Centre for Youth Mental Health - Research Publications

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    Prevalence and Correlates of Mental Health Symptoms and Well-Being Among Elite Sport Coaches and High-Performance Support Staff
    Pilkington, V ; Rice, SM ; Walton, CC ; Gwyther, K ; Olive, L ; Butterworth, M ; Clements, M ; Cross, G ; Purcell, R (SPRINGER, 2022-12)
    BACKGROUND: There is growing understanding of mental health needs in elite athletes, but less is known about the mental health of coaches and support staff who work within elite sport settings. This study examined the prevalence and correlates of mental health symptoms in elite-level coaches and high-performance support staff (HPSS) and compared rates against published elite athlete samples. A cross-sectional, anonymous, online survey was administered to coaches and HPSS working in Australia's high-performance sports system. Main outcomes were scores on validated measures of psychological distress, probable 'caseness' for a diagnosable psychological condition, alcohol consumption and sleep disturbance. RESULTS: Data were provided by 78 coaches (mean age = 46.4 years, 23.8% female) and 174 HPSS (mean age = 40.0 years, 56.7% female). Overall, 41.2% of the sample met probable caseness criteria, 13.9% reported high to very high psychological distress, 41.8% reported potential risky alcohol consumption and 17.7% reported moderate to severe sleep disturbance, with no statistically significant differences between coaches and HPSS. The most robust correlates of psychological distress and probable caseness were dissatisfaction with social support and dissatisfaction with life balance, while poor life balance was also associated with increased alcohol consumption and poor social support with sleep disturbance. Coaches and HPSS reported similar prevalence of mental health outcomes compared to rates previously observed in elite athletes, with the exception of higher reporting of alcohol consumption among coaches and HPSS. CONCLUSIONS: Elite-level coaches and HPSS reported levels of psychological distress and probable caseness similar to those previously reported among elite-level athletes, suggesting that these groups are also susceptible to the pressures of high-performance sporting environments. Screening for mental health symptoms in elite sport should be extended from athletes to all key stakeholders in the daily training environment, as should access to programs to support mental health and well-being.
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    Exploring Teacher and Parent Perspectives on School-Based Masculinities in Relation to Mental Health Promotion
    Wilson, MJ ; Gwyther, K ; Simmons, M ; Swann, R ; Oliffe, JL ; Casey, K ; Rice, SM (FRONTIERS MEDIA SA, 2022-06-13)
    The capacity for boys' and young men's mental health promotion to act via shifting masculine norms that are linked to poor mental health outcomes, highlights the need to improve the extent to which school-based programs can promote mental health through leveraging more positive embodiments of masculinity. To-date, the perspectives of parents and teachers on such processes are understudied. This qualitative study presents teacher and parent views regarding adolescent masculinities and avenues for school-based developmental programming for boys and young men. In this study, 16 individual qualitative interviews were undertaken with 10 parents (six females, four males), and six teachers (three females, three males), recruited from an independent all-boys' grammar school in Melbourne, Australia. Thematic analysis of parents' and teachers' perspectives indicated their perception of the role of context-dependent "public" and "private" masculinities, the influence of Australian masculinity norms, and the role of private boys' school cultures in the development of adolescent masculinities. Additionally, strategies for development encompassed participants' appetite for boys' exposure to positive role models, in addition to consistent and relevant developmental programming to support positive masculinity development. Findings have implications for efforts to support prosocial masculine identity development via school-based initiatives, as an avenue to promoting mental health of boys and young men.
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    Psychological safety in elite sport settings: a psychometric study of the Sport Psychological Safety Inventory
    Rice, S ; Walton, CC ; Pilkington, V ; Gwyther, K ; Olive, LS ; Lloyd, M ; Kountouris, A ; Butterworth, M ; Clements, M ; Purcell, R (BMJ PUBLISHING GROUP, 2022-05)
    OBJECTIVES: Effectively supporting the mental health of elite athletes and coaches requires validated tools that assess not only individual-level factors but organisational-level influences. The aim of this study was to develop a bespoke scale assessing perceived psychological safety within high-performance environments. METHODS: 337 elite athletes (M=24.12 years) and 238 elite-level coaches and high-performance support staff (HPSS; M=41.9 years) identified via the Australian Institute of Sport provided data across a range of mental health and well-being domains. Exploratory factor analysis (EFA; n=169 athletes) with parallel analysis identified the Sport Psychological Safety Inventory (SPSI) factor structure. Confirmatory factor analysis (CFA) validated the identified structure in separate validation subsamples of athletes (n=168) and coaches/HPSS (n=238). RESULTS: EFA identified the 11-item, 3-factor SPSI. Factors assessed domains of the Mentally Healthy Environment, Mental Health Literacy and Low Self-Stigma. All scale items loaded strongly on their specific domain. CFA model fit indices validated scale structure for athletes and coaches/HPSS. Internal consistency and convergent and divergent validity were evident. Logistic regression indicated that incrementally higher Mentally Healthy Environment scores reduced the likelihood of athletes scoring in the 'moderate' range of general and athlete-specific distress, with a stronger endorsement of the Low Self-Stigma subscale reducing the likelihood of being identified for athlete-specific distress. CONCLUSION: Psychometric properties of the SPSI support scale utility among athletes and coaches/HPSS in elite sports settings, though further psychometric efforts are needed. This brief measure may support benchmarking efforts across elite sporting contexts to improve mental health culture and broader well-being among athletes and coaches/HPSS.
