How are YOU ?

The Critical Difference Between
Mental Skills and Mental Health

It was an 80-degree day in Boston, so neither of us should’ve been particularly surprised that our coffees were melting faster than we could drink them. Sitting across from me was the talented student-athlete at UMASS Boston, Bella Nadeau, Founder of Let’s Get Real (LGRAAMH), a nonprofit that provides athletes with a safe place to share their experiences with mental health. Bella and I recently connected through Instagram where I started an account for Ehrhart Singer Therapy Group. Ehrhart Singer Therapy Group is a practice I co-founded with my colleague, Hannah Singer. We provide clinical mental health services for collegiate and professional athletes in the greater Boston area. I was thrilled to have found Bella and inspired by her initiatives at LGRAAMH. I asked Bella out for coffee so I could pick her brain. (I also looked forward to the opportunity to commiserate with her on a significant observation I’ve found in my work with elite athletes).

I jumped right in and asked her how she felt about how the difference between Mental Skills and Mental Health is generally regarded as synonymous among the athlete community and that the misunderstanding of their difference acts as a barrier for athletes to receive the appropriate mental health care. After announcing my declared frustration, I leaned back, took a sip of my diluted coffee, and waited for her enthusiastic validation…


“Wait, there’s a difference?”


I was struck. How was it that an NCAA Division III student athlete deeply involved with mental health awareness and advocacy did not know the difference between the question “How’d you do?” and “How are you?” This is when it really hit me: As an athletic community, we’ve got a whole lot of work to do. Bella and I spent the rest of our time together talking about the cultural conflation of services provided by mental skills coaches and sports psychologists and the services provided by clinical mental health specialists. We began to explore different ways we can work to bring awareness and education on the difference.

Step One: Begin Talking about it.

So, what is the difference between Mental Skills and Mental Health? The difference is the former focuses on performance execution and enhancement, and the latter focuses on the specific clinical mental health needs of the athlete such as chronic anxiety & depression, mood & panic disorders, past and current traumas, disordered eating, and other diagnostic mental health conditions. Mental skills coaching helps an athlete improve their value through increased performance. Mental health services help an athlete know they have value regardless of their performance.

Many leagues, colleges and teams offer mental skills coaches and/or sports psychologists. Mental skills coaches and sports psychologists are essential to the success of a team and the individual athlete. You will hear them use language like “mentally tough” or “mentally strong” as a metric in their work. Their services help prepare and train elite athletes for highly pressured and competitive situations. They provide athletes with a series of behavioral skills and thought based interventions to optimize the athlete’s ability to perform. Mental skills coaches and sports psychologists will ask the athlete after the game: “How’d you do? Did you feel prepared? What do we need to do next time to improve confidence and performance?”

…here comes the difference…it’s nuanced, but essential…

The clinical mental health specialists will ask the athlete after the game: “How are YOU? What was it like for you to experience that kind of pressure and competition? What kinds of protective factors can be put in place to keep you feeling emotionally and psychologically stable?” Clinical mental health specialists provide a therapeutic context for an athlete to identify and express their emotional and psychological world. In this type of work, the athlete can address their clinical mental health needs and become curious about how these issues impact them as an athlete AND as a person. The mental health specialist and the athlete identify ways to regulate and manage emotions and psychological implications that impact them on AND off the field.

Why is recognizing the difference between them so important? In short, by not acknowledging the difference, the athlete community is inadvertently creating a barrier to accessing clinical mental health services. Elite athletes such as Michael Phelps, Naomi Osaka, Simone Biles, Kevin Love (just to name a few), are coming out to talk about their MENTAL HEALTH not their MENTAL TOUGHNESS.

The distinction between Mental Skills and Mental Health is essential in determining the appropriate mental health care for the athlete. If an athlete is struggling with clinical mental health needs such as the ones mentioned above, mental skills training will not be effective in supporting their emotional and psychological needs. In fact, if an athlete is emotionally dysregulated, dealing with unprocessed traumas, managing pressures at home and/or within important personal relationships, they will not even have the emotional capacity to receive the benefits of mental skills training.

Finally, it’s essential to note that Mental Skills and Mental Health services are not in competition with one another. To provide holistic care for the athlete, and to optimize the athlete as an athlete AND a person, these services should work alongside one another. Clinical mental health specialists and mental skills coaches and sports psychologists should all collaborate care to fully support the athlete’s overall wellbeing.

As for Bella and I? Well, we became quick close friends looking to take on Step Two: Moving into Action.

We are actively bringing awareness of this difference to the greater athlete community via Instagram. You can follow our calls to action on our pages @people_too_  and @lgraamh

I will end by thanking you for reading and move my talking into action by asking:

How are YOU today?

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Allison Ehrhart Allyn, LICSW
Co-Founder & Lead Clinician at Ehrhart Singer Therapy Group
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