Matt Butterworth of the Australian Institute of Sport reflects on the organisation’s mental health services.
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“Traditionally, it centred around careers and education,” Matt Butterworth, Mental Health Manager at the Australian Institute of Sport [AIS], tells the Leaders Performance Institute. “There may have been some mental health support but nothing as formal and structured as a mental health service. Then there was a fundamental shift in how the AIS did things.”
One of the key milestones was the launch of the AIS’s Wellbeing & Engagement initiative in 2018. “The resulting services were a statement that we’re helping people to be the best athletes but we’re also helping them to develop into well-rounded people that can get on with their lives while they’re athletes. They’re also as well prepared as possible when they transition out,” Butterworth adds. “It’s not ‘you’re a high performance athlete and that’s it’, it’s more about ‘you’re a high performance athlete and we’re here to support you as an overall human being as well’.”
Within the theme of wellbeing, the AIS Mental Health Referral Network overseen by Butterworth operates as a national service where athletes, coaches and high performance support staff can see a mental health professional such as a psychologist for individual support that is confidential and at no cost to them. “The benefit of a national service is that you can operate at a larger scale to benefit more people across sports in terms of the resources we can build and offer in the mental health space. Then the sports themselves can choose to engage with the services they find useful.”
Here we explore where mental health sits in the wider picture for Australian athletes, coaches and practitioners.
Matt, where does the line sit between mental health and mental skills?
MB: There is a network of performance psychologists who are employed by individual sports and they focus more on helping people with matters related to their performance on the field, on the track or in the pool. This is more mental skills-focussed. Our mental health services at the AIS focus less on performance or execution of a sporting skill, and more on helping people in managing wider aspects of their lives, such as their overall mood, relationships, and day to day functioning. The issues that my team assist with, such as anxiety difficulties, may be happening during an athlete’s performance but they’d also be occurring in other important areas of their lives such as during work, study, or with family and friends.
Can you truly balance wellbeing and performance?
MB: I think a balance can be achieved. The way I’ve heard others explain it really well is for people to be aware of what their priorities are and to spend most of their time doing things that are important to them. That’s the terminology that I think we’ll start using a bit more down here because usually when you say ‘lifestyle balance’ you see people roll their eyes and start turning away from you. If we’re aware of what our priorities are, the important things for us to be doing, the things to make life quite meaningful and enjoyable for us, then that’s a good way to be spending most of our time.
How can you address the common fear, that mental health services are only for making athletes feel better about poor performance?
MB: I think the people who choose to come into a high-performance system, whether they are athletes, coaches, or high performance support staff, like physios, dietitians etc. they probably self-select in that they are quite focused on performing and wanting to win. My perspective would be ‘what are the things we can do to help them move towards that?’ There are times when you have setbacks, there are times when you don’t win. If you can accept not necessarily feeling awesome, accept when things don’t go to plan, it is quite important to manage your emotions and figure out what you need to do to change the result or get a better result in the future. If that involves people feeling a bit better instead of being absolutely crushed and devastated every time that they have a set back or they don’t win an event, then I’m OK with that. I would say it’s more about the journey and the trend to where you’re heading rather than feeling devastated any time you lose. That’s not helpful either.
How are the mental health issues facing Australian athletes evolving?
MB: Typical presentation issues for us are anxiety and depression. That’s the same for pretty much most mental health services around the world and it’s not that different in sport. It is not necessarily a new issue but we’re becoming better at detecting more things. I think our system is now doing more work in the space of eating disorders. We’re becoming aware of just how common traumatic experiences are for people generally in life and that people in our system experience traumatic experiences too. So we’re starting to get better at how we might educate people around that, how we best provide services to support people. An athlete, coach or staff member can go and see a psychologist or mental health clinician for one-to-one support if they want. The Mental Health Referral Network has been operating since 2018 and referral rates are continuing to trend upwards. Generally, the people who access the service have difficulties at the mild to moderate end rather than needing to go to hospital or anything like that, and I think that’s an indication that people feel less stigma and are more comfortable reaching out for support. We’ve evaluated our services in the last year too and our clients are telling us that our services are helping them to be more aware of what’s more important for mental health, and how to look after their mental health as well. We’re thinking about how we continue to make this sustainable and accessible for more people as well.
