DOI: 10.1097/jsm.0000000000001185 ISSN:

Screening and Referral for Behavioral Health Symptoms in Collegiate Athletes

Tyler Thompson, Sebastian Kaplan, Rachel Conway, Christopher Miles
  • Physical Therapy, Sports Therapy and Rehabilitation
  • Orthopedics and Sports Medicine


We aim to investigate the prevalence of behavioral health symptoms in collegiate athletes and the frequency of referrals prompted by a preparticipation behavioral health screener.


Athletes completed a screening battery to detect behavioral health symptoms and sports psychology clinicians designed criteria for intervention based on the severity of symptoms reported. Data from the screener was retrospectively de-identified and analyzed.


National Collegiate Athletic Association Division-I university.


All athletes on active rosters were required to complete the screener as a component of the preparticipation examination.


Sports psychology clinicians created a protocol for intervention based on the number and severity of symptoms reported on the screener.

Main Outcome Measures:

Communication with athletes and referrals made to behavioral health services.


Of the 1126 surveys completed, 39% had behavioral health symptoms necessitating behavioral health referral. Twelve percent required a safety check-in, given the severity of their symptoms. Seven percent of the respondents were newly established with behavioral health services.


Symptoms of behavioral health disorders are common among athletes and yet, for a myriad of reasons, many choose to forgo treatment. By implementing a behavioral health screening battery, the prevalence of behavioral health symptoms among athletes at our institution was elucidated and many athletes were newly established with behavioral health services. The tiered intervention protocol in this study allowed for appropriate assessment and triage of high-risk individuals, while simultaneously providing lower-risk individuals with appropriate resources. Surveillance for behavioral health symptoms among college athletes using a screening battery with a tiered intervention protocol can ensure at-risk athletes are identified, contacted, and referred to behavioral health services, potentially improving their athletic performance and overall well-being, while averting poor outcomes.

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