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Mental Health and Wellbeing Interventions in Sport: a Review and Recommendations

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Mental Health and Wellbeing Interventions in Sport: a Review and Recommendations Mental Health and Wellbeing Interventions in Sport: A Review and Recommendations MENTAL HEALTH MENTAL HEALTH Research Team Dr Gavin Breslin, Stephen Shannon, Tandy Haughey, Dr Paul Donnelly and Professor Gerry Leavey - Sport and Exercise Sciences Research Institute, Sport Northern Ireland and the Bamford Centre for Mental Health and Wellbeing. Members of the Strategy Steering Group for Mental Health and Wellbeing In and Through Sport Dr John Kremer - Independent Chair Dr Paul Donnelly - Sport Northern Ireland Dr Gavin Breslin - Ulster University Robert Heyburn - Department for Communities Fiona Teague - Public Health Agency Tom McEneaney - Aware Beth Gibb - Action on Mental Health Edward Gorringe - Mindwise Ciaran Kearney - Northern Ireland Sport Forum Maura McMenamin - Ulster Council Gaelic Athletic Association Keith Gibson - Irish Football Association Chris Shields - Ulster Rugby Kate Hills - Swim Ireland Joseph Donnelly - TAMHI Paul Stephenson - NSPCC Child Protection in Sport Unit Northern Ireland Ciarán Kearney - Ulster University Gary Woods - Psychiatrist Alan Curran - Sport Northern Ireland John News - Sport Northern Ireland Colm Jennings - Sport Northern Ireland Contents MENTAL MENTAL HEALTH HEALTH Executive Summary 01 Aims 01 Findings 01 Introduction 02 Research Review Aims and Objectives 03 Method 04 Results 07 Recommendations 12 Appendix 14 • Table 1 14 • Table 2 15 • Table 3 17 References 18 Executive Summary MENTAL HEALTH While participation in To do so, two key phases of the • Who should attend training? sport can have positive research were completed by physical and mental health the Research Team: Questions were also raised with benefits, evidence suggests reference to what would be the that, particular aspects of 1. A desk-based review using specific role of a Club Wellbeing competitive sport may also, Preferred Reporting Items Officer, if established, and paradoxically, contribute to for Systematic Reviews and whether this was to sign post deterioration in mental health. Meta-Analyses (PRISMA) to already existing services or The sport setting lends itself to guidelines; and provide support. the communication of positive 2. Focus group discussions and mental health and wellbeing face-to-face interviews with Recommendations include: messages, yet the best way of key stakeholders in mental achieving the delivery of these health and wellbeing in • The need to develop a Mental messages remains uncertain. Northern Ireland. Health and Wellbeing In and Through Sport Strategy In response to this uncertainty, Findings / Action Plan and secure a review of mental health resourcing; and wellbeing awareness The findings from the current • Determining which programmes in sport was review suggest that while programmes for mental undertaken in order to provide knowledge-based mental health health and wellbeing direction to the Strategy programmes in sport settings awareness are effective and Steering Group for Mental may improve mental health should be introduced in sport Health and Wellbeing In and literacy and reduce stigma, the settings for coaches, athletes Through Sport on how best to evidence base is limited. and club members; engage the sporting community. • The introduction of a Mental The interviews and focus group Health and Wellbeing Officer Aims discussions indicated the to sport clubs; and existence of at least 16 sport- • Integrating mental health • To identify and examine the based programmes in Northern and wellbeing within already effectiveness of international Ireland. To our knowledge, these established networks across peer reviewed programmes programmes have not been sport in Northern Ireland. that promote mental health evaluated. Participants also had and wellbeing awareness in concerns related to: sport; and • To review regional mental • Who should deliver training in health and wellbeing policies, clubs? strategies and interventions. • The resources available? 