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College athlete suicide rates have doubled over the past two decades, according to a new study published in the British Journal of Sports Medicine.

The study analyzed the deaths of NCAA varsity athletes that occurred between July 1, 2002 and June 30, 2022. During that period, the share of deaths by suicide rose from 7.5 percent to more than 15 percent, making it the second most common cause of death after accidents. The majority of student athletes who died by suicide were men (77 percent). The two sports most affected by suicide were cross country and track and field.

The study was authored by researchers from the University of Washington, the University of Wisconsin at Madison and Oregon Health and Science University.

“Athletes are generally thought of as one of the healthiest populations in our society, yet the pressures of school, internal and external performance expectations, time demands, injury, athletic identity and physical fatigue can lead to depression, mental health problems and suicide,” the authors wrote.