Objective: To assess whether a difference exists in prevalence of mild or more severe depressive symptoms between high-performance athletes and non-athletes. Design:Comparative odds-ratio meta-analysis. Data sources:We searched PSYCHINFO, PUBMED, MEDLINE, CINHAL, SPORTDiscus, and Google Scholar as well as the reference lists of reviews of mental health issues in highperformance athletes. Eligibility:We included studies that compared high-performance athletes and non-athletes, included a validated measure of depressive symptoms, and included the prevalence of individuals who indicated at least mild depressive symptoms.Results: Five articles reporting data from 1545 high-performance athletes and 1811 non-athletes were examined. A comparative odds-ratio meta-analysis found high-performance athletes were no more likely than non-athletes to report mild or more severe depressive symptoms (OR=1.15, 95% CI=.954, 1.383, p=.145). Male high-performance athletes (n=940) were no more likely than male non-athletes (n=605) to report mild or more severe depressive symptoms (OR=1.17, 95% CI=.839, 1.616, p=.362). For females, high-performance athletes (n=948) were no more likely than non-athletes (n=605) to report mild or more severe depressive symptoms (OR=1.11, 95% CI=.846, 1.442, p=.464). Overall, male high-performance athletes (n=874) were 52% less likely to report mild or more severe depressive symptoms than female high-performance athletes (n=705) (OR=.48, 95% CI=.369, .621, p<.001).Comparing depressive symptoms 4 Summary/conclusions: High-performance athletes were just as likely as non-athletes to report depressive symptoms. Researchers need to move beyond self-report measures of depressive symptoms and examine the prevalence of clinically diagnosed depressive disorders in athletes.

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Although research has explored stress in coaches, little is known about their mental health literacy and how this is associated with their mental health. Their mental health literacy may have an impact on the wellbeing of their young players. This study examined levels of mental health literacy, help-seeking behaviours, distress, and wellbeing, as well as relationships amongst these variables, in coaches in the United Kingdom. Coaches were recruited through social media and asked to fill out questionnaires. A total of 103 coaches ( n = 65 men, n = 37 women, n = 1 other gender) participated in the study. Coaches had an average age of 27.9 (SD = 10.6) years. Most self-identified as heterosexual ( n = 85, 82.5%), had four or more years of experience ( n = 46, 44.7%), coached children ( n = 77, 74.8%), and coached at either the beginner ( n = 30, 29.1%) or amateur levels ( n = 66, 64.1%). In total, 20 (19.4%) coaches indicated a previous diagnosis of a mental disorder. A total of 51 (49.5%) coaches indicated that, at the time of the completion of the survey, they exhibited symptoms of a mental disorder. Overall, the average mental health literacy score was 123.10 and lower than in previous studies. Mental health literacy was not significantly associated with help-seeking behaviour, distress, or wellbeing. General help-seeking behaviour was positively correlated with wellbeing. The results suggest that coach certification programmes could adopt strategies to help coaches improve their knowledge of mental health services and how such services may be accessed. These changes may improve the wellbeing of coaches and may benefit their athletes.

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In this article we theorise and explain Exercise is Medicine (EiM), as indicative of broader physical activity (PA) health promotion, from a sociological perspective through the lens of health equity. Data were collected through two independent ethnographic studies that bookend the EiM endeavour: the production of knowledge in the laboratory, and the creation and implementation of health policy and PA interventions. First, we demonstrate how conceptualising exercise as medicine assumes narrow pathology and (prescribed) solution a priori, which has given rise to a new form of movement intellectuals (Turner 2012). Within such context we explain how the study of physical (in)activity (especially by exercise scientists) is shaped by broader social and political contexts of the university sector and disciplinary legitimacy produced through alignment with other (medical) institutions. Second, we review the 'causes of the causes' of ill-health and wider social determinants of health as related to exercise. Presenting exercise as a therapy of freedom (Rose 1999) that is to some extent epiphenomenal (Coalter 2013) we examine the lifestyle drift (Hunter et al. 2010) which inhibits equitable access to this health promoting behaviour. We then outline an original qualitative methodological development: duoethnographic creative nonfiction, which has enabled the synthesis of two independent ethnographic studies. Findings of this accessible and engaging methodology, in the form of two stories, show the need for an alternative approach that values activity, prioritises equity, and underscores methodological collaboration. For this reason we conclude by proposing greater interdisciplinarity by aligning EiM with the Behavioural Justice Movement.