Nancy Gillen ©ITG

In recent years, an increasing number of sportspeople have spoken out about their struggles, contributing to a worldwide trend of ending the stigma surrounding mental health.

Athletes have long been considered to have fun and exciting jobs, often with great personal or monetary reward, but it has become clear that they also endure their own troubles. 

Momentum to address mental health issues in sport was beginning to grow, but like everything else, was brought to a crunching halt by the coronavirus pandemic.

Now, more than ever, athletes’ mental health is at great risk. Reports have emerged of sportspeople struggling in lockdown, with their ability to train severely curtailed. Their regimented routines are in disarray, and the camaraderie and social side of sport is absent.

Add this to the uncertainty surrounding the return of sport, and a dangerous mix to the mental wellbeing of athletes is being formed.

Those who were set to compete at the Olympics and Paralympics in Tokyo this summer may be feeling the strain more acutely.

Some had already qualified for Tokyo 2020, while others were still vying for remaining places. Years of preparation had gone into an event which was just months away. 

All of a sudden, the Games were pushed back to 2021, with the rapid spread of coronavirus making it abundantly clear that competition could not take place safely later this year.

Callum Skinner, a former track cyclist, competed at Rio 2016, earning a gold medal in the team sprint and silver in the individual sprint. He sits on the British Olympic Association Athletes’ Commission and is lead athlete for the pressure group Global Athlete. 

The 27-year-old announced his retirement from cycling in March 2019 in order to focus on these roles and lobby to improve the rights and working conditions of athletes.

Having experienced the build-up to an Olympic Games himself, Skinner revealed to insidethegames why athletes would be struggling with the postponement of Tokyo 2020.

"For Olympic athletes, who have one opportunity every four years to make a name for themselves, to have that put on hold for a year is going to be a major stress," he said.

"Sometimes people would say to me in the lead up to 2016 that you must be training hard for the Olympics, maybe a couple of months out, when it's actually been a 10-year project, pretty much.

"So, there’s that level of dedication, which I think sometimes people don’t understand. And also, the intensity by which the athletes conduct themselves, their lives get tightened and tightened as they get closer to an Olympic Games.

"You start to miss family events, social events, trying to get yourself to absolute peak perfection.

"You make a lot of worthwhile sacrifices towards that single date, and then to have it moved, with not even that much certainty of it happening in 2021, is always going to be a major stress."

Britain's Rio 2016 Olympic cycling medallist Callum Skinner revealed why athletes would be mentally impacted by the postponement of Tokyo 2020 ©Getty Images
Britain's Rio 2016 Olympic cycling medallist Callum Skinner revealed why athletes would be mentally impacted by the postponement of Tokyo 2020 ©Getty Images

Indeed, there are concerns the pandemic may still be an issue next year, once again throwing doubt on the Games. Japan Medical Association President Yoshitake Yokokura said last month it would be "hard to host them unless an effective vaccine is developed".

Tokyo 2020 President Yoshirō Mori added to the apprehension when he said the Games would be scrapped if they cannot take place in 2021, while International Olympic Committee member Richard Pound concurred that 2021 would be the only chance for the event to be staged.

This uncertainty will again be playing at the back of athletes’ minds.

"We have seen the Tokyo 2020 Organising Committee say that it won’t be postponed again, it will just be cancelled," Skinner said.

"That would be devastating for the athletes.

"What the athletes needed the most was clarity on postponement, and then the call can be made as soon as possible on what happens next if it looks like the Games can’t be hosted in 2021.

"It’s a stressful time for athletes."

Non-Olympic athletes are also under strain, however, and following the suspension of sport, do not even have a future date to look forward to, no matter how precarious. Mental health issues are being widely reported among football players during the pandemic, for example.

Football is, of course, an Olympic sport, but the men’s contest is only for under-23 players and it is not considered the pinnacle of a career. Instead, domestic seasons have stopped dead in their tracks, with footballers uncertain about when matches will resume.

