The brave decision made by many Canadian athletes to share their experience with mental illness has fed a growing dialogue surrounding mental health in competitive and high-performance sport. To affect real change for individuals, sport culture must change to meet demands for psychologically safe, supportive, and accepting sport environments. This position statement addresses mental health in competitive and high-performance sport in Canada, presenting solutions to current challenges and laying a foundation for a unified address of mental health by the Canadian sport community. The paper emerged from the first phase of a multidisciplinary Participatory Action Research (PAR) project, in which a sport-focused mental health care model housed within the Canadian Centre for Mental Health and Sport (CCMHS) is currently being designed, implemented, and evaluated by a team of 20 stakeholders, in collaboration with several community partners and advisors.

This paper summarises current research on the mental health status of older African-Americans with a specific focus on late-life depression, one of the most common forms of mental disorder among older persons. Social gerontologists have brought to the forefront the need to consider the impact of historical eras, cohort location, and lifecourse development when studying various dimensions of the ageing process. Unfortunately, this type of theorising is still in its infancy, and has not been widely applied to the general population and all dimensions of health, let alone investigations into the mental health status of older African-Americans. Virtually none of the empirical studies we reviewed adequately address the historical, biographical, or structural factors related to the mental health status of older African-Americans. We suggest that to understand contemporary manifestations of racial presumptions, there must be an appreciation of the historical antecedents. African-Americans live with the corrosive effects of a legacy of slavery that presumed black inferiority. The identification of salient factors of risk and resilience among this population is critical to developing effective intervention and mental health maintenance programmes. By emphasising the socio-historical influences on the mental health of older African-Americans, we can develop a greater understanding of this population's mental health needs ; thus paving the way for improved mental health services and a reduction in mental health disparities.

Objective: To apply the International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1) to determine the prevalence of mental health symptoms in a cohort of university student athletes over an academic year. A secondary objective was to explore the internal consistency of the screening tools from the SMHAT-1. Design: Cross-sectional design with 3 repeated measurements over an academic year. Setting: A large university multisport program. Participants: Five hundred forty-two university-level student athletes from 17 sports. Intervention: N/A. Main Outcome Measures: On 3 occasions, the participants completed the SMHAT-1, which consists of the Athlete Psychological Strain Questionnaire. If an athlete's score was above the threshold ($17), the athlete completed step 2, consisting of (1) Generalized Anxiety Disorder-7; (2) Patient Health Questionnaire-9; (3) Athlete Sleep Screening Questionnaire; (4) Alcohol Use Disorders Identification Test Consumption; (5) Cutting Down, Annoyance by Criticism, Guilty Feeling, and Eye-openers Adapted to Include Drugs; and (6) Brief Eating Disorder in Athletes Questionnaire. Internal consistency of the SMHAT-1 was also measured. Results: Participants reported mental health symptoms with prevalence of 24% to 40% for distress, 15% to 30% for anxiety, 19% to 26% for depression, 23% to 39% for sleep disturbance, 49% to 55% for alcohol misuse, 5% to 10% for substance use, and 72% to 83% for disordered eating. Female athletes were more likely to suffer psychological strain, depression, and sleep disturbance; male athletes were more likely to report substance use. Conclusions: The SMHAT-1 was feasible to implement with good internal consistency. University-level athletes suffer from a variety of mental health symptoms underscoring the necessity for team physicians to have the clinical competence to recognize and treat mental health symptoms.

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Introduction: Athletes can experience the same mental illnesses as the general population. Sports create additional circumstances that can influence the mental health of its participants. Sport and Exercise Medicine (SEM) physicians are often on the front lines of providing medical assessment and treatment to athletes for a variety of presenting complaints. Enhancing the knowledge base and clinical approach of Sport and Exercise Medicine physicians for assessment and management of mental health challenges in athletes can assist in early identification, assessment, treatment initiation, or referral to a sports psychiatrist. Providing SEM trainees with formal clinical exposure to Sports Psychiatry can better equip them for their future practice. This article describes a formalized clinical rotation in Sports Psychiatry for SEM Fellows in one Canadian university. Methods: In collaboration with the SEM Fellowship program, a formal Sports Psychiatry rotation was created to ensure every Fellow had exposure to mental health assessment and management of athletes appropriate to what would be expected of SEM physicians. Results: A four-week curriculum which included direct clinical assessment, treatment initiation, follow up, and presentation of case-based mental health topics appropriate for SEM physicians. This program was reviewed during accreditation as part of the Enhanced Skills curriculum of the postgraduate Family Medicine program at McMaster University in 2023. Conclusion: An integrated Sports Psychiatry rotation during a SEM Fellowship provides an opportunity for future SEM physicians to have exposure to a clinical population of athletes with mental health concerns to develop tools for assessment, management, and collaborative care.