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    An Evidence-Informed Framework to Promote Mental Wellbeing in Elite Sport
    Purcell, R ; Pilkington, V ; Carberry, S ; Reid, D ; Gwyther, K ; Hall, K ; Deacon, A ; Manon, R ; Walton, CC ; Rice, S (FRONTIERS MEDIA SA, 2022-02-16)
    Elite athletes, coaches and high-performance staff are exposed to a range of stressors that have been shown to increase their susceptibility to experiencing mental ill-health. Despite this, athletes may be less inclined than the general population to seek support for their mental health due to stigma, perceptions of limited psychological safety within sport to disclose mental health difficulties (e.g., selection concerns) and/or fears of help-seeking signifying weakness in the context of high performance sport. Guidance on the best ways to promote mental health within sporting environments is increasing, though current frameworks and position statements require greater focus on a whole of system approach, in which the needs of athlete, coaches and high-performance staff are considered within the context of the broader ecological system in which they operate and perform. This paper synthesizes existing research, reviewed for translatability by mental health professionals working in elite sport, to provide an evidence-informed framework with real world utility to promote mentally healthy environments for all stakeholders in elite sporting organizations, from athletes through to administrators. Recommendations are provided to positively impact the mental wellbeing of athletes and support staff, which may in turn influence athletic performance. This framework is intended to provide sporting organizations with evidence-informed or best practice principles on which they can develop or progress their policies to support mental health promotion and prevent the onset of mental health difficulties. It is intended that the framework can be adapted or tailored by elite sporting organizations based upon their unique cultural, contextual and resourcing circumstances.
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    Sleep interventions for performance, mood and sleep outcomes in athletes: A systematic review and meta-analysis
    Gwyther, K ; Rice, S ; Purcell, R ; Pilkington, V ; Santesteban-Echarri, O ; Bailey, A ; Walton, CC (Elsevier, 2022-01-01)
    Sleep is fundamental to sports performance and other health outcomes such as mental wellbeing. This systematic review explored the effects of sleep interventions implemented among athletes on performance, sleep, and mood outcomes. Five databases were searched, returning 5996 records for screening. Of these, 27 articles met the inclusion criteria (16 controlled deigns, 11 uncontrolled; athletes n = 617; male n = 432, female n = 93, non-binary/other n = 0 or not reported n = 92). Narrative synthesis of all studies based on intervention type suggested that sleep hygiene, assisted sleep, and sleep extension interventions may be associated with improved sleep, performance, and mood outcomes. Twelve controlled trials were eligible for quantitative meta-analysis, investigating the effect of sleep interventions on athlete sleep, performance, and negative affect, compared to controls post-intervention. Utilizing random-effects meta-analyses, sleep interventions improved subjective sleep quality (g = 0.62, 95% CI [0.21, 1.02]), reduced sleepiness (g = 0.81, 95% CI [0.32, 1.30]) and decreased negative affect (g = 0.63, 95% CI [0.27, 0.98]), but did not appear to influence subjective sleep duration. No effects were identified for objective sleep measures (e.g., actigraphy), or aerobic/anaerobic performance indices. While sleep interventions may offer some benefit to athletes, caution is warranted given limitations of the extant research relating to small, non-representative studies with methodological concerns.
