Kansas Athletics Mental Health Policy

Procedures for the Identification and Referral of Student-Athletes for Mental Health Services

I. Purpose
“Inter-Association Consensus Document: Best Practices for Understanding and Supporting Student-Athlete Mental Wellness” (“Best Practices”) is a practical extension of the NCAA publication “Mind, Body and Sport: Understanding and Supporting Student-Athlete Mental Wellness” http://www.ncaa.org/sport-science-institute/introduction-mind-body-and-sport.

These “Best Practices” are designed to provide athletics and sports medicine departments with recommendations for supporting and promoting student-athlete mental health. Kansas Athletics (KAI) has adopted these best practices to ensure that appropriate resources are provided to meet student-athletes’ mental health wellness needs.

II. Background
Mental and physical health are inextricably linked. For example, evidence suggests an elevated risk of injury among athletes who experience anxiety or depression, who abuse alcohol, or who have an eating disorder. Furthermore, the athlete’s psychological response to injury has the potential to exacerbate existing vulnerabilities to depression or anxiety, substance abuse, or disordered eating behaviors. Insomnia and sleep disorders can be an indicator or risk factor for mental health challenges, and can compromise academic and athletic performance through direct or indirect pathways. Mental health is a key component of student-athlete wellness, and the athletics department can play a pivotal role in providing an environment that supports wellness while also providing resources so that student-athletes can obtain referrals to mental health services.

KAI in collaboration with The University of Kansas Health Systems (UKHS) or Kansas Team Health shall work with qualified mental health practitioners to ensure that student-athletes perform at their highest levels, both academically and athletically. This must be a collaborative effort between student-athletes KUHS primary athletics health-care providers: Head Team Physician (HTP), Physician Assistant (PA), Certified Athletic Trainers (ATC), Student-Athlete Wellness Coordinator (WC), and Qualified mental health practitioners. (See Best Practices)

III. Best Practices
A. Collaboration. Collaboration between the student-athlete primary health care providers (Head Team Physician (HTP), Physician Assistant (PA), and certified athletic trainers (ATC) and the KAI Student-Athlete Wellness Coordinator (WC) as well as licensed mental health care practitioners is crucial to ensuring that the student-athletes at the University of Kansas receive the best possible care. “Such integration links professionals in a collaborative model of care that can enhance the ability of individual service providers and maximize support of student-athlete wellness.” (Best Practices).

B. Licensure. KAI shall only refer student-athletes to mental health providers who are qualified to provide mental health services (e.g. psychiatrists, clinical or counseling psychologists, licensed clinical social workers, psychiatric mental health nurses, licensed mental health counselors, board certified primary care physicians with core competencies to treat mental health disorders).

C. Professional Ethics. Individuals providing mental health care to KAI student-athletes shall have autonomous authority consistent with their professional licensure and ethical standards to make mental health management decisions for the student-athlete.

IV. Identification, Evaluation, and Referral for Mental Health Services
All new and returning student-athletes shall complete annually a mental health questionnaire as part of the pre-participation exam (PPE) to help assist the HTP during PPE evaluation. This form will consist of questions as designated indicators of mental health issues as suggested by the NCAA. Upon review of the questionnaire, the HTP, in collaboration with the WC, will recommend student-athlete meet individually with WC to determine if additional services might be recommended.

For referrals to qualified mental health providers, a student-athlete may choose to self-refer or consult with a member of their primary care health team (ATC, PA, WC, HTP).

For non-immediate referrals, (non-life-threatening), referrals that involve medical necessity (eating disorder, e.g.) or KAI follow-up (drug testing, code of conduct violations) – the primary care provider (ATC, PA, or HTP) shall recommend consultation with WC to help facilitate referral process.

For student-athlete’s mental health services to be covered through athletic department, the student-athlete must notify a member of their primary care athletics team (ATC, PA, WC, HTP).

For immediate referrals (including life threatening situations), the ATC, PA, WC, or the HTP will utilize campus and community resources as needed. These include, but are not limited to: Lawrence Memorial Hospital, Watkins Student Health Clinic, or KU Public Safety. Examples of immediate referrals could include: suicidal/homicidal ideation, harm to others, sexual assault, highly agitated or threatening behavior, acute psychosis or paranoia, acute delirium/confusion state, or acute intoxication or drug overdose.

