A Message On Addressing Mental Health in Students

I graduated in May from The University of Pennsylvania. I was pre-med, president of my a cappella group, vice president of marketing for my sorority, a tutor, a mentor…stress was not a stranger to me. Despite the pressure of preparing for, and applying to, medical school there was one thing I didn’t have to deal with – the daily practices, training sessions, games, meets and matches that being a college athlete means not only attending but performing in optimally. While I was not a varsity athlete myself, I dated one for a good part of college and was exposed to, if only vicariously, the stress that comes along with trying to perform your best academically and athletically –this, while still making time for people you care about, the hobbies you promised yourself you’d keep up with in college, and most importantly, your own mental health.

As I’m sure many have seen through various social media outlets in the earlier half of this week, last weekend, University of Pennsylvania Track Team member, Madison Holleran, took her life by jumping off of a Center City, Philadelphia parking garage. She was said to have left a note for her parents as well as a gift for each member of her family. I am not claiming to be a reporter — I am only telling you what I read in various news stories. And while I feel a perhaps unwarranted connection to this young girl, attributed maybe only to the fact that we share an alma mater, Madison’s actions have highlighted something that runs deeper.



Whilst perusing Instagram in the days following Madison’s incident, I came across a powerful statement written by another female athlete whom I had known in college:

After experiencing two suicides in the athletic community at Penn within four years, my stance on the matter remains clear: universities need to do a better job at providing supports for student athletes and educating them on mental health. We have strength coaches, nutritionists, tutors, etc. But we continue to neglect mental health as a society, and regard it as a ‘touchy’ subject. Athletes, coaches, and administrators should feel safe to discuss these pressing matters that often affect too many of us student athletes. Keeping Penn athletics, friends and family in my thoughts.

The other suicide to which she is referring is that of Owen Thomas who, within weeks of being made captain of UPenn’s football team, hung himself in his campus house. After completing his autopsy, scientists found that Owen had chronic traumatic encephalopathy, “a disease linked to depression and impulse control primarily among N.F.L. players, two of whom also committed suicide in the last 10 years.”



While it is unknown whether Madison had the same disease, the link between these two well-liked, successful, and smart young adults is in the form of a question: “Could they have been helped?”

Unfortunately, many news articles covering the issue have taken the tone of: “But she was so beautiful, and popular..” but he was “so popular, and was just made captain.” It reminds me of the psychological phenomena I learned through several of my psychology courses: the “Beautiful is good” hypothesis and the “Halo effect,” the former being the assumption that physically attractive people have superior personalities and the latter being the assumption that how someone appears on the outside must reflect their inner qualities. I am not saying that both Madison and Owen were not smart, funny, talented, and well-liked, but rather that it would be impossible to know this from seeing only a picture. We are taught, “Don’t judge a book by its cover” or “Success does not equal happiness.” We must look past a person’s exterior to uncover the beauty within and we are often surprised that what is inside is even more beautiful.

It is hard to know if these athletes were aware of the severity of their mental illness or whether they would have aggressively sought out counseling if it was provided by the university. The same holds true for medical schools — though most students focus primarily on coursework and research and may not have the added stress of athletics, the light-hearted but very true “drinking water from a fire hose” can place tremendous stress on students. The message rings loudly: we need to de-stigmatize mental illness, especially in our youth, and universities, who most closely handle young adults in their formative years, may be where we should start. As future healthcare providers it is our responsibility to view depression as seriously as a broken arm, to treat bipolar disorder with the same haste in which we would complete an angioplasty, and to realize that, like any disease, mental illnesses have causes, signs and symptoms and thus, by very definition, treatments.

Update: Two Penn Alumni, friends of the late Owen Thomas and one of whom is the brother of Kyle Ambrogi, another Penn football player who committed suicide in 2005, have taken steps to help student athletes. They have spearheaded the Penn Mentorship Program, an organization aiming to set up student athletes with former Penn athletes and other Penn alumni for mentorship purposes. “The program is still in its infancy, but we believe having at strong list of mentors will help spark collaboration with Penn’s Administration. Your participation is crucial to the success of this program. We truly believe we can create a space where young people feel safe talking about their struggles. If you are a Penn alumni, you can sign up to be a mentor here.

