The care models for the screening and management of mental health issues in professional athletes often do not consider sport-related factors that are unique to this population
A career in an elite or professional sport is not in itself a risk factor for suicide, according to a review published in the Journal of Psychiatric Practice®, part of the Lippincott portfolio from Wolters Kluwer. But physicians, coaches, and family members should be alert to supporting elite and professional athletes as they approach retirement, a potential athlete-specific risk factor for suicide.
George A. Wilson, MBBS, of the University of South Wales in the UK, and his colleagues write, "The data we reviewed showed that former athletes were likely to be more at risk of suicide when compared to the global average. However, overall, when compared with age-matched controls, professional and elite athletes were likely to be at an equal or lower risk of suicide. It is recommended that future research aim to develop and implement resources to help athletes prepare for life after retirement, such as life skills training and educational groups to mitigate the risk of suicide within this cohort."
Participation in elite and professional sports does not increase the risk of suicide
The authors based their conclusions on a review of 9 studies of suicide in elite or professional athletes who were at least 16 years old. Collectively, the studies involved 23,836 athletes: 2,407 women and 21,429 men.
Besides finding no elevated risk of suicide overall, Dr. Wilson and his colleagues found no trends in suicide risk related to specific sports. The exceptions were elite or professional sports in which the use of anabolic androgenic steroids was suspected to be high and shooting sports where athletes have access to firearms.
Several factors may contribute to a lower risk of suicide in athletes, the reviewers note. Regular exercise is well established to have a positive effect on mental health and well-being, and belonging to a sports community or team can lead to decreased feelings of social isolation and loneliness. "Athletes may also develop effective coping skills through sport, which can foster a sense of resilience and mastery that can be applied to other areas of life." The social conditions and higher socioeconomic status of professional athletes may also help protect against suicide.
Elite and professional athletes do have certain potential risk factors for suicide
The reviewers did find evidence of potential risk factors for suicide among elite and professional athletes:
- Retirement from sport
- Anabolic androgenic steroid use
- Sexual abuse victimization
- The use of self-blame or behavioral disengagement as a coping strategy
"Retirement from athletic careers is often a stressful and challenging experience," the authors emphasize. "Athletes may experience a loss of purpose, a loss of identity, emotional distress, social isolation as well as financial challenges and difficulties in adjusting to a new lifestyle outside of sport. The psychology of athlete retirement is complex and multifaceted. It is therefore important to ensure support and resources are in place to help athletes cope with the emotional aspects of the process."
Dr. Wilson and his colleagues emphasize that as the field of sports psychiatry continues to develop, physicians need to consider other sport-related factors that are unique to elite and professional athletes. "A comprehensive understanding of these factors is required to provide guidance for those working with athletes to enhance models of care, improve emotional wellbeing, and increase quality of life in this population."
