The role of certified athletic trainers in the recognition and referral of mental health issues in intercollegiate student-athletes.

Abstract

Currently, limited statistics are available regarding the incidence, recognition and treatment of psychiatric conditions in college student-athletes (Glick & Horsfall, 2001). A University of Minnesota study (Mattern & Ware, 2007) indicated that 25.1% of college students had been diagnosed with a mental health condition in their lifetime; therefore, it is probable that student-athletes are experiencing these conditions at similar rates. Certified athletic trainers may be in the best position to notice when student-athletes are experiencing psychological problems (Ray & Wiese-Bjornstal, 1999). The purpose of this study was to interview 18 certified athletic trainers regarding their role in the recognition and referral of mental health issues in intercollegiate student-athletes. Semi-structured interviews in an interpretivist phenomenology were conducted. Questions were posed regarding the recognition and referral of mental health issues in student-athletes and the educational and experiential backgrounds that prepared certified athletic trainers to recognize, intervene and refer mental health issues in student-athletes. The recognition and referral process was impacted by both positive and negative aspects which either improved or hindered recognition and referral. Positive factors were concepts such as performance declines, the advantage of personal experiences, knowledge of comorbid conditions, convenience of Division I resources, cost and convenience of campus counseling centers, confidentiality and coaches' influence. Negative factors which hindered recognition and referral were lack of confidence in recognition and referral, detrimental coaches' influence, Division III resources, campus counseling location, confidentiality and emotional impact. Certified athletic trainers interviewed saw a variety of mental health issues in their student-athletes ranging from anxiety and depression to substance abuse and disordered eating. Referrals were made to many different medical professionals ranging from team physicians and neuropsychologists to emergency room physicians. Certified athletic trainers felt their educational background did very little to prepare them to recognize and refer mental health issues in their student-athletes, however practical experiences assisted them in gaining this knowledge. Curricular and practical implications such as implementation of additional coursework into existing athletic training curricula and incorporation of mental health protocols into athletic training room policies was also reviewed.