Student-athletes are often viewed as resilient by default—disciplined, high-performing, and “built for pressure.” In reality, athletics can amplify stressors that many students already carry: academic demands, identity development, social pressures, injuries, sleep disruption, and the emotional weight of performance expectations. The NCAA Sport Science Institute’s Mental Health Best Practices (Second Edition, updated 2024) reinforces a critical message: mental health is an essential dimension of overall health, and schools are expected to make mental health services and resources available to student-athletes consistent with this consensus guidance.
From a district leadership perspective, I read this document through two lenses: what it asks schools to build (systems, not slogans), and what it takes to implement those systems when staffing is tight and needs are growing. The good news is that the Best Practices are organized into four practical “building blocks” that can be scaled to fit local resources—while still meeting the expectation of access, safety, and quality.
Foundational principles: What schools should understand first
Before jumping into checklists and procedures, the document emphasizes several foundational principles that shape effective implementation:
- Mental health exists on a continuum. Student-athletes may be thriving, coping, struggling with sub-clinical symptoms (like insomnia or anxiety), or experiencing conditions that significantly impair functioning.
- Emerging adulthood is a high-risk window. Many mental health challenges first appear in late adolescence/early adulthood, even among students who have never needed support before.
- Risk and protective factors are multilevel. Individual traits matter, but so do team culture, coaching behaviors, campus climate, and broader societal influences.
- Mental and physical health are linked. Injury can increase risk for depression/anxiety, and mental health symptoms can increase injury risk and affect recovery.
- Discrimination and trauma matter. Experiences such as racism, hazing, bullying, sexual violence, and other maltreatment can significantly elevate risk and require trauma-informed responses.
- Social media is an evolving risk factor. Public scrutiny, online harassment, body image pressure, and performance commentary can be intensified for athletes.
- Collaboration and continuous improvement are essential. No single department can carry this alone; systems must be reviewed and refined over time.
These principles align with what many of us see in schools: a student-athlete may look “fine” in one setting and be unraveling in another. That’s why the Best Practices focus on creating structures that catch concerns early and route students to qualified care quickly.
Best Practice 1: Create healthy environments that support mental health
The first recommendation is proactive: schools should have a written plan for mental health promotion that is developed in collaboration with a licensed mental health care provider. Importantly, the plan should be multilevel—not just a one-time presentation or a poster campaign.
Core components include:
- A written plan co-developed and approved with a licensed mental health provider
- Programming that addresses multiple levels (individual, team, athletics department, campus, societal influences)
- Intentional attention to diversity, equity, and inclusion (DEI) as a mental health factor—not an add-on
Additional elements schools should consider include annual training and support for coaches (mental health literacy, empathic listening, trauma-informed coaching), sleep education, guidance related to social media and Name/Image/Likeness (NIL) pressures, engaging families, and supporting transitions (injury, transfer, being cut, graduation).
In practice, I encourage schools to treat this as culture work plus policy work. Culture changes when adults consistently model help-seeking as normal, respond to concerns without minimizing them, and build routines that protect sleep, recovery, and belonging.
Best Practice 2: Identify student-athletes with mental health symptoms through screening
Identification can happen anywhere—on the field, in the training room, in the classroom, or at home. But the document highlights one specific expectation: using a validated screening tool, schools should screen all student-athletes at least once annually for psychological distress.
Core components include:
- Use of validated tools (meaning there is reputable evidence the tool measures what it claims)
- Consultation with primary athletics health care providers and/or licensed mental health providers
- Screening that at minimum identifies psychological distress
- Annual screening for all student-athletes (often aligned to pre-participation exams, with optional additional screenings during high-stress periods)
One of the most important “implementation” points in the document is trust. Student-athletes should understand:
- Why screening is being done
- What happens after screening
- How privacy is protected
- That screening is not used to determine playing time, eligibility, or scholarship status
From a systems standpoint, screening without capacity is a risk. If you screen, you must be ready to respond—quickly and appropriately—when results indicate concern. This is where many schools feel the pinch of staffing shortages.
Best Practice 3: Written and rehearsed mental health action plans
The third building block is where planning becomes safety infrastructure. Schools should have written and rehearsed mental health action plans with clear pathways for both routine and emergency needs.
Core components include:
- Plans that address the full spectrum of care: identification, referral, evaluation, treatment, follow-up, and reentry when appropriate
- Defined pathways for self-referral and response timelines for screening results
- Emergency plans that address situations such as suicidal/homicidal ideation, acute psychosis/paranoia, overdose/intoxication, highly agitated behavior, and sexual assault response considerations
- Rehearsal of the plan (not just writing it and filing it away)
Additional recommendations that I find especially actionable:
- Create a brief visual summary (decision tree/flow chart) that includes 911 and 988
- Conduct annual outreach so every stakeholder knows their role
- Include post-crisis supports (for teams, staff, and the broader community)
- Build in trauma-informed practices: safety, trust, transparency, empowerment, and cultural responsiveness
- Consult disability services to consider accommodations and accessibility supports
In my experience, rehearsals are where gaps show up: unclear roles, outdated phone numbers, uncertainty about after-hours response, or confusion about when to involve campus security versus mobile crisis. Practicing the plan is how you prevent hesitation during real events.
Best Practice 4: Ensure providers are licensed and practicing within scope
The fourth best practice is a clear compliance and quality statement: formal evaluation and treatment should be performed by a licensed mental health provider acting within the scope of their licensure and ethical guidelines.
The document also notes that providers may be:
- Employed within athletics or sports medicine
- Located in student health or campus counseling
- Off-campus community providers
- Telehealth providers
This is an important point for schools facing staffing shortages: the Best Practices explicitly recognize telehealth as a viable option when delivered by appropriately licensed professionals. Access and choice matter, and schools are encouraged to consider provider diversity and cultural responsiveness so student-athletes can connect with someone who understands their lived experience.
What this means for schools right now
Whether you are a K-12 district supporting student-athletes, a charter network, or a higher education partner, the direction is consistent: build a system that promotes well-being, identifies distress early, routes students to qualified care, and responds effectively in emergencies.
If you are looking for a practical starting point, I recommend these next steps:
- Inventory what you already have (programming, staff, referral pathways, crisis response) and compare it to the four Best Practices.
- Confirm who is responsible for oversight and how licensed providers are involved in planning and decision-making.
- Adopt or refine a validated annual screening process with a clear response workflow.
- Write (or update) routine and emergency action plans and rehearse them with the adults who will implement them.
- Address access barriers—especially wait times—by expanding provider options, including telehealth where appropriate.
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