











































MANUSCRIPT TYPE


QUALITY IMPROVEMENT (PDSA CYCLE) REPORT 

 

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                              Volume 1 – Issue 1 – June 2018 
 

Implementing a Behavior Health Policy in the Secondary School  
Jamie Nikander, DAT, LAT, ATC1; Lindsey E. Eberman, PhD, LAT, ATC2 

1West Olympia Sports Medicine, Olympia, WA; 2Indiana State University, Terre Haute, IN 

 
ABSTRACT 

Site-specific policies and procedures outlining the available 
services and emergency action plan (EAP) is vital to any 
athletic training clinic. The purpose of the following document 
is to provide athletic trainers with a framework for the 
development and successful implementation of evidence-
based policies and procedures to improve athletic training 
services at secondary schools. Using a behavioral health 
policy as an example, the challenges and barriers to the 
development and implementation of new policies at a 
secondary school will be discussed. Policy development was 
largely influenced by each of the individual stakeholders 
involved in the approval process including school 
administration, school nurses and counselors, as well as 
community organizations. As in any setting, challenges to 
implementation of the behavioral health policy in these 
schools did occur. Each secondary school or school district will 
have a different model for medical services that will 
inherently change the policy at each location. Athletic trainers 
must know the resources available to them on and off-
campus, and develop policies and procedures dependent on 
these resources. For clinicians in any athletic training setting, 
it is important to review your current policy and procedure 
manual to determine where improvements can be made. 
These documents help ensure patients are being provided the 
best possible care and help protect athletic trainers legally.  
 
Key Phrases 
Policy and Procedure Development, Professional Standards, 
Secondary Schools Patient Population 
 
Correspondence 
Dr. Jamie Nikander, West Olympia Sports Medicine, 1620 
Cooper Point Rd SW, Olympia, WA 98502. 
E-mail: Jamie.nikander@providence.org 
Twitter: @jnikanderATC 
 
Full Citation 
Nikander J, Eberman LE. Implementing a behavior health 
policy in the secondary school. Clin Pract Athl Train. 
2018;1(1):21-29. 
https://doi.org/10.31622/2018/0001.5 
 
Submitted: May 8, 2018 Accepted: May 29, 2018 
 
 
 
 
 
 
 

 

 

CURRENT MODEL 

In 2011, The Commission on Accreditation of 
Athletic Training Education (CAATE) published the 
5th edition of the competencies required to be 
taught and evaluated in entry-level athletic 
training education.1 “Psychosocial Strategies and 
Referrals”1 remains to be a stand-alone 
competency vital to the minimum education for 
athletic trainers.1 Identification, referral, and 
support for patients with behavioral health 
conditions will also be included in the updated 
competencies that will apply in 2020 as minimum 
athletic training education advances to a Master’s 
degree.2 Athletic trainers must have the ability to 
recognize when a patient is experiencing a social, 
emotional, or psychological concern.1,3 In addition 
to simple recognition, the Role Delineation Study,4 
which guides practicing athletic trainers4, states 
that athletic trainers must understand the steps for 
intervention which includes emergency 
management, emergency action planning, and 
appropriate referrals. Although athletic trainers 
may currently be familiar with the impact of injury 
on mental health as it relates to athletic identity 
and participation, it may be even more important 
to understand underlying behavioral health 
conditions and when life events that are related, 
or unrelated, to athletic participation may trigger 
a more serious psychological concern.3 
 
In the college and university setting, athletic 
trainers have resources from both the National 
Athletic Trainers Association (NATA), the National 
Collegiate Athletics Association (NCAA), and each 
individual institution regarding psychological 
concerns in this population. However, for athletic 
trainers in the secondary school setting, there may 
be limited resources. As most colleges and 
universities have student health centers and 
psychological services available for referral on 
campus, secondary school athletic trainers may be 
in a unique setting to require community resources 
and outside relationships to assist in management 
and referral of these patient cases. Athletic 
trainers in the secondary school setting need to 
have an understanding of the common conditions 

https://doi.org/10.31622/2018/0001.5


Implementing a Behavior Health Policy in the Secondary School 
 

 

22 
Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                              Volume 1 – Issue 1 – June 2018  

experienced by their patient population, and 
have site-specific policies and procedures 
reflective of best practices. 
 