KAI Coaching staff, KAI academic staff, Sports Medicine staff shall receive educational information on: mental health disorders, ways to support individuals who are facing mental health wellness challenges, as well as appropriate procedure to refer student-athletes to their primary care athletics team (ATC, PA, WC, HTP)

A. The KAI Mental Health Emergency Action Management Plan (MHEAMP) shall be provided to all stakeholders and health providers who work with student-athletes, clearly specifying each stakeholder’s role in managing a crisis situation and the referral process for student-athletes for mental health care.

V. Mental Health Emergency Action and Management Plan
(Note: for life-threatening mental health emergencies, dial 911)

A. The following procedures are developed for management of emergency mental health situations. Each stakeholder is expected to respond appropriately during a crisis situation. If the situation occurs locally, the HTP will coordinate the response process, to include (as appropriate) emergency room transport, parental notification, involuntary retention, contacting a trained counselor, etc. If the situation occurs while the student-athlete is traveling with a KAI team, the Head Coach or designee will be the responsible party to ensure both immediate medical services (as appropriate) and the notification of the HTP for additional response protocol.

Situation/symptom/behaviors considered mental health emergenciesResponsible stakeholder(s) designated to collaborate/manage situation
Suicidal or homicidal ideation911, HTP, PA, WC
Sexual Assault*HTP, PA, WC, KU CARE Coordinator
Highly agitated or threatening behavior, acute psychosisHTP, PA, WC (may necessitate 911)
Acute delirium/confusion stateHTP, PA, WC
Acute intoxication or drug overdose911, HTP, PA, WC
*in addition, always follow KAI/KU reporting procedures in cases of sexual assault


B. Depending on the situation, circumstance, and location of the mental health emergency, a non-health professional may be the first responder. The potential role of each stakeholder as an initial responder to an emergency mental health situation is described below.

KAI Staff PositionRole of Stakeholder
Athletic CoachNotify HTP
Team Trainer (ATC)Perform triage, notify HTP, potentially transport to ER
Sport Performance CoachNotify HTP
Academic CounselorNotify HTP
Sport AdministratorNotify HTP and AD
Head Team Physician (HTP)Perform triage, potentially transport to ER, notify parents, determine “need to know” staff list, consider contacting outside licensed practitioner
Physician Assistant (PA)Perform triage, notify and collaborate with HTP, potentially transport to ER
SA Wellness Coordinator (WC)Perform triage, notify and collaborate with HTP, potentially transport to ER


C. Once the situation has transformed to a non-emergency status, the WC will schedule a debriefing for all KAI stakeholders involved in the resolution of the emergency. This meeting will include a critique of the process, a discussion of any preventative measures that may have been in place, and the determination of appropriate resources and follow-up care to the student-athlete who experienced the mental health emergency.

D. The list of licensed practitioners qualified to provide mental health services to student athletes is available through the Student-Athlete Wellness Coordinator.

VI. Routine (non-emergency) Mental Health Referral Plan
A. All stakeholders within athletics who work with student-athletes should be aware of these procedures regarding the referral of student-athletes with non-emergency mental health concerns. The point person within Kansas Athletics who is responsible for facilitating such referrals is the Student-Athlete Wellness Coordinator (WC).

B. The WC will establish ongoing dialogue with campus and off-campus community resources that could potentially be involved in caring for a student-athlete who is experiencing a mental health challenge and consider consulting with them during the protocol development process. This protocol will be used to determine what resources will be made available to the student-athlete (academic, counseling, campus security/accommodations, etc.) as well as the plan for engaging in/returning to athletic-related activities.

C. The HTP, working in collaboration with the WC and any licensed practitioner will be transparent with the student-athlete and parent(s) (if release is signed for parent) about the content of the protocol and the circumstances under which they could be invoked.

D. Principles of confidentiality shall be clearly established and communicated to all stakeholders. Some student-athletes may find that a limited level of communication with coaches about their mental health care is appropriate. KAI has an informed consent process that identifies the construct of care and includes a release of information in order to allow a clinician to confirm athlete participation in counseling.