This document contains questions and answers to assist the NCAA membership in its understanding and implementation of the NCAA Mental Health Best Practices: Understanding and Supporting Student-Athlete Mental Health, second edition. Additional questions may be sent to ssi@ncaa.org. 

Question No. 1: What is the purpose of the Mental Health Best Practices?

Answer:  The Mental Health Best Practices provide Association-wide guidance and recommendations for schools to support student-athlete mental health. The Mental Health Best Practices are not intended as a substitute for the independent clinical and/or medical judgment and care provided by health care professionals to individual student-athletes.

Question No. 2: How were the Mental Health Best Practices developed?

Answer: The Mental Health Best Practices were developed by the Committee for Competitive Safeguards and Medical Aspects of Sports, as informed by expert- and consensus-based recommendations from its Mental Health Advisory Group. The Mental Health Advisory Group consists of over 30 representatives from scientific, medical, sports medicine organizations and all divisions of the NCAA membership. 

The Mental Health Best Practices is an inter-association consensus document that was first published in 2016 (updated in 2017 and 2020) following the convening of the NCAA Mental Health Task Force. After the 2020 Diverse Student-Athlete Mental Health and Well-Being Summit, the Committee for Competitive Safeguards and Medical Aspects of Sports determined the need to further update the Mental Health Best Practices. To accomplish this, the Committee for Competitive Safeguards and Medical Aspects of Sports created the Mental Health Advisory Group in 2021. 

Question No. 3: How is the second edition different from the first edition of the Mental Health Best Practices?

Answer:

The four best practices remain substantively the same. However, the document has been restructured to emphasize that establishing an environment that promotes mental health is a foundational step to supporting student-athlete mental health and well-being. The restructuring also reflects the way the care system often applies on campus. The document now contains: 

1. Foundational Principles: Foundational principles provide further education on risk and protective factors related to student-athlete mental health and a lens through which each best practice can be operationalized by member schools. The foundational principles consider the role of coaches and other stakeholders, the impact of maltreatment/discrimination/trauma, social media, the importance of collaboration and the importance of continuous improvement processes.
2. Best Practices (core components and additional elements): As with the first edition, the updated document contains four best practices. Each best practice contains “core components” that should be incorporated into each school’s approach to supporting student-athlete mental health and well-being, as well as “additional elements to consider” that may also be of benefit for school to consider in their approach.
3. Checklist. An updated checklist that clearly identifies each best practice, core component and additional element for consideration. 
4. Resources. Resources with supplemental information and implementation strategies for the Mental Health Best Practices are available on a webpage, so the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports can regularly consider new resources and update as appropriate.

	Highlights from Second Edition	First Edition
Foundational Principles	The foundational principles consider the role of coaches and other stakeholders, the impact of maltreatment/discrimination/trauma, social media, the importance of collaboration and the importance of continuous improvement processes.	N/A
Best Practice 1:  Promoting Healthy Environments	Core components include development of a multi-level (SEM) mental health promotion plan that is created in collaboration with a licensed provider and responsive to diversity, equity and inclusion; Emphasizes the role of coaches in creating a culture that fosters wellness and normalizes health care seeking- including considerations for support and training; Acknowledges the importance of trauma-informed approaches to interacting with student athletes.  Additional considerations include name, image and likeness, engagement with families and prospective student-athletes, supporting student-athletes experiencing a transition in and/or out of sport and continuous improvement efforts (monitoring and responding to dynamic multilevel risk and protective factors).	Best Practice 4
Best Practice 2:  Identification & Screening	Core components include screening for psychological distress at least once annually using a validated screening tool. Screening may occur at any point in the academic year with consideration for screening at multiple points including high stress times; Screening should be done in collaboration with a licensed mental health provider.   Additional considerations include screening that addresses social determinants of health, building trust with student athletes, training in mental health literacy and provides strategy considerations for continuous improvement efforts.	Best Practice 3
Best Practice 3:  Action Plans	Core components include the rehearsal of written routine and emergency action plans; acknowledges the need to address the full spectrum of care in plans; simplifies language of recommended components to include in emergency and routine action plans.  Additional considerations include regular outreach about action plans; developing a trauma-informed approach; creating a post-crisis plan; providing strategy considerations for institutions to develop a continuous improvement framework that regularly reviews the plans and incorporates SA feedback and other performance indicators.	Best Practice 2
Best Practice 4:  Provider Licensure	Core components include ensuring providers who oversee and manage student-athlete mental health, including the formal evaluation and treatment of student-athletes with mental health signs, symptoms and conditions, have a license to provide mental health care.   Additional considerations include developing a diverse and inclusive staff; discussing with student-athletes their preferences and needs; and soliciting feedback from student-athletes to continuously improve care strategies and efforts.	Best Practice 1
Additional Resources	Includes a list of resources to support planning and implementation of each best practice including the SAMHSA Treatment Improvement Protocol: Trauma-Informed Care in Behavioral Health Services, Sport Mental Health Assessment Tool – 1, Sport Mental Health Recognition Tool – 1 and Navigating a Mental Health Crisis, among others.	N/A

Question No. 4: Are schools required to follow the Mental Health Best Practices?

Answer: Association-wide legislation requires all schools to provide mental health services and resources consistent with the Mental Health Best Practices. 

Question No. 5: How can a school ensure it is meeting the legislated requirement to provide mental health services and resources consistent with the Mental Health Best Practices?

Answer: As schools vary in size, geographic location and local resources, member schools have flexibility to determine how each best practice may be best implemented on their campus. The Mental Health Best Practices includes a checklist which clearly identifies the core components of each best practices. The core components of each best practice have been identified by the NCAA Committee for Competitive Safeguards and Medical Aspects of Sports as the most necessary to providing services and resources consistent the Mental Health Best Practices. In addition to the core components, the Mental Health Best Practices include foundational principles that provide important contextual considerations for all of the best practices. Additional elements of consideration are also noted in each best practice and provide additional options to be considered by each school. 

Question No. 6: What resources are available to help implement the Mental Health Best Practices?

Answer: The following resources are available: 

1. Mental Health Best Practices Checklist: The Mental Health Best Practices include a checklist that identifies each best practice, core component and additional element for consideration.
2. Mental Health Best Practices Resources: A webpage that includes resources, supplemental information and potential strategies to assist schools in implementing the Mental Health Best Practices. The list of resources is intended to evolve over time, as the Committee on Competitive Safeguards and Medical Aspects of Sports will regularly consider review and update as appropriate.
3. Additional Resources: The NCAA Sport Science Institute mental health website contains additional educational materials, including mental health fact sheets, videos, learning modules and more. 

Additionally, a variety of educational opportunities specific to the second edition will be made available to the membership, which may include additional SSI Spotlight sessions, learning modules and other materials. Specific questions can be submitted to ssi@ncaa.org. 

Question No. 7: When are the Mental Health Best Practices effective?

Answer: The Mental Health Best Practices are effective August 1, 2024. The first edition of the Mental Health Best Practices remains effective until then.