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Sports Medicine

Open Access 22-09-2023 | Current Opinion

Psychological Safety for Mental Health in Elite Sport: A Theoretically Informed Model

Authors: Courtney C. Walton, Rosemary Purcell, Vita Pilkington, Kate Hall, Göran Kenttä, Stewart Vella, Simon M. Rice

Published in: Sports Medicine

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Abstract

Elite sports contexts are highly pressurised and frequently enforce a win-at-all-costs approach. This narrow focus on performance outcomes can potentially contribute in negative ways to the mental health of those within these environments. In this Current Opinion paper, we propose a model that outlines how key elements contributing to psychologically safe or unsafe environments may contribute to better or worse mental health outcomes, respectively. In an environment in which individuals feel safe to show their authentic selves rather than ‘wear a mask’, different experiences of mental health are likely to be normalised, help-seeking behaviour increased, and thus, mental health outcomes enhanced. We outline how sports teams and organisations can contribute to this through the creation of appropriate policies and procedures, in addition to leaders modelling and reinforcing positive cultural norms. It is intended that the theoretical model can inform stakeholders in elite sport as well as future research directions.
Footnotes
Literature
1.
Mountjoy M, Brackenridge C, Arrington M, Blauwet C, Carska-Sheppard A, Fasting K, et al. International Olympic Committee consensus statement: harassment and abuse (non-accidental violence) in sport. Br J Sports Med. 2016;50(17):1019–29. PubMedCrossRef
2.
Kuettel A, Larsen CH. Risk and protective factors for mental health in elite athletes: a scoping review. Int Rev Sport Exerc Psychol. 2019;2:1–35.
3.
Rice SM, Purcell R, De Silva S, Mawren D, McGorry PD, Parker AG. The mental health of elite athletes: a narrative systematic review. Sports Med. 2016;46(9):1333–53. PubMedPubMedCentralCrossRef
4.
Gouttebarge V, Castaldelli-Maia JM, Gorczynski P, Hainline B, Hitchcock ME, Kerkhoffs GM, et al. Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis. Br J Sports Med. 2019;53(11):700–6. PubMedCrossRef
5.
Pilkington V, Rice SM, Walton CC, Gwyther K, Olive L, Butterworth M, et al. Prevalence and correlates of mental health symptoms and well-being among elite sport coaches and high-performance support staff. Sports Med Open. 2022;8(1):89. PubMedPubMedCentralCrossRef
6.
Åkesdotter C, Kenttä G, Eloranta S, Håkansson A, Franck J. Prevalence and comorbidity of psychiatric disorders among treatment-seeking elite athletes and high-performance coaches. BMJ Open Sport Exerc Med. 2022;8(1):e001264. PubMedPubMedCentralCrossRef
7.
Purcell R, Pilkington V, Carberry S, Reid D, Gwyther K, Hall K, et al. An evidence-informed framework to promote mental wellbeing in elite sport. Front Psychol. 2022;13:780359. PubMedPubMedCentralCrossRef
8.
Purcell R, Gwyther K, Rice SM. Mental health in elite athletes: increased awareness requires an early intervention framework to respond to athlete needs. Sports Med Open. 2019;5(1):46. PubMedPubMedCentralCrossRef
9.
Feddersen NB, Morris R, Littlewood MA, Richardson DJ. The emergence and perpetuation of a destructive culture in an elite sport in the United Kingdom. Sport Soc. 2020;23(6):1004–22. CrossRef
10.
Taylor J, Collins D, Ashford M. Psychological safety in high-performance sport: contextually applicable? Front Sports Active Liv. 2022;25:169.
11.
Vella SA, Mayland E, Schweickle MJ, Sutcliffe JT, McEwan D, Swann C. Psychological safety in sport: a systematic review and concept analysis. Int Rev Sport Exerc Psychol. 2022;25:1–24. CrossRef
12.
Henriksen K, Schinke R, McCann S, Durand-Bush N, Moesch K, Parham WD, et al. Athlete mental health in the Olympic/Paralympic quadrennium: a multi-societal consensus statement. Int J Sport Exerc Psychol. 2020;25:1–18.
13.
International Olympic Committee AP. IOC Mental health in elite atheltes toolkit. Lausanne: International Olympic Committee AP; 2021.
14.
Rice S, Walton CC, Pilkington V, Gwyther K, Olive LS, Lloyd M, et al. Psychological safety in elite sport settings: a psychometric study of the Sport Psychological Safety Inventory. BMJ Open Sport Exerc Med. 2022;8(2):e001251. PubMedPubMedCentralCrossRef
15.
Swann C, Moran A, Piggott D. Defining elite athletes: issues in the study of expert performance in sport psychology. Psychol Sport Exerc. 2015;16:3–14. CrossRef
16.
Purcell R, Henderson J, Tamminen KA, Frost J, Gwyther K, Kerr G, et al. Starting young to protect elite athletes’ mental health. Brit J Sports Med. 2023;20:2022–106352.
17.
18.
Edmondson AC, Bransby DP. Psychological safety comes of age: observed themes in an established literature. Annu Rev Organ Psych Organ Behav. 2022;20:20.
19.
Schein E, Bennis WG. Personal and organizational change through group methods: the laboratory approach. New York: Wiley; 1965.
20.
Kahn WA. Psychological conditions of personal engagement and disengagement at work. Acad Manage J. 1990;33(4):692–724. CrossRef
21.
