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The Mental Health of Elite Athletes: A Narrative Systematic Review
Open accessAbstract
BACKGROUND: The physical impacts of elite sport participation have been well documented; however, there is comparatively less research on the mental health and psychological wellbeing of elite athletes. OBJECTIVE: This review appraises the evidence base regarding the mental health and wellbeing of elite-level athletes, including the incidence and/or nature of mental ill-health and substance use. METHODS: A systematic search of the PubMed, EMBASE, SPORTDiscus, PsycINFO, Cochrane and Google Scholar databases, up to and including May 2015, was conducted. RESULTS: The search yielded a total of 2279 records. Following double screening, 60 studies were included. The findings suggested that elite athletes experience a broadly comparable risk of high-prevalence mental disorders (i.e. anxiety, depression) relative to the general population. Evidence regarding other mental health domains (i.e. eating disorders, substance use, stress and coping) is less consistent. These results are prefaced, however, by the outcome of the quality assessment of the included studies, which demonstrated that relatively few studies (25 %) were well reported or methodologically rigorous. Furthermore, there is a lack of intervention-based research on this topic. CONCLUSION: The evidence base regarding the mental health and wellbeing of elite athletes is limited by a paucity of high-quality, systematic studies. Nonetheless, the research demonstrates that this population is vulnerable to a range of mental health problems (including substance misuse), which may be related to both sporting factors (e.g. injury, overtraining and burnout) and non-sporting factors. More high-quality epidemiological and intervention studies are needed to inform optimal strategies to identify and respond to player mental health needs.
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“To date, research has primarily examined the mental health outcomes of elite athletes [15–18], with comparatively less research focusing on understanding these psychological experiences among coaches [19].”
From The Mental Health of Elite-Level Coaches: A Systematic Scoping Review (2024) · cites this paper as [17]
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de Mendonça, I. C. P., & Bastos, A. D. A. (2022) · Revista Brasileira de Psicologia do Esporte · doi:10.31501/rbpe.v11i1.12352
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“2016) [3] conducted a systematic narrative review and also suggested the prevalence of mental illness in elite athletes was comparable to the general population.”
ResultDurukan, E., & Çataldirek, S. (2023) · Özgür Yayınları eBooks · doi:10.58830/ozgur.pub176.c830
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“YPP could also be effective in acting as a support, as described low social support from trainers or coaches was associated with burnout in the review of the mental health of elite athletes.[36] While the importance of elite athlete mental health is gaining attention, targeted, disorder‐specific models of care are yet…”
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“Rice et al. (2016) stated that: “Athletes tend to not seek support for mental health problems for reasons such as stigma, lack of understanding about mental health and its potential influence on performance, and the perception of help-seeking as a sign of weakness” (p. 1334). A review mentioned in the article found th…”
BackgroundInfluentialCiências do Esporte e Educação Física: contribuições contemporâneas em pesquisa
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The female athlete’s mind: mental health experiences and support in women’s cricket academies
Brooker, R. S., Ogden, D. J., Plateau, C. R., & Barker, J. B. (2025) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2025.2474036
“However, for athletes, the developmental challenges are compounded by sport-specific stressors which can impede good mental health and exacerbate the risk of mental illness (e.g. injury, selection concerns and pressure to perform; Biggin et al., 2017; Rice et al., 2016).”
Ojio, Y., & Kawamura, S. (2025) · Discover Mental Health · doi:10.1007/s44192-025-00162-0
Sleep and mental health following retirement from sport (PhD Academy Award)
Montero, A. (2025) · British Journal of Sports Medicine · doi:10.1136/bjsports-2025-109859
Mental Health Symptoms and Disorders in Elite Paralympic Athletes
Zhang, A. (2025) · Advances in Psychiatry and Behavioral Health · doi:10.1016/j.ypsc.2025.02.002 · Cited by 1
Chia-Smith, Y.-D. (2024) · International Journal of Racket Sports Science · doi:10.30827/ijrss.33192
“If untreated stress escalates into health issues it can lead to lasting emotional scars that are tough to overcome (Gustafsson et al. 2011; Rice et al., 2016).”
Metadata
- Authors
- Rice, S. M., Purcell, R., De Silva, S., Mawren, D., McGorry, P. D., & Parker, A. G.
- Affiliations
- The University of Melbourne (AU)
- Orygen (AU)
- Corresponding author
- Rice, Simon M.
- Venue
- Sports Medicine
- Published
- 2016-02-20
- Volume
- 46
- Issue
- 9
- Pages
- 1333-1353
- ISSN
- 0112-1642 (ISSN-L)
- 1179-2035
- PMC
- PMC4996886
- OpenAlex
- W2278084024
- Cited by
- 1,205
- References
- 110
- Citations by year
- 2026: 175 · 2025: 161 · 2024: 157 · 2023: 148 · 2022: 155 · 2021: 129 · 2020: 105 · 2019: 74 · 2018: 64 · 2017: 27 · 2016: 10
- FWCI
- 10.78
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Sports Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Victoria University Research Repository (Victoria University) (submittedVersion, cc-by)
- Minerva Access (University of Melbourne) (submittedVersion, cc-by)
- Swinburne figshare (Swinburne University of Technology) (submittedVersion, cc-by)
- Funders
- Society for Mental Health Research (Early Career Fellowship)
- Topics
- Social Sciences › Psychology › Developmental and Educational Psychology › Sport Psychology and Performance
- Social Sciences › Psychology › Clinical Psychology › Psychological Treatments and Assessments
- Social Sciences › Psychology › Clinical Psychology › COVID-19 and Mental Health
- Keywords
- elite athletes, mental health, psychological well-being, anxiety, depression, eating disorders, substance use, stress coping, burnout, overtraining, injuries, mental health interventions
- MeSH terms
- Adaptation, Psychological, Anxiety, Feeding and Eating Disorders, Competitive Behavior, Depression, Humans, Mental Health, Risk Factors, Stress, Psychological, Incidence, Substance-Related Disorders, Athletes
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