Sports Psychiatry
Today professional sports organizations such as NFL, NBA, MLB and NHL require all players to have access to mental health care professionals as a part of their medical team. In 2013, Dr. Brian Hailine became the Chief Medical Officer of the NCAA. His first task as CMO was to understand needs and concerns of the organization. He found that the number one response of the student-athlete was mental health and wellness. Since this time, the NCAA has created a mental health task force with guidelines on services. These guidelines will shape behavioral health services provided to athletes at the University of Arkansas.
“Student-athlete mental health is an under recognized health issue and if managed improperly can lead to poor performance in sport and the classroom and can potentially lead to life threatening emergencies.” Dr. Brian Hailine CMO, NCAA
The goal of behavioral health services for the athlete is to become involved as soon as symptoms and impairment starts to emerge and before significant problems and impairment develop. By focusing on prevention, offering resources and support for improving quality of life, performance and recovery, we can strive to prevent the athlete from suffering impairments in athletics, school/work and relationships. Athletes will have access to behavioral health resources beyond traditional medication management and therapy.
The first encounter with an athlete for any mental health concern will lead to a medical laboratory workup to look for any possible medical conditions that could be causing the symptoms, including underlying micronutrient deficiencies or macronutrient deficiencies. We will use optimal lab range values, as opposed to standard laboratory values, helping the athlete reach optimal health and ensuring their body has the nutrients it needs to perform and recover under high demand. The plan of action for each athlete will include education and recommendations for sleep, nutrition, supplements and/ or medications when indicated. The athlete will have resources on time management, stress management, healthy coping skills and relationships when needed.
Tools available to help with performance and stress management will include mindfulness, visualization techniques, breathing techniques, meditation, and progressive muscle relaxation. We can utilize technology including heart rate variability (HRV) to teach how to calm the body and focus the mind. HRV could have significant utility for high-pressure moments. Endurance athletes often use HRV as a tool for managing overtraining. HRV also can monitor the body’s response to emotional stress and physical stress, as well as for training readiness.
An in depth knowledge of non-prescription interventions will be available. Recommendations for supplements including vitamins, minerals, amino acids, fatty acids, adaptogens and herbal medications will be available when indicated to treat symptoms, assist with recovery, or to supplement deficiencies so the athlete will be at their optimal health. Supplements can be used before medications are indicated or with medications.
Strategies from cognitive behavioral therapy, motivational interviewing, dialectical behavioral therapy, trauma focused therapy, acceptance and commitment therapy will be used in therapeutic encounters when needed. These strategies can address maladaptive behaviors and thought patterns associated with depression, anxiety, substance abuse, and disordered eating.
A sport’s psychiatrist can prescribe medications, when necessary, but also give recommendations for improving wellness and wellbeing. Nike Master Trainers describe the five facets of training as movement, recovery, sleep, nutrition, and mindset. To perform at one’s personal best an athlete needs both the information and the coaching in how to best master each facet of training. Mental health professionals can be a valuable member of the team to assist with behavioral change techniques and information about how to improve sleep, nutrition and mindset. All while providing the best care possible for individuals who are suffering from a mental health condition so they are able to get back to the sport and the life that they love.
