Psychiatric disorders: The psychiatrist’s contribution to sport

Abstract

Athletes experience a range of mental health problems with at least an equivalent prevalence to the general population. This chapter explores the psychiatrist's role in sport, along a pathway of mental healthcare from 'upstream' prevention, screening, and early detection of mental stress to 'downstream' assessment, treatment, rehabilitation, and recovery from mental illness. At each stage on this pathway the psychiatrist has a broad spectrum of bio-psycho-social strategies to employ in clinical practice. Upstream, the importance of psychological resilience is described along with the concept of mental 'pre-habilitation' (a term usually associated with the prevention of physical injury). Alongside these preventative measures, early detection is improved by education, increased awareness, and by the use of effective mental health screening measures. Further downstream ready access to psychiatric expertise and good collaboration between the psychiatrist and the world of sport improve access to treatment, delivery of that treatment, rehabilitation, and return to sport during recovery.

Associations Between Motivation and Mental Health in Sport: A Test of the Hierarchical Model of Intrinsic and Extrinsic Motivation

“…Task (α = 0.90) and ego (α = 0.89) climates, competence (α = 0.89), autonomy (α = 0.86), relatedness (α = 0.83), STAI-Y2 (α = 0.89), and POMS-B (α = 0.87) had acceptable reliability. Although the QIDS-SR (α = 0.58) and PSQI (α = 0.57) did not reach the 0.70 criterion (Nunnally, 1978 ), both have been widely used and demonstrated strong psychometric properties in sport research (Currie and Johnston, 2016 ; Gupta et al, 2016 ).…”

Mental health in elite athletes: International Olympic Committee consensus statement (2019)

“…When conducting an emergency mental health assessment, the physical environment should be uncluttered and provide both containment and escape routes 678. However, such environments may be unavailable when assessing an athlete at a training or competition venue 694. Although pathways and available personnel may differ from country to country,339 it is best practice to develop and rehearse a mental health emergency action management plan for all relevant sport stakeholders.…”

Advancing elite athlete mental health treatment with psychedelic-assisted psychotherapy

“…With athletes' consent, sport psychologists may also play a pivotal role in informing the specialist clinician on some of the relevant sport-specific factors and themes that may be addressed during therapy, based on their experience from a more established therapeutic relationship and understanding of elite sport stressors and processes. Sport psychiatrists may also be well aligned to assist in the ongoing management of athletes throughout the treatment phase, given their specialist training in medical management of athlete mental health (Currie and Johnston, 2016). Therefore, this treatment approach will, by its very nature, be multidisciplinary if implemented within sport.…”