This FastFact highlights the recently published International Olympic Committee (IOC) consensus statement on the mental health of athletes1. While this comprehensive review gives an overview of the issues relating to the mental health of elite athletes, this FastFact investigates some of the barriers to footballers seeking help when problems arise.
Mental health symptoms are often not reported by elite or top-level footballers despite evidence that depression and anxiety, as well as other mental health disorders, are at least as frequent in footballers as among the general population. Some of the barriers to seeking help for mental health issues are well known while others are harder to identify and can be specific for different populations. An important consideration is that mental health symptoms commonly recur, and the support should be there for footballers to continue to access services as needed.
Busy football schedules, especially at the elite level, allow little time to discuss mental health symptoms unless they are seen as a priority. As a physical contact sport, football players may be more likely to have negative attitudes about mental health services. The self (and public) stigma of mental health disorders can affect the athletes attitude towards opening up to team members or medical professionals. It is not uncommon for footballers to have had negative experiences seeking help, while there may also be limited access to mental health services. The understanding and treatment of mental health can, in some countries, fall outside of evidence based management, and health literacy may be low. Players who may be less likely to seek help appear to be male, of younger age, black race, reserved and high achieving personality types, those with gender role conflicts and those of American nationality (vs European). Women appear more likely to be stereotyped for seeking mental health care, which may also reduce the level of self or team reporting among female players.
There appear to be some simple strategies that can remove some of the barriers to the reporting of mental health problems. Coaches who are advocates for positive mental health care, can increase the probability that their players will seek help. Encouraging coaches to be open about mental health issues and implementing symptoms to identify at risk players should allow for early identification and referral. Player education can also enhance a sense of self-care and increase the likelihood a player will seek help. Finally health providers have a big role here by being open and non-judgemental. Psychology input from specific providers who understand football and who commonly treat athletes appears to be especially valued.
It is important that the broader footballing community, staff and players recognise the importance of good mental health and the need to seek early treatment when issues arise. Managing the mental health of our players should improve a player’s overall well-being and help foster success in football.
1Reardon CL, Hainline B, Aron CM, et al. Mental health in elite athletes: International Olympic Committee consensus statement (2019) British Journal of Sports Medicine 2019;53:667-699.