Kimberly Quinn, MSW, LCSW, LCADC, ICADC February 25, 2013

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1 , MSW, LCSW, LCADC, ICADC February 25, 2013

o Increase awareness of behavioral health risk factors specific to student athletes o Have a greater understanding of your unique opportunity

2 o Increase awareness of behavioral health risk factors specific to student athletes o Have a greater understanding of your unique opportunity to recognize, refer and influence health decisions of athletes o Review options to create, collaborate on, and modify student wellness policies

4 o 1 in 4 adults 18 and older have a diagnosable mental D/O annually 13 o MH leading cause of disability in US 13 o 2 million (8.2%) youths age had MDE in past yr 20 o 3.1 million (12.7%) youths aged received tx/counseling past yr 20 o 47.3% of youth received tx for depression in

Depression Precipitants: overtraining, injury, competitive failure, aging, end of competitive career, psychosocial stressors 19 Higher risk: female, freshman, pain 19 Eating Disorders Division I-A

5 Depression Precipitants: overtraining, injury, competitive failure, aging, end of competitive career, psychosocial stressors 19 Higher risk: female, freshman, pain 19 Eating Disorders Division I-A college athletes: 58% (F), 38% (M) at risk of diagnosable eating d/o 7 9% (F), 1% (M) needed treatment for eating d/o 7 Sports: long distance runners, gymnastics, figure skating, rowers, wrestling 19

6 o 3 rd leading cause of death in adolescents/young adults 11 o Among yr olds 12.9% of all deaths are a result of suicide 11 o 7-10% of college students attempt or contemplate suicide in a given yr 12 o Men: completion rates are 6xs their female counterparts 11

7 Rank Order: Most to least Football Basketball Swimming Track and field Baseball Risk factors Substance abuse End of competitive career Eating disorder Anabolic steroid use Family history of suicide Homosexuality & sexual abuse (includes sexual abuse by (all bullets:19) coaches)

8 Psychosocial Health Academic problems Relationship problems Conduct problems: criminal behavior, legal Performance Health Physiological perspective: decreased performance not eating, sleeping, tired, and fatigue Emotional/Cognitive: low mood, decreased motivation, poor concentration, negative thinking Effect on injuries: depression can precede an injury or injury can (all bullets: 12) increase risk

9 Males In-season alcohol use 42%, off season 60% 9 Drinking night: Saturday 25 Performance enhancing drugs, nutritional supplements, chew 25 Social drug use 2x: methamphetamines 25 Hockey: 2x higher binge drinking and marijuana use 5 Team Leaders higher level of binge drinking 5 Females In season alcohol use 26%, off season 41% 9 Drinking night: Tuesday 2 Performance enhancing drugs and nutritional supplements 25 Social drug use 4x: hallucinogens 25 Soccer: 48% more binge drinking, 72% marijuana use, 2.5x more use of other illicit drugs 5

Risky Behavior and the Student Athlete Extreme styles of alcohol consumption Binge drink at higher rates Driving under the influence Greater

10 Risky Behavior and the Student Athlete Extreme styles of alcohol consumption Binge drink at higher rates Driving under the influence Greater number of sexual partners Less contraceptive use Increased involvement in physical fights Increased involvement (all bullets:3) in sexual crime

11 Body Alcohol 24 hours prior to athletic activity alters aerobic performance by 11.4% Impairs essential psychomotor skills Decreases overall performance In cases of extreme weather, alcohol impairs the body temperature regulation system Injury Drinker vs nondrinker: (1x) 54.8% vs 23.5% Upper respiratory tract infections greater among male runners who consume alcohol Alcohol: significant factor in spinal cord injuries for recreational (all bullets:15) water sports

12 Athlete 10-15% experience psychological issues warrant counseling 23 Over 5 year period 7% of athletes came for services 18 Athletes referred to services 10% more often 18 Non Athlete 8-9% campus wide student average who warrant counseling 23 Over 5 year period: 8.5% non athletes came for services 18 Non athletes returned for services 3x more 18

13 Obstacles Denial: individual, team, coach Team culture: does the group value or prohibit seeking assistance? Stereotypes macho male, all-american woman, reinforce denial Counter-dependence on other departmental services more accepted (all bullets:18)

15 o You and coaches have the biggest impact on student-athletes o You are there for early morning work outs, long bus rides, despair of the season/career ending injury o You help rehab the athlete physically, you have the power to be part of the mental rehab o You are in a position to spot vulnerabilities o You make recommendations to coach o Athletes respect your advice and expertise o You have the ability to talk to the athletes and de-stigmatize mental health

16 o What did you think your role was prior to coming to this presentation? o Protocol for Student-Athletes in Crisis? (age will have an impact) Examples: a.) Suicidal Athlete b.) Homicidal Athlete o Policy at your institution? (responsibility will vary based on policy)

17 ocontact person for behavioral health concerns? Examples: a.) Team physician b.) Chief Athletic Trainer c.) Director of Counseling/Guidance Counselor oresources ofollow-up

18 Our Protocol Chief Athletic Trainer Coordinator of Alcohol Drug Assistance Services Clinician

20 Adult Mobile Crisis / Screening Centers State of New Jersey Department of Human Services Division of Mental Health Services, County Lists ters/ Children s Mobile Response (24hrs/7days week) (Access number for all of NJ including Essex County) NJ Children s System of Care Website

1.) Appaneal, R.N., Levine, B.R., Perna, F.M., & Roh, J.L. (2009): Measuring Post injury Depression Among Male and Female Competitive Athletes, Journal of Sport & Exercise Psychology, 31, 60-76 2.

