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Tasked with a heady issue

Only weeks into his new role as the NCAA’s first chief medical officer, Brian Hainline roamed the halls at the 2013 NCAA Convention, convinced he would hear that concussions were the membership’s chief health and safety concern. To his surprise, though, when he met with members of the Student-Athlete Advisory Committee, they stressed that finding a way to address the array of mental health concerns that permeated training rooms, dorms and playing fields was their biggest worry. Help us solve this silent, yet significant, problem, they asked him.

So Hainline, along with the NCAA Sport Science Institute staff and mental health experts from around the country, has started down the road  finding solutions. In mid-November, nearly two dozen scientists, clinicians, policy experts, team physicians, administrators, coaches and student-athletes – dubbed the NCAA Mental Health Task Force – convened in Indianapolis to discuss the myriad mental health issues facing today’s NCAA athletes.

“Student-athlete mental health is an under-recognized health issue, and if managed improperly, leads to poor performance in sport and the classroom, and can potentially lead to life-threatening emergencies,” Hainline said. 

The transition from high school to college is often psychologically daunting. Adjusting to a new coach can be particularly trying, task force members said. Several referenced data that indicated coaches have more influence than any other factor over whether student-athletes view their college experience as positive or negative. Coaches who do not understand or acknowledge mental health issues negatively affect student-athlete well-being.

Schedules crammed with academic and athletic commitments and very little leisure time are major stressors that can trigger emotional distress, task force members indicated. One study found that more than a quarter of NCAA athletes across an array of sports claimed that an overwhelming schedule was the element of their college experience they most wanted to change.

Injuries, too, are commonly linked with depression and other psychological problems, task force members said. They can result in the loss of one’s athletic identity, and the time spent away from the sport, the team and vigorous exercise – particularly among lengthy rehabilitations, such as from an ACL injury – often incites problems such as depression, anxiety and self-medication. 

But getting student-athletes to open up is not easy. Before many will feel comfortable speaking up about psychological problems, barriers must be broken down. Even student-athletes who want to open up may not know where to turn, and access to mental health professionals may be limited. 

Breaking barriers to mental health access was a major theme at the task force meeting. The group determined that an institution’s entire team of athletic trainers, physicians, athletics directors and coaches should address both mental and physical health issues at the beginning of the season. There should be a plan to address all injuries and illnesses that may confront a student-athlete, without the stigma commonly associated with psychological issues, and there should be a point of contact for mental health problems. Getting coaches and athletics staffers to understand that mental health problems are tied directly to poor athletic, school and social performance is integral to the task force’s mission, Hainline said.

The task force will be developing educational programs for coaches, medical providers and student-athletes via the SSI website and other means. The group is expected to reconvene annually but will continue its work through assigned working groups focused on mental health issues.

“Through the assembling of the task force members, we hope to develop concrete educational, management and research guidelines for NCAA member institutions,” Hainline said. “Mental health issues may well be the most important health concern of student-athletes.”