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

Context: Universal screening for mental health concerns, as part of the preparticipation examination in collegiate sports medicine settings, can be an important and feasible strategy for facilitating early detection of mental health disorders. Objective: To assess whether sports medicine departments at National Collegiate Athletic Association (NCAA) member colleges have policies related to identifying student-athlete mental health problems, the nature of preparticipation examination screening related to mental health, and whether other departmental or institutional screening initiatives are in place. I also aimed to characterize the variability in screening by institutional characteristics. Design: Cross-sectional study. Setting: College sports medicine departments. Patients or Other Participants: Team physicians and head athletic trainers at NCAA member colleges (n = 365, 30.3% response rate). Main Outcome Measure(s): Electronic survey of departmental mental health screening activities. Results: A total of 39% of respondents indicated that their institution had a written plan related to identifying student-athletes with mental health concerns. Fewer than half reported that their sports medicine department administers a written or verbal screening instrument for symptoms of disordered eating (44.5%), depression (32.3%), or anxiety (30.7%). The strongest predictors of mental health screening were the presence of a written plan related to identifying student-athlete mental health concerns and the employment of a clinical psychologist. Additionally, Division I institutions and institutions with a greater ratio of athletic trainers to student-athletes tended to engage in more screening. Conclusions: The substantial among-institutions variability in mental health screening suggests that opportunities exist to make these practices more widespread. To address this variability, recent NCAA mental health best-practice guidelines suggested that institutions should screen for a range of mental health disorders and risk behaviors. However, at some institutions, staffing deficits may need to be addressed to allow for implementation of screening-related activities.