Mental health challenges in elite sports, barriers to treatment, and quality of psychiatric care at an elite sports-centered mental health clinic—a mixed-methods study

In elite sport, athletes and staff may face unique personal- and sports-related stressors that can both bolster and undermine their mental health. Meanwhile, toughness, perfectionism, stigma, and unwanted attention can serve as exacerbating factors and help-seeking deterrents. Two outpatient psychiatric clinics specializing in elite sport and health have been established in Sweden, including one in Malmö, to provide tailored-clinical care, narrow the patient-clinician gap, and foster greater acceptance for mental health care in sport. This population's full journey from first developing symptoms to seeking and receiving treatment in this unique context has not been previously described. This study aimed to characterize this population through a retrospective medical record review (n = 96, Study 1) and explore patient experiences with mental health, help-seeking, and the quality of care at the Malmö clinic through semi-structured interviews (n = 15 athletes and staff, Study 2). The majority of Study 1's sample were female (71 %) and identified as actively competing athletes at admission (87 %). Stress-related and somatoform disorders (53 %) were most common, followed by affective (18 %) and behavioral disorders (16 %). Participants described how their mental health was shaped and expressed through internal, external, and sport-culture-specific causes, factors, and outcomes, while barriers and facilitators to seeking treatment included perceptions of mental health, logistical aspects, and the role of support networks. Overall, participants were satisfied with the care they received, identifying strengths and limitations related to treatment approach, access, and availability. Implications and future directions are discussed.