While perceptions have largely changed when it comes to physical injuries, where adjusting training to accommodate proper recovery is no longer considered a sign of weakness, when it comes to mental health, denial, fear and stigma often mean that athletes suffer in silence.

To find out more about the issue, World Rowing spoke with Dr. Chris Shambrook, long-time sport psychologist for British Rowing and Dr. Simon Rice, an expert in mental health research at the University of Melbourne in Australia.

Who’s at risk?

“There are popular misconceptions that athletes are invulnerable, that athletes are a protected species when it comes to mental ill health,” says Rice, whose recent work includes a large review of studies on the mental health of elite athletes. “Our conclusion is that athletes suffer about the same rate of prevalence as the general population.”

How frequent is mental ill health?

“Current estimates would be that 1 in 4 people have a mental health issue, regardless of profession,” says Shambrook. “We should be focusing on understanding how to manage mental health and provide a supporting environment wherever you are.”

Even coaches are not immune, he adds.

Mental ill health or just a bad day?

“We’re all prone to ups and downs and having a bad day,” says Rice, “but when symptoms are frequent, moderate to severe and having an impact on functioning, that’s when we start to be worried.”

While many common mental health disorders have particular symptoms and signs, there are some simple indicators of mental ill health that Rice points to. “It might vary a bit from athlete to athlete,” he says, “and might manifest in areas of motivation, feeling burnt out, experiencing concern about the trajectory they are on or their life after sport, troubles eating or sleeping, worry about everything that’s going on, (even) using substances.”

“Pressure varies for different people at different times during the season and Olympiad,” says Shambrook, “depending upon their standing in the squad, level of support, prior experience and personality. Understanding individual sources of stress is therefore worth getting to know so that coping strategies can be practices and developed.”

“There is also a strong relationship between physical state and mental state,” he adds. “So understanding times when psychological stressors are likely to be at their peak together is worth considering, so additional coping skills and support mechanisms can be called upon at this time.”

Normalising the discussion

While openness to discussing mental health issues is becoming more accepted in general in the sporting context, Rice acknowledges, “there are tricky issues of who knows what and who can share what with whom.”

“Coaches focus a lot on resilience. At the same time they are having a battle (determining) how to (allow athletes) to be vulnerable. It is an area of contradictory messages,” says Rice who notes that athletes don’t want to be seen to be weak or vulnerable to their coach who ultimately can determine whether the athlete makes it into the boat. “If something is going on, talk to your coach. But then the coach expects you to be at your best ever. I think it is hard for coaches to tread that line and develop a framework of how to do that.”

Although these sorts of situations will take time to resolve, there are positive steps that can be taken, says Shambrook. “Right now, everyone can be involved in raising awareness, normalising the discussion and ensuring that pathways to support are as widely available to everyone as for physical problems.”

Is prevention possible?

“There is a lot of mental ill health that could be prevented,” says Rice. “Through good early identification and early intervention, we want to detect the presence of mental ill health symptoms before it gets to the disorder level.”

Shambrook echoes the idea, adding that an important step is “creating environments that are aware of the early signs of mental health being impaired and making it commonplace for everyone to play their part in looking after their own mental health and the mental health of those around them.”

“If you are clear as an individual what your risk factors are and what your early warning signs are,” says Rice, “you can use that in your own training to make sure this doesn’t happen again. When you start to see the needle dipping into the red a bit, (know) what you can do to bring it back.”

“Mental ill health can at times be impairing,” Rice concludes. “But intervening early tends to result in much better outcomes and quicker recovery.”

What now?

Starting a conversation about mental health can be difficult. If supports aren’t in place where you row, the first best step, agree the experts, is to contact a trained mental health professional, such as sport psychologist or physician.

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