Sports Psychiatry: A Game-Changing Force For Athlete Mental Health

There has been a rapid rise in media coverage surrounding athlete mental health, and I have seen firsthand the increasing need for professional mental health services within sports at all levels. Through my work as a Concierge Sports & Performance Psychiatrist with NBA, MLB, and NFL players, I have witnessed the transformative power that working with a sports psychiatrist can have on athlete well-being. Not only can that work positively impact athletes’ professional lives, but it also helps in their personal lives, as they learn to cope with stressors, as well as set healthy boundaries with those around them.

There is often a multidisciplinary approach when addressing mental health conditions in athletes, and these key specialists usually include sports psychiatrists, mental performance coaches, sport & performance psychologists, counselors, and others. “Integrating a sports psychiatrist in a team environment dramatically enhances the success of both athletes and the high-performance teams that support them,” says Adam Loiacono, PT, DPT, CSCS, Former Director of Rehabilitation, NBA Phoenix Suns.

What is a Sports Psychiatrist?

Sports psychiatrists often work with athletes individually and with sports teams or organizations. When a sports psychiatrist is brought into a professional sports team environment, they often provide a multitude of services, including education, workshops, policy development, emergency action planning, and individual services. Treatment interventions for athletes can include medications, psychotherapy, and lifestyle modifications.

“Sports psychiatrists are vital members of the sports medicine and performance team with broad responsibility for the integrated management of the general health and mental wellbeing of athletes, coaches, team staff, and their family members,” says David R. McDuff, M.D., Author of Sports Psychiatry: Strategies for Life Balance & Peak Performance and International Olympic Committee Mental Health Working Group Member.

How do you become a sports psychiatrist?

While a psychiatrist is a medical doctor or doctor of osteopathic medicine who specializes in “diagnosis, treatment, and prevention of mental, emotional, and behavioral disorders,” according to the American Psychiatrist Association, a sports psychiatrist is a psychiatrist with additional training and expertise in the diagnosis and treatment of mental health disorders among athletes.

The International Society for Sports Psychiatry (ISSP), founded in 1994, has been instrumental in advancing the specialty of sports psychiatry through its growing membership platform and linkages with sports psychiatry clinical and research groups across the globe. There is also a new national certification available through the American Board of Sports and Performance Psychiatry, which is also dedicated to advancing the field and maintaining the highest standards for certification, education, and professional practice for board-certified psychiatrists working in sports.

What are the primary functions of a sports psychiatrist?

Sports psychiatrists provide mental health assessments and diagnoses in the athlete population (commonly mood disorders, anxiety disorders, ADHD, substance use disorders, and eating disorders). “The accurate assessment of problems and diagnoses need to take into account the unique stressors and contours of life of the elite athlete,” says Victor Schwartz, M.D., Senior Associate Dean for Wellness and Student Life at CUNY School of Medicine. Once an assessment is completed, the treatment may include using medications, offering psychotherapy, and recommending various lifestyle modifications. “Treatment decisions need to incorporate questions of flexibility of care, timing of medication trials, and particular sensitivity to medication effects, which might be innocuous in the general population but very disruptive to elite athletes,” says Schwartz. I have seen how detrimental it can be to have a psychiatrist working with an athlete who is not certified or well-versed in sports psychiatry, as there are many intricacies to consider such as controlled substance policies and the potential effects of medications on performance.

Brady Howe, MS, ATC, CSCS, former VP of Health & Performance for the NBA Phoenix Suns, describes the importance of mental health programming and policy development that a sports psychiatrist brings to teams and organizations. “With an endless array of psychological obstacles athletes and coaches experience in their pursuit of greatness, having sed sport psychiatrist helps team members focus, build resilience, and sustain high levels of motivation, ultimately optimizing performance and consistency,” says Howe. Sports psychiatrists support all team members and athletes in times of mental health crises. To set teams up to prepare for possible crises, sports psychiatrists are often involved in writing mental health emergency action plans for organization-wide distribution.

Sports psychiatrists provide support and education to athletes, coaching staff, family, agents, and others involved in supporting athletes. “Sports psychiatrists can also help address team and interpersonal dynamics, which can be intense and complicated in highly competitive settings and can help teams establish systems of care that address athletes’ special needs successfully,” says Schwartz, who has been consulting for several years for the NBA’s Mind Health Program as well as the NCAA, USOPC, and NFL.

A sports psychiatrist supports the high-performance staff “by educating them on the appropriate tools, teaching them awareness to certain emotion cues, or providing them with mental skills training that can help them better support the emotional journey that athletes endure,” says Loiacono. This sub-specialty of psychiatry truly helps athletes and high-performance team staff be psychologically equipped to manage the high-pressure environment in sports.

There is a tremendous amount of care coordination with other specialists involved in treating an athlete. “In collaboration with team physicians, athletic trainers, mental performance consultants, and strength and conditioning staff, sports psychiatrists are uniquely positioned to support optimal performance, life balance, stress control, injury recovery, substance prevention, and mental health and wellbeing,” says McDuff. He continues, “These inter-professional team approaches are the future and will ensure the expansion of whole person approaches in safe and supportive team environments.”

“The ultimate goal in team sports is to develop a high-performance team and cultural model that sets each athlete up for success,” says Howe, and sports psychiatrists are instrumental in helping move the needle to achieve these goals.

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Disclaimer: I am on the board of the American Board of Sports & Performance Psychiatry, a 501(c)6 non-profit organization.