A new U.S. analysis spanning more than 800,000 students finds that middle and high school students who participate in sports are significantly less likely to report suicidal thoughts or behaviors — even as youth suicide rates have climbed nationwide. Yet sports participation has declined for a number of reasons, potentially limiting access to this important protective factor.
The analysis, “Assessing the Association Between Sport Participation and Suicide Ideation and Behaviors Among Middle and High School Students in the U.S. Between 2007 and 2023,” is published in the August 2025 Annals of Epidemiology and led by Massy Mutumba, assistant professor at the School of Public Health at Washington University in St. Louis. She completed the research while at the University of Michigan. Co-authors are Philip T. Veliz, John Jardine and Ashley Cureton, all of the University of Michigan.
“Historically, organized sports have been an important protective factor against suicidal thoughts and behaviors, and they still are,” Mutumba said. “But fewer students are participating, especially in middle school, and we need to find new ways to expand access and integrate mental health into sports settings.”
Suicide is rising at an alarming rate among children and teens in the U.S., creating a serious public health crisis. It is the eighth leading cause of death for kids ages 10-14 and the third for youth ages 15-24. In this study, researchers analyzed Youth Risk Behavior Survey data from 2007 to 2023 drawing on responses from 326,085 middle schoolers and 508,737 high schoolers across 41 states. Among middle school students, 20.5% had seriously considered suicide, 13.5% had made a plan and 8.6% had attempted it. Among high school students, 16.6% reported suicidal thoughts in the past year, 13.5% had made a plan and 9.2% had attempted suicide.
As part of the analysis, researchers explored the link between suicide risk and past-year participation in organized sports — a protective factor that could be leveraged more broadly.
Key findings
- Suicide risk (rates of suicide ideation, planning and attempts) increased sharply among youth between 2007 and 2023.
- Sports participation dropped from 57.4% of high school students in 2019 to 49.1% in 2021 and has remained consistently lower than before the pandemic.
- This decline was exacerbated by increasing costs (which disproportionately affect students from low-income households), the COVID-19 pandemic and growing psychosocial challenges. These challenges — including depression, generalized and social anxiety and body image issues — often emerge around puberty and may prevent students from participating in organized sports.
- For high schoolers, the protective link between sports and mental health remained strong both before and after the pandemic.
- Among middle schoolers, the link between sports participation and reduced suicide risk was slightly weaker in 2023 than before the pandemic — a pattern that may reflect developmental differences. Psychosocial challenges tend to intensify with age, which could explain why this association is stronger in high school students, Mutumba noted.
The study is among the first to track these trends before, during and after the pandemic across nationally representative samples. Additionally, the study gives careful focus to middle schoolers. Despite rising suicide rates among younger kids, most large-scale studies have focused on older teens, leaving a major gap in research and prevention efforts, Mutumba said. Suicide is still widely viewed as a concern primarily for older teens.
Sports participation has numerous physical and mental health benefits, such as reduced depressive and anxiety symptoms, lower stress, enhanced general well-being and improved self-esteem, the researchers assert.
The findings underscore sports as an accessible, scalable and sustainable public health strategy for suicide prevention, but indicate that taking full advantage of the power of sports may require new approaches.
The authors call for greater investment in equitable access to sports opportunities — especially in communities where risk is highest. Adolescents in marginalized communities particularly have elevated odds of suicidal behavior and reduced access to mental health services. To help close these gaps, the report outlines concrete strategies such as subsidizing or fully covering fees for school and community-based programs, investing in local facilities (green spaces, basketball courts and baseball fields) and implementing sliding-scale fee models. These efforts are particularly important in middle school when early engagement in sports can build lasting habits and offer critical mental health protection.
The authors also advocate for incorporating evidence-based mental health programs into organized sports programs. This aligns with Mutumba’s ongoing efforts to develop scalable, community-embedded strategies that integrate mental health support into systems that serve adolescents.
“Sports offer more than physical activity,” Mutumba said. “They create structure, social connection and a sense of belonging that can help buffer the intense pressures that adolescents face today.”
