry when teammates ran to their dads after games. During a May 2018 recruiting visit, Day was walking the halls with a Massillon, Ohio, high school official. He asked why the halls were so empty. Day was told students were not in attendance as the campus was dealing with its seventh suicide of the school year.
Several studies show death by suicide has been on the rise for a while. In a May study, the NCAA stated the rates of mental exhaustion, depression and anxiety among college athletes continue to be 1.5-2 times higher than before the pandemic.
"I think it's ever-changing," Day said. "The way that players were built 20 years ago is different than 10 years ago, is different than 5 years ago, and is going to be different 5 and 10 years from now."
We're already in a time where the on-field aspect of college football is almost a distraction. It's an era filled with handwringing about player empowerment, NCAA deregulation, the transfer portal and realignment all while the sport generally moves toward a professional model.
The college mental health crisis has taken an even darker turn with recent deaths by suicide.
Before the year was half over, four female college athletes died of suicide, keeping the subject in the headlines across a condensed timeline: Sarah Shulze (21, Wisconsin cross country), Lauren Bernett (20, James Madison softball), Arlana Miller (19, Southern cheerleading) and Katie Meyer (22, Stanford soccer).
"The pursuit of perfection can be a dangerous one," said Jamey Houle, lead sports psychologist at Ohio State.
Houle saw a sports psychologist as a high school sophomore after massive success in gymnastics, including a national championship. After competing for Ohio State, Houle got his doctorate in the discipline that helped him at a young age. Since 2019, he has led the sports psychology department for what is regularly the richest athletic department in the country.
"[The crisis is] really shedding a light on what has existed, in one way, for hundreds of years," Houle said. "Because there is so much light on athletes now more than ever, the level of exposure has never been seen like this. One person [on social media] could have 15 people make horrible comments about them in 30 seconds. It used to be, they'd have to send a letter."
Smith played in a day when mail wasn't electronic. As a Black football player in his first year at Notre Dame in the mid-1970s, he had issues. He just didn't know how to describe them.
"Six student-athletes were kicked out of Notre Dame. Two of them were my roommates," Smith recalled. "They were suspended for one year. I was a student-athlete by myself for one year. All the depression that I went through, I managed. I didn't know because I didn't know it. I just dealt with it."
Former Washington State quarterback Tyler Hilinski died by suicide in 2018. He was described by teammates and coaches as an outgoing leader. One day, he wasn't there, having taken his life. His parents have become nationwide crusaders for suicide awareness, forming the Hilinski's Hope Foundation.
"It's a struggle without him," Kym Hilinski said. "I cry every day. I'm going to do that no matter what. I'd rather help people through my pain."
Kim and her husband, Mark, have channeled their grief with incredible grace and outreach. They will visit 17 states in the next three months giving a series of on-campus "Tyler Talks." Inevitably, at each talk, at least one athlete will come up to Mark and say, "You saved my life," he shared.
"We try to get across to the student-athlete; it's a complex issue," Mark added. "Somehow, because it's your mind, kids have this feeling that everything that is related to depression, anxiety, bipolar is based on how you were brought up. We want them to understand it can be related to brain chemistry. Nobody asked to get [a disease]."
Aaron Taylor, a College Football Hall of Famer from Notre Dame and CBS Sports college football analyst, has dealt with mental issues since age 9. He stands as an outspoken advocate of #SameHere, a global mental health movement.
"There is a tsunami of a mental health crisis that is coming post-COVID, post Ukraine-Russian war, that is coming post-election not going the way we wanted," Taylor said. "These last three years have been the single greatest period of uncertainty that our generation have seen worldwide. We're looking at fish flopping on the beach and wondering what's going on."
Reuben Faloughi was a walk-on linebacker at Georgia from 2009-12, but his aim was always to earn his doctorate in clinical psychology (Missouri, 2019). While at Mizzou, Faloughi became involved in the football players' boycott against racism. This year, he left South Florida as a staff psychologist to start his own practice in the Tampa, Florida area.
His experience gives him the unique experience of feeling an athlete's typical anxiety and being on the front lines fighting it.
"Mental health is in a very different place today than when I was in college," Faloughi said. "I tell some of the athletes I work with, 'I didn't know what the counseling center was when I was in college.'"
Faloughi noted that he and his Black teammates were reluctant to see a campus counselor who didn't look like them (white and female). These are the little things the public doesn't see.
"I remember feeling tension, but tension for some in football was a means for people around me to be a provider for themselves and their families," he explained. "That made it turn into more of a transactional experience. It was very different than high school where there was more fun in it. It's not stated explicitly, but implicitly along the way you learn you're a revenue generator for the university."
In 2015, a landmark Pac-12 study might have revealed the mental health crisis that was coming. The study concluded an average athlete spent 50 hours per week on their sport. The NCAA weekly limit on sports activities is 20 hours. The study suggested those rules were flouted causing an "emotional toll."
The NCAA eventually adopted legislation that kept any practice from beginning after midnight and before 6 a.m. That change suggested some practices were actually being conducted in the middle of the night.
NCAA also updated its best practices regarding mental health in 2020. But as is typical with the NCAA, it usually cannot mandate change as mandates only work if there are penalties for violating them.
Taylor credits NCAA chief medical officer Brian Hainline for paying attention to the issue.
"In my opinion, that's the best part of what the NCAA does," Taylor said. "His give-a-shit factor is through the roof."
Big Ten commissioner Kevin Warren has made mental health a priority. Warren languished as a child, bed-ridden for months after being hit by a car. In a previous professional life, Warren was in player development for the St. Louis Rams.
"There are far too many suicides that are going on our campuses," Warren said. "That damn social media. People live on it. You can't even have a meal with someone because they're looking at their phone."
Day credits Miller for having the strength to walk into his office that day last year. At the time, Day said he was only aware Miller would "get a little anxious" about snapping the ball.
"Nothing to lead us to believe there was this much going on," Day said. "There's a lot of stress that comes with playing the game. It's hard to tell when it gets to that point."
If all this mounting stress sounds like a slow unraveling of society, Rosa acknowledges that is exactly the case.
"It's just not what we're genetically and evolutionarily put on the planet to be," said Rosa, who manages 17 clinics in the Maryland and Virginia area. "The exponential changes are not OK. From the Ice Age on there's been changes over thousands of years to where we are. "All those things took forever. … All of a sudden, in the last 50 years, the dynamic has changed so fast we don't have the ability to adapt to that fast change."
Oregon basketball star Sedona Prince recently decided to take a break from posting on TikTok. Prince's video in March 2021 showing the inequities between the men's and women's NCAA Tournament weight rooms went viral. She is now a minor celebrity.
"My mental health has been declining for a long time," she said in a post, "to the point where I'm really at my lowest right now."
Veteran Arizona associate AD for medical services Randy Cohen summed up the crisis succinctly.
"Looking back over the last 30 years, I think mental health issues saw us, but we didn't see them," he observed.
This story began with the guts it took for Harry Miller to walk into Ryan Day's office.
"For me, it speaks courage," Houle said. "On the other hand, it also speaks to Ryan Day's openness to be able to have that conversation. I do that for a living, and it's still scary to hear that."
The overall story, unfortunately, does not have end. At least not yet. For the likes of Miller, life and his renewed journey continue day-to-day.
"If we're going to recruit people and say we're going to be there [to] help them grow and be part of the family … then we have to do that," Day said.
"It can't just be on the football field."