Consensus recommendations to inform an update of the NCAA Mental Health Best Practices

We sought to generate consensus-based recommendations to inform updates to the National Collegiate Athletic Association (NCAA) Mental Health Best Practices. A two-phase modified Delphi consensus process was used to identify foundational premises and actionable recommendations for NCAA member schools. Participants were members of the NCAA's Mental Health Advisory Group (n=31), including student-athletes, representatives from leading national organisations involved in college student or athlete mental health and higher education, and licensed mental health providers who work with student-athletes. The consensus process produced 11 foundational premises and 36 recommendation statements that were considered useful and feasible for NCAA member schools. Foundational premises addressed multiple levels of risk factors that may adversely impact student-athlete mental health. Recommendations for member schools were broadly grouped into (1) creating healthy environments that support mental health and promote well-being; (2) developing procedures for identifying student-athletes with mental health symptoms and disorders, including the use of validated mental health screening tools; (3) establishing mental health action plans that outline referral pathways of student-athletes to licensed mental health providers; and (4) ensuring licensure of providers who oversee and manage student-athlete mental healthcare. These premises and recommendations provide guidance for understanding and supporting student-athlete mental health needs.