Subsequently, the Professional Footballers’ Association reported a worrying spike in the number of footballers seeking mental health support in England. So far this year, 299 players have requested support. This is in comparison to the 653 who did so across the whole of 2019, as reported by BBC Sport.

The same data is being picked up by Professional Footballers Australia, who recently published findings from a survey of more than 150 of its members. Fifty-eight per cent of players reported symptoms of anxiety, while 45 per cent demonstrated symptoms of depression.

These figures are exponentially higher than during regular periods of time, when, for example, moderate-to-severe anxiety symptoms peak at about eight per cent.

Such trends are also being picked up worldwide, demonstrated by a FIFPro study of 1,602 professional players from 16 countries, conducted between March 22 and April 14.

It discovered that 22 per cent of 468 female players and 13 per cent of 1,134 male players reported symptoms consistent with a diagnosis of depression.

It also found that 18 per cent of women and 16 per cent of men reported markers of generalised anxiety.

The level of stress demonstrated by this ample evidence has been attributed to financial worries, boredom, social isolation and anxiety over the future.

Symptoms of depression and anxiety have been reported among footballers worldwide during the pandemic ©Getty Images
Symptoms of depression and anxiety have been reported among footballers worldwide during the pandemic ©Getty Images

It is also interesting to note the increased susceptibility for mental health issues among female players. The pandemic has been disproportionately affecting sportswomen, and so accordingly, they have been struggling more.

This was confirmed by Jordan Guard, spokeswoman of The Women's Sport Alliance (WSA), an organisation set up pre-pandemic to support elite sportswomen.

"We have seen a 100 per cent increase in female footballers experiencing depressive-like symptoms since the lockdown and we should assume that this is a trend across all other women’s sports," she said.

"Women are generally more likely than men to show symptoms of depression or anxiety and this is something that should be taken into consideration when putting support systems in place.

"The number of female athletes that did not have access to specialist mental health support, prior to the launch of The WSA, is severely worrying. These athletes have suddenly been thrown into isolation and are having to take time out from being the only person they know how to be - a competitor.

"Left without sport, many sportswomen are feeling lost and uncertain. Reports suggest that this uncertainty comes from concerns about their individual future and more worryingly, the future of their entire sport.

"We know that when athletes go through horrific injuries or retire from competing as an athlete, there are negative mental health implications that need to be acknowledged and managed with coping strategies.

"This is no different and even though it might seem like a temporary issue, athletes cannot be sure of how women’s sports will look once the pandemic is over."

The mental health issues female athletes are facing are even beginning to have physiological effects, highlighting the stress they are under.

"Job insecurities and financial stains are causing physiological responses to the current pandemic on female athletes," said Guard.

"A change in routine and a sudden alteration in training load, nutrition norms and sleep norms have instigated menstrual cycle irregularities, according to reports received by The WSA.

"More frequent and more severe symptoms are being reported, adding to the stress of the pandemic."

There is no doubt athletes all round the world are coming up against mental health issues, then, but the situation is worsened by a lack of structural support for sportspeople.

Female athletes are particularly susceptible to mental health issues during the pandemic ©Getty Images
Female athletes are particularly susceptible to mental health issues during the pandemic ©Getty Images

When Skinner retired last year, he cited a wish to focus on other roles as the main reason. A few months later, however, he revealed to BBC Sport that he also stepped back because he believed there was too much focus on performance and "not enough on getting better", despite disclosing his mental health problems to British Cycling.

He still believes this is an issue, and that governing bodies should not just focus on sports psychology alone in order to help athletes.

"It's about the limitations of sports psychologists and practitioners, and when you’re dealing with lifestyle issues, sometimes that can be a bit of a barrier," he said.

“You have to seek help from more general healthcare but then an athlete’s lifestyle is very unique.

"I remember when I was suffering they said to me, we want you to take time off work, and I had to explain the scenario to them, saying that if I take a month off then it will take six months to get back to where I was and I would be in a far worse position.  

