Athletes should receive more regular and targeted mental health support, the International Olympic Committee (IOC) has agreed, with a new consensus statement featuring Australian experts highlighting the intersecting factors impacting this at-risk group.
Mental health symptoms and disorders are common among elite athletes, and the new consensus statement, published in the British Journal of Sports Medicine, argues for an ecological approach to understanding the determinants of mental ill-health – recognising that elite athletes are impacted by social and environmental factors far beyond the individual.
The new statement brings together current evidence reviewed by an international panel of 31 experts who brought lived, clinical, and scientific expertise to the process - and calls for a more proactive approach to mental health in sport, and greater focus on health promotion, prevention and early intervention.
Key to a shift in thinking has been the contribution of Australian researcher Professor Rosemary Purcell, Scientific Director of Orygen’s Global team, whose ecological framework forms a foundation for the statement.
Prof. Purcell said the framework – which highlights the multiple layers of sport-related factors impacting an athlete’s mental health – offered a new way for sporting bodies, teams and the community to understand and support athlete mental health.
“Taking an ecological approach to understanding an individual’s mental health is common outside of sport – but applying this approach to elite athletes is new, and important,” Prof. Purcell said.
“The framework acknowledges that athletes operate within multiple systems that impact them – from coaching staff, teammates and family, to governing bodies whose rules might impact athlete mental health – as seen in regard to how uniforms can influence body image – and even more broadly the public and social media.
“It’s important to understand any number of factors can have an impact on the athlete, not just their own individual circumstances, or coping skills.
“We need to consider all these elements when creating systems and cultures to support athletes’ mental health and wellbeing, and focus on being proactive, rather than simply reactive in a crisis.”
The consensus statement makes ten key recommendations, including:
- Routine screening and monitoring of elite athlete mental health should be undertaken at predefined points and significant events
- Clinicians and sporting bodies should proactively address stigma around mental health
- Coaches, support staff and health professionals for elite athletes should receive appropriate mental health education
- Psychological responses to injury should be routinely assessed, and return-to-sport for elite athletes with mental ill health should incorporate athlete safety, stability, and function as guiding principles.
Prof. Purcell said elite athletes experienced mental health conditions at higher rates than the general population, and their needs may differ from those of non-athletes.
“We need to ensure clinicians, coaches and sporting organisations know how to recognise and respond to the unique challenges faced by many in elite sport,” Prof. Purcell said.
“There are also certain times when athletes may be more vulnerable to mental ill-health, such as when they’re just starting out, if they are injured, or when transitioning out of elite sport.
“We need to do better when it comes to the prevention, recognition, and management of athlete mental health, and the responsibility for this lies not just with coaches, teammates and families, but extends across the entire elite sport ecosystem.
"With this statement we're seeing the focus shifting from how clinicians and mental health professionals can treat athletes impacted by mental ill-health, to how we can better create mentally healthy sports environments that promote and support mental health for all those in sport."