Site-specific policies and procedures outlining the 
available services and emergency action plans 
(EAP) is vital to any athletic training clinic to 
minimize organization and personal risk.4 The first 
step for athletic trainers is to establish the need 
for site-specific policies and prioritize the 
development of these policies based on patient 
needs. In review of the current policies and 
procedures manual at the target high school, there 
was a clear need for several new or updated 
policies. Within the needs assessment, we noted 
that a behavioral health policy was not currently 
included in the policy and procedure manual. As 
athletic trainers are bound by the practices set 
forth in position and consensus statements 
provided by the NATA, it was clear that our clinic 
could be legally vulnerable in a legal setting 
without procedures guiding the management of 
psychological concerns. Of the identified needs, 
the behavioral health policy then became our first 
priority. The purpose of the following document is 
to provide athletic trainers with a framework for 
the development and successful implementation of 
evidence-based policies and procedures to 
improve athletic training services at secondary 
schools. Using the process of developing a 
behavioral health policy for three high schools 
within a rural school system in Indiana as an 
example, the challenges and barriers to the 
implementation of new policies at a secondary 
school will be discussed. 
 
PDSA CYCLE 

Plan - Researching the topic for your chosen 
policy and procedure is important for the 
drafting of the document, as well as the 
advocacy and education that may be required 
for staff and stakeholders to buy-in to 
implementation. For the behavioral health policy, 
research was focused on epidemiology of mental 
health concerns in adolescents5,6, 
recommendations for best practices3,7, athletic 
trainers practice analysis4, and what athletic 
trainers already know about identifying 
psychosocial concerns.8 In the research phase, we 
also chose to reach out to school counselors as a 
key resource in the development of the policy. 
The school counselors provided us with specific 

contact information for community behavioral 
health resources, contact information for 
appropriate school administration as well as 
current policies for management of behavioral 
health concerns during school hours. During school 
hours, teachers and other school personnel had 
direct access to guidance counselors as well as 
an established emergency response team. 
Although these individuals were not on campus 
during most athletic practices and events, it 
served as a framework for the hierarchy of 
communication within the school administration 
that we needed to implement when an incident 
did occur. After discussion with guidance 
counselors, we were also able to establish the 
best mechanism for follow-up of non-emergent 
concerns that could be addressed during the 
following school day, which was an important 
portion of our final document. 

Table 1. Timeline for Implementation of 
Behavior Health Policy. 
Draft document  January 12  
Review draft with supervisor  January 20 
Schedule meeting with 
outreach coordinator 

January 31 

Develop educational 
materials 

February 15 

Schedule meeting with school 
counselors 

February 20 

Schedule meeting with school 
nurse 

February 25 

Schedule meeting with school 
administration  

February 28 

Edit document with 
stakeholder feedback  

March 1 

Submit for final approval  March 15 
Disperse to each secondary 
school  

March 20 

Discuss policy with staff and 
students 

March 25  

 
It is also important to consider each of the 
individual players that might be involved in the 
approval process of a new policy. Stakeholder 
buy-in is a common challenge encountered when 
attempting to implement change in any setting. 
The timeline for implementation included 
individual meetings with each stakeholder that 
would be impacted or included in the policy. 
Developing education materials such as handouts 
and Microsoft PowerPoint® presentation may be 



Implementing a Behavior Health Policy in the Secondary School 
 

 

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                              Volume 1 – Issue 1 – June 2018  

an effective way to communicate the importance 
of the change you are intending to implement at 
each of these stakeholder meeting. The individual 
meetings and discussions that were included in 
the process of implementing a behavioral health 
policy were integral to the successful approval 
by the school board (Table 1). 
 
Do - The behavioral health policy was 
developed for a hospital-based athletic training 
outreach program that provided services to three 
area secondary schools. The purpose of the 
policy was to outline the referral and 
management processes for psychological 
concerns. The policies were highly reflective of 
the suggestions from the NATA Interassociation 
Recommendations for Developing a Plan to 
Recognize and Refer Student-Athletes with 
Psychological Concerns at the Secondary School 
Level: A Consensus Statement.3 Table 2 outlines 
the sections that were present in our policy and 
procedure document that were developed based 
on best-practice guidelines. 
 
