Donna Johnson of Zena Sports discusses her organization’s protective vests and the wider need for education around breast injuries in sports.
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A 2020 study by the University of Wollongong in Australia surveyed 297 female athletes (rugby players and Australian rules footballers) and 242 team employees, like coaches and medical staffers.
On the player side, 58% said they had experienced a breast injury in their careers, with 48% feeling that their play had been affected following the injury. On the team side, half of the staffers “were not aware that breast injuries were a problem for female contact football players.”
In 2022, Wollongong released another study that said that 60% of female athletes had experienced previous breast injury, but 90% of those athletes never reported those injuries.
Donna Johnson wasn’t armed with those stats when she first dreamed up the Zena vest in 2017, but she recognized a void. The idea came over coffee with a friend with three daughters who just started playing Australian rules football. The conversation made Johnson, a mother of two, think about the amount of equipment she would purchase for her son’s sports. She didn’t see nearly as many options for her daughter.
“We were just discussing how fierce these girls were playing and the impact that they were receiving,” Johnson said. “I was just concerned that these girls were sort of at an adolescent age, crucial stage of their physical development, and they weren’t wearing any form of impact protection.”
Later that day, Johnson spoke with her husband, Brad, a hall of fame Australian rules footballer. After some initial research, the only chest protection she found for women was a hard chest plate meant for martial arts. It was not nearly nimble enough to move around in, much less sprint and jump.
For the next 12 months, Johnson tried to find a manufacturer with no luck, and the idea nearly died on the vine. One final internet search yielded Sydney-based Modulus Design, a sportswear company with expertise and manufacturing contacts. During that same time, Johnson toured Australia, meeting with different female athletes in sports, trying to understand the need for this product. The responses both validated and shocked her.
“I was really surprised by the feedback I got from them in terms of the type of breast injuries that they had, in terms of bruising, what they were doing to try and prevent it,” Johnson said. “A lot of girls talk about wearing two sports bras, a lot of girls talk about bandaging padding to their ribs or something like that.”
Fast forward to now, Zena Sport’s product uses a polyurethane foam that is injected into the molding (which Johnson compared, visually, to an ice cube tray). It’s then heat-sealed against the fabric so there’s no stitching into the nylon and elastane material, all of which increases durability.
Johnson said 70 to 80 players in top-level Australian competition wear the Zena Sport vest. “We don’t have any research yet to tell us what the long-term impacts of a breast injury could be,” Johnson said. “So we’re sort of in that unknown space and trying to educate people.”
Zena Sport is still a small company. The only employees right now are Donna and Brad, who oversees lead operations. Brad has spent some time in the US, building connections with governing bodies. Johnson said the company sees real growth potential in options like soccer, basketball, lacrosse and flag football.
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Leaders Performance Advisor Dr Megan Popovic sets out her requisites for a wellbeing strategy that creates a culture of care, resilience and excellence.
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A memory
The energy in the building has dialled down, music in the gym turned off. Our players have gone home after a practice day and the remaining staff members in the building are quickly shuffling to finish their tasks and head home early as playoffs are around the corner and time will be a fluid flow of ‘rinse and repeat’ until the end of the season.
I decided to stay late and bypass the rush hour traffic, sitting upstairs in my office and hear a knock on the door