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    The making of men program: A mixed-methods evaluation of a gender-sensitive rite of passage program for adolescent males
    Wilson, MJ ; Gwyther, K ; Swann, R ; Casey, K ; Keele, S ; Rubinstein, A ; Rice, SM (University of Toronto Press Inc. (UTPress), 2021-02-12)
    Introduction Current gendered health disparities impacting the wellbeing of boys and young men require new early intervention-focussed approaches. Health promotion programs developed with young men’s health needs and preferences in mind commonly report positive outcomes. Male-specific rite of passage programs aim to formally acknowledge the life-stage transition from boyhood to manhood through a holistic focus on identity, community, and social responsibility. While these programs are growing in popularity, there is limited data available on their effectiveness. Methods This study undertook a pilot evaluation of the Making of Men rite of passage program in a sample of secondary school boys (n=61, age M=16.0, SD=0.5) and their accompanying fathers or male mentors (n=47, age M=52.1, SD=5.8 years) providing non-matched pre-test, post-test, alongside follow-up data for participating boys. Qualitative interviews were also undertaken with 15 individuals (5 mothers, 6 staff members, 4 fathers). Results Quantitative program feedback indicated acceptability, with most respondents providing positive feedback, particularly from participating fathers. Exploratory quantitative effects indicated potential improvements in subjective social support and open communication among boys. Fathers appeared to report lower conformity to traditional masculine norms post-program, in addition to more open communication. Qualitative interviews identified three main themes: enabling relational bonds, creating a men-specific context, and supporting developmental transitions. Conclusions Positive program acceptability and promising outcome effects highlighted the present rite of passage program as a promising mechanism for supporting healthy masculine identity development among adolescent males. Finally, limitations and future directions are discussed, particularly in terms of gender equality integration for rite of passage programs.
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    Taking Youth Suicide Prevention to the Schools: Pilot Evaluation of School-Based Clinician Outcomes and Perspectives of a Multi-Modal Program Including Post-Training Online Consultations for Management of Ongoing Suicide Risk
    Gwyther, K ; McKechnie, B ; Nicoll, H ; Gersh, E ; Davey, CG ; Robinson, J ; Mawson, E ; Crlenjak, C ; Rice, SM (MDPI, 2020-09)
    School-based youth-specific suicide prevention and early intervention initiatives are presently underdeveloped. The current study conducted a pilot evaluation of a multi-modal suicide prevention training program for school-based social workers, ‘Management of Youth Suicidality Training for Schools’ (MYSTS). The program comprised a two-day workshop and six fortnightly post-workshop webinar online consultations. Participants were 36 social workers (years’ experience M = 11.23, SD = 8.29) employed by the Department of Education in Tasmania, Australia. Outcomes were self-rated confidence, competence, and knowledge of self-harm in young people, and attitudes toward suicide prevention and suicide-related behaviors. Exploratory quantitative results indicated significant improvements with large effect sizes for participants’ self-reported competence (d = 1.33), and confidence (d = 1.29) to identify and respond therapeutically to youth suicidality following the workshop. Confidence remained significantly higher than baseline following the online consultations (d = 0.90). Qualitative analysis of online supervision consultations indicated key themes of accessibility, communication and information sharing, and clinical management. Participants endorsed the MYSTS package as well-presented, with relevant topics, and effective learning activities. This study highlights the need for continued supervisory or implementation support to practitioners following suicide prevention training initiatives and suggests web-based teleconference technology as a feasible strategy for this. Further evaluation of the MYSTS package, including a suitable comparison or control condition, is indicated.
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    Athlete Experiences of Shame and Guilt: Initial Psychometric Properties of the Athletic Perceptions of Performance Scale Within Junior Elite Cricketers
    Rice, SM ; Treeby, MS ; Olive, L ; Saw, AE ; Kountouris, A ; Lloyd, M ; Macleod, G ; Orchard, JW ; Clarke, P ; Gwyther, K ; Purcell, R (FRONTIERS MEDIA SA, 2021-04-29)
    Guilt and shame are self-conscious emotions with implications for mental health, social and occupational functioning, and the effectiveness of sports practice. To date, the assessment and role of athlete-specific guilt and shame has been under-researched. Reporting data from 174 junior elite cricketers (M = 17.34 years; females n = 85), the present study utilized exploratory factor analysis in validating the Athletic Perceptions of Performance Scale (APPS), assessing three distinct and statistically reliable factors: athletic shame-proneness, guilt-proneness, and no-concern. Conditional process analysis indicated that APPS shame-proneness mediated the relationship between general and athlete-specific distress (p < 0.01), with this pathway non-contingent on sex or past 12-month help-seeking for mental health concerns (p's > 0.05). While APPS domains of guilt-proneness and no-concern were not significant mediators, they exhibited correlations in the expected direction with indices of psychological distress and well-being. The APPS may assist coaches and support staff identify players who may benefit from targeted interventions to reduce the likelihood of experiencing shame-prone states.