In “past, present, future” we ask clinical or academic experts to reflect on selected Sports & Exercise Medicine topics. Today Vincent Gouttebarge on Athlete Mental Health. 


Vincent Gouttebarge


Tell us more about yourself.

I am a former professional footballer who suffered from two anterior cruciate ligament ruptures and two concussions over my 14 seasons in France and The Netherlands. I am an Extraordinary Professor at the Section Sports Medicine of the University of Pretoria. Still, I am based at the Orthopaedic Surgery department of the Amsterdam University Medical Centers (one of the International Olympic Committee (IOC) Research Centers of Excellence). I am also Chief Medical Officer at FIFPRO (Football Players Worldwide), the sole international union for professional footballers. My work focuses on a wide range of sports medicine domains being relevant in professional sports (emphasis on football), striving to protect and promote the health of active and former professional athletes. I am Chair of the IOC Mental Health Working Group, co-Director of the IOC Programs on Mental Health in Elite Sport, member of the Concussion Expert Group of the International Football Association Board (The IFAB), and member of the Medical Expert Group of the French Professional Football League (LFP). I am also a member of the Editorial Board of the South African Journal of Sports Medicine and Injury Epidemiology.


What was happening 10 years ago?

Ten years ago, we just had had the suicide of Robert Enke (German goalkeeper), and we were about to have the suicide of Gary Speed (Welsh defender and national team manager). These two high-profile players put forward that professional footballers, either during or after their career, were likely as any human beings to suffer from mental health symptoms and disorders. These two tragic events emphasized the existing stigma around the mental health of professional athletes in general. At the same time, it also addressed the minimal scientific knowledge we had about the extent of mental health symptoms and disorders in elite sports. Therefore, Professor Gino Kerkhoffs (Chair of the Orthopaedic Surgery department of the Amsterdam University Medical Centers) and I started an international research program aiming to explore the occurrence of mental health symptoms among active and former professional athletes across sports and to identify the stressors contributing to these conditions. Parallel to that, many other scientists initiated great researches about mental health symptoms in elite sports. At the same time, we saw an increasing number of elite athletes speaking up about their mental health challenges. All this has been extremely instrumental in where we are now.


What are we doing now?

At the present time, much more scientific work about mental health symptoms and disorders in elite sports is ongoing, while practical support for athletes has been developed and put in place. Also, leading sport stakeholders have been addressing the mental health of elite athletes in various manners. For instance, the IOC has recently published its first consensus statement about mental health in elite athletes. It has subsequently established its Mental Health Working Group to coordinate research and develop resources for athletes and their entourage. Within few weeks, the IOC will release a mental health toolkit for Olympic Movement stakeholders (International Federations, National Olympic Committees, athletes’ entourage members, healthcare professionals, clubs and teams) to be used in developing and implementing initiatives and best practices related to the protection and promotion of mental health and well-being in elite athletes. For the professional football industry, FIFPRO has recently developed an awareness video and toolkit aiming to increase players’ knowledge about mental health symptoms.


Where do you think we will be 10 years from now?

Firstly, I hope to have more scientific knowledge about mental health symptoms and disorders in elite sports. Therefore, we will need to conduct robust epidemiological studies that include matched controls from the non-elite sports population. Also, these studies should not only be based on a cross-sectional design: prospective cohort studies should be conducted to observe trends over time. Secondly, I hope that elite athletes and their entourage will be able to rely on a high level of mental health literacy so that the context of elite sport can prevent any forms of stigmatization. Thirdly, I hope that the medical support for elite athletes will be delivered by interdisciplinary teams, including sports psychiatrists or clinical psychologists. Lastly, I hope that systematic screening for mental health symptoms and disorders among elite athletes will be common practice as it is already the case for orthopaedic or cardiovascular conditions. With that regard, it is worth mentioning that the IOC Mental Health Working Group has recently developed the IOC Sport Mental Health Assessment Tool 1 (SMHAT-1) to assess elite athletes that are potentially at risk for or already experiencing mental health symptoms and disorders. Ten years from now, we might have the SMHAT-3 well implemented in elite sports!


Would you like to learn more on this topic? Here is a selection of Athlete Mental Health publications in our journal.
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