Physical injuries are common among athletes, but psychological injuries are also common yet often overlooked.

Outbursts, irritability and anxiety are some of the many signs of a student-athlete who needs help. These signs may indicate a possible underlying psychological injury.

Proper preparation, management and referral may make a significant impact on a student’s life. Here are important factors to consider when working with a psychologically injured student-athlete, drawing from NATA’s Consensus Statement Guidelines. Use these guidelines to develop a plan that helps you recognize and properly refer student-athletes with psychological concerns.

Be Aware Of Stressors

As a frontline healthcare provider who interacts with student-athletes every day, you should be prepared to deal with a crisis and to be aware of stressors that are bothering the student. You should also be able to recognize when something more may be going on in a student athlete’s life.

Take the time to engage psychologically challenged athletes in a private conversation to learn more about what’s behind their reactions and about what may be bothering them. Be prepared for the response you might get. Bullying, sexual abuse, parental issues, atychiphobia (fear of failure) and burnout can all create behavioral and psychological issues for student-athletes.

Know the Referral Process

If you’re not sure about where to refer a student for help, collaborate with the school nurse, school counselor and team physician to identify a potential psychological problem. The school should also have an Emergency Action Plan in place you can refer to if you need immediate support after school when in-school support is no longer there.

Get Familiar With Signs Of Psychological Injury

Knowing signs and behaviors related to psychological injury could alert you to what’s going on in a student athlete’s life. Sometimes, it’s important to take the time to ask a student-athlete “what’s going on,” but it’s equally important to be prepared, know how to manage the situation and know which professional they should be referred to.

Some signs and behaviors of psychological injury include:

• Outbursts
• Evasiveness
• Over-the-top reactions.
• Irritability and mood swings
• Anxiety or severe nervousness
• A withdrawn demeanor
• Fatigue and constant tiredness
• Negative changes in mood and thinking
• Alcohol and substance abuse
• Eating disorders
• Bullying and hazing
• ADHD symptoms
• Concussion symptoms

Follow School Policy and Get the Right Training

Familiarize yourself with the school’s formal policy for managing students who have psychological issues. Know when it’s your duty to report your concerns when you recognize a potential issue and whether you will be liable if you don’t. Comply with state laws and adhere to secondary school district policies.

Also, make sure you receive formal training for managing those with a psychological injury. Do a practice run that allows you to be evaluated and critiqued for your ability to handle psychological injuries. Discuss any concerns with your supervisor, and make sure all conversations and training are properly documented.

Keep in mind that having the ability to recognize a psychological injury could lead to your making a huge difference in that student’s life. Work closely with the staff at your school to make sure students get the help and support they need if they are struggling with a psychological problem.