The Conceptualisation and Management of Mental Health and Mental Illness in High-Performance Sport

The aim of this research was to develop a holistic understanding of mental health and illness in high-performance sport by exploring three research questions and the interconnection between them; 1) how are mental health and mental illness conceptualised in high-performance sport? 2) how does the culture of high-performance sport influence the experience, and associated behaviours, of mental health and illness? and 3) how are mental health and illness managed in high-performance sport? A three-phase data collection approach was adopted that included a survey (N = 60), semi-structured interviews (N = 30), and photo-elicitation interviews (N = 7). Participants were support staff and athletes operating in high-performance sports across the United Kingdom. Data were interpreted and discussed in relation to each other, and presented using descriptive statistics, primary quotations, and composite vignettes. Findings indicate that, in high-performance sport, mental illness is conceptualised in relation to the medical model, with precedence placed on diagnostic criteria and clinical expertise. Comparatively, the conceptualisation of mental health is ambiguous and uncertain with participants understanding this as negative and a sign of emotional weakness. Some participants understood mental health vis a vis performance and physical health. Consequently, mental illness is valued as a more legitimate experience in high-performance sport compared to mental health. Findings also indicate that the culture of high-performance sport, cloaked in narratives of performance, sacrifice, and mental toughness, combine to create a culture of silence, where athletes are unwilling to disclose personal weaknesses associated with mental illness and health due to potential repercussions to their athlete-status. The management of mental health and illness in high-performance sport is complex with data revealing that recent policy and academic recommendations for the management of mental health and illness is only partially enacted. Sport psychologists were highlighted as central in the support of mental health and illness, but these agents remain uncertain of how they should or are qualified to help. As such, the default management practice is to refer athletes to external support for help with mental health or illness concerns. By aiming to develop a holistic understanding of mental health and illness in high-performance sport, this research highlights the interconnection between conceptualisations, culture, and the management of mental health and illness and, as such, furthers previous research that has tended to focus on these topics in isolation. The implications of these findings suggest that conceptualisations of mental health and illness in sport need to broaden so that they better reflect the lived experiences of both. Furthermore, policy concerning mental health and illness in high-performance sport must consider the influence culture has on their management to better support athletes