21 1.) Appaneal, R.N., Levine, B.R., Perna, F.M., & Roh, J.L. (2009): Measuring Post injury Depression Among Male and Female Competitive Athletes, Journal of Sport & Exercise Psychology, 31, ) Bonci, C. M., Bonci, L.J., Granger, L.R., Johnson, C.L., Malina, R.M., Milne, L.W., Ryan, R.R., & Vanderbunt, E.M. (2008): National Athletic Trainers Association Position Statement: Preventing, Detecting, and Managing Disordered Eating in Athletes, Journal of Athletic Training, 43(1): ) Brenner, J. & Swanik, K. (2007): High-Risk Drinking Characteristics in Collegiate Athletes, Journal of American College Health, 56:3, ) Ford, J.A. (2008): Nonmedical Prescription Drug Use Among College Students: A Comparison Between Athletes and Nonathletes, Journal of American College Health, 57:2, ) Ford, J.A. (2007): Substance Use Among College Athletes: A Comparison Based on Sport/Team Affiliation, Journal of American College Health, 55:6, ) Fullerton, C.M.: Stress and Anxiety in Athletics, United States Sports Academy America s Sports University, The Sports Digest- ISSN: ) Geisner, I.M., Geisner, J.G., Tollison, S., & Larimer, M. E. (2012): Differences between Athletes and Non-Athletes in Risk and Health Behaviors in Graduating High School Seniors, Journal of Child & Adolescent Substance Abuse, 21:2, ) Grossbard, J., Hummer, J., LaBrie, J., Pederson, E. & Neighbors, C. (2009): Is Substance Use a Team Sport? Attraction to Team, Perceived Norms, and Alcohol and Marijuana Use Among Male and Female Intercollegiate Athletes, Journal of Applied Sports Psychology, 21:3, ) Higher Education Center for Alcohol and Other Drug Abuse and Violence Prevention (2008) Info Facts Resources, College Athletes and Alcohol and Other Drug Use ) Leichlter, J.S., Meilman, P.W., Presley, C.A., & Cashin, J.R. (1998): Alcohol Use and Related Consequences Among Students With Varying Levels of Involvement in College Athletics, Journal of American College Health, 46:6, ) Miller, K., & Hoffman, J. (2009): Mental Well-Being and Sport-Related Identifies in College Students, Sociology of Sport Journal, 26, ) National Collegiate Athletic Association (2012): National Study of Substance Use Trends NCAA College Student-Athletes,

22 13.) National Institute of Mental Health, Science Writing, Press and Dissemination Branch 14.) Nelson, T.F., & Wechsler, H. (2000): Alcohol and College Athletes, Official Journal of the American College of Sports Medicine, ) O Brien, C.P., and Lyons, F. (2000): Alcohol and the Athlete, SportsMed, 5/29 (5): ) Padina, R.J., Johnson, V.L., Lagos, L.M., & White, H.R.(2005): Substance Use Among High School Athletes, Journal of Applied School Psychology, 21:2, ) Page, R.M., & Roland, M.(2004): Misperceptions of the Prevalence of Marijuana Use Among College Students: Athletes and Non-Athletes, Journal of Child & Adolescent Substance Abuse, 14:1, ) Pinkerton, R.S., Hinz, L.D., & Barrow, J.C. (1989): The College Student-Athlete: Psychological Considerations and Interventions, Journal of American College Health, 37:5, ) Reardon, C.L., & Factor, R.M. (2012): Sport Psychiatry A Systematic Review of Diagnosis and Medical Treatment of Mental Illness in Athletes, Sports Med, 40(11) ) Substance Abuse and Mental Health Services Administration, Result from the 2011 National Survey on Drug Use and Health: Mental Health Findings, NSDUH Series H-45, HHS Publication No. (SMA) Rockville, MD: Substance Abuse and Mental Health Services Administration, ) Thompson, R. A., & Sherman, R.T.: The National Collegiate Athletic Association, Managing Student-Athletes Mental Health Issues, 22.) Ward, B.W.; & Gryczynski, J. (2007): Alcohol Use and Participation in Organized Recreational Sports Among University Undergraduates, Journal of American College Health, 56:3, ) Watson, J. C., & Kissinger, D.B. (2007): Athletic Participation and Wellness: Implications for Counseling College Student- Athletes, Journal of College Counseling, Volume 10, ) Youtube video: ) Yusko, D.A., Buckman, J.F., White, H.R., & Padina, R.J. (2008): Alcohol, Tobacco, Illicit Drugs, and Performance Enhancers: A Comparison of Use by College Student Athletes and Nonathletes, Journal of American College Health, 57:3,

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The APPLE Model. The Core of a Healthy Athletics Department

The APPLE Model. The Core of a Healthy Athletics Department The APPLE Model The Core of a Healthy Athletics Department 2015 Rector and Visitors of the University of Virginia, Gordie Center Substance Abuse Prevention. This work is licensed under a Creative Commons