How can we help elite sports competitors take better care of their mental health? © Getty Images/Abbie Parr

How can we help elite sports competitors take better care of their mental health?

The recent actions of Olympic gymnast Simone Biles and tennis star Naomi Osaka have highlighted the mental health issues faced by elite athletes. A psychologist explains what we could be doing better.

Recently, mental health in sports was thrust into the public spotlight when Olympic gymnast Simone Biles and tennis star Naomi Osaka both chose not to compete, citing concerns over their mental wellbeing due to the pressures of elite competition.

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Both athletes strongly expressed concerns over the ongoing effects of being in an intense competitive environment, and both argued that a deterioration in mental health is a legitimate reason for withdrawing from competition.

Although some reporters have been less than sympathetic, arguing that these highly paid athletes should accept and deal with the pressure, we should not be so easy to dismiss the notion that elite sportspeople need support for their mental health. After all, regardless of their talents, athletes are human beings just like the rest of us, and being able to play sport at an elite level does not provide immunity to poor mental health.

Some commentators have said that the two young athletes simply lack mental toughness. But arguably, withdrawing from such high-profile competition after years of training and preparation was a more difficult decision to make than to go ahead and compete. Moreover, if they had cited a physical injury, such as an injured knee, their withdrawal would not even be questioned.

So, the key questions are why are elite sportspeople under so much pressure, and how can we learn from this experience to provide better mental health provision?

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To do this it is important to understand the factors that make elite sporting competition such a highly pressured environment. Firstly, competitions are won and lost in mere moments. Consider a gymnast with their sights set on Olympic gold, for example. One slip, or one lapse of concentration, and that ambition is gone in an instant.

Athletes spend years training to perform to the best of their abilities in that one specific moment. When you add to that the fact that they are representing an entire country, and that they feel that the focus of thousands, including their family and friends, is on their performance, this generates a huge sense of pressure.

So, elite athletes experience intense emotions surrounding competition, and some of these are likely to be unpleasant emotions such as anxiety over the uncertainty of the outcome, and possibly guilt, shame and misery if they anticipate not performing at their best.

A team of international researchers recently carried out a systematic review of 600 studies comparing athletes’ performance to their scores in a commonly used mood-profiling test designed to assess a person’s relative levels of anger, confusion, depression, fatigue, tension and vigour. They found that poor mental health and poor sporting performance were both linked to high scores on unpleasant mood states and low scores for vigour. As such, mood profiling is one potential strategy for managing athletes’ mental health.

Emotions experienced before and during sporting competition also have a significant effect on athletes’ performance in everything from interacting with teammates to improving their economy of movement. So, the regulation of emotions is regarded as an important skill by sports psychologists.

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When it comes to describing how athletes regulate emotions, sports psychologists have developed a strong theoretical model based on five distinct strategies: situation selection, situation modification, attention deployment, cognitive change, and response modulation.

Situation selection is the process by which an athlete actively chooses to place themselves in one situation rather than another, while situation modification refers to attempts to modify external aspects of the environment. By doing either of these things, an athlete can make it more likely that a desirable emotional state is attained or an undesirable one avoided.

Attention deployment is the process whereby an athlete directs their attention away from things that could have a negative impact on their emotions. One example would be listening to music on headphones to avoid hearing the crowd prior to an event.

Cognitive change involves the athlete consciously changing the meaning of an event. For example, a football player who has just missed a penalty may reappraise the extent of self-blame by saying, “It was a great shot, but an even better save by the keeper.”

Finally, response modulation refers to strategies designed to regulate the physiological and cognitive aspects of emotion as directly as possible. This could involve strategies such as progressive muscular relaxation or centring.

So, where does this leave us? We recognise that elite athletes are prone to experiencing deterioration in mental health and therefore it is important that we provide support. Developing interventions that help athletes improve their ability to regulate their emotions should be a key part of training programmes with the aim of helping them take care of their mental health. This is opposed to an approach where we simply wait for athletes to develop mental health issues and then treat the effects. Prevention is better than cure, and positive mental health should be the prize that all athletes strive for.

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