Reducing barriers to mental health care for student-athletes: An integrated care model.

Abstract

Research suggests that National Collegiate Athletic Association (NCAA) Division I student-athletes have higher levels of stress and other behavioral health issues, including substance use, than nonathletes. For several reasons, student-athletes may be less likely to admit to behavioral health issues and seek mental health care. Integrated care is a model of care that integrates behavioral health into a medical practice. This article explores the newly released NCAA Best Mental Health Practice guidelines and the application of integrated care to a Division I athletic training room setting using the three-worldview framework for successful integration, incorporating clinical outcomes, operational reliability, and financial stability. (PsycINFO Database Record

Toward an Understanding of Critical Success Factors for Student-Athlete Mental Health and Wellness, Academic Success, and Athletic Performance at the NCAA Division III Level

“…According to data from the National College Health Assessment surveys, about 31% of male and 48% of female National Collegiate Athletic Association (NCAA) student-athlete respondents from 92 different institutions reported either depression or anxiety symptoms each year of the 2008 and 2012 academic years due to the many aforementioned challenges and stressors (ACHA, 2018). A more recent study reports that of the approximately 400,000 NCAA student-athletes participating in sports at more than 1,000 member institutions across the United States (U.S.), rates of depression range 15.6% to 21.0%, and freshman are at greater risk than other collegiate class years to develop depressive symptoms (Sudano, Collins, & Miles, 2017). Evidence has also shown that due to the extensive time demands, pressures, and added stressors, collegiate athletes are at significant risk for other mental health related problems such as clinical or subclinical eating disorders, sleep disturbances, gambling addictions, substance abuse, mood disorders, and even suicide (Moreland, Coxe, & Yang, 2017).…”

“…Despite the growing population of student-athletes who can benefit from support of a sport psychologist, only 40% of NCAA Division I university athletic training rooms use screening instruments to assess student-athletes for mental health issues, i.e., depression, anxiety, eating disorders, substance use, mood disorders, and attention deficit hyperactivity (Sudano & Miles, 2017). Some athletic trainers surveyed in a study reported that they lacked a formal mental health referral process inside their athletic department (Clement, Granquist, & Arvinen-Barrow, 2013).…”

“…At the professional association level, the NCAA Best Mental Health Practices (2016) document states that mental health providers and general student support services should be easily accessible to student-athletes and should include multiple disciplines (e.g., athletic trainers, primary care physicians, licensed mental health providers, life skills support staff, registered dieticians, etc.). It may be assumed that use of such general support services is no higher due to lack of knowledge about integrated care and support services, lack of access to and availability of care and services, and stigma associated with mental health and illness and help-seeking behaviors, especially among student-athletes (Sudano et al, 2017).…”

“…One way to provide comprehensive care to student-athletes is first, using an integrated care and support services model approach (Sudano et al, 2017). The foundation of an ecological model is biopsychosocial and combines medical, mental, and behavioral health services to help studentathletes who present to primary care and tertiary care settings.…”

“…The Mental Health Best Practices document (2016) suggests an increase in collaboration between mental health and physical care to provide comprehensive services to student-athletes, noting that a student-athlete's well-being is best served through: (a) a collaborative process in which the mental health provider(s) and life skills support staff are easily accessible and within or proximate to athletic department facilities; (b) an interdisciplinary team that consists of primary care and mental health providers, and; (c) an interdisciplinary team that reviews the medical care of student-athletes. Incorporating and presenting an ecological model approach into the athletic facilities, training room, department offices, etc., can provide coaches and student-athletes with knowledge and access to comprehensive care options available to them and may reduce stigma associated with mental health and illness and help-seeking behaviors (Sudano et al, 2017).…”