Mental health disorders are common among elite athletes (those who competed at the professional, Olympic, or collegiate/university levels) with depression, anxiety, alcohol abuse, sleep-related issues, and eating disorders occurring in 5-35% annually Although elite athletes experience symptoms of mental illness at the same intensity as the general population, the number that seeks help for these conditions is alarmingly low. João Mauricio Castaldelli-Maia, MD, Ph.D., and colleagues performed a systematic literature review examining the barriers to trying to get professional help for mental health disorders and the cultural influences of mental health in elite athletes.
The authors evaluated 52 articles and identified the essential topics for data collection. They presented these to a panel of experts consisting of "psychiatrists, psychologists, primary care sports medicine physicians, a neurologist, a neurosurgeon, an exercise scientist, a social worker, and elite athletes" at the International Olympic Committee Consensus Meeting on Mental Health in Elite Athletes in Lausanne, Switzerland. The objectives of the study were determined to summarize the literature based on "barriers, facilitators, influencing factors, preferred characteristics of counselors, and interventions regarding elite athletes accessing mental health resources and "cultural issues that impact the mental health of elite athletes including gender, gender identity, sex, sexual orientation, race, ethnicity, socioeconomic status, and religion."
The most frequently reported barrier to seeking mental health services was stigma. Although stigma-related avoidance for getting help is decreasing in younger athletes, all elite athletes continue to have problems divulging anything that can be seen as a 'weakness,' which are attitudes still held by some individuals. Other barriers to seeking care included negative past experiences, low mental health literacy, and busy schedules.
Some of the cultural factors that influence the mental health of elite athletes include refusal to accept women as athletes, lack of acceptance of mental health disorders in non-white athletes, non-disclosure of religious beliefs, and greater dependence on monetary benefits.
Eliminating stigma and cultural influencers regarding seeking mental health services among elite athletes begin with the coaches. Since coaches can influence athletes' perceptions and beliefs, exhibiting positive attitudes about mental health and encouraging their athletes to seek treatment will go a long way to change the current culture of stigmatizing elite athletes dealing with mental illness.