Table 2. Sections of Behavioral Health Policy 
& Procedure Document. 
Policy                     Brief statement of guiding 

principles 
 

Recognition           Depression, anxiety 
disorders, substance and 
alcohol abuse, ADHD, eating 
disorders/disordered eating, 
bullying, and hazing  
 

Procedures             Emergency referral, non-
emergent referral, bullying, 
suspected child abuse, 
documentation  
 

Contacts School administration, school 
counselors and nurses, 
community emergency rooms, 
community behavioral health 
centers 

 
When developing the document, keep the 
audience, most likely highly influential 
stakeholders, in mind. The final policy and   
Procedure (Appendix A), whereby the 
introduction included information to establish the 
need for the patient population as well as the 

policy. Especially for a topic such a psychosocial 
concerns, it was important to educate 
stakeholders on what the impact of these 
conditions are in secondary school settings, as 
well as the educational background and role that 
athletic trainers are prepared to play when such 
situations arise.4  
 
When drafting a document, it is also important to 
remember that a policy is very different from 
procedures, and they should be easily identified 
as separate components of a document. A policy 
should be a short 2-3 sentence summary of the 
overall expectations or principles for the policy. 
A procedure on the other hand, are typically 
long, very descriptive, step-by-step instructions 
on how to achieve the policy.9 The following is an 
example of the behavioral health policy 
developed for these schools: 
 
The athletic trainer is responsible for the recognition 
and referral of psychological concerns in student-
athletes. The athletic training staff will differentiate 
between emergent and non-emergent concerns and 
refer to the school administration and appropriate 
medical professionals in all cases. The athletic 
training staff will report any concerns to the high 
school administration and parents/guardian for 
further case management. 
 
Study - As in any setting, challenges to 
implementation of a new policy in the secondary 
school setting did occur. For this particular model 
of outreach athletic training services, a 
policy/procedure had to be developed that was 
broad enough to cover 3 different athletic 
training facilities. This document did not include 
any site-specific contact information or 
emergency action plan details. This model would 
then allow for the approval of an overarching 
behavioral health policy that would then require 
each individual clinic to develop an amendment 
to this document that included site-specific 
contact information and locations. The biggest 
challenge was the lack of accountability for 
individual clinics to develop site-specific policies 
and procedures. The response to a behavioral 
health incident may not be as effective without 
the requirement of this amendment from each 
individual clinic. 

Another unexpected barrier was the 
inconsistency of hours that school nurses spent on-



Implementing a Behavior Health Policy in the Secondary School 
 

 

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                              Volume 1 – Issue 1 – June 2018  

campus. The school district has a pool of school 
nurses that provide services during limited hours 
at several different locations depending on 
weekly needs. During initial drafting of this 
document, school nurses played important roles 
as potential healthcare providers to assist in 
response and follow-up care for emergency 
cases such as self-harm or physical violence 
towards others. However, after meeting with 
several stakeholders, we decided to edit the 
document to reflect minimal requirements of 
school nurses to respond or be involved in these 
patient cases. Although the model for secondary 
school services will be different at each site, it is 
important for athletic trainers to know the 
resources available to them on-campus and 
within the community, and develop policies and 
procedures dependent on these resources.  
 
An additional barrier during implementation was 
the sharing of medical information related to a 
patient. The Health Insurance Portability and 
Accountability Act (HIPAA) and the Family 
Education Rights and Privacy Act (FERPA) place 
strict and important guidelines for the protection 
of personal health information of minors.10 In the 
development of the behavioral health 
procedures, school counselors were a required 
call after an emergent situation, as well as a 
resource for athletic trainers in non-emergent 
cases. Upon review of the confidentiality waiver 
located in athlete’s pre-participation evaluation, 
it appeared that school counselors were not 
specifically listed as individuals in which health 
information may be shared. To avoid any 
potential legal complications for sharing medical 
or personal information between athletic trainers 
and school counselors, the form was modified to 
specifically list school guidance counselors. This 
will hopefully ensure that each patient and 
parent will be agreeing to the collaboration of 
these individuals in patient care. 
 
Act - For clinicians in any athletic training setting, 
it is important to review your current policy and 
procedure manual to determine where 
improvements can be made. Policy and 
procedure manuals are meant to guide clinical 
practice at your site, and include details about 
any services you may provide. These documents 
help ensure your patients are being provided the 
best possible care, but they also help protect you 
legally. Although the current project remains in 

the “study” phase, the information gathered will 
need to be used to enhance and continually 
evolve this policy. School administrators and 
athletic trainers should conduct an end-of-year 
review to discuss modifications and improvements 
to the policy. The efficiency of emergency 
response, timeliness of communications and 
referrals, as well as patient outcomes may be 
areas worth evaluating. 

