The NFL has taken another key step forward in its holistic approach to player health and safety. Together with the NFL Players Association (NFLPA), the league is educating clubs about how to advance their pain management and mental and behavioral health programs. New features for both are required for the 2019 season as part of joint agreements between the NFL and NFLPA.

Across two club information sessions held this summer, head team internal medicine physicians, head athletic trainers, behavioral health team clinicians, pain management specialists, player engagement personnel and other club staff gathered to discuss the new agreements and the changes clubs will need to make to build upon their current programs.

NFL Chief Medical Officer Dr. Allen Sills and NFLPA Medical Director Dr. Thom Mayer kicked off the sessions by applauding the collaboration between the league and the NFLPA on these important issues.

“There is no daylight between the NFL and NFLPA on doing what’s best for players’ mental and behavioral health and pain management,” Dr. Mayer said.

The joint agreements codified many of the best practices that exist throughout the NFL. The summer sessions gave club personnel the opportunity to share their experiences and learn about the agreements’ implementation for the 2019 season and beyond.

Expanding Behavioral Health Resources for NFL Players

The new agreement on mental and behavioral health builds upon existing resources to support players, with NFL clubs now required to retain a behavioral health team clinician who will be available to players at the team facility for at least 8-12 hours per week.

NFL Vice President of Wellness and Clinical Services Dr. Nyaka NiiLampti led a conversation about implementation of the changes, emphasizing how to build a program that players trust and fits the culture of the club and its players.

Behavioral health team clinicians from NFL teams with robust mental health programs shared their experiences and best practices for effectively serving players – from navigating confidentiality to the benefits of simply being visible as a resource. Clinicians stressed the importance of establishing trust with players, offering support through both casual catch-ups and in-depth clinical sessions, and being a resource for players’ families and support systems.

Much of the conversation focused on identification and treatment of mental health concerns before they become acute crises, though Mental Health Emergency Action Plans are also required to be created and rehearsed ahead of the season as mandated by the joint agreement. These plans are being developed by the behavioral health team clinicians and will be approved by Dr. Ciara Dockery, the director of the NFL Life Line – an existing resource for current and former NFL players in need of mental health support.

Prescription Medication and Pain Management Among NFL Players

Dr. Sills and Dr. Mayer highlighted the formation of a new Joint Pain Management Committee, a feature of the pain management joint agreement. The role of this committee – which includes medical experts appointed by both the league and the NFLPA alongside Dr. Sills and Dr. Mayer – is to establish uniform standards for club practices and policies regarding pain management and the use of prescription medication by NFL players, as well as to conduct research concerning pain management and alternative therapies.

As part of the agreement, NFL clubs are required to appoint a Pain Management Specialist before the start of the 2019 season. Since the role is new for some clubs, Dr. Sills and Dr. Mayer led club conversations on the qualifications, responsibilities, opportunities and challenges of the role.

Dr. Sills and Dr. Mayer also educated clubs on the development of a Prescription Drug Monitoring Program that will monitor all prescriptions issued to NFL players by club and unaffiliated physicians who will provide periodic updates on their monitoring to the Joint Pain Management Committee.

The Joint Pain Management Committee will meet several times throughout the upcoming year.