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The mental health of professional athletes has become an important and visible global issue requiring strong and immediate action. Major organisations and governing bodies in sport psychology and sport science have published 10 position stands and statements on mental health in sport since 2016 (see table 1). These position stands and statements explicitly address, or emphasise, elite athletes (as defined by Swann et al).1 None of the position stands, consensus statements, or guidelines directly address athletes that could be considered subelite participants–for example, standards below talent development programmes or university-level participation.1 These existing position stands exclude organised recreational sports where the vast majority of individuals participate.2 3 We call on sporting organisations and relevant professional bodies to urgently enact policy in regard to mental healthcare in recreational sport—which encompasses all sports participation outside of those who are investing or specialising in one or a few sports with the intended outcome of elite performance.4
At least 40% of children and adolescents in a majority of countries worldwide, and approximately 20% of all adults globally, participate in organised recreational sports.2 3 Fewer than 6% of these are likely to be elite athletes and covered under current statements pertaining to mental healthcare in sport.5 Nonetheless, recreational sports organisations have an obligation to provide psychologically safe and mentally healthy environments for all participants. However, they are often under-resourced and may lack the specific knowledge to implement appropriate strategies.6 This is important because, based on worldwide prevalence and participation data, approximately 8% of the population may participate in sport and have a mental health problem.2 7 Many more potential participants may be disinclined to participate in organised recreational sports due to mental health concerns, and some recreational sports environments—such as those that induce large amounts of pressure through an overemphasis on competition—can exacerbate the symptoms of mental health problems.8 Sporting organisations and policy-makers therefore have the opportunity and obligation to positively impact mental health on a large scale by targeting recreational athletes.
Why the elite athlete guidelines do not suffice for recreational sport
There are key differences between elite and recreational sport participants that render existing guidelines ungeneralisable to recreational sports. Elite athletes are often embedded within structured support systems including professional coaches, trainers, sport psychologists and sports physicians.1 In contrast, recreational sports clubs are typically run by volunteers whose time and administrative resources are stretched, have little training in how to enact their role (eg, as coach), and typically have much less contact time with participants.6 Further, the psychological stressors experienced by elite athletes may be different in nature and degree than those experienced by recreational participants. Clinicians should therefore think critically about the application and implementation of current statements when addressing mental healthcare within recreational sports with particular regard given to the resourcing and training available. We call on sporting organisations and governing bodies to respond to the urgent need for mental healthcare policy that is applicable within recreational sports.
The only statement to date that explicitly focused on recreational sport was an international consensus statement.9 This statement was important in setting out a series of necessary considerations for researchers and policy-makers working in mental health in sport. For example, this statement recommends that: mental health awareness be defined; standards for data collection, analysis and reporting be identified; minimal competencies for training be articulated; theory-based and evidence-based guidance is provided on the selection of mental health programmes; and identification of the role administrators, parents, officials, coaches, athletes and other volunteers be provided. A basic starting point for policy-makers would be to fulfil these recommendations. However, while these considerations are informative for writing mental health policies, it remains that both clinicians and recreational sports clubs require more practical guidance.
A call to action
To enable practical guidance for recreational sports clubs, policy action should pay specific attention to several issues. First, sport clubs and clinicians working in recreational sports should be able to access policies and procedures which help them provide a safe and healthy environment that: (1) facilitates mental health and well-being for all stakeholders and (2) is free from factors that may contribute to the development, onset or deterioration of mental health problems. Second, those within sports clubs should be able to recognise and appropriately respond to participants with mental health problems or mental health crises (eg, through early recognition of mental health problems and appropriate referral), actioned through policies which require relevant training from appropriate providers. Finally, sports clubs should receive direction and guidance from policy on the ways in which they can promote the inclusion of those living with, or who have experienced, mental health problems (eg, by providing guidance to coaches). Such guidance must be evidence based, and culturally appropriate.9 A comprehensive strategy to facilitate the uptake and implementation of actionable strategies may include: specification of minimum standards to be met by sports clubs; a clear strategy for oversight and regulation of the policy at the recreational level; and, the provision of appropriate resources to recreational clubs and organisations.
we call on policy-makers from within a range of organisations including national and international sporting bodies, and relevant regulatory bodies, to respond to the urgent need for mental healthcare policy within recreational sports. Providing practical policy and guiding recreational sport clubs is critical so that they are able to enhance mental health safely and effectively, on a large scale.
Contributors SAV and CS drafted the manuscript and approved the final version.
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 SAV and CS are engaged as consultants to Movember on projects related to mental health care in recreational sports.
Patient consent for publication Not required.
Provenance and peer review Not commissioned; externally peer reviewed.