Note: Thanks for all the support with this piece. I decided to do a follow-up last night – An Addendum: It’s Time to Get Real About Suicide in the Healthcare Field. I’d humbly ask that you continue sharing this very important message with your friends and family. And if you or people you know have personal stories or insights to share on this topic, our inbox is always open at almostdocs@thedoctorschannel.com. Thanks again!

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Rachel Greenberg, "Almost" MD

Rachel Greenberg is an editor for The Almost Doctor's Channel hailing from Great Neck, NY. She graduated from the University of Pennsylvania with a degree in Psychology, where she spent much of her time either singing a cappella or being a pre-med. In addition to maintaining an interest in holistic medicine, Rachel boasts a world-class Carrie Underwood impression.


  1. GrudgeRuns

    In regard to the comment from the Former UPenn athlete I think not just student athletes need this support. Just as many students are working hard in school and at their jobs that this could benefit. And may I add this young girl was extremely close to a few of my freinds and I am truly truly sadden by this news.

    Her spirit will live on and though I don’t know her personally she will always be in my thoughts (for some reason i can’t shake this from my mind and i don’t think i can).

    RIP. You have reached others such as myself in such unbelievable ways. May your parents overcome their sorrow and appreciate everything you were and still are.

    jackson drake

    • Rachel Greenberg

      Thanks for your comment and your support. I agree that all students need this support and plan to further cover the issue.

      • Jim

        With all due respect, I believe it’s a bit irresponsible to summarily dismiss that Madison Holleran perhaps suffered from CTE from her soccer playing days. Prior to doing the specific CTE exam on Owen Thomas, everyone thought it “unlikely” that he had CTE given his relatively young age.

        • Rachel Greenberg, "Almost" MD

          Good Point, Jim…I did not consider her soccer playing days. I will correct. Thanks!

        • Rachel Greenberg

          Thanks for pointing that out, I went back and changed that. Thanks for the interest

          • Jim

            No, thank you 🙂

  2. Kayla

    I posted this on Facebook and really appreciate your insight on this for so many of us who have had Madison on our minds each minute of the day this last week. Although I didn’t know her and have no right to them, I have to admit that I have prayed for answers to her mystery myself. Your article helped put my mind at ease a bit and I do hope her family can find the answers they are searching for have it be through her letters or her autopsy.

  3. hollymom

    It is fairly unlikely that Madison suffered from CTE. This is most often associated with chronic brain trauma like that which a football player might suffer. The bottom line is that it is an extreme RED FLAG for anyone, especially a teen, to disclose thoughts of suicide. Teenagers have very little perception of the length of life vs. transient struggles. As such, they are much more likely to act on suicidal thoughts than an older adult with a better frame of reference. Some commit suicide with no disclosure of suicidal thoughts. This disclosure should always be considered as a plea for help. Action to intercede should be swift and sure. Regardless of what she later said, Madison should have been prevented from returning to school until such time that her despair and hopelessness had passed. This is a lesson going forward to all parents that this can happen to anybody and you must be proactive in getting your teen the help they need.

    • Jim

      How can you be so sure it’s “fairly unlikely?” See the link below. It’s worth exploring if it’s not too late because if it IS the case, it too is groundbreaking because no one, including you, associates soccer with head trauma. I also think second-guessing her parents is a bit shameful. We don’t have all the facts and never will if a CTE exam is not, or unable, to be done now.


  4. zinaru13

    The issue extends well beyond athletics for many college students. While attending UC Berkeley, Zach Dion, a gifted runner as well, fell to his death in October. He resided in the PDD spectrum (Asperger’s), a high risk group for suicide.

  5. John Hurley

    Thanks for the writing this Rachel. I was on the football team with Owen and he was one of my very close friends. The more we get this message out there from health professionals like yourself the better. I do not have faith that professional organizations will move fast on setting examples because their actions are dictated by dollar signs. The worst sport of all is the NHL – they completely deny any linkage of sport injury, specifically head trauma, to depression and suicide.

    After playing football most of my life, I wonder if the recorded history 500+ years from now will look back on some current sports as clearly barbaric in the same ways we may think of gladiators or medieval sports like jousting.

