Implementation of the International Olympic Committee Sport Mental Health Assessment Tool 1: Screening for Mental Health Symptoms in a Canadian Multisport University Program

Abstract

Objective: To apply the International Olympic Committee Sport Mental Health Assessment Tool 1 (SMHAT-1) to determine the prevalence of mental health symptoms in a cohort of university student athletes over an academic year. A secondary objective was to explore the internal consistency of the screening tools from the SMHAT-1. Design: Cross-sectional design with 3 repeated measurements over an academic year. Setting: A large university multisport program. Participants: Five hundred forty-two university-level student athletes from 17 sports. Intervention: N/A. Main Outcome Measures: On 3 occasions, the participants completed the SMHAT-1, which consists of the Athlete Psychological Strain Questionnaire. If an athlete's score was above the threshold ($17), the athlete completed step 2, consisting of (1) Generalized Anxiety Disorder-7; (2) Patient Health Questionnaire-9; (3) Athlete Sleep Screening Questionnaire; (4) Alcohol Use Disorders Identification Test Consumption; (5) Cutting Down, Annoyance by Criticism, Guilty Feeling, and Eye-openers Adapted to Include Drugs; and (6) Brief Eating Disorder in Athletes Questionnaire. Internal consistency of the SMHAT-1 was also measured. Results: Participants reported mental health symptoms with prevalence of 24% to 40% for distress, 15% to 30% for anxiety, 19% to 26% for depression, 23% to 39% for sleep disturbance, 49% to 55% for alcohol misuse, 5% to 10% for substance use, and 72% to 83% for disordered eating. Female athletes were more likely to suffer psychological strain, depression, and sleep disturbance; male athletes were more likely to report substance use. Conclusions: The SMHAT-1 was feasible to implement with good internal consistency. University-level athletes suffer from a variety of mental health symptoms underscoring the necessity for team physicians to have the clinical competence to recognize and treat mental health symptoms.

Analysis of the Sport Mental Health Assessment Tool 1 (SMHAT-1) in Team USA athletes

“…In our sample, female athletes tended to score higher on the APSQ, GAD-7 and PHQ-9 compared with male athletes, consistent with previous findings 12 14–17. Some preliminary data also suggest that Paralympic and Winter sport athletes experience a greater degree of psychological distress,17 which supports our observation of greater scores on the APSQ and other subscales compared with the Olympic and Summer sport counterparts.…”

Preliminary report of the Japanese version of the International Olympic Committee Sport Mental Health Assessment Tool 1

“…This prevalence is slightly higher compared to the Australian professional soccer players (up to 62.9%) [47], professional golfers (51.7%) [48], and active and former elite athletes (57.1%) who participated in the IOC survey [18]. Depending on the subject's background and the timing of the screening implementation, the prevalence of psychological distress varies widely; another report on Canadian student-athletes showed different APSQ positive rates at three-time points, ranging from 24.3 to 39.6% [19]. This study presented the reference values for the prevalence of each mental health symptom using the Japanese version of SMHAT-1.…”

“…While the SMHAT-1 is used broadly and disseminated gradually in research and practice, the feasibility of the SMHAT-1 and how to apply it in sports are under study across the globe. A study from a sample of Canadian university-level student-athletes [19] showed it to be feasible to implement with good internal consistency. In addition, a recent study by Taylor and colleagues [20] indicated that the SMHAT-1 were generally a reliable screening tool for mental health symptoms.…”

Female athlete health domains: a supplement to the International Olympic Committee consensus statement on methods for recording and reporting epidemiological data on injury and illness in sport

“…This supplement focuses on cisgender female athletes (assigned female at birth) due to the sex-specific health issues outlined. We also acknowledge mental health and the gendered sports environment, which may influence injury risk12 and health outcomes 13 14. These are not unique to cisgender female athletes, but are more prevalent than in cisgender male athletes 14.…”

“…We also acknowledge mental health and the gendered sports environment, which may influence injury risk12 and health outcomes 13 14. These are not unique to cisgender female athletes, but are more prevalent than in cisgender male athletes 14. Additionally, women and girls with variations of sex development, transgender women and girls and gender diverse athletes may experience some of the same health concerns and gendered experiences as cisgender female athletes.…”