Stigma of mental health issues a barrier to treatment for athletes

When Washington State quarterback Tyler Hilinski took his own life just three weeks after playing in what would be his last college football game, it again brought a spotlight to mental health issues in sports.

Researchers are now beginning to look at how mental health care can impact on-the-field performance

A recent study reported in the Journal of Science and Medicine in Sport  looked at 224 elite Australian athletes and found that the rates of mental disorders were similar to that of the general population, showing that physical fitness and focus on training did not diminish the prevalence of disorders like depression, eating disorders, general psychological distress and anxiety.

For athletes however, the stigma of seeking help can be a huge barrier to understanding and managing mental health issues. A study published in BMC Psychiatry pointed to the need to create strategies to reduce the stigma of seeking help and increasing mental health literacy among young athletes.

As noted in the BMC report:

“Stigmatisation of athletes who seek psychological services has been documented, and those who do seek help for mental health problems may be viewed by other athletes and coaches as being weak.”

Further, the BMC study noted:

“A study of general college students’ attitudes revealed that non-athletes tended to stigmatise male athletes who consulted a sport psychologist for a performance consistency problem, but not those who consulted their coach for the same problem.”

Cleveland Cavaliers’ center Kevin Love might be a guidepost for changing those views. After his moving account of realizing a debilitating panic attack he suffered during a game was anxiety, rather than hide the fact he experienced it, he wrote about his struggles. Ron Artest, the former Los Angeles Laker, also notably thanked his psychiatrist after winning an NBA title.

Increasing the mental health literacy is a first step. A small study also found that “mental health literacy and destigmatization improves knowledge and may decrease stigma but does not increase help-seeking.”

Often, when confronted with an athletic patient, doctors see the claims of lack of energy or motivation, irritability and discouragement and have placed the cause as burn out or overtraining. But those symptoms in athletes could point to mental health issues that may go undiagnosed.

A paper in the British Journal of Sports Medicine says this could be because:

“Current nomenclature defines overreaching as a short term decrement in performance in which recovery may take a few days to weeks, usually through a temporary and modest decrease in training load.4 Overreaching is the athletic equivalent of an adjustment reaction, grieving, or a more minor depression in which psychosocial loss or stressors lead to a temporary decrement in social or work function. Overtraining (OT) is defined as a long term decrement in performance,4 usually with various physiological, immunological, hormonal, and metabolic changes that are remarkably similar to those in MDD, the only difference being the nature of the role dysfunction: athletic performance in the case of the overtrained athlete, social, cognitive, and work in the case of the depressed patients.”

While most studies site the lack of large study groups, treating and diagnosing mental health must first bypass the stigma associated with it.