When it comes to student athletes, the concerns about mental health don’t end with concussions.

And the National Collegiate Athletic Association (NCAA) is keeping tightly focused on the issue. Last month, at its annual meeting, the association’s Sport Science Institute released updated guidelines [PDF] for dealing with the mental health issues of student athletes.

Mental health struggles, the institute explains, manifest themselves at high levels among college students in general, but student athletes, who take active roles in competition, face the added pressure that the drive for success creates. On the plus side, resources are plentiful for student athletes through their university athletic departments, but types of treatment vary at different schools. While the NCAA isn’t setting mandatory rules, the guidelines set best practices to help ensure a level of quality in mental health care.

“It is really critically important to think of mental health not apart from but rather as a part of athlete health,” Dawn Buth, the institute’s associate director of strategic communication and education, told Inside Higher Ed last month. “Establishing these protocols means more equitable care across sports and institutions. The way we look at it, the implementation of these best practices is an important step in ensuring a real quality of care.”

In a speech at Drexel University, Dr. Brian Hainline, the Sport Science Institute’s senior vice president and chief medical officer, noted that among the challenges highlighted by the guidelines are a tendency toward physical aggression by male athletes, a fifth of whom had been involved in a fight over the past year, as well as the prevalence of binge drinking among both male and female athletes. Another sign of mental illness he mentioned was depression, which a significant percentage of college athletes suffer from.

Hainline noted that the guidelines are meant to emphasize a topic that has often been left out when discussing the health of student athletes.

“Just generally speaking, mental health has not been always the priority…It’s sort of like a silent injury because you can’t see it on an X-ray and the culture is often just to tough it out,” Hainline said during his talk at Drexel, according to The Triangle. “As an athlete [you’re kind of expected to be] mentally tough. Your coaches are hard on you at practice sometimes and you’re expected to get stronger from that.”