Minds matter: How COVID-19 highlighted a growing need to protect and promote athlete mental health

Mental health symptoms are common among professional, Olympic/Paralympic and collegiate athletes, with prevalence rates (15%-35%) equivalent to or exceeding those of non-athletes.1 Mental health symptoms are also common among youth and adolescent athletes, with a prevalence of up to one-third in some samples.2 Recent epidemiological evidence collected during the COVID-19 pandemic suggests increased rates of mental health symptoms among athletes during lockdown.3 In professional football (soccer), the prevalence of anxiety and depression doubled during the COVID-19 emergency period compared with immediately prior in both females (N=600; 18% vs 8% for anxiety) and males (N=1309; 13% vs 6% for depression).4 A significant difference was also found in US professional endurance athletes (N=114; 27% vs 5% for feeling anxious; 22% vs 4% for feeling depressed),5 as well as in the top leagues of Swedish football, ice hockey and handball (N=327), all correlated with COVID-19 pandemic distress.3 In Norway, symptoms of insomnia (38.3%) and depression (22.3%) were common among female and male elite athletes during COVID-19 (n=378).3 Among US high school athletes, the prevalence of moderate to severe depression more than tripled during the COVID-19 emergency period compared with years prior in both female (N=1877; 37% vs 11%) and male athletes (N=1366; 27% vs 6%).6 Increased mental health symptoms among athletes in the aforementioned studies might be linked to a range of pandemic-associated factors.7 Of concern, while athletes who have been able to return to sports participation after the end of the emergency period have shown some improvement in mental health, in many cases their mental health has not fully recovered to prepandemic status.7