Every consultation provides the opportunity for screening for mental health problems. Although there are several groups that are at a higher risk of depression and related disorders, all players should be screened for depression when there are systems in place to ensure accurate diagnosis, effective treatment and appropriate follow-up. 6
Screening may simply involve having awareness that the players you look after have the same risk of mental health problems as the general population. Enquiring regularly about their well-being and being clear that you are available to talk with them should problems arise is a practical first step. You may also elect to also incorporate more formal screening tools into your pre-competition medical assessment (PCMA) or to perform these at regular intervals throughout the year. There are a number of validated tools that can be used to do this.
The three most widely used tools to screen for depression are the nine-question patient health questionnaire – depression (PHQ-9), the Beck Depression Inventory-II (BDI-II) and the depression screener from the Center for Epidemiologic Studies Depression Scale (CES-D). 7
It is important to recognise the limitations of these screening tools. When players report symptoms of mental health problems, it is important to then follow up with a clinical assessment. Similar tools exist for all major mental health conditions. They are not limited to just depression.