Mental health in sports is increasingly in the public eye with the recognition that even elite sports people can suffer with mental health issues. Sports people including boxer Frank Bruno, cricketers Mike Yardy and Jonathan Trott, footballer Stan Collymore, athlete Kelly Holmes, cyclist Victoria Pendleton and rugby player Duncan Bell have all publically discussed their own personal fight with mental illnesses.

In March 2015 the then deputy prime minister, Nick Clegg, alongside UK sports organisations launched their commitment to stopping mental health discrimination in sport and signing up to the Mental Health Charter for Sport and Recreation.

With one in four people suffering a mental health problem every year, and an estimated one in six of the adult population having a significant mental health problem at any one time (more than 7 million*) it is natural that mental health will affect people in sport at every level. The Rugby Football Union, England and Wales Cricket Board and Football Association are just three of around 20 organisations that are involved and have signed the charter aimed at removing the stigma and prejudice around mental health in sport.

As a medical sports professional there is a duty to look out for the signs of mental illness and to help with treatment and advice. If you are working with a sports person that has mental health issues, extra care is required in assessing other illnesses and injuries. As one of the highest anxieties for sports people is their ability to continue in their sport following an injury it is even more important that you make assessments in their best interest.

The mental health charity MIND published a report which called for a national network to tackle mental health in sport following an increasing number of sports personalities testifying about their own mental health struggles. The report called Mental Health in Elite Sport (pdf) outlines their research, learnings and recommendations that everyone in sport from coaches to club owners should be supporting sports people with mental health issues.

It was The Sport and Recreation Alliance alongside the Professional Players Association and MIND that created the Mental Health Charter for Sport and Recreation. The Charter sets out how sport can uses its collective power to tackle mental ill health and the stigma that surrounds it.

Part of the mental charter includes

  • publicly promoting and adopting good mental health policies and best practice within sports and recreational activities
  • actively tackling discrimination on the grounds of mental health to ensure that everyone is treated with dignity and respect
  • supporting the establishment of a pan-sport platform to work closely with the mental health sector to develop and share networks, resources and best practice
  • regularly monitoring performance, assessing progress and taking positive action on mental health issues

The FA, for example, have recognised that there are millions of people involved in grassroots football with mental health problems. They say that “mainstream clubs should be comfortable including people with mental health problems, in training, matches and socially. We want to make coaches and team mates confident and comfortable about talking about mental health problems, in the same way that people discuss physical injuries.”

So as more and more sports bodies and clubs, coaches and managers are recognising and vowing to deal with mental health issues in sport it means that the medical professional must also ensure they handle the issues too particularly with healthcare decisions.

Assessing best interest

When it comes to mental illness a medical professional will need to decide whether a patient has the capacity to make a decision about healthcare. Under the law the Medical Capacity Act (MCA) there is a checklist of key factors to be considered:

  • Do not make assumptions about someone’s best interest based on the person’s age, appearance, condition or their behaviour
  • Consider all of the relevant circumstances relating to the decision in question
  • Consider wither the person will regain capacity (following treatment) and if so can the decision wait until then?
  • Involve the person as much as possible about the decision that is being made on their behalf

The medical professional must particularly consider:

  • The person’s past and present wishes
  • Any beliefs and values for example religious, cultural or moral that would influence their state-of-mind

As far as possible the decision maker must involve other people if it is appropriate to do so and take their views into account.

It is often necessary to make difficult decisions regarding treatments, prescribing drugs and operations for patients in sports, but these have added complications when mental health is also involved. Ensuring procedures are carried out within the code of conduct will ensure that medical professionals also work within the law.



The following organisations have signed up to the Mental Health Charter for Sport and Recreation:

National governing bodies:

  • The ASA, Swim for Life
  • British Swimming
  • England and Wales Cricket Board (ECB)
  • The FA (Football Association)
  • RFL (Rugby Football League)
  • RFU (Rugby Football Union)
  • LTA (Lawn Tennis Association)
  • UKA (United Kingdom Athletics)

Players associations:

  • British Athletes’ Commission
  • European Tour
  • 1eagu3 (Super League Players’ Association)
  • LMA (League Managers’ Association)
  • PCA (Professional Cricketers’ Association)
  • PDPA (Professional Darts Players’ Association
  • Professional Footballers’ Association
  • PFA Scotland
  • PGA (Professional Golfers’ Association
  • Professional Jockeys’ Association
  • The Rugby Players’ Association
  • WRPA (Welsh Rugby Players’ Association)
  • WPBSA (World Professional Billiards and Snooker Association)

Other bodies:

  • English Institute of Sport
  • Tennis Foundation

Help from Professional Players Association

Professional Players Association (PFA) has set up a helpline and a network of counsellors to help current and former players. This service will enable current/former members the opportunity to receive and access a 24 hour/365 days a year support service to deal with any issues that they may encounter.

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