Experiences of Athletic Trainers Following the Death of a Student-Athlete by Suicide, Part 2: Institutional and Personal Response.

Abstract

Context: The NCAA's 2016 and 2024 Mental Health Best Practice documents outline essential guidelines for athletic programs, including mental health recognition, referral pathways, and critical incident management. Despite these recommendations, there remains a significant gap in literature and practice regarding the response to and management of suicide bereavement among athletic trainers (ATs), highlighting the need for further exploration of their experiences and institutional responses following a student-athlete's death by suicide.

Objective: To explore the lived experiences of collegiate ATs following the death of a student-athlete by suicide.

Design: Qualitative.

Setting: Individual interview.

Participants: 12 ATs (age=37±7 years; credentialed experience=14±7 years) who were providing patient care to a student-athlete who died by suicide.

Main outcome measures: Each AT completed a semi-structured, audio-only interview. Interviews were audio-recorded and transcribed verbatim. Analysis followed the consensual qualitative research tradition using a 3-person coding team. Credibility and trustworthiness were established through member checking, triangulation, and internal auditing.

Results: Participants revealed several experiences and reactions following the death of a student-athlete by suicide that focused on their institutional reaction, their emotional reaction and coping mechanisms, and shared advice for other ATs moving forward. Following the student-athlete death by suicide, ATs shared their institutional reaction, which included a collaborative approach with resources and changes to policy, procedures, and their overall system. They also shared their emotional reaction and coping mechanisms following the death, which included a grief response influenced by guilt, concern for other student-athletes, and the use, and lack of use, of support systems and formal therapy. Finally, they provided shared advice concerning death by suicide that included taking care of oneself and taking mental health seriously.

Conclusions: Following the death, most participants expressed grief and concern for others but often did not recognize themselves as needing help. Institutional policy and provider postvention strategies are recommended.