CLINICAL BOTTOM LINE 

The first step to in improving your policies is to 
establish the need. This step may include 
researching NATA position and consensus 
statements to evaluate how your current practices 
compare to best practice guidelines. During 
development of policies and procedures, it is 
important to meet and discuss procedures with 
each stakeholder who may be involved and 
impacted after implementation. After approval 
from the needed stakeholders, it is also 
important to remember that the process is not yet 
complete. Staff education and evaluation of 
policy and procedure implementation success is a 
continuous process. Although barriers will 
undoubtedly arise during the development and 
implementation process, improving policies and 
procedure manuals for athletic training services 
in the secondary school setting is possible with a 
clear plan and the inclusion of stakeholders 
throughout the process to improve buy-in. 

REFERENCES 

1. National Athletic Trainers Association. The 
Athletic Trainer Educational Competencies. 5th 
Edition. The Comission on Accredidation of 
Athletic Training Education, Austin TX. 2011. 
Accessed January 2017. 

2. CAATE 2020 Standards for Accreditation of 
Professional Athletic Training Programs. 
Comission on Accreditation of Athletic 
Training Education Website. 
https://caate.net/new-standards-release-
for-professional-masters-level-athletic-
training-programs/. Accessed May 2018. 

3. Neal TL, Diamond AB, Goldman S, et al. 
Interassociation recommendations for 
developing a plan to recognize and refer 
student-athletes with psychological concerns 
at the secondary school level: A consensus 
statement. J Athl Train. 2015;50(3):231-249. 



Implementing a Behavior Health Policy in the Secondary School 
 

 

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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
All rights reserved. ISSN Online 2577-8188                                                                              Volume 1 – Issue 1 – June 2018  

https://doi.org/10.4085/1062-6050-
50.3.03 

4. Henderson, J. The 2015 Athletic Trainer 
Practice Analysis Study. Omaha, NE: Board of 
Certification; 2015. Accessed January 2017. 

5. Mental Health Information. National Institute 
of Mental Health Website. 
www.nimh.nih.gov/health/topics/index.shtml. 
Accessed January 2017.  

6. Substance Abuse and Mental Health Services 
Administration, Results from the 2013 
National Survey on Drug Use and Health: 
Mental Health Findings. NSDUH Series H-49, 
HHSPublication No. (SMA) 14-4887. 

7. Rockville, MD: Substance Abuse and Mental 
Health Services Administration, 2014.  

8. Bonci CM, Bonci LJ, Granger LR, et al. 
National athletic trainers' association position 
statement: Preventing, detecting, and 
managing disordered eating in athletes. J 
Athl Train. 2008;43(1):80-108. 
https://doi.org/10.4085/1062-6050-
43.1.80 

9. Cormier ML, Zizzi SJ. Athletic trainers' skills in 
identifying and managing athletes 
experiencing psychological distress. J Athl 
Train. 2015;50(12):1267-1276. 
https://doi.org/10.4085/1062-6050-
50.12.02 

10. Ray R, Konin JG. Management Strategies in 
Athletic Training. 4th Edition. Champaign, IL: 
Human Kinetics; 2011. 

11. Department of Education. Joint Guidance on 
the Application of the Family Educational 
Rights and Privacy Act (FERPA) and the Health 
Insurance Portability Act of 1996 (HIPAA) To 
Student Health Records. 2008. 
https://www2.ed.gov/policy/gen/guid/fpc
o/doc/ferpa-hipaa-guidance.pdf. Accessed 
January 2017. 

 
 
 
 
 
 
 
 
 
 
 
 
 

 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

https://doi.org/10.4085/1062-6050-50.3.03
https://doi.org/10.4085/1062-6050-50.3.03
https://doi.org/10.4085/1062-6050-43.1.80
https://doi.org/10.4085/1062-6050-43.1.80
https://doi.org/10.4085/1062-6050-50.12.02
https://doi.org/10.4085/1062-6050-50.12.02


Implementing a Behavior Health Policy in the Secondary School 
 

 

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All rights reserved. ISSN Online 2577-8188                                                                              Volume 1 – Issue 1 – June 2018  

 
 

 
 

APPENDIX A -  PSYCHOLOGICAL CONCERN: RECOGNITION AND REFERRAL POLICY 

INTRODUCTION 

The rate of mental disorders in youth is high, with approximately 1 in every 4-5 meeting the criteria.1 
Athletic trainers in the secondary school setting may play a vital role in identifying and referring patients 
with psychological concerns. Adolescent athletes are exposed to the same stressors that place them at-risk 
for new or worsening mental disorders as other adolescents; however, performance expectations, time-loss, 
career ending injuries, team conflict, and other sports-related pressure may cause additional strain.1 
Although approaching patients regarding mental health may be uncomfortable or new for athletic trainers, 
we may have unique relationships with our patients that allow them to confide, seek help, or speak openly 
in our presence. The secondary school athletic trainer must be prepared to recognize, respond, refer and 
advocate for a patient’s mental health appropriately. 

