Mental health treatment engagement of athletes: Self-determination theory as a “Prescription for excellence”

Athletes, like all human beings, require timely and effective mental health treatment in order to attenuate the risk of chronic functional impairment. Unfortunately, social stigma and stereotypes regarding mental illness, along with competitive performance pressures, can foster denial and avoidance of one’s distress, especially for the athlete who feels a need to conform to the athletic ideal of self-sufficiency, imperturbability, and action over contemplation. The decision by an athlete to engage versus forgo the pursuit of treatment can be positively influenced through an understanding of human beings’ core psychological needs. Self-determination theory (SDT) is predicated on the assumption that the satisfaction of one’s needs for relatedness, competence, and autonomy ultimately determines goal-directed behavior. By attending to the threats to belonging, competence, and autonomy that arise as a function of social stigma and stereotypes, it is possible to reframe mental health treatment as socially acceptable, capable of fostering optimal performance, and facilitative of self-rule. In that vein, sports medicine professionals are uniquely positioned to assist athletes in embracing timely treatment engagement by offering a “prescription for excellence.”.