Opinion: Sport may be considered a simple hobby, but for devoted athletes, it is an integral aspect of who they are. When challenged to stop or reduce their level of engagement, their sense of identity and purpose can become threatened.

By Dr Gavin Breslin and Professor Gerard Leavey, Ulster University

Sport participation brings a lot of pleasure enjoyment and happiness to many people, a sense of identity, community connectedness, and long-enduring friendships. It is these positive experiences and opportunities that help explain why we participate and invest time and energy in sport. 

The beneficial health and wellbeing aspects of sport participation - particularly through exercise - are scientifically well-established, and the promotion of exercise and its benefits are increasingly part of the public health message in Ireland for all age groups. 

However, the demands of elite-level sport participation can become too much for some, particularly so when performance expectations and the pursuit of perfection begin to overshadow the wellbeing of athletes.

Recent evidence suggests that competitive elite sport can overwhelm athletes when exposed to additional stressors such as: 

Relentless striving to achieve success; long periods of separation from family; negative psychological sequelae following injury; alcohol and substance misuse; fear of failure and anticipated social opprobrium; social media intrusion; relationship difficulties; financial and long-term employment challenges. 

For some readers, sport may be considered a simple hobby, but for devoted athletes, it is a way of life, an integral aspect of who they are. When challenged to stop or reduce their level of engagement, their sense of identity and purpose can become threatened. 

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Going back to the ancient Greeks and Romans, society has adopted a lionised view of athletes as paragons of health and attendant virtues of discipline, morality, strength, and beauty. Unfortunately, a more realistic understanding of athletes and athleticism has seldom been examined.

Historically, athletes have been poorly supported to manage their mental health needs; mental health promotion within sports settings was considered as superfluous and irrelevant. Instead, like the ancient Greek gymnasia, sport club culture has fostered the celebration of mental toughness and disapproval of weakness disclosure.

Consequently, emotional and psychiatric problems can remain hidden with the stigma of mental illness preventing athletes from seeking timely and appropriate help. Furthermore coaches - that is those who instruct athletes on technique, lifestyle behaviours and key decisions for success - can also experience stressors and require support for managing their mental health.

Our discussions with coaches suggests that all too often they strive to exude a steely projection of confidence and composure, while inwardly feeling fragile and vulnerable within a culture that demands peak performance and rewards winning. Unfortunately, athletes and coaches alike are often trapped in a culture of denial in which the mental health costs are high. 

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There has been a recent surge of interest in supporting the mental health and wellbeing of those involved in sport and their supporters (e.g., athletes, coaches, officials, parents, fans and the local community). Commendably, several policy and consensus statements have been launched to support athletes and provide guidance.

Furthermore, psychological approaches and theoretical frameworks have been applied in attempts to tackle mental health and wellbeing of athletes, but theory, policy, and practice in this field is still embryonic.

Such approaches include i) increasing knowledge about mental health to aid prevention and promote help-seeking, ii) the development of cognitive behavioural techniques to enhance coping (i.e., mindfulness, resilience, rational emotive-behaviour therapy), and iii) the use of sport organisations to engage groups (i.e., men, those from low income areas) to promote psycho social wellbeing. 

Our recent book Mental health and Wellbeing Intervention in Sport: Research Theory and Practice is about describing what has been in place in sport to support those engaged in club competitive sport.

We have focused on how psychology can be applied to the development of interventions to enhance mental health and wellbeing.

Our focus is on the evidence-based design process and the content of the interventions, with an emphasis on methodological advances and what has been shown to improve awareness of mental health and wellbeing.

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Our principal goal is to help the sporting community to understand better, the sport setting-based mental health interventions and what would work best in their governing body, association or club. Throughout the book we bring awareness to the inherent performance requirements but also wellbeing challenges that sport culture fosters.

In section 1, case studies of mental health support services are presented for a range of sports. Examples include a lean athlete experiencing eating disorder pathology, a swimmer experiencing depression, burnout and chronic stress, delivering a mental health literacy programme to university athletes (State of Mind Ireland), parents, adolescents, and a reflection on the support provided to a Paralympic athlete.

In Section 2, we detail how sport especially football and rugby have been used to promote mental health awareness programmes in the community.

Finally, a critical reflection and the way forward for mental health in sport are presented, as is an outline of the new Wellbeing in Sport Five Year Action Plan for Northern Ireland.

The wish is that - as well as developing an appreciation for the strives made in bringing about positive changes to many people’s lives - the reader takes this information and applies it in their own practice, with an open mind that they to will strive to improve mental health in sport. 

Dr. Gavin Breslin is a member of the Sport and Exercise Sciences Research Institute (SESRI), and The Bamford Centre for Mental Health and Wellbeing, Ulster University. His research was instrumental in establishing the national Wellbeing In Sport Action Plan for Northern Ireland (2019-2024).

Professor Gerard Leavey is Director of the Bamford Centre for Mental Health and Wellbeing at Ulster University. Current research includes studies on young people, trust and help-seeking, mental health promotion evaluations in sport, and service use in the context of suicide in Northern Ireland. 

The views expressed here are those of the author and do not represent or reflect the views of RTÉ.