"It’s a difficult sell.

"Before this crisis, I started making a call to say we need to start investing in general health, and not necessarily sport psychologists but just general psychologists.

"It was definitely one of the shortcomings that I was starting to find, it wasn’t so much my performance on the track but it was getting help with stuff that was going on off the track, so I think that’s something that needs to be boosted.”

Convincing governing bodies to invest in such healthcare may be tricky, however, due to the financial pressure put on such organisations by the pandemic.

The suspension of sport has resulted in a loss of ticket, broadcasting and sponsorship revenue, while the postponement of Tokyo 2020 has also caused widespread economic woes. 

Some organisations such as the United States Olympic and Paralympic Committee (USOPC) have had to let staff go, while others such as World Archery and United World Wrestling have furloughed staff or cut their wages.

Skinner conceded governing bodies and sporting organisations would have finances on the mind when considering an investment into mental health support, but considered such a move worthy.

"I totally appreciate that a lot of teams and governing bodies are in a very difficult position," he said.

"In the United Kingdom, their funding was set with that Olympic date in mind, and it is not yet completely clear if that kind of funding is going to be there for another year.

"Many governing bodies are looking at furloughing or making staff redundant.

"I can see why it’s a hard sell to invest more money into athletes’ healthcare, but it’s a worthwhile cause for sure."

The United States Olympic and Paralympic Committee have formed a mental health task force to try to help athletes during the COVID-19 pandemic ©Getty Images
The United States Olympic and Paralympic Committee have formed a mental health task force to try to help athletes during the COVID-19 pandemic ©Getty Images

Athletes may also be reluctant to speak out due to the worry that their issues may seem trivial compared to others suffering during the pandemic.

Skinner raised this pertinent point and encouraged athletes to still speak out if they felt like this.

"Possibly a contributing factor to some of the mental health issues is that athletes will feel that their issues pale in comparison to what a lot of society is facing," he said. 

"The death toll in the United Kingdom is huge, and I think that sometimes to raise your voice and say you’re struggling over something like a sporting event, makes it feel a bit insignificant.

"What I would say to athletes is, just because someone is suffering worse than you, does not make your problem invalid.

"Regardless of what you are going through, it’s important to speak up."

Despite the struggles the sporting world is facing during the pandemic, some organisations have still put resources into mental health support.

One example is the cash-strapped USOPC, which has created a mental health task force for athletes.

The taskforce, comprised of Olympians, Paralympians, coaches, medical and mental health professionals, will be responsible for advising and collaborating with an internal USOPC mental health working group.

"We are acutely aware of the mental health concerns facing our athletes - heightened by the current environment in the Olympic and Paralympic community - and are fully dedicated to being an active leader in providing support and resources to help athletes navigate the pressures, and at times, uncertainty, of their careers," USOPC chief medical officer Jonathan Finnoff said.

"The goal of the taskforce is to ensure athletes, and the staff who are entrusted with their care, are well-informed and prepared to recognise and respond to individuals in need, both before and once mental health concerns arise."

Elsewhere, the Canadian Olympic Committee, Canadian Paralympic Committee, Canadian Olympic and Paralympic Sport Institute Network, Canadian Centre for Mental Health in Sport and not-for-profit organisation Own The Podium have combined to create a task force for athletes in the North American country. 

This will develop counselling plans that will be offered across numerous platforms such as webinars to athletes, coaches and team staff. 

The hope will be that these initiatives will be continued post-pandemic, encouraging similar task forces worldwide. If athletes continue to speak out of their experiences under lockdown, this may also create an increased awareness of mental health issues in sport. 

Indeed, the current crisis is expected to change the nature of sport forever. This could include the perception of mental health in the sporting world, and allow for athletes' struggles to be taken more seriously. 

There is a more pressing urgency for athletes to be looked after now, however, as the pandemic continues. Ensuring mental wellbeing in sport has never been more important.