Mental Health of Top Athletes
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1 School of Sport, Exercise and Health Sciences Mental Health of Top Athletes Dr David Fletcher Introduction What is Mental Health? Mental health is an integral and essential component of health 1 Mental health is more than just the absence of mental disorders or disabilities 1 Mental health is a state of well-being in which an individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and is able to make a contribution to his or her community 1 1 World Health Organization: Loughborough University Annual Health and Safety Forum 1
2 What is a Mental Health Problem or Disorder? Diagnostic and Statistical Manual of Mental Disorders (DSM) 1 Example: Depression Ranges from mild to severe (otherwise known as major or clinical depression) Diagnosis of clinical depression: Must have five or more depression-related symptoms over a two-week period, most of the day, nearly every day. At least one of the symptoms must be either a depressed mood or a loss of interest or pleasure Symptoms must be severe enough to cause noticeable problems in relationships with others or in day-to-day activities 1 American Psychiatric Association (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5) (fifth edition). American Psychiatric Publishing; Arlington, VA. Mental Health in Elite Sport: The Performance-Problem Paradox Physical activity and exercise are purported to have a beneficial dose-response effect on mental health 1 ; however, elite sport performers still report mental health problems and disorders The word Olympian, with it s roots in Greek mythology, is associated with Gods and superhuman beings; not with mortals who have health problems or illnesses 1 Biddle, S.J.H., Fox, K.R., & Boucher, S.H. (Ed.) (2000). Physical activity and psychological well-being. Routledge; Abingdon, OX. A (Brief and Selective) History of Mental Health in Elite Sport 2001: Publication of Silence of the Heart by David Frith 2007: Publication of Coming Back to Me by Marcus Trescothick 2009: Suicide of German football goalkeeper, Robert Enke 2009: Broadcasting of BBC Inside Sport: Mind Games Depression in Sport 2011: Death of British football ex-player and manager, Gary Speed Loughborough University Annual Health and Safety Forum 2
3 A (Brief and Selective) History of Mental Health in Elite Sport 2014: Broadcasting of BBC Football s Suicide Secret 2017: United Kingdom Government Duty of Care in Sport Review 2018: United Kingdom Government Mental Health and Elite Sport Action Plan Autobiographies, suicides/deaths, and broadcasts 2017: United Kingdom Government Duty of Care in Sport Review 2018: United Kingdom Government Mental Health and Elite Sport Action Plan Loughborough University Annual Health and Safety Forum 3
4 What do we Know about Mental Health in Elite Sport? Elite athletes experience a broadly comparable risk of high-prevalence mental disorders relative to the general population Athletes at elevated risk: Retirement phase Performance failure Negative life events Sports requiring lean body shape Females Low social support 1 Rice, S. M., Purcell, R., De Silva, S., Mawren, D., McGorry, P. D., & Parker, A. G. (2016). The mental health of elite athletes: A narrative systematic review. Sports Medicine, 46, What Makes the Best Better than the Rest? Most Important Psychosocial Discriminators Between Super-Elite and Elite Athletes 1 Achievement Career turning point How they behaved Mastery and outcome focus Total preparation for competition Counterphobia Importance of sport Who/what they became Ruthlessness and selfishness Need for success Obsessiveness and perfectionism Experiences Early negative life event plus positive sport event 1 Hardy, L., Barlow, M., Evans, L., Rees, T., Woodman, T., & Warr, C. (2017). Great British medallists: Psychosocial biographies of super-elite and elite athletes from Olympic sports. Progress in Brain Research, 232, Loughborough University Annual Health and Safety Forum 4
5 Should Top Level Sport Come With a (Mental) Health Warning? Risk factors Childhood adversity and trauma Dark personality characteristics Nature of the sport environment Personal and performance outcomes Complex interaction of (biopsychosocial) risk factors The Goldman Dilemma 1 If there existed a drug that would make you unbeatable for the next five years, after which you would die would you take it? 1 Goldman, R., Bush, P. J., & Klatz, R. (1984). Death in the locker room: Steroids and sports. London; Century. Connor, J., Woolf, J., & Mazanov, J. (2013). Would they dope? Revisiting the Goldman dilemma. British Journal of Sports Medicine, 47, What Does it Take to Be Great? Loughborough University Annual Health and Safety Forum 5
6 Personality and Sporting Success Winning in sport at the highest level isn t normal. Thus it is unlikely that sportspersons with normal personalities, normal relationships, or who fit into a normal system will achieve sporting excellence. The world s best athletes are different and have idiosyncrasies that make them exceptional, and possibly difficult to understand and communicate with Hardy, L., Barlow, M., Evans, L., Rees, T., Woodman, T., & Warr, C. (2017). Great British medallists: Psychosocial biographies of super-elite and elite athletes from Olympic sports. Progress in Brain Research, 232, Some Uncomfortable Truths? 1 Will a happy performer be a great performer? 2 Are the world s best athletes fuelled by something more than just happiness? 1 Maybe a bit of unhappiness is not such a bad thing? 1 Do nice guys finish last? Is a happy, successful, champion a myth? 1 Hardy, L., Barlow, M., Evans, L., Rees, T., Woodman, T., & Warr, C. (2017). Great British medallists: Psychosocial biographies of super-elite and elite athletes from Olympic sports. Progress in Brain Research, 232, Hardy, L. (2015). Epilogue. In S. D. Mellalieu, & S. Hanton (Eds.) Contemporary reviews in sport psychology (pp.258-x). Abingdon, UK: Routledge. Could or Should we Try to Emulate the World s Best Athletes? Loughborough University Annual Health and Safety Forum 6
7 Success: It Not Always What You See Professional and Popular Reading Gogarty, P., & Williamson, I. (2009). Winning at all costs: Sporting gods and their demons. London: JR Books. Hemery, D. (1991). Sporting excellence: What makes a champion? London: CollinsWillow. Oakley, B. (2014). Podium: Sporting champions' paths to the top. London: Bloomsbury. Slot, O., Timson, S., & Warr, C. (2017).The talent lab: The secret to finding, creating and sustaining success. London: Ebury Press. Syed, M. (2017). The greatest: The quest for sporting perfection. London: John Murray. Thank you for your attention Please take a handout Any questions? Dr David Fletcher D.Fletcher@lboro.ac.uk Loughborough University Annual Health and Safety Forum 7
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