The COVID-19 pandemic created stressors that raised the likelihood of elite athletes experiencing mental health problems. Understanding how individual traits promote resilience is key to offering treatments specific to this population. This prospective study explores the relationship between mindfulness skills, resilience, and athletic identity on anxiety and depression. The initial assessment was during the first UK lockdown April–May 2020 (T1), and the second during the return to competition July-August 2020 (T2). The sample was 160 elite rugby players. Measures included: Personal Health Questionnaire-9, General Anxiety Disorder-7, Cognitive Affective Mindfulness Scale, Connor-Davidson Resilience Scale, and Athletic Identity Measurement. The prevalence of anxiety and depression was profiled with descriptive statistics, and relationships between variables with bi-variate correlations and forward stepwise regression modelling. Depression decreased significantly between lock down (T1) and return to competition (T2) (MT1 = 4.20, MT2 = 3.24, p < 0.01), with no significant change in anxiety. Significant correlations were found between mindfulness, resilience, and anxiety and depression (≤0.001). Regression showed that mindfulness (T1) predicted lower anxiety and depression during the return to competition (T2) after controlling for baseline mental health symptoms. Returning to competition after lockdown was associated with a reduction in depression but not anxiety. Mindfulness skills potentially confer protection against anxiety and depression.

ObjectiveTo determine the effectiveness of mindfulness-based programmes (MBPs) on the mental health of elite athletes.DesignSystematic review and meta-analysis.Data sourcesEight online databases (Embase, PsycINFO, SPORTDiscus, MEDLINE, Scopus, Cochrane CENTRAL, ProQuest Dissertations & Theses and Google Scholar), plus forward and backward searching from included studies and previous systematic reviews.Eligibility criteria for selecting studiesStudies were included if they were randomised controlled trials (RCTs) that compared an MBP against a control, in current or former elite athletes.ResultsOf 2386 articles identified, 12 RCTs were included in this systematic review and meta-analysis, comprising a total of 614 elite athletes (314 MBPs and 300 controls). Overall, MBPs improved mental health, with large significant pooled effect sizes for reducing symptoms of anxiety (hedgesg=−0.87, number of studies (n)=6, p=0.017,I2=90) and stress (g=−0.91, n=5, p=0.012,I2=74) and increasing psychological well-being (g=0.96, n=5, p=0.039.,I2=89). Overall, the risk of bias and certainty of evidence was moderate, and all findings were subject to high estimated levels of heterogeneity.ConclusionMBPs improved several mental health outcomes. Given the moderate degree of evidence, high-quality, adequately powered trials are required in the future. These studies should emphasise intervention fidelity, teacher competence and scalability within elite sport.PROSPERO registration numberCRD42020176654.