The brave decision made by many Canadian athletes to share their experience with mental illness has fed a growing dialogue surrounding mental health in competitive and high-performance sport. To affect real change for individuals, sport culture must change to meet demands for psychologically safe, supportive, and accepting sport environments. This position statement addresses mental health in competitive and high-performance sport in Canada, presenting solutions to current challenges and laying a foundation for a unified address of mental health by the Canadian sport community. The paper emerged from the first phase of a multidisciplinary Participatory Action Research (PAR) project, in which a sport-focused mental health care model housed within the Canadian Centre for Mental Health and Sport (CCMHS) is currently being designed, implemented, and evaluated by a team of 20 stakeholders, in collaboration with several community partners and advisors.

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We examined the level and prevalence of mental health functioning (MHF) in intercollegiate student-athletes from 30 Canadian universities, and the impact of time of year, gender, alcohol use, living situation, year of study, and type of sport on MHF. An online survey completed in November 2015 (N = 388) and March 2016 (n = 110) revealed that overall, MHF levels were moderate to high, and more student-athletes were flourishing than languishing. MHF levels did not significantly differ across time based on gender, alcohol use, living situation, year of study, and type of sport. Eighteen percent reported a previous mental illness diagnosis and yet maintained moderate MHF across time. These findings support Keyes’ (2002) dual-continua model, suggesting that the presence of mental illness does not automatically imply low levels of well-being and languishing. Nonetheless, those without a previous diagnosis were 3.18 times more likely to be flourishing at Time 1 (November 2015).

We examined the level and prevalence of mental health functioning (MHF) in intercollegiate student-athletes from 30 Canadian universities, and the impact of time of year, gender, alcohol use, living situation, year of study, and type of sport on MHF. An online survey completed in November 2015 (N = 388) and March 2016 (n = 110) revealed that overall, MHF levels were moderate to high, and more student-athletes were flourishing than languishing. MHF levels did not significantly differ across time based on gender, alcohol use, living situation, year of study, and type of sport. Eighteen percent reported a previous mental illness diagnosis and yet maintained moderate MHF across time. These findings support Keyes’ (2002) dual-continua model, suggesting that the presence of mental illness does not automatically imply low levels of well-being and languishing. Nonetheless, those without a previous diagnosis were 3.18 times more likely to be flourishing at Time 1 (November 2015).

The purpose of this study was to evaluate the acceptability and appropriateness of a sport-centered, collaborative mental health service delivery model implemented within the Canadian Center for Mental Health and Sport (CCMHS) over a period of 16 months. The study is situated within a larger Participatory Action Research (PAR) project to design, implement and evaluate the CCMHS. Primary data were collected from CCMHS practitioners (n = 10) and service-users (n = 6) through semi-structured interviews, as well as from CCMHS stakeholders (n = 13) during a project meeting, captured via meeting minutes. Secondary data derived from documents (e.g., clinical, policy, procedural; n = 48) created by the CCMHS team (i.e., practitioners, stakeholders, board of directors) during the Implementation Phase of the project were reviewed and analyzed to triangulate the primary data. The Framework Method was used to organize, integrate and interpret the dataset. Overall, results indicate that both practitioners and service-users found the model to be both acceptable and appropriate. In particular, practitioners' knowledge and experience working in sport, a robust intake process carried out by a centralized Care Coordinator, and the ease and flexibility afforded by virtual care delivery significantly contributed to positive perceptions of the model. Some challenges associated with interprofessional collaboration and mental health care costs were highlighted and perceived as potentially hindering the model's acceptability and appropriateness.

IntroductionCollaborative care is considered a best practice in mental health care delivery and has recently been applied in high-performance sport to address athletes’ mental health needs. However, how the collaborative process unfolds in practice in the sport setting has not yet been well documented. The purpose of this illustrative case study was to investigate a novel interdisciplinary approach used within the Canadian Centre for Mental Health and Sport (CCMHS) to provide mental health care to clients. Focusing on ‘how’ the approach was implemented, the aim of the study was to provide insight into the collaboration that occurred between mental performance and mental health practitioners to provide care to a high-performance athlete over an 11-month period, as well as factors facilitating and impeding the team’s collaboration. The case involved three practitioners and a 16-year-old female athlete experiencing chronic pain, low mood, and elevated anxiety.MethodsIn the first phase of the data collection process, each practitioner engaged in guided reflective journaling to describe the case and reflect on their practice and outcomes. During the second phase, practitioners co-created a case timeline to describe the collaborative process using clinical documents. Lastly, practitioners participated in collaborative reflection to collectively reflect more broadly on collaboration practice occurring within the CCMHS and Canadian sport system.ResultsThe data depict a complex care process in which the necessity and intensity of collaboration was primarily driven by the client’s symptoms and needs. A content analysis showed that collaboration was facilitated by the CCMHS’ secure online platform and tools, as well as individual practitioner and team characteristics. Collaboration was, however, hindered by logistical challenges, overlapping scopes of practice, and client characteristics.DiscussionOverall, there were more perceived benefits than drawbacks to providing collaborative care. While flexibility was required during the process, deliberate and systematic planning helped to ensure success. Factors such as interdependence of collaborative practice, complementarity of practice within care teams, compensation for collaboration, in-person versus virtual delivery, and intricacies of care coordination should be further examined in the future to optimize collaborative mental health care in sport.