    • Rachel Greenberg

      Thanks for the support, John. It’s really amazing to see how the Penn community had come together to support this cause and spread the message

  6. Molly

    The need for better mental health care and a change in college working environments is not something just athletes need. Any student who consistently pushes themselves and is never satisfied with his/her performance is at risk for mental health issues at a place like Penn. I went there a perfectly happy person and came out fairly damaged. I wasn’t in varsity sports, I wasn’t the president of anything, but my need to exceed in everything I did do lead to immense stress and an eventual mental breakdown that I’m still healing from. Its the environment as a whole that needs changing.

  7. Cece Carsky-Bush

    This article is wonderful and speaks to so many things that I try to promote everyday. I lost my older brother to suicide 5 years ago this March. I am a college student and am in a committee that promotes mental health awareness in an effort to de-stigmatize and educate. Thank you so much for writing this.

  8. A DAD

    I have been shocked to the extent of the issue. Frankly, I am appalled at knuckled headed coaches who are not in tune with the stress level these young people are under, and continue to “SCREAM” at their players and push them toooooo hard. The NCAA needs mandatory training for both the colleges and especially the hard-headed insensitive coaching bullies (that’s right, I said it, BULLIES) who have these young people’s lives in their hands.

  9. Mrs. Emily Cohen

    Rachel, your article is insightful and “real.” As a person who grew up and was educated in Great Neck, I remember that there were always support systems in the public schools, whether it was teachers, administration, or trained professionals (counselors and school psychologists). Even my rabbi took on this role, and held many sessions during our senior year to help with our transition into a world of college that may be drastically different than our ideal town of Great Neck. Some colleges and universities have mental health support systems in place, but the student must take an active role in pursuing it. I love the idea that there should be that type of support for athletes, no different than the physical training, nutrition, etc.

  10. Maryann Nelson

    Your article is well written and right on target. It is our society, our leaders our friends , ourselves.. that the issue / problem begins.
    Our view of what others will think of our children .. then of ourselves if they do not succeed. It begins when children can first talk, walk then read. What nursery school to attend and God Forbid if people share with you their childs SAT score.or what college they applied to. They can’t because it is better to appear perfect then to expose oneself of less.. those who have mental illness .. shy away from seeking help because it would make them appear less than perfect.
    It is not a ACL that is torn or a concussion or a broken bone that is from a sports injury.. that would be accepted..
    when one is depressed or has a mental illness. what do we tell our friends our family.

    My heart breaks every day for the family ..the parents who will have to deal with the
    emotional rollercoaster of their life..
    We as a society need to unravel what we have created,
    focus on our children and their mental health..de-stigmatize this disease.
    perhaps with young writters like yourself get the acceptance level up so others like Madison can feel free to seek treatment and perhaps save another family from the unbearable, unimaginable heartache of losing a child.

  11. Mal

    @disqus_78y0X8VW3P:disqus i shared this on my wall yesterday (a request from my son who is a sophomore at NYU and an intern at thedoctorschannel)….i heard today that a 19 yo freshman at NYU jumped to his death last night/early morning….as a parent, i am sharing your article with EVERYONE i know so we all can be vigilant about the pressures our kids face. thank you for bringing this to the forefront.

  12. Stefanie

    Lets not forget about Kyle Ambrogi. This is an issue that must be addressed at every level – high schools especially where I teach Yoga daily to offset the societal and academic pressures. I will always remember Kyle, his smile, and his incredible way of lighting up a room; and for those reasons, I have dedicated my life to helping others – on and off their yoga mats. As a UPENN alum, I too second everything you said wholeheartedly.

  13. Seth Levine

    Being a Penn graduate and a graduate from Great Neck South I wrote two pieces following Madison’s tragic suicide.

    This is a letter I wrote to UPENN (I submitted it to the DP, but I think it may be too long) – http://writerhymesigoblind.blogspot.com/2014/01/open-letter-to-upenn-administrators.html

    and this is a poem i wrote after her death – http://writerhymesigoblind.blogspot.com/2014/01/everybody-smiles-in-photographs.html

    After hearing about Madison’s tragic suicide, I was heart broken. Being a Sports fan and a Penn fan/alumni, I had followed Madison’s career. When I read about her last semester, I was so proud that a girl like that decided to go to Penn. When she passed away, my friends and I took it very hard.

    Writing has always been an outlet for me and I’m happy that someone else from Great Neck was able to write a great piece. The saddest part is knowing that there is a major problem, but nobody is really willing or qualified to fix it..

    Hopefully things will get better in the future.