Mental Health Emergency Action Planning

Why this matters

Young athletes today face unprecedented pressures from multiple sources. Beyond the typical challenges of childhood and adolescent development, student athletes navigate sport-related stressors including anxiety, burnout, depression, disordered eating, sleep difficulties, performance-based identity concerns, substance use, injury management, and the pressure to compete from coaches, parents/guardians, and peers. These pressures are compounded by broader societal challenges including social unrest, public health concerns, social media, and increased exposure to violence and trauma. The combination of high external stressors, internal pressure to perform, limited mental health resources, and a culture that sometimes devalues help-seeking behavior can increase an athlete's risk of experiencing a mental health crisis.

A mental health crisis involves an acute disturbance that puts the safety of the student athlete or others at risk or renders the student incapable of self-care. Just as youth sport programs maintain emergency action plans for physical injuries such as concussions, cardiac events, or heat illness, they must also be prepared to respond effectively to mental health emergencies. Having a comprehensive Mental Health Emergency Action Plan (MHEAP) ensures that all staff members understand warning signs, know their roles during a crisis, and can connect athletes to appropriate care quickly and effectively.

A MHEAP is a critical safety protocol designed to manage acute psychiatric crises and collective trauma. This plan details specific symptoms that constitute an emergency, clear roles and responsibilities for immediate response, and protocols for contacting parents/guardians and emergency services.

Implementation protocol

1. Establish a crisis response team

   Someone has to coordinate the response. A named team removes the hesitation of "who handles this?" at the moment it matters most.

   Implementation list

   • Assemble the team: athletic or program director, head coaches, athletic trainer or medical staff (if available), school counselor or an identified community mental health professional, local emergency services contact, and school or program leadership.
   • Ensure each member understands their specific role during a mental health emergency.
   • Meet at least annually to review and update the plan.

   Mental Health Emergency Action Plan

2. Develop written emergency procedures for mental health emergencies

   Under stress, people fall back on what is written down. Detailed procedures remove judgment calls from the worst possible moment to be making them.

   Implementation list

   • Specify how to activate the MHEAP; when to contact the crisis team; when to immediately contact emergency services (911); when to involve parents/guardians; and when to consult mental health professionals.
   • Include clear flowcharts or decision trees staff can reference during high-stress situations.
   • Produce a quick reference card that lives with the physical EAP and in every coach's bag.

   Mental Health Emergency Action Plan

3. Develop written emergency procedures for collective traumatic events

   With the rise in collective traumatic events — political and other violence, fires, hurricanes, earthquakes — organizations need to understand how they will respond and what the boundaries of their response will be.

   Implementation list

   • Recognize that collective trauma affects an entire community and requires a coordinated, trauma-informed response addressing both individual and collective impact.
   • Define what the program will do, what it will not do, and who it will hand off to.
   • Plan for the staff response as well as the athlete response.
   • Decide in advance that no communication goes out — to staff, athletes, families or the public — until the affected family has agreed what may be shared and in what words. Where a death was by suicide, cause of death is the family’s to disclose, and safe messaging applies to anything you do send.

   Collective Trauma Response Protocol

4. Practice de-escalation techniques

   Staff need concrete, rehearsed behaviors that stabilize a situation until additional help arrives.

   Implementation list

   What to do	What not to do
   Keep your voice calm	Overreact
   Listen to the person	Make judgmental comments
   Express support and concern	Argue or try to reason with them
   Ask how you can help	Make them feel trapped
   Keep the stimulation level low	Stare at them
   Move slowly	Touch them without permission
   Be patient and give them space	Crowd or rush them
   Offer options instead of taking control	Make demands or give ultimatums
   Gently announce actions before initiating them	Engage in sudden movements

5. Create post-crisis support protocols

   The crisis ending is not the end of the response. Athletes, teammates and the staff who responded all need support afterward — and the program needs to learn from what happened.

   Implementation list

   • Connect the athlete to ongoing mental health care and communicate with their family within legal parameters.
   • Provide support for affected teammates who may be experiencing secondary trauma.
   • Offer resources for staff who responded to the crisis.
   • Conduct a review of the incident to improve future responses.
   • Use a structured re-entry process when the athlete returns.

   Post-Crisis Re-Entry Protocol

6. Review and update the plan regularly

   Contact lists go stale, staff change, and lessons from drills are lost unless they are written back into the plan.

   Implementation list

   • Review the MHEAP at least annually, and after any crisis event.
   • Update contact information for local resources.
   • Incorporate lessons learned from drills or actual events.
   • Reflect changes in staff or leadership, and ensure compliance with new legal or regulatory requirements.

Additional resources

• OSU LiFEsports Student-Athlete MHEAPA complete example plan (PDF), developed for use in accordance with OIAAA criteria for high-quality athletic programs. The closest thing here to a model you can work from directly.
• NFHS — Emergency Action Planning for Afterschool ProgramsFree online course at coach level, covering how to build and rehearse an emergency action plan.
• NFHS — Coaching Mental WellnessFree online course for coaches, Levels 1–3, on recognising and responding to mental health concerns.
• Korey Stringer Institute EAP TemplatesWidely used athletic emergency action plan templates that can be customised to include mental health protocols.
• NATA Position Statement on Emergency Planning in AthleticsNational Athletic Trainers’ Association guidelines for comprehensive emergency action plans.

Key evidence and supporting research

A systematic review and meta-synthesis of mental health policy and position statements from key organizations found repeated consensus on the value of writing a mental health plan and sharing it with all stakeholders. Documented plans are recommended to include explicit guidelines on referrals and how athletes access referral services, a plan for high-risk events, and emergency protocols for handling mental health emergencies. Note that the vast majority of these statements are contextualized in professionalized settings — key modifications will be needed to support community organizations.