Recognizing and Referring Athletes with Psychological Concerns

Most weeks when writing this blog I usually focus on providing you information on how to recognize signs and symptoms of potentially dangerous injuries and illnesses.  I’ve also advocated for having emergency action plans in place and an athletic trainer on site at all times.  When thinking sport safety I think we can all get a little caught up in the physical injury and illness side of things, but this week is a reminder that we need to be on the lookout for signs of mental health concerns as well.

Back in September the National Athletic Trainers’ Association published an executive summary for a coming inter-association taskforce position statement titled, “Inter-Association Recommendations for Developing a Plan to Recognize and Refer Student-Athletes with Psychological Concerns at the Collegiate Level.”  The primary goal of the statement is to help colleges develop an evidence-based action plan for recognizing, referring and managing student-athletes who may be suffering from mental illness.    According to statistics published in the statement 1 in 4-5 youths meet the criteria for a mental health disorder and experience a severe level of impairment across a lifetime.  Based on a 2012 study, 45.9 million adults 18 years or older experienced mental illness during 2010.  Of those 46 million, the 18 – 25 year olds comprised 29.9% of the total group experiencing mental illness.  Mental health issues are a growing concern, but especially in the 18-25 year old age group. 

Athletic trainers are taught to recognize and refer athletes who they believe may be suffering from mental health issues, however overall care for the athlete must be a team effort.  Colleges need to have an action plan for how mental health issues will be addressed and it should involve the team physician, athletic trainer, and university and community counseling services.  If you have a child in college and playing sports do you know what the action plan is should they need care regarding a mental health issue?    Did their pre-participation physical examination questionnaire include questions about their mental health history?  Do you what types of physical conditions can predispose someone to mental health issues? 

The executive summary provided by the NATA provides some of the basic answers to the questions I have posed and the full position statement will be published for public viewing shortly.  I recommend that you take a look at the statement and do the work to become aware of the resources available to your college-aged children (whether they’re athletes or not).  It’s always better to be prepared and know what to do before mental health referral is needed than to scramble for answers once you realize there is a concern.  As always, be prepared and plan ahead for the best results.

Moving forward, based on feedback from readers I am happy to discuss/review specific mental health concerns.  To suggest a topic you would like me to blog about you can send an email to Heather Clemons or tweet me @AlfredSB10.

Submitted by Heather L. Clemons, MS, MBA, ATC

Mental Health Resources for Children and Adolscents

In light of the tragic events in Newtown, Connecticut at Sandy Hook Elementary School the topics of gun control and appropriate mental health care for our nation’s young people is again at the forefront.  As the debate continues following the events in Newtown there will be many discussions about gun control legislation as well as the current mental health system in the United States.  This blog entry is not a commentary on how to prevent other tragedies through various political and social actions.  My intention is to shed some light on who to connect with and how to access resources around mental health issues for parents who have questions.  Addressing one's mental health should be as important as addressing physical ailments, but because of the stigma connected with mental health conditions this aspect of overall wellness is often overlooked. 

MENTAL HEALTH CONDITIONS:

Children and adolescents can suffer from a variety of mental health issues, just as adults.  The list of mental health concerns includes depression, anxiety disorders, personality disorders, autism, eating disorders, ADHD, and post traumatic stress disorder (PTSD), among others.  Discussing each of these disorders is beyond the scope of this post, but I will provide a few recent statistics made available by the National Institute of Mental Health (NIMH).  Further description of each condition can be found by searching the condition name on the American Psychiatric Association or American Psychological Association websites.

• The lifetime prevalence for depression in 13 – 18 year old children is 11.2%, with 3.3% of this same group having a severe depressive disorder.

• Attention Deficit-Hyperactivity Disorder (ADHD) has a lifetime prevalence of 9% in 13 – 18 year old children. 

• Anxiety disorder is the general description that includes the specific diagnosis of general anxiety disorder (GAD), obsessive-compulsive disorder, panic disorder, PTSD, and phobias.  GAD has a lifetime prevalence of 1% in 13 – 18 year old children according to the NIMH. 

MENTAL HEALTH PROVIDERS:

When seeking mental health care one of the first questions often asked is, who should I see?.  Speaking with your family physician or pediatrician is often a great place to start when looking for recommendations in your local community.  It is also helpful to understand the major types of professionals available.  You will find a brief summary of psychiatrists, psychologists and clinical social workers.  You may also have the option of counselors and marriage and family therapists depending on your specific need.

  

Psychiatrists

Psychiatrists are medical doctors (MD, DO) who graduated from a medical school and further specialized in the area of psychiatry.  This means that following medical school they complete a four-year residency in the area of psychiatry.  Some choose to specialize even further and obtain additional training.  Some specialization areas include child and adolescent, geriatric, and addition psychiatry among others.

They specialize in the diagnosis, treatment, and prevention of mental illnesses.  Psychiatrists treat both the physical and mental aspects of mental illness.  Their treatment options can range from psychotherapy (talk therapy), medications, and other treatment options.  For further information visit the American Psychiatric Association website.

Psychologists

Psychologists with a doctoral degree (PhD, PsyD, EdD), have at least seven years of education and training beyond their undergraduate education.  Psychologists have dozens of career options in research, teaching or clinical practice.  Specialties can include educational, industrial or clinical psychology among others.

The psychologists we most often think of who provide talk therapy treatment are clinical psychologists.  These psychologists have a doctoral degree and must me licensed in the state in which they work.  They typically provide treatment for people who need help coping with life issues and mental issues using a variety of theories and techniques based on the patient’s values.  Many of them are also qualified to administer and interpret a variety of tests and assessments.  Unlike psychiatrists, psychologists cannot prescribe medications.  For further information visit the American Psychological Association (APA) website.  Other associations you may wish to investigate include the Society of Clinical Psychology, Division 12 and Society of Counseling Psychology, Division 17.

Social Workers

Social workers can earn degrees at bachelors (BSW), masters (MSW) and doctorate (DSW, PhD) level, each with their own particular knowledge and competencies.  A licensed clinical social worker (LCSW) typically has two years of graduate school and internship (supervised field instruction) in the area of psychotherapy.  Other specialty areas where you will find social workers include adolescent health, aging, violence, and children, youth and family among others.

Clinical social workers provide psychotherapy (talk therapy) to patients who need help coping with life issues and mental health issues.  This is much in the same way as a psychologist.  For more information about clinical social workers and the other specialties in social work visit the National Association  of Social Workers (NASW).

To find out more information about counselors visit the American Counseling Association website.

MENTAL HEALTH RESOURCES:

Specific to Sandy Hook

Tips for talking to children about the shooting

Tips for talking to children about the shooting from APA

Tips for restoring a sense of safety after the shooting

Grief/loss resources from NASW

General Resources

Mental Health Resources from American Psychiatric Association

Mental Health Resources from American Psychological Association

National Institute of Mental Health (NIMH) child and adolescent mental health

National Alliance on Mental Illness (NAMI) Internet resource list

Submitted by Heather L. Clemons, MS, MBA, ATC