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Editorial
Athlete mental health: future directions
  1. Alan Currie1,
  2. Cheri Blauwet2,3,
  3. Abhinav Bindra4,
  4. Richard Budgett5,
  5. Niccolo Campriani6,
  6. Brian Hainline7,
  7. David McDuff8,
  8. Margo Mountjoy9,10,
  9. Rosemary Purcell11,12,
  10. Margot Putukian13,14,
  11. Claudia L Reardon15,
  12. Vincent Gouttebarge16,17
  1. 1 Regional Affective Disorders Service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
  2. 2 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, Massachusetts, USA
  3. 3 Medical Committee, International Paralympic Committee, Bonn, Germany
  4. 4 Athletes’ Commission, International Olympic Committee, Lausanne, Switzerland
  5. 5 Medical and Scientific Department, International Olympic Committee, Lausanne, Switzerland
  6. 6 Sports Department, International Olympic Committee, Lausanne, Switzerland
  7. 7 National Collegiate Athletic Association (NCAA), Indianapolis, Indiana, USA
  8. 8 Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland, USA
  9. 9 Family Medicine, McMaster University Michael G DeGroote School of Medicine, Waterloo, Ontario, Canada
  10. 10 Sport Medicine, FINA, Lausanne, Switzerland
  11. 11 Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
  12. 12 Knowledge Translation, Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
  13. 13 Major League Soccer, New York, New York, USA
  14. 14 Robert Wood Johnson Medical School, Rutgers University, New Brunswick, New Jersey, USA
  15. 15 Department of Psychiatry, University of Wisconsin Madison School of Medicine and Public Health, Madison, Wisconsin, USA
  16. 16 Sports Medicine, University of Pretoria, Pretoria, South Africa
  17. 17 Amsterdam UMC, University of Amsterdam, Department of Orthopaedic Surgery, Amsterdam Movement Sciences, Amsterdam, The Netherlands
  1. Correspondence to Dr Alan Currie, Regional Affective Disorders Service, Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, NE3 3XT, UK; alan.currie{at}ntw.nhs.uk

https://doi.org/10.1136/bjsports-2021-104443

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    The impact of mental health symptoms and disorders in elite athletes is increasingly recognised. This led the International Olympic Committee (IOC) to produce a consensus statement1 and establish a Mental Health Working Group. Members of this group have extensive experience in research and practice in the field of athlete mental health and have collectively ascertained gaps in current knowledge and practices. This editorial reflects the authors’ opinions and aims to provide researchers and practitioners with future directions relating to mental health symptoms and disorders in elite sport, focusing on prevalence/incidence, prevention, screening, assessment and treatment.

    Prevalence and incidence

    The prevalence studies that are currently available have significant limitations,2 including the lack of data distinguishing mental health symptoms from disorders. The latter require a clinical assessment accounting for the intense and unique demands athletes face, which influence how symptoms and disorders may manifest. An example is the presence of mental health symptoms in overtrained athletes, how these are understood from perspectives such as low energy availability or impaired immune function and where existing classification systems may be inadequate.

    Studies are limited by the influence of stigma related to mental health symptoms and disorders both in and out of sporting contexts, which likely impact athletes’ responses and do not take account of additional barriers to reporting, specifically cultural barriers including sex, religion, …

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    Footnotes

    • Twitter @DrAlanCPsych346, @CheriBlauwetMD, @Abhinav_Bindra, @campriani, @BrianHainline, @dmcduff52, @margo.mountjoy, @Mputukian, @vgouttebarge

    • Contributors AC, CB, DM, MM, RP, MP, CLR, VG: substantial contribution to conception and design; acquisition, analysis and interpretation of data; drafting the work and revising it critically; agreement to be accountable for all aspects of the work. AB, RB, NC, BH: substantial contribution to conception and design; interpretation of data; drafting the work and revising it critically; agreement to be accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests MP wishes to declare the following: consulting fees from Major League Soccer (USA); participation on advisory board as senior advisor, NFL (USA), Head, Neck and Spine Committee; participation on advisory board as committee member, US Soccer Medical Advisory Committee; participation on advisory board as committee member, USOPC Mental Health Task Force. All authors are members of the IOC Mental Health Working Group.

    • Provenance and peer review Not commissioned; externally peer reviewed.