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Effect of media on the mental health of elite athletes
  1. Marcia Faustin1,2,
  2. Monique Burton3,4,
  3. Shelley Callender5,6,
  4. Rhonda Watkins7,8,
  5. Cindy Chang7,9
  1. 1 Physical Medicine and Rehabilitation, UC Davis, Davis, California, USA
  2. 2 Family and Community Medicine, UC Davis, Davis, California, USA
  3. 3 Pediatrics, Seattle Children’s Hospital, Seattle, Washington, USA
  4. 4 Orthopedics and Sports Medicine, Seattle Children’s Hospital, Seattle, Washington, USA
  5. 5 Pediatrics, Mercer University, Macon, Georgia, USA
  6. 6 Family Medicine, Mercer University, Macon, Georgia, USA
  7. 7 Orthopaedics, UCSF, San Francisco, California, USA
  8. 8 Pediatrics, UCSF, San Francisco, California, USA
  9. 9 Family and Community Medicine, UCSF, San Francisco, California, USA
  1. Correspondence to Dr Cindy Chang, Orthopaedics; Family and Community Medicine, UCSF, San Francisco, California, USA; cjchangsportsmd{at}

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After Naomi Osaka declined press conferences at the 2021 French Open due to concern that it would negatively impact her mental health, she was fined and threatened with expulsion. She withdrew, and questions arose about the impact of media relations and the mental health of elite athletes. The incident also raised questions regarding the contractual obligations of athletes regarding press conferences. Would she have been fined for missing a press conference due to a physical illness? Is mental health valued less than physical health?

Increasing attention to athlete mental health

Vulnerability about mental health has been considered inconsistent with competitive athletic culture and assumes elite athletes are role models of toughness both physically and mentally.1 Thankfully in recent years, sports medicine organisations have been focusing more attention on athlete mental health. In 2019, the International Olympic Committee (IOC) and the Canadian Center for Mental Health and Sport released publications regarding mental health evaluation, treatment and prevention.2 3 Soon after, the American Medical Society for Sports Medicine (AMSSM) published their position statement addressing psychological and environmental factors that commonly impact athlete mental health.4

Several recent efforts have aimed to better identify mental health challenges in athletes. The depression screening tool PHQ4 was added to the Preparticipation Physical Evaluation Monograph,5 and the IOC expanded provider resources with its mental health toolkit, which included the Sports Mental Health Assessment Tool.6 For the first time, the US Olympic and Paralympic Committee also required mental health screening for all Team USA athletes and brought mental health officers to the …

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  • Contributors Every author listed has contributed to the writing of the paper. The senior author, Dr CC, is the guarantor and accepts full responsibility for the finished 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 MF, MD—USA Gymnastics Athlete Health and Wellness Committee (unpaid). MB, MD—Chair, USA Track and Field Sports Medicine and Science Committee (unpaid); Chair, AMSSM Diversity Equity and Inclusion Subcommittee (unpaid); Leadership Team, King County Play Equity Coalition (unpaid). SC, MD—AMSSM Board of Directors (unpaid); ACSM Pronouncement Committee (unpaid). RW, MD, MPH—none declared. CC, MD—Korey Stringer Institute—review of AED policies in schools (consulting fee); independent lecturer for MCE conferences (Honorarium/travel); Pollara Law Group (Expert witness); Chair, CA Interscholastic Federation Sports Medicine Advisory Group (support for travel to two meetings a year to LA pre-COVID); NFL Research and Innovations Commttee (stipend); Agency for Student Health Research medical advisory board member (stock options); Baseline Global medical advisory board member (stocks); Neuroslam medical advisory board member (stock options); KSI Medical Advisory Board (unpaid); Ossur (Grant made to UCSF PCSM fellowship); TotalCare (Grant made to UCSF PCSM fellowship); AMSSM Practice and Policy Committee (unpaid).

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.