Athletic trainers should be on the lookout for mental health problems among student-athletes, a panel said on Wednesday.

Representatives from the National Athletic Trainers’ Association, the American Academy of Pediatrics and other organizations said athletic trainers are in a unique position to reach out to college athletes and refer them to counseling.

“As an athletic trainer, we’re usually right there with the student-athletes during some of their worst moments,” Timothy Neal, chair of the task force and assistant director of athletics for sports medicine at Syracuse University in New York, said. “You have their trust.”

About 30 percent of college-aged people reported having some type of mental illness during 2010 and 2011, according to the Substance Abuse and Mental Health Services Administration.

Neal said he has seen everything from athletes with anxiety and eating disorders to those who are suicidal. Some students come to him for help, but in other cases he reaches out when it seems like something’s not quite right.

“What I look for is someone who is acting opposite of as you know them - someone who’s more irritable than they normally would be, someone who’s more withdrawn than they normally would be,” Neal told Reuters Health.

When that’s the case, athletic trainers should approach students and offer to refer them for counseling services at the school or in the community. It helps to already have a relationship with those services, Neal said, and to talk with mental health counselors about the particular stressors facing student-athletes.

Athletic trainers should also be prepared to make an emergency referral if student-athletes are a threat to themselves or others, the task force noted. Trainers should follow the protocol of their institution and call law enforcement if the person is violent.

Neal said he talks with student-athletes at the beginning of every season about the importance of psychological health to try to reduce the stigma associated with having a mental health problem.

It can be especially difficult to convince athletes that it’s okay to have a mental illness, Dr. Thomas L. Schwenk, dean of the University of Nevada School of Medicine in Reno, who has studied mental illness among athletes, said.

“With special populations, especially populations of people who are particularly goal-oriented, particularly high achievers, particularly focused, there still is a sense of stigmatization, a sense of shame,” Schwenk, who was not part of the task force, told Reuters Health.

“We still have to work really hard with special populations like student-athletes to help them understand that they get sick just like everybody else, they have mental health problems just like everybody else.”

A particular time to be aware of psychological issues is when athletes get injured and have to take time out from their sport, according to the task force’s recommendations, published in the Journal of Athletic Training.

“Many athletes especially at a collegiate level identify themselves as a person as an athlete,” Neal said. So when they get hurt, they may start losing that identity and feel isolated.

Schwenk said underlying mental illnesses such as depression also occur among athletes. Symptoms don’t have to stem from athletic-related stress, he pointed out.

He said one strategy for reaching out to athletes is to frame mental healthcare as a way to improve their performance in their sport.

“An athlete may not be too enthused,” Schwenk said, “until you say, ‘This is the way you can be better.’”

SOURCE: Journal of Athletic Training, online September 25, 2013.

###

Inter-Association Recommendations for Developing a
Plan to Recognize and Refer Student-Athletes With
Psychological Concerns at the Collegiate Level: An
Executive Summary of a Consensus Statement
Timothy L. Neal, MS, ATC (Chair)*; Alex B. Diamond, DO, MPH

Scott Goldman, PhD,
David Klossner, PhD, LAT, ATC,
Eric D. Morse, MD, DFAPA,
DavidE.Pajak,MBA,DRM,ARM*;MargotPutukian,MD,FACSM; Eric F.
Quandt, JD; John P. Sullivan, PsyD**; Cory Wallack, PhD*; Victor Welzant,PsyD