This policy was developed for a hospital-based athletic training outreach program with the purpose of 
outlining the referral and management process of psychological concerns. The policies outlined below were 
highly reflective of the suggestions from the National Athletic Trainers’ Association (NATA) Interassociation 
Recommendations for Developing a Plan to Recognize and Refer Student-Athletes with Psychological Concerns 
at the Secondary School Level: A Consensus Statement, 1 and athletic trainers should familiarize themselves 
with this resource. This consensus statement, as well as an NATA position statement regarding mental health, 
can be found on the NATA website. 

POLICY 

The athletic trainer is responsible for the recognition and referral of psychological concerns in student-
athletes. The athletic training staff will differentiate between emergent and non-emergent concerns and 
refer to the school administration and appropriate medical professionals in all cases. The athletic training 
staff will report any concerns to the high school administration and parents/guardian for further case 
management. 

Recognition 

Distinguishing an emergent versus a non-emergent case is crucial in the management of psychological 
concerns in athletes and is outlined in the consensus statement as well as later in this policy. As athletic 
trainers we interact with our patients often daily, and build close relationships. Triggering events in life or 
sport can cause the worsening or development of a psychological concern. It is important for athletic 
trainers to be empathetic and recognize when these triggering events may have occurred to better monitor 
the patient’s status. Triggering events specific to athletes may be overtraining, termination of sport 
participation, inability to manage sport, academic, and personal expectations, injury, as well as any 
changes in home or social environments. Athletic trainers may see these events begin to affect motivation, 
pain levels, injury occurrence, attention, mood, or behavior. Although there does not always need to be a 
specific triggering event prior to development or worsening of a mental disorder, athletic trainers need to 
recognize these changes as they are some of the primary signs of mental disorders. The primary mental 
disorders discussed in the NATA consensus statement include: 

• Depression 
• Anxiety Disorders 
• Substance and Alcohol Abuse 
• ADHD 
• Eating Disorders 



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Copyright © by Indiana State University                                                                                Clinical Practice in Athletic Training  
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• Bullying and Hazing.  

Athletic trainers should read this consensus statement and understand the signs and symptoms of each. 
Detailing each disorder is beyond the scope of this policy, but athletic trainers should attest to having read 
and understood this document, as well as the consensus statement, prior to patient contact. 

Suicide 

Any student-athlete who has expressed intent, indicated a plan, or has attempted or discussed attempted 
suicide, should be treated as an emergency referral. Athletic trainers should not engage in an attempt to 
determine the seriousness of the expressed thoughts. Stay with the patient, listen, and make an immediate 
referral. 

• If an attempt is in progress: Call EMS. 
• If an attempt has not already begun: Call the school counselor and/or school administrator. 

Parent/guardian will also be notified immediately. If these individuals are not available to 
respond, call the “insert community resource name.” 

PROCEDURES 

As stated in NATA Interassociation Recommendations for Developing a Plan to Recognize and Refer Student-
Athletes with Psychological Concerns at the Secondary School Level: A Consensus Statement, a “Yes” to ANY 
of the following questions should constitute an emergency: 

o Am I concerned the student-athlete may harm himself/herself? 
o Am I concerned the student-athlete may harm others? 
o Am I concerned the student-athlete is being harmed by someone else? 
o Did the student-athlete make verbal or physical threats? 
o Is the student-athlete exhibiting unusual ideation or thought disturbance that may or may 

not be due to substance use? 
o Does the student-athlete have access to a weapon? 
o Is there potential for danger or harm in the future? 

Any threat or perceived suicide attempt, changes in mental status or destructive behaviors constitutes an 
emergency under any circumstances and EMS should be activated. 

In the case of a “yes,” school administration (principal/athletic director and school counselor) should be 
immediately notified. If administration is currently not on-site, they should still be notified about the incident 
as soon as reasonably possible. If possible, one athletic trainer will continue to monitor and manage the 
patient, while another athletic trainers call administration, parents, and/or referral. If a second athletic 
trainer is not available, a school administrator can be used to contact parents. The responding school 
administrator will also be responsible for activating EMS if needed. 

