Proposed UK government strategy for mental health and elite athletes: six key points and commentary

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With the rise in elite athletes disclosing mental health difficulties in the United Kingdom, it seemed clear that a strategy for protecting mental health was required in order to protect individuals and families from the traumas associated with mental ill-health.

In response to the rise in incidents and disclosures, the UK government has proposed that all elite sports develop a clear mental health strategy by 2024. A long way off? Perhaps – but a much-needed development to ensure that young athletes, along with those facing the challenges of retirement, are not emotionally damaged through their participation in various sports.

The recent government policy document `Mental Health and Elite Sport Action Plan` comments:

`As part of the sport strategy, ‘Sporting Future’ government has been looking at how sport can improve its offer of mental health support to elite sports people. ‘Sporting Future’ not only recognised the impact sport has on physical and mental health but also highlighted the sacrifices athletes make in striving for success.`(Gov.UK, 2018)

The need for regulation,

It is now evident that the unregulated nature of elite sports presents a grave risk to the mental health and well-being of athletes along with a potential for exploitation, particularly in the young and aspiring. In recent years, there has been a significant increase in athletes documenting their struggles with the demands of recurrent achievement across the spectrum of elite sports.

To illustrate, footballer Chris Kirkland has spoken of experiencing marked anxiety and depression because of the demands made on him through his role as a goalkeeper. Rebekah Wilson, a member of Great Britain’s two-woman bobsleigh crew at the 2014 Sochi Winter Olympics, also spoke of her anxiety concerned with performing consistently at high levels resulting in her deliberately self-harming. (BBC Sport, 2018)

Similarly, England rugby international Johnny Wilkinson has spoken about his struggles with anxiety and low-mood and how material wealth and affirmation has not provided the necessary buffers to protect from mental ill-health.

Casualties of perfectionism

Without the need for an exhaustive list of casualties, it seems apparent that anxiety and depression in relation to the competitive nature of elite sports are endemic along the spectrum of elite sports and are common to all perfectionist cultures.

The demands for high performance: Devils in the detail

According to Ian Braid (2018), the managing director of Duty of Care in Action:

`The effects of living in a high-performance environment constantly worrying about selection, funding, injury and struggling with their identity on transition cannot be underestimated.` (BBC Sport, 2018)

Braid believes that proposals should extend to a duty of care for coaches, administrators and sports support more generally, although he states that `the devil will be in both detail and budgets` suggesting possible difficulties ahead. Funding nevertheless, seems a contentious issue given the finances generated through sponsorship within many of the elite sports and `the devil in the detail` perhaps exquisitely reflects the multiple pressures faced by many elite athletes on a daily basis.

Research and mental health

The mental health of elite athletes has been an ever growing cause for concern recently. Research conducted by The State of Sports (2018) has suggested that many athletes struggle with retirement, find difficulty establishing a new identity and grieve previous roles. Transitions can be difficult for each of us yet for those whose identity is completely immersed in professional roles, mental health problems can ensue.

The proposed strategy

Subsequently, the government’s strategy indicates the need for a well developed and recognised pathway to ensure good mental health in elite athletes and one which is on a parity with physical health. Clear policies should cover every phase of the athlete’s developmental pathway.

There are also the following six recommendations:

Training for performance directors, coaches and governing bodies on how to identify signs of mental ill-health and promote positive mental well-being.

A mental health pathway.

National Lottery funded athletes to visit mental health units to reduce stigma.

Sharing of best practice across the sports sector.

Improved mental health education and training.

An online resource and tailored guide to be produced. (BBC Sports, 2018)

The strategy is as yet in its early stages. As such, more detailed information is required to evaluate potential measures prior to implementation.

However, the recommendations might usefully include the following:

`In collaboration with local colleges or universities, sound educational structures should be put in place to help neophyte athletes, and all involved with elite sports, to make the necessary adaptions to success and perceived failure.`

`Each young athlete might benefit from the guidance and protection of a personal tutor and, where appropriate with the involvement of family members, have a clear view of strengths, weakness and personal progress throughout their period spent participating in elite sports. That is to say, an appropriately structured and ethical sports curriculum ensuring a duty of care is upheld for all participants in elite sports. (Jones, 2015)

First aid mental health practitioners

It is also an imperative that adequate training and appropriate levels of education are provided to mental health practitioners new to the field. Discussing emotional difficulties can be helpful but also has the potential to arouse deep and embedded anxieties, which require careful management. Experiential knowledge concerning elite sports alone, is unlikely to be sufficient.

For example, Blumenthal (2018) has recently argued that:

`Practitioners in mental health…have to manage challenging risk issues in their day to day work, often without the necessary tools for doing so. This can be a daunting task in cultures which attribute blame when things go wrong. It can lead to defensive practice and detracts from understanding the complex and subtle issues involved in making sense of why people engage in behaviours which are harmful to themselves and others, when they are likely to carry out such acts and interpersonal context of managing them.` (Blumenthal, 2018)

Although discussing challenges confronting established mental health professionals, it seems apparent that adequate and effective referral pathways are established along with sound clinical supervision structures to allow mental health practitioners, involved with elite sports, to function safely and efficiently

The proposed government strategy for mental health is nonetheless timely, given that elite athletes now seem increasingly ready to discuss emotional difficulties related to their occupations and address the stigma concerning mental ill-health. Importantly, perhaps critical transitions and competitive environments might be better facilitated with less impact on the emotional health and well-being of elite athletes. However, an appropriate curriculum, specific training and professional preparation for mental health practitioners should be considered carefully.

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