01 MENTAL MENTAL HEALTH HEALTH Introduction times of career transition (e.g. Culture Arts and Leisure (DCAL) , retirement), non-selection or DCAL and Sport Northern Ireland Sport and health benefits whilst being injured. drafted a pilot programme in Sport can have positive support of the Public Health psychosocial benefits, and Organisations within sport are Agency’s (PHA) campaign to moderate-to-vigorous intensity just starting to address the raise awareness of mental health physical activity can improve management of mental health issues for sports clubs. physical and mental health (Bauman, 2016). However, (Biddle, Mutrie & Gorely, 2015). athletes are poorly supported The ‘Mood Matters in Sport’ However, evidence suggests to manage their mental health; report (Breslin, et al. 2015; that competitive sport may instead, sporting culture 2017), an evaluation of a pilot contribute to poor mental celebrates mental toughness psycho- educational programme health (Bauman, 2016) and and is disapproving of any to enhance knowledge and may lead to specific stressors weakness disclosure. This help-seeking of coaches in that hinder an athletes’ mental situation has not been helped sport, indicated that sports health optimisation (Donohue when an athlete’s mental clubs provide an effective and et al., 2007). These stressors health is discussed using accessible environment for are: language related to mental tackling mental health issues. illness (Hughes and Leavey, Engagement in awareness • Pressure to achieve success 2012). Consequently, emotional raising and training opportunities (Evans, Weinberg, & Jackson, and psychiatric problems for enables sports clubs to enhance 1992); many athletes remain hidden people’s knowledge and • Extended times being (Bauman, 2016). It is through confidence in supporting others, separated from family the delivery of mental health and also promote mental health (Masland, 1983); training to coaches and players, at club level. Despite the positive • Negative emotional within their own sport settings, outcomes reported from the consequences of injury that awareness to managing Mood Matters in Sport report, (Wiese-Bjornstal, 2010); mental health concerns can several questions remained: • Substance and alcohol abuse increase (Breslin et al, 2017). (a) what other interventions are (King, Dowdall, & Wagner, effective?; (b) what has been 2010); and Linking sport and wellbeing evaluated?; (c) who have been • Relationship problems together in Northern Ireland delivering programmes to, (i) (Donohue et al, 2007). Following a roundtable athletes, (ii) coaches and (iii) discussion 12 October, 2012 on club members?; and finally what The likely times of higher mental health and wellbeing, was the content and duration stress or risk of mental health chaired by Carál Ní Chuilín, the of programmes being delivered problems for athletes are during then Minister Department of across Northern Ireland. By 02 MENTAL HEALTH addressing these questions, the Several actions from the 1Research development, implementation meeting were: Review Aims and dissemination of subsequent programmes 1. Appoint a lead officer within and Objectives can be determined. Sport Northern Ireland for Mental Health and Wellbeing The aim of the current report Round table discussion In and Through Sport who is to review interventions that on mental health in and would be responsible for have used sport as a tool for through sport both the strategic direction promoting mental health and On 26 January, 2016, Sport and operational aspects to wellbeing to provide guidance Northern Ireland hosted the drive this initiative forward; to the Strategy Steering first stakeholder workshop 2. Sport Northern Ireland to Group. ‘Mental Health and Wellbeing sign up to the Mental Health In and Through Sport’ which Charter for Sport created To achieve this aim, the was attended by: Department and launched by Sport and research findings presented for Communities (DfC) Recreation Alliance in 2015; in this summary report had representatives; national 3. Establish a Mental Health and two main objectives: governing bodies of sport; Wellbeing In and Through 1. Conduct a systematic health professionals; university Sport Strategy Steering review of peer reviewed academics; community Group from all relevant interventions available groups; and representatives statutory and voluntary across the world which from psychology, psychiatry, partner organisations; promotes positive mental sports clubs, and mental health 4. Complete a desk-based health and wellbeing in charitable organisations. The review of relevant policies, sport; and aim of the workshop was to strategies and interventions 2. Conduct a regional begin discussions on the need that have used sport as a tool review of mental for a strategy / action plan for for promoting mental health health and wellbeing mental health and wellbeing and wellbeing; and finally, policies, strategies and in and through sport. At the 5. Develop a Mental Health and interventions. workshop a report, considered Wellbeing In and Through and approved by the Board of Sport Strategy / Action Plan Sport Northern Ireland, was with an associated research tabled for discussion. monitoring and evaluation framework. 1 To date, progress has been made by Sport Northern Ireland with Ulster University (Breslin et al.) in relation to points 1 and 3. Progress is being made with point 2; the current report addresses point 4, with the findings from the research contributing to point 5. 03 MENTAL MENTAL HEALTH HEALTH Method studies examining the effect of of sport (i.e. physical activity,
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