Variability in Institutional Screening Practices Related to
Collegiate Student-Athlete Mental Health

E. J Athl Train. 2016;51(5): ahead of print

Take Home Message: Only
39% of respondents indicated that they had a written mental health screening
plan. There is a wide variability between mental health screening practices
among NCAA institutions.

athlete’s psychological response to injury or performance pressure may
precipitate or exacerbate mental health vulnerabilities. The preparticipation
examination (PPE) is an important opportunity to recognize health conditions,
such as mental heath concerns, prior to the sport season. Unfortunately, we
have no information about whether collegiate institutions are engaging in
mental health screening or how they vary between institutions. Therefore, the
author distributed a survey to 1076 NCAA supervising sport medicine clinicians
to assess whether NCAA sports medicine departments have policies to identify
student-athletes with mental health concerns and how these were instituted. A total
of 365 clinicians (307 head athletic trainers, 54 physicians, 4 did not report
credentials) completed a survey with 4 parts: sports medicine department
policy, preparticipation screening, screening initiatives, and institutional
characteristics. Only 39% of institutions had a written plan for identifying
student-athletes with mental health concerns. Almost one-third of respondents
(32%) failed to screen for any of the 6 mental health concerns (eating
disorder, depression, anxiety, alcohol abuse, prescription drug abuse, illegal
drug abuse). Only 20% of the respondents screened for all 6 mental heath
concerns. Many of the respondents indicated that the PPE screened for history
of diagnosis for eating disorders (85%), depression (79%), and anxiety (76%). However,
less reported using specific screening instruments for symptoms of eating
disorders (45%), depression (32%), anxiety (31%), alcohol abuse (57%),
prescription drug abuse (52%), and illegal drug abuse (47%). A higher
proportion of Division I institutions screened for eating disorders,
depression, anxiety, and illegal drug abuse compared to Divisions II and III

athletes for mental health issues could help limit their health burden, and
negative effects on athletic performance. It was alarming to note that 32% of
respondents failed to assess any of the 6 primary mental health concerns. The
NATA PPE position statement
contains 8 questions that broadly assess psychosocial functioning; however, the
reliability and validity of these questions for screening for mental health
concerns needs to be evaluated. Only 39% of the sports medicine professional
respondents noted that they have a written plan for identifying student-athletes
with mental health concerns. Division I institutions were more than twice as
likely to have a policy than other institutions. This study is important since
it highlights the need for more mental health screens among collegiate
institutions, which could help improve health outcomes, understand athletes
coping strategies, and enable referral of athletes for appropriate care. Screening
for mental health vulnerabilities during the PPE seems like a viable
opportunity to screen athletes for mental health concerns. Future research
needs to be established in validating a screening
instrument for use during the PPE,
or we need to consult more frequently with  medical professionals who are skilled and
trained to use currently established mental screening tools (e.g., sport

Questions for Discussion:
Do you screen for mental health? Do you think screening for mental health
problems could improve health outcomes or coping strategies for patients later?

Jane McDevitt, PhD
by: Jeff Driban


Kroshus E (2016). Variability in Institutional Screening Practices Related to Collegiate Student-Athlete Mental Health. Journal of Athletic Training PMID: 27111587