Experiences of Athletic Trainers in Tactical Athlete Settings When Managing Patients With Mental Health Conditions

Abstract

Context Research demonstrates that job demands impair tactical athletes' mental health. Mental health stigma in this population and limited resources prevent individuals from receiving care. Athletic trainers (ATs) are often the first, and sometimes only, contact for mental health concerns. Previous literature indicates that ATs desire more psychosocial training and experience. Objective To investigate ATs' preparedness and experiences managing patients with mental health conditions in the tactical athlete setting. Setting One-on-one, semistructured interview. Design Consensual qualitative research. Patient or Other Participants 15 athletic trainers [males=7, females=8; age=36±10 years; experience in tactical athlete setting=4 years (range = 6 months-20 years); military=12, law enforcement=2; fire service=1]. Main Outcome Measures Interviews followed a 9-question protocol focused on job setting preparation, mental health training, and perceived role managing mental health concerns. Interviews were audio recorded and transcribed verbatim. A 3-person coding team convened for data analysis using the consensual qualitative research tradition. Credibility and trustworthiness were established using a stability check, member checking, and multi-analyst triangulation. Results Four domains emerged surrounding ATs mental health management experiences in tactical athletes: 1) population norms, 2) provider preparation, 3) provider context, and 4) structure of job responsibilities. Most ATs felt their educational experiences lacked comprehensive mental health training. Some participants described formal employer resources that were optional or mandatory for their job, while others engaged in self-education to feel prepared for this setting. Participants shared that unfamiliar experiences, such as divorce and deployment, influenced their context as providers. Most ATs had no policy related to mental healthcare and referral, indicating it was outside their responsibilities or were unsure of role delineation. Conclusion ATs working with tactical athletes suggested additional mental health education and training are necessary. The ATs also indicated improvement is needed in job structure regarding role delineation and establishment of policies regarding behavioral health.