Global practitioner assessment and management of mental fatigue and mental recovery in high-performance sport: A need for evidence-based best-practice guidelines.

BACKGROUND: Mental fatigue and mental recovery have gained scientific attention in relation to sporting performance, yet best practice assessment and management methods are lacking. A greater understanding of current knowledge and practices in high-performance sport are necessary. OBJECTIVE: To understand the contemporary knowledge, beliefs, monitoring processes, management strategies, perceived responsibility, sources of evidence, and challenges, when assessing the mental fatigue and mental recovery of athletes in high-performance sport. METHODS: A mixed-methods survey approach obtained information from 156 multi-disciplinary high-performance sport practitioners. Descriptive outputs were reported and potential differences between key concepts were detected using Wilcoxon-signed rank analysis. Thematic analysis interpreted open-text responses. RESULTS: Only 11.5% and 5.1% of respondents indicated they were "very" knowledgeable about mental fatigue and mental recovery, respectively. Knowledge (p < 0.001) and confidence in application (p = 0.001) were significantly greater for mental fatigue than mental recovery. Nearly all respondents perceived mental fatigue and mental recovery impacted training and competition performance, with a greater negative impact during competition (p < 0.001). A limited number of respondents reported deliberate assessment (31.1%) or management (51.2%) of mental fatigue and mental recovery. A combination of sources of evidence were used to inform practice, with common challenges to implementation including staff knowledge, athlete-buy in, time-availability, and a lack of evidence. Practitioners reported that assessing and managing mental fatigue and mental recovery was multi-disciplinary in nature. CONCLUSION: Practitioners reported that mental fatigue and mental recovery did impact performance, yet this was not reflected in the implementation of evidence-based assessment and management practices in high-performance sport.

Assessment and treatment of mental fatigue after a traumatic brain injury.

Mental fatigue is a frequently occurring symptom after mild, moderate or severe traumatic brain injury (TBI). Such mental fatigue may become a long-lasting problem, irrespective of severity and even after recovery from other neurological or psychiatric symptoms. Two characteristics of this mental fatigue are that patients easily become exhausted and there is generally a long recovery time. There is a need to increase knowledge and awareness of mental fatigue as it interferes considerably with work, studies, and social activities. Assessment is difficult and few treatment studies have been carried out. For the purposes of assessment, the development of the Mental Fatigue Scale is described here, and we also summarise the few treatment studies found for fatigue after TBI. Symptom alleviation is reported through Mindfulness-Based Stress Reduction (MBSR), light therapy and for the psychostimulant methylphenidate and the dopamine stabiliser (-)-OSU6162. However, more knowledge of the origin of mental fatigue and its underlying mechanisms is needed for development of more efficient therapeutic methods. Prospective randomised trials focusing on long-term outcomes are warranted and should include both pharmacological and non-pharmacological treatments.

Characteristics of an external employee assistance programme in Japan.

BACKGROUND: Mental health care is now a major occupational health issue in Japan. Although realizing effective use of external employee assistance programmes (EAPs) has been identified as crucial for mental health care, few scientific papers describe or analyse the characteristics of EAPs in Japan. AIMS: This study sought to clarify the characteristics of an external EAP in Japan. METHODS: The characteristics of an external EAP were clarified in terms of programme description and utilization. A total of 10,260 counselling sessions from 1996 to 2000 were used for utilization analysis. RESULTS: The EAP studied had contracts with 133 organizations, half of which were health insurance societies. The EAP provided employees and family members with free, confidential counselling. Annual mean utilization rate per 1000 individuals increased from 1.3 in 1996 to 2.7 in 2000. Less than one-third of counselling sessions were for work-related mental health issues, and male users (30%) consulted significantly more often than female users (14%) for such problems. Among men, career development issues were most common, while job dissatisfaction was highest among women. Absenteeism, depression and fatigue were the most frequently observed problems in both sexes. CONCLUSIONS: EAP use in Japan is rising. The majority of its use is for non-work-related health issues. Male users were more likely to consult for work-related mental health problems.