Mental Health in Elite Coaches.

CONTEXT: Coaches play an important role in promoting mental health in elite sports. However, they themselves are exposed to risks affecting their mental health, and their fears and worries are often overlooked. Moreover, it remains unclear how coaches' mental health affects their athletes' mental health. OBJECTIVE: To create a compilation of the literature on (1) elite coaches' mental health and (2) how coaches' mental health influences elite athletes' mental health. Building on this, recommendations for improving coaches' psychological well-being should be elaborated upon and discussed. DATA SOURCES: A literature search was conducted up to November 30, 2021, using the following databases: PubMed, PsycINFO, Scopus, Web of Science, and SportDiscus. STUDY SELECTION: Studies reporting elite coaches' mental health symptoms and disorders and the influence of elite coaches' mental health on elite athletes' mental health were included. STUDY DESIGN: Scoping review. LEVEL OF EVIDENCE: Level 4. DATA EXTRACTION: Data regarding elite coaches' mental health, as well as their influence on athletes' mental health and performance, were included in a descriptive analysis. The PRISMA guidelines were used to guide this review. RESULTS: Little research has been done on elite coaches' mental health disorders, although studies confirm that they do experience, for example, symptoms of burnout, anxiety, and depression. The influence of coaches' mental health on their athletes is underinvestigated, with research focused mainly on the influence of coaches' stress. CONCLUSION: Knowledge about coaches' mental health is still limited. Coaches' poor mental health diminishes coaching performance and might impair athletes' mental health. Coaches should receive more support, including sports psychiatric care and education on the importance of mental health. This could improve the mental health of both coaches and athletes, and positively affect athlete performance.

[Cantonal Differences in The Implementation of Involuntary Admission in Switzerland]. / Kantonale Unterschiede bei der Umsetzung der fürsorgerischen Unterbringung in der Schweiz.

OBJECTIVE: To examine sociodemographic and clinical characteristics of persons hospitalized in five psychiatric hospitals from regions with different structural characteristics compared with persons hospitalized voluntarily. METHODS: Descriptive analyses of routine data on approximately 57000 cases of 33000 patients treated for a primary ICD-10 psychiatric diagnosis at one of the participating hospitals from 2016 to 2019. RESULTS: Admission rates, length of stay, rates of further coercive measures, sociodemographic and clinical characteristics of the affected persons differ between the different regions. CONCLUSION: There are considerable regional differences between regulations and implementation of the admission procedures and the sample. Causal relationships between regional specifics and the results cannot be inferred.

Violence and Abuse in Competitive Sports.

Violence and abuse in competitive sports, such as physical and emotional abuse, physical and emotional neglect and sexual abuse, affect children, adolescents and adults alike and lead to severe physical, psychological and social consequences. In current medical and educational care concepts of athletes, there is a lack of consistent integration of sports/psychiatric, clinical psychological and psychotherapeutic, developmental pediatric and developmental psychological expertise. Problem areas arise from fine lines between harassment, non-physical and physical violence. The present position paper includes recommendations for the development of a concept for the protection of mental health in competitive sports and for coping with mental stress and psychological disorders by qualified medical experts in mental health, i.e., child, adolescent and adult psychiatrists with specific expertise in competitive sports: sports psychiatrists. According to the recommendations, experts should also have and further develop competence in other fields, especially in ethics, child protection, protection against violence and abuse in competitive sports, awareness of and dealing with transgression of boundaries, knowledge about child development, and transparency in training structures and relationships.

[Violence and Abuse in Competitive Sports]. / Gewalt und Missbrauch im Leistungssport.

Violence and Abuse in Competitive Sports Abstract. Violence and abuse in competitive sports, such as physical and emotional abuse, physical and emotional neglect and sexual abuse, affect children, adolescents and adults alike and lead to severe physical, psychological and social consequences. In current medical and educational care concepts of athletes, there is a lack of consistent integration of sports/psychiatric, clinical psychological and psychotherapeutic, developmental pediatric and developmental psychological expertise. Problem areas arise from fine lines between harassment, non-physical and physical violence. The present position paper includes recommendations for the development of a concept for the protection of mental health in competitive sports and for coping with mental stress and psychological disorders by qualified medical experts in mental health, i.e., child, adolescent and adult psychiatrists with specific expertise in competitive sports: sports psychiatrists. According to the recommendations, experts should also have and further develop competence in other fields, especially in ethics, child protection, protection against violence and abuse in competitive sports, awareness of and dealing with transgression of boundaries, knowledge about child development, and transparency in training structures and relationships.

Clinical course and prevalence of coercive measures: an observational study among involuntarily hospitalised psychiatric patients.

AIMS OF THE STUDY: In daily clinical work, coercion continues to be highly prevalent, with rates differing between countries and sometimes even within countries or between wards of the same hospital. Previous research found inconsistent characteristics of individuals who underwent coercive measures during psychiatric treatment. Furthermore, there continues to be a lack of knowledge on the clinical course of people after being involuntarily committed. This study aimed to describe the rate and duration of different coercive measures and characterise a cohort of involuntarily committed patients regarding sociodemographic and clinical variables. METHODS: In this observational cohort study, we analysed clinical data from the patients' medical files, the use of coercive measures (seclusion, restraint, coercive medication) and other procedural aspects in involuntarily hospitalised patients (n = 612) at the University Hospital of Psychiatry Zurich. For analysis, we used cross-tabulation with chi-square tests for categorical variables and, owing to a non-normal distribution, the Mann-Whitney U-test for interval variables. RESULTS: Coercive measures were documented in 170 patients (28% of those who were involuntarily hospitalised). The total number of seclusions was 344, with a mean duration of 9 hours per seclusion. A total of 89 patients (15%) received 159 episodes of coercive medication (oral and intramuscular). Also, 11 episodes of restraint were recorded in 7 patients (1%) with a mean duration of 12 hours per restraint. Patients subjected to coercion were significantly more often male, violent prior to admission, diagnosed with psychosis or personality disorder, and had a history of frequent hospitalisations with long durations of hospitalisation. CONCLUSIONS: The prevalence of coercive measures is still high in involuntarily hospitalised patients. Seclusion was the most frequently used coercive measure, which may be based on cultural and clinical aspects and differs from findings in other countries where restraint is more frequently used. Some sociodemographic and clinical characteristics were associated with the use of coercion. This underlines the importance of developing treatment strategies for patients at risk to prevent situations in which the use of coercion is necessary. To enable comparison between different study sites, standardised protocols should be used to document frequency and duration of coercive measures.