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CLINICAL REVIEW
International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes’ mental health. Vincent Gouttebarge, Abhinav Bindra, Cheri Blauwet, Niccolo Campriani, Alan Currie, Lars Engebretsen, Brian Hainline, Emily Kroshus, David McDuff, Margo Mountjoy, Rosemary Purcell, Margot Putukian, Claudia L Reardon, Simon M Rice, Richard Budgett.
Br J Sports Med 2020;0:1–9. doi:10.1136/bjsports-2020-102411
By Amanda O’Reilly ABSTRACT
The prevalence of mental health symptoms and disorders in elite athletes is substantial, and similar to the prevalence in the general population. The risk of mental health symptoms and disorders can increase due to sport-specific stressors such as severe musculoskeletal injuries, surgeries with long recoveries, and transitioning out of elite sport. In 2017 the International Olympic Committee (IOC) established an expert panel to review the available literature regarding mental health symptoms and disorders among active and former elite athletes leading to a consensus statement. A recommendation from this statement was the need for an appropriate screening tool for elite athletes. This article describes the development, and preliminary reliability and validity of the tool. The IOC established a Mental Health Working Group with 11 international experts (10 of whom were involved in the consensus statement). The group reviewed the literature, and assessed the views of current and former elite athletes on mental health symptoms and disorders. From that information they formulated a three-stepped approach to assessing elite athletes (defined as professional, Olympic, Paralympic or collegiate level; aged 16 years and older) potentially at risk for (ie, exposed to one or more stressors), or already experiencing, mental health symptoms and disorders to facilitate timely management and/or referral to adequate support and/or treatment.
The Sport Mental Health Assessment Tool 1 (SMHAT-1) This tool can be used by sports medicine physicians and other registered health professionals but the clinical assessment step (3B) must be conducted by a sports medicine physician or a registered mental health professional. STEP 1: Triage The Athlete Psychological Strain Questionnaire (APSQ) is a 10 item, self-reported rating (5-point) scale specific to the sport context. A score of 17 or more is indicative of a high risk for psychological distress. A positive triage leads onto the subsequent step. STEP 2: Screening The following six disorder-specific screening questionnaires are used: • General Anxiety Disorder-7 (GAD-7): assesses the presence of symptoms of anxiety. • Patient Health Questionnaire-9 (PHQ-9): assesses the presence of symptoms of depression. • Athlete Sleep Screening Questionnaire (ASSQ): assesses the presence of sleep disturbance. • Alcohol Use Disorders Identification Test Consumption (AUDIT-C): assesses the presence of alcohol misuse. • Cutting Down, Annoyance by Criticism, Guilty Feeling, and Eye-openers. Adapted to Include Drugs (CAGE-AID): assesses the presence of substance misuse, being slightly adapted for the CONTINUED ON NEXT PAGE >>
