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Responding to Mental Health Emergencies in Athletics

By Monique Paris on August 27, 2020 hst Print

A recent experience as coach of our girls tennis team was one most coaches have never experienced – and hopefully will not experience.

After losing a match, one of our team’s seniors was acting strangely. Although she usually socializes with teammates during practices, this time she was sulking and sitting away from other players. The athlete’s body language was closed off and her facial expression reflected emotional distress. Although sulking, the player accepted my invitation to take a walk.

In an attempt to think what might be bothering the player, various possibilities came to mind: maybe she failed a math test, maybe she had a fight with a friend or maybe she was upset with the way she played the match.

After some discussion about her current issues, her response was something all coaches hope they never hear: “Coach, I tried killing myself last week.”

Over the course of an athletic season, there are many routines that students and coaches practice. Those include getting to know the team cheer, lineups for specific games, and even pre-game and post-game debriefing sessions.

Students also experience how caring coaches keep them safe. Players and coaches know what to do if a student suffers an injury, feel the effects of heat exhaustion, and understand the importance of reporting suspected concussions. It is in these medical routines that our athletes learn how to activate the chain of survival to keep safety a priority.

However, in this particular scenario, an immediate answer was needed to assist this individual with a mental health emergency.

Fortunately, in this case, my training in crisis prevention and intervention training (CPI) – however limited it was – and a campus administrator’s cell phone number were helpful as this incident happened well after school hours. Thankfully, I was able to navigate through this emergency successfully as the student received medical help and returned to the team.

Through this process, all of our coaches have a better under standing of how to help students who experience mental health emergencies. These types of emergencies may not be as easy to recognize as someone who faces breathing distress, heat exhaustion or a broken bone, but the social/emotional health of student-athletes is just as fundamental to the overall well-being of the student.

To prepare for these emergencies, coaches can practice four steps to address mental health to achieve positive outcomes.

1) Recognize the Student in Crisis

Being observant of a player’s performance is part of coaching high school athletics. Noticing a player limping or favoring a leg during a drill may call for stopping play and consulting an athletic trainer. It is also important to be in tune with a player’s emotional well-being as it affects his or her mental game during play and is indicative of the student’s overall mental health.

Having a positive coach-to-athlete relationship, positive team culture and open channels of communication serve as preventive strategies; however, this can be hard at the beginning of a season when coaches are still getting to know their athletes. Signs of an athlete in emotional distress may not be overt, like crying or yelling.

Some observable behaviors to look for include being withdrawn, fidgeting, lack of effort or motivation not due to fatigue, or simply just not acting themselves. Checking in with an athlete can be the first step in preventing a mental health crisis and provide coaches an opportunity to recognize students in need.

2) Listen to Athletes and Respond to Those in Need

When checking in with an athlete, it is important for coaches to remain calm and attend to the athlete’s feelings. Coaches should engage in active listening, acknowledge or validate the athlete’s emotions when appropriate, and watch for any signs of distress. If the athlete begins crying or becomes upset, let the player collect himself/herself and take a break prior to rejoining the team.

If the coach suspects a more severe mental health emergency, the athlete should not leave the school site, and he or she should not be isolated or left unsupervised until the coach can get a second opinion from school personnel. In these cases, coaches can assign an assistant coach or other adult to stay with the student to console and observe the player, and to report behavior changes as necessary. Above all, coaches must ensure the safety of the student, and the student should not be left alone.

It is also critical that coaches have open dialogue with the athletic director and school counseling staff. Not only does this serve as a resource for coaches, but allows the school support system to enable mental health-care options that are not always available to athletic coaches.

3) Working with School Administration to Determine Immediate Intervention if Necessary

It is also during this time that coaches can work with the athletic director and school administration to determine if the mental health emergency requires immediate medical attention. In some cases, state and district mandates may have additional requirements.

For instance, some students who face mental health emergencies may need to be first assessed by medical personnel before parents are notified. This may seem counter to every other medical emergency a student faces; however, if the source of the distress is the parent/guardian of the student, some states and districts may have medical personnel intervene for the safety of the student.

In those cases of mental health situations that are deemed non-emergency, it may be required to contact parents and for school administration to notify teachers, which will allow all stakeholders to observe and be responsive to student needs so that the situation does not evolve into something more dangerous. Regardless of the type of incident, it is important to make sure that school administration is aware of the incident so that they can support the student in being safe.

4) Implement a Plan to Follow Up and Return to Play

Physical injuries require rest and a plan to phase-in an athlete’s prior level of athletic performance and intensity of training. When an athlete has suffered an emotional stressor or mental health emergency, it is important for coaches to follow similar restorative practices. Coaches can collaborate with school personnel, such as an administrator, athletic director, school counselor or school psychologist, to develop a return-to-play plan.

A return-to-play plan can include safety protocols to follow if the athlete exhibits another mental health emergency; check-ins with the coach; modified team duties or obligations, playing time or positions; and structured time off from and during practices.

Additionally, coaches should abide by professional mental health recommendations that are shared by school personnel. The return-to-play plan should be followed and modified as needed, and coaches need to maintain open channels of communication with the athlete, his or her family, and corresponding school personnel as appropriate.

Even under the best of circumstances, mental health crises and emergencies sometimes still happen. When a player endures a mental health emergency, any coach – on-campus or off-campus – may not be equipped with a socioemotional “chain of survival” or know a given school protocol for a mental health emergency; however, a simple protocol for athletic departments to implement, such as the aforementioned four steps, can be critical to help those athletes in crisis.