Mental health surveillance in elite Para athletes: early identification and follow-up of athletes at risk of mental health problems

Objective There is a lack of prospective data on mental health of elite Para athletes. The objective was to identify and follow elite Para athletes at risk of mental health problems. - Methods In a 124-week prospective cohort study, mental health of German elite Para athletes was monitored using the...

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Main Authors: Meidl, Verena (Author) , Dallmann, Petra (Author) , Steffen, Kathrin (Author) , Bretthauer, Berit (Author) , Busch, Aglaja (Author) , Kubosch, Eva Johanna (Author) , Leonhart, Rainer (Author) , Hirschmüller, Anja (Author)
Format: Article (Journal)
Language:English
Published: 1 July 2024
In: British journal of sports medicine
Year: 2024, Volume: 58, Issue: 16, Pages: 902-909
ISSN:1473-0480
DOI:10.1136/bjsports-2023-107995
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.1136/bjsports-2023-107995
Verlag, kostenfrei, Volltext: https://bjsm.bmj.com/content/58/16/902
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Author Notes:Verena Meidl, Petra Dallmann, Kathrin Steffen, Berit Bretthauer, Aglaja Busch, Eva Johanna Kubosch, Rainer Leonhart, Anja Hirschmueller

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520 |a Objective There is a lack of prospective data on mental health of elite Para athletes. The objective was to identify and follow elite Para athletes at risk of mental health problems. - Methods In a 124-week prospective cohort study, mental health of German elite Para athletes was monitored using the Patient Health Questionnaire-4 (PHQ-4). In case of positive screening (PHQ-4≥5) over 2 weeks, a follow-up contact was conducted by a sports psychiatrist, who asked the athletes about their mental condition and sources for their mental distress and offered support. - Results 7543 PHQ-4 scores were obtained from 122 Para athletes with a mean weekly response rate of 84%. The PHQ-4 screening was considered positive for symptoms of depression or anxiety with a prevalence of 6.7%, affecting 48.4% (n=59) of all participants at some point during the study period. In 76.6% (n=49) of all follow-up contacts, athletes (n=34) reported at least one mental health problem, most frequently mental distress (n=31), followed by symptoms of depression (n=19) including acute suicidality (n=1). The most common mental stressors cited were related to education and problems with the team, coaches or federation. At follow-up, almost two-thirds of the athletes were either already in professional psychiatric or psychological care (25%) or were recommended to seek such care (32.8%). - Conclusion Our screening and follow-up system revealed high rates of mental health problems in elite Para athletes. Programmes for early identification with mental health monitoring under the supervision of mental health professionals should be considered by sports federations for Para athletes. 
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