Mental Health

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13 Lessons

The WHO defines mental health as “a state of well-being in which every individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community”. Rather than being viewed as a “disorder”, mental health should be regarded as a continuum with mental well-being at the one end and severe mental disorders at the other. The diagnostic criteria for mental and behavioural disorders are defined in the ICD-10 and DSM-5.

“We all have mental health, like we all have physical health. Both change throughout our lives. And, like our bodies, our minds can become unwell.”

The aim of this module is to develop an awareness of the specific issues that relate to football players and the football context. It is important to appreciate that the prevalence of symptoms of depression and anxiety, and likely other mental health disorders, is at least as high as the prevalence seen in the general population. There are some specific conditions that can increase the risk of mental health problems. It is important to consider the possibility of a mental health diagnosis when conducting a pre-competition medical assessment and to be able to identify and treat these symptoms appropriately. In many cases, referral to other clinicians may also be needed.

Presented by

Margo Mountjoy

Learning outcomes

After studying this topic, you should:

  • have an understanding regarding the prevalence of and risk factors for mental health disorders, especially depression and anxiety;
  • be able to conduct a basic assessment, including an assessment of safety (including the suicide risk), of a football player you think might have a mental health disorder;
  • have an awareness of the issues relating to depression, anxiety and eating disorders/disordered eating and how they may present in a football context;
  • be aware that suicide affects everyone (including football players and coaches) and be able to enquire about this and initiate an appropriate action plan;
  • be aware that football players may be exposed to harassment and abuse and be able to assist with the development of a programme to address and prevent this at your club or organisation.


  • Review the media content and read the provided text.
  • Read the “required” articles
  • Complete the case-based assessment task


  1. North Lincolnshire Council. Mental health and emotional wellbeing. Updated 2015. Accessed December 19, 2016.
  2. Prinz B, Dvorák J, Junge A. Symptoms and risk factors of depression during and after the football career of elite female players. BMJ Open Sport & Exercise Medicine. 2016;2(1).
  3. Gouttebarge V, Frings-Dresen MH, Sluiter JK. Mental and psychosocial health among current and former professional footballers. Occup Med (Lond). 2015;65(3):190-196.
  4. Vahdat Shariatpanaahi M, Vahdat Shariatpanaahi Z, Moshtaaghi M, Shahbaazi SH, Abadi A. The relationship between depression and serum ferritin level. Eur J Clin Nutr. 2007;61(4):532-535.
  5. Machnik M, Sigmund G, Koch A, Thevis M, Schänzer W. Prevalence of antidepressants and biosimilars in elite sport. Drug Testing and Analysis. 2009;1(6):286-291.
  6. U.S. Preventive Services Task Force. Screening for depression in adults: U.S. preventive services task force recommendation statement. Ann Intern Med. 2009;151(11):784-792.
  7. Radloff LS. The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement. 1977;1(3):385-401.
  8. BECK AT, WARD CH, MENDELSON M, MOCK J, ERBAUGH J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561-571.
  9. Junge A, Feddermann-Demont N. Prevalence of depression and anxiety in top-level male and female football players. BMJ Open Sport & Exercise Medicine. 2016;2(1).
  10. Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: The GAD-7. Arch Intern Med. 2006;166(10):1092-1097.
  11. Mountjoy M, Sundgot-Borgen J, Burke L, et al. The IOC consensus statement: Beyond the female athlete triad–relative energy deficiency in sport (RED-S). Br J Sports Med. 2014;48(7):491-497.
  12. World Health Organisation. Preventing suicide: A global imperative. Updated 2016. Accessed December 19, 2016.
  13. Mountjoy M, Brackenridge C, Arrington M, et al. International olympic committee consensus statement: Harassment and abuse (non-accidental violence) in sport. Br J Sports Med. 2016;50(17):1019-1029.
  14. Gouttebarge V, Jonkers R, Moen M, Verhagen E, Wylleman P, Kerkhoffs G. The prevalence and risk indicators of symptoms of common mental disorders among current and former Dutch elite athletes. J Sports Sci. 2016 Nov 29:1-9.
  15. Gouttebarge V, Johnson U, Rochcongar P, Rosier P, Kerkhoffs G. Symptoms of common mental disorders among professional football referees: a one-season prospective study across Europe. Phys Sportsmed. 2016 Oct 14. [Epub ahead of print]