Edmondson AC, Lei Z. Psychological safety: the history, renaissance, and future of an interpersonal construct. Annu Rev Organ Psych Organ Behav. 2014;1(1):23–43. CrossRef
22.
Edmondson A. Psychological safety and learning behavior in work teams. Adm Sci Q. 1999;44(2):350–83. CrossRef
23.
Edmondson AC. The fearless organization: creating psychological safety in the workplace for learning, innovation, and growth. New York: Wiley; 2018.
24.
Clark TR. The 4 stages of psychological safety: defining the path to inclusion and innovation. San Francisco: Berrett-Koehler Publishers; 2020.
25.
Jowett S, Do Nascimento-Júnior JRA, Zhao C, Gosai J. Creating the conditions for psychological safety and its impact on quality coach-athlete relationships. Psychol Sport Exerc. 2022;2:102363.
26.
Gosai J, Jowett S, Nascimento-Júnior JRAD. When leadership, relationships and psychological safety promote flourishing in sport and life. Sports Coach Rev. 2021;25:1–21.
27.
Fransen K, McEwan D, Sarkar M. The impact of identity leadership on team functioning and well-being in team sport: is psychological safety the missing link? Psychol Sport Exerc. 2020;20:51.
28.
Poucher ZA, Tamminen KA, Kerr G, Cairney J. A commentary on mental health research in elite sport. J Appl Sport Psychol. 2021;33(1):60–82. CrossRef
29.
Castaldelli-Maia JM, Gallinaro J, Falcao RS, Gouttebarge V, Hitchcock ME, Hainline B, et al. Mental health symptoms and disorders in elite athletes: a systematic review on cultural influencers and barriers to athletes seeking treatment. Br J Sports Med. 2019;53(11):707–21. PubMedCrossRef
30.
Gulliver A, Griffiths KM, Christensen H. Barriers and facilitators to mental health help-seeking for young elite athletes: a qualitative study. BMC Psychiatry. 2012;12(1):157. PubMedPubMedCentralCrossRef
31.
Crawford KL, Wilson B, Hurd L, Beauchamp MR. Reaching out: help-seeking among professional male ice hockey athletes. Qual Res Sport Exerc Health. 2022;25:1–18.
32.
Bennie A, Walton CC, O’Connor D, Fitzsimons L, Hammond T. Exploring the experiences and well-being of Australian Rio Olympians during the post-Olympic phase: a qualitative study. Front Psychol. 2021;12:685322. PubMedPubMedCentralCrossRef
33.
Åkesdotter C, Kenttä G, Sparkes AC. Elite athletes seeking psychiatric treatment: stigma, impression management strategies, and the dangers of the performance narrative. J Appl Sport Psychol. 2023;5:1–21. CrossRef
34.
Gucciardi DF, Hanton S, Fleming S. Are mental toughness and mental health contradictory concepts in elite sport? A narrative review of theory and evidence. J Sci Med Sport. 2017;20(3):307–11. PubMedCrossRef
35.
36.
Frost J, Walton CC, Purcell R, Rice SM. Supporting the mental health of elite-level coaches through early intervention. Arthrosc Sports Med Rehabil. 2023;5:100734.
37.
Bauman NJ. The stigma of mental health in athletes: are mental toughness and mental health seen as contradictory in elite sport? Br J Sports Med. 2016;50(3):135–6. PubMedCrossRef
38.
Poucher ZA, Tamminen KA, Kerr G. Olympic and Paralympic athletes’ perceptions of the Canadian sport environment and mental health. Qual Res Sport Exerc Health. 2023;25:1–18.
39.
Clement S, Schauman O, Graham T, Maggioni F, Evans-Lacko S, Bezborodovs N, et al. What is the impact of mental health-related stigma on help-seeking? A systematic review of quantitative and qualitative studies. Psychol Med. 2015;45(1):11–27. PubMedCrossRef
40.
Mountjoy M. ‘Only by speaking out can we create lasting change’: what can we learn from the Dr Larry Nassar tragedy? Br J Sports Med. 2019;53(1):57–60. PubMedCrossRef
41.
Hägglund K, Kenttä G, Thelwell R, Wagstaff CRD. Is there an upside of vulnerability in sport? A mindfulness approach applied in the pursuit of psychological strength. J Sport Psychol Action. 2019;10(4):220–6. CrossRef
42.
Walton CC, Osborne MS, Gilbert P, Kirby J. Nurturing self-compassionate performers. Aust Psychol. 2022;57(2):77–85. CrossRef
43.
Moesch K, Kenttä G, Kleinert J, Quignon-Fleuret C, Cecil S, Bertollo M. FEPSAC position statement: mental health disorders in elite athletes and models of service provision. Psychol Sport Exerc. 2018;38:61–71. CrossRef
44.
Van Slingerland K, Durand-Bush N, DesClouds P, Kenttä G. Providing mental health care to an elite athlete: the perspective of the Canadian Centre for Mental Health and Sport team. Case Stud Sport Exerc Psychol. 2020;4(S1):S1-17.
45.
Rice S, Butterworth M, Clements M, Josifovski D, Arnold S, Schwab C, et al. Development and implementation of the national mental health referral network for elite athletes: a case study of the Australian Institute of Sport. Case Stud Sport Exerc Psychol. 2020;4(S1):S127–35. CrossRef
46.
Kerr G, Battaglia A, Stirling A. Maltreatment in youth sport: a systemic issue. Kinesiol Rev. 2019;8(3):237–43. CrossRef
Metadata
Title
Psychological Safety for Mental Health in Elite Sport: A Theoretically Informed Model
Authors
Courtney C. Walton
Rosemary Purcell
Vita Pilkington
Kate Hall
Göran Kenttä
Stewart Vella
Simon M. Rice
Publication date
22-09-2023
Publisher
Springer International Publishing
Published in
Sports Medicine
Print ISSN: 0112-1642
Electronic ISSN: 1179-2035
DOI
https://doi.org/10.1007/s40279-023-01912-2