Mental health help-seeking in young elite athletes
Date
2012
Authors
Gulliver, Amelia Jane Granville
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Mental disorders are more common in early adulthood than at any other life stage. Despite this, young people have low rates of seeking professional help for mental health problems. Evidence shows that young elite athletes have less positive attitudes toward seeking help than non-athletes and thus may be particularly unlikely to seek help. Therefore, it is important to increase the likelihood of professional help-seeking in this group. This thesis reports the findings from five related studies that primarily investigated help-seeking for mental health problems in young elite athletes. The first was a systematic review examining published qualitative and quantitative studies of barriers and facilitators to help-seeking for young people in the general community. The review of 23 papers demonstrated that young people perceived stigma and embarrassment, poor mental health literacy, and a preference for self-reliance as the most important barriers to help-seeking. Although facilitators of help-seeking were found to be comparatively under-researched, there was evidence that positive past experiences, and social support and encouragement from others aid help-seeking. The second study involved focus groups conducted with 15 young elite athletes. It demonstrated that the help-seeking barriers were similar to those reported in the community: stigma, lack of mental health literacy, and negative past experiences of help-seeking. Facilitators of help-seeking were encouragement from others, having an established relationship with a provider, pleasant previous interactions with providers, the positive attitudes of others, especially their coach, and access to the Internet. The third study was a systematic review of randomised controlled trials (RCTs) of help-seeking for depression and anxiety (n = 6), most of which targeted young adults. Mental health literacy content was effective in improving help-seeking attitudes in most studies at post-intervention, but had no effect on help-seeking behaviour. There was less evidence for other intervention types such as destigmatisation or provision of help-seeking sources. The fourth study was a cross-sectional survey of the mental health of 639 young elite athletes. Half of the athletes met caseness for at least one mental health problem. In addition, the athlete sample was similar to the general community on symptom measures including depression and anxiety. The fifth study was an RCT investigating the effectiveness of three Internet-based interventions compared with a control condition for increasing help-seeking attitudes, intentions and behaviour in 59 young elite athletes. The interventions were a list of help-seeking sources, a feedback intervention, and a mental health literacy/destigmatisation intervention. The latter showed a non{u00AD} significant trend toward increased help-seeking behaviour among athletes, significant increases in depression and anxiety knowledge and some evidence of reduced stigma. However, the size of the sample able to be recruited was insufficient to detect a moderate effect size in help-seeking. In conclusion, mental health problems are common among elite athletes and there is a need to identify evidence-based interventions for increasing help-seeking behaviour in this group. Based on the current findings, further investigation of the effectiveness of online mental health literacy and stigma reduction content is warranted using a suitably powered trial.
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2099-04-02
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