If possible, the athletic trainer should always defer the incident to a school counselor, administrator, or the 
school nurse or health assistant. As a school nurse is not always on campus, athletic trainers should report to 
the guidance counselor first. Once a non-emergent situation is deferred to a school administrator, the 
athletic trainer can be relieved of immediate responsibility and return to other duties. 

Bullying: The school corporation has a no-tolerance policy for bullying of any kind. Bullying can include 
physical, sexual, or emotional abuse. If the athletic trainer witnesses or suspects bullying, this includes 
hearing student-athletes discussing previous events, they are to report to the school administration or school 
guidance counselors immediately. The athletic trainer will intervene in the case of active bullying. 

Child Abuse: SUSPICION alone mandates and justifies action by a healthcare provider. Athletic trainers will 
make a direct report to Department of Children’s services or a law enforcement agency. However, athletic 



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trainers will report that a call was made to appropriate school administrators and the sports medicine 
director. 

• Child Protective Services: 1-800-800-5556 

Emergent Referral Process  

Listed below are the options for referral or resources in the case of an emergency. 

1. List local behavioral health organizations & contact information 
2. List local emergency rooms & contact information 
3. National Suicide Prevention Lifeline: 1-800-273-TALK (8255) 
4. Child abuse/neglect hotline: 1-800-800-5556 

Non-Emergent Referral Process 

Student-athletes must be referred to the school counselor prior to non-emergent referral to the local 
behavioral health clinic. Our school corporation has a working relationship with this clinic and the proper 
forms required for referral are available from a school guidance counselor and attached to this document. 

Notify parents, school administration, and counselors. 

Documentation 

After any of the above incidents, multiple levels of documentation are required within 48 hours of the 
incident. 

1. “Incident Report” form- This form is available from the athletic office. Upon completion, follow 
instructions on the form to distribute to the Athletic Director or appropriate administrator. 

a. This form can be saved on the computer, but needs to be password protected. 
2. Sportsware (Medical Records System)-Document this incident in the “Notes” tab under the 

“athletes” tab. No specific injury needs to be created unless relevant. This documentation needs to 
at least include: 

a. Date 
b. Time 
c. Observations 
d. Summary of patient encounter 
e. Who was contacted and when 
f. Referral 
g. Plan of care/follow-up. 

3. Following a mental health referral, a note from the treating healthcare provider should be 
obtained prior to return to activity. 

Legal Considerations 

In the case of self-harm, or harm to others, patients and parents should be aware that patient and 
personal information will be shared among appropriate personnel.  This is addressed in the medical 
release form of the pre-participation physical packet. 

Contact Information 

Each individual school should compile a contact list and working relationships with the following personnel 
to effectively execute these policies and procedures: 

• Principal 



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• Assistant Principal 
• Athletic Directors 
• Assistant Athletic Directors 
• School Nurse/Nurses and health assistants 
• School Counselors 
• Local behavioral health centers and hospitals. 

SOURCES OF ADDITIONAL INFORMATION 

• Emergency Action Plan Guidelines: Mental Health Emergency Secondary School Athletes 
https://www.nata.org/sites/default/files/mental_health_eap_guidelines.pdf 

• Interassociation Recommendations for Developing a Plan to Recognize and Refer Student Athletes 
with Psychological Concerns at the Secondary School Level: A Consensus Statement 

• Indiana State Suicide Prevention Plan: http://www.in.gov/issp/files/plan.pdf 
• Indiana State Statutes: https://www.childwelfare.gov/topics/systemwide/laws-

policies/state/?CWIGFunctionsaction=statestatutes:main.getResults 
• Suicide prevention organizations in Indiana (contacts) http://www.in.gov/isdh/25392.htm 

REFERENCE 

1. Neal TL, Diamond AB, Goldman S, et al. Interassociation recommendations for developing a plan 
to recognize and refer student-athletes with psychological concerns at the secondary school level: 
A consensus statement. J Athl Train. 2015;50(3):231-249.

 

https://www.nata.org/sites/default/files/mental_health_eap_guidelines.pdf
http://www.in.gov/issp/files/plan.pdf
https://www.childwelfare.gov/topics/systemwide/laws-policies/state/?CWIGFunctionsaction=statestatutes:main.getResults
https://www.childwelfare.gov/topics/systemwide/laws-policies/state/?CWIGFunctionsaction=statestatutes:main.getResults
http://www.in.gov/isdh/25392.htm