How can an athlete refer themselves?
MB: Athletes and other eligible people can refer themselves to the Mental Health Referral Network directly by calling or emailing us. They can also be referred to us by another person, typically this would be by an Athlete Wellbeing Manager in their sport, but we also get referrals on behalf of people such as family members, performance psychologists, coaches, doctors or other support staff. Anyone can make a referral on behalf of an eligible person.
What about the mental health of coaches?
MB: Any coach or high performance support staff member can access the Mental Health Referral Network. Our stakeholders told us back in 2019 that if we want a healthy system then we’ve got to look after as many parts of the system as possible – particularly the coaches and performance staff that work directly with athletes. Coaches play a crucial role in the wellbeing of athletes and the broader system. We know that the expectations and pressure on coaches are very high, their roles are multifaceted, and their job security can be low. This combination of factors can take a high toll on them and their families. With coaches in particular, there’s been a development at the AIS in the past two years of having a specific High Performance Coach Development team. They focus on how best to develop coaches in the Australian high performance system. Part of their work has a wellbeing aspect as well. We liaise with their team about how they best get information about services available to them in front of the coaches that they’re working with.
Have you enjoyed much success?
MB: Yes, I think so. Independent research that we’ve commissioned over the last four years has told us that mental health rates in our high performance system have been fairly stable across that time but access to our Mental Health Referral Network has continued to increase year on year. We take this as a positive sign that people are increasingly aware of the need to take care of their mental health and that they’re feeling more comfortable, and less stigmatised, to proactively reach out for support when they need it. A recent independent survey of people who’ve accessed the Mental Health Referral Network also told us that the service has helped them in managing their mental health, in some cases they said it had saved their life, and they want the service to continue to be available to them. We also know from this research that we’ve got work to do around building more awareness, continuing to have the right skills mix of professionals, and we’re about to do some work around how we keep the service sustainable into the future as demand continues to increase.
Do you feel these initiatives have built the credibility of the Mental Health Referral Network?
MB: Yes. The credibility of our programs such as the Mental Health Referral Network has been built by a number of factors. A key one which I think is a hallmark for any type of success has been having great leadership. My team and I have been fortunate to have excellent leadership sitting above us so that we could get on with the job of helping athletes, coaches and staff. There’s been many leaders who’ve assisted. Our current Acting Director of the AIS, Matti Clements, has been a leader at executive level and has really owned and driven the AIS’s approach to wellbeing over the last four years. I think it’s accurate to say that her vision and leadership has been transformative for our system. I think that other factors that have helped in building credibility is the authenticity and work ethic of the people providing mental health services to athletes, coaches and staff. The people involved have taken the approach that if we say we’re going to do something then they’ve worked really hard to deliver that for our stakeholders, whether that’s an individual athlete or a national sporting organisation or one of the organisations that runs the various games in terms of Olympic, Paralympic and Commonwealth Games.
What is next in the mental health space for the AIS?
MB: I think moving more into how we best support mental health at a systemic level, so the overall Australian sport system or the National Sporting Organisations (NSOs/NSODs) who are running their high performance programs but, at the same time, also needing to support the mental health and wellbeing of their athletes.
Does that research tend to back up what you thought in the first place?
MB: Yes, I think so in a number of areas. It’s also given us insights into particular issues we should be targeting more. The trauma space is one of those, the eating disorder space is another one as well, which is why in our Mental Health Referral Network we’ve done a lot of work to ensure professionals with those skillsets are available to help people in our system. Moving forward, we want to create pathways for people who experience more serious mental health difficulties. While the rate is probably lower than we have in the broader community, we’ve got some work that we need to do in that space around having good