Mental Health Best Practices

Mental health is a vital part of overall health. As such, the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports developed the Mental Health Best Practices: Understanding and Supporting Student-Athlete Mental Health. The Mental Health Best Practices provide evidence- and consensus-based recommendations to member schools for supporting and promoting student-athlete mental health.

The NCAA Constitution requires all athletics programs to be conducted in a manner designed to protect, support and enhance the mental and physical health of student-athletes. Additionally, NCAA legislation requires all schools to make mental health services and resources available to student-athletes consistent with the Mental Health Best Practices.

A summary of the mental health best practices is below.

1. Create Healthy Environments That Support Mental Health and Promote Well-Being

Schools should have a written plan related to mental health promotion efforts that is responsive to risk and protective factors at multiple levels, including individual, team, athletics department, campus and societal factors. This plan should be developed in collaboration with a licensed mental health care provider. Diversity, equity and inclusion are important influences on mental health and well-being that should be addressed in this plan.

Create Healthy Environment Resources:

Mental Health First Aid: The National Council for Mental Wellbeing offers Mental Health First Aid training as an option to teach ways to assist and support others who may be experiencing a mental health or substance use challenge.
U.S. Surgeon General's Advisory on Social Media and Youth Mental Health: This advisory was developed by the U.S. Department of Health and Human Services and the Office of the U.S. Surgeon General to describe the impacts of social media on children and adolescents, as well as outlines steps to mitigate risk of harm.
American Psychological Association Health Advisory on Social Media Use in Adolescents: In this document, psychological scientists examine the potential beneficial and harmful effects of social media use in adolescents.
Can the Metaverse Be Good for Youth Mental Health?: This resource was developed by the JED Foundation to discuss youth-centered strategies for ensuring and enhancing the mental health and safety of young people in the metaverse.
Sleep and Wellness for Collegiate Athletes: This document provides recommendations that were a product of the NCAA's Interassociation Task Force on Sleep and Wellness.

2. Procedures for Identification of Student-Athletes with Mental Health Symptoms and Disorders, Including Mental Health Screening Tools

Identification of student-athletes with mental health symptoms and disorders may occur in multiple settings; however, screening for mental health symptoms and disorders is one important way to identify student-athletes who may benefit from further support. Using a validated screening tool, all student-athletes should be screened for psychological distress at least once annually. Screening tools should be used in consultation with the primary athletics health care provider and/or licensed mental health provider.

Procedures for Identification of Student-Athletes with Mental Health Symptoms and Disorders Resources:

Sport Mental Health Assessment Tool – 1: This tool was developed by the International Olympic Committee Mental Health Working Group. It is a standardized assessment tool aimed at identifying elite athletes at risk of or already experiencing mental health symptoms and disorders.
Sport Mental Health Recognition Tool - 1: This tool was developed by the International Olympic Committee Mental Health Working Group. It is a tool that can be used by athletes, family members, coaches and non-clinical staff to recognize, but not diagnose, mental health concerns.

3. Mental Health Action Plans that Outline Referral Pathways of Student-Athletes to Qualified Providers

All member schools should have written and rehearsed mental health action plans with well-defined pathways to mental health care, addressing both routine and emergency mental health care needs. While mental health action plans will look different across schools as a result of differences in organizational structures and in campus and community resources for mental health care, all mental health action plans should address the full spectrum of care from identification of student-athletes with mental health symptoms and disorders to ongoing treatment, follow-up and reentry when indicated.

Mental Health Action Plan Resources:

Navigating a Mental Health Crisis: This resource was developed by the National Alliance on Mental Illness to outline warning signs of and strategies for managing and deescalating a mental health crisis.
988 Suicide & Crisis Lifeline: The 988 Lifeline provides free and confidential support for people in distress 24/7, as well as prevention and crisis resources.
Suicide Hotline for LGBTQ Youth: This hotline, provided by The Trevor Project, is available 24/7 to connect youth to counselors that understand LGBTQ young people.
Teen and Young Adult HelpLine: This HelpLine is provided by the National Alliance on Mental Illness and offers a nationwide teen peer-support service for teens and young adults with mental health conditions and/or experiencing a difficult time in their life.

4. Licensure of Providers Who Oversee and Manage Student-Athlete Mental Health Care

Formal evaluation and treatment of student-athletes with mental health symptoms and disorders should be performed by a licensed mental health provider acting within the scope of activities covered by their clinical licensure. The licensed provider who is qualified to provide mental health services may be employed by the athletics department, sports medicine department or by an administrative unit outside of athletics such as student health services or campus counseling. The provider may also be a local, off-campus provider or telehealth provider.

Licensure of Providers Resources:

The NCAA Mental Health Advisory Group consensus-based recommendations note that mental health care for athletes, which includes formal evaluation and treatment, should be performed by a licensed mental health care provider within the scope of activities covered by their clinical licensure. This may include:

Clinical or counseling psychologists.
Licensed clinical social workers.
Licensed mental health counselors.
Licensed family therapists/licensed marriage and family therapists.
Physicians with mental health training, including psychiatrists and primary care physicians.
Nurse practitioners with mental health training, including psychiatric and primary care nurse practitioners.
Physician assistants/physician associates with mental health training, including PAs with a Psychiatry Certificate of Added Qualification (CAQ) or primary care PAs.

Resources for consideration in support of Mental Health Best Practices Foundational Principles:

NCAA Diversity Equity and Inclusion Review Framework: This document was created by the NCAA Office of Inclusion at the request of the NCAA membership and provides a sample framework that shares a suggested structure and questions to ask in a thorough, collaborative and proactive diversity, equity and inclusion review process.
SAMHSA Treatment Improvement Protocol: Trauma-Informed Care in Behavioral Health Services: This document was developed by the Substance Abuse and Mental Health Services Administration within the U.S. Department of Health and Human Services to provide topic-specific guidance related to trauma-informed approaches to care.
NCAA Sexual Violence Prevention Toolkit: This toolkit can provide member schools and athletics departments with collaborative strategies to support safer campus environments.
NCAA Substance Abuse and Prevention and Intervention: An Athletics Toolkit: This toolkit is designed to help support athletics administrators, in partnership with campus colleagues, reduce substance misuse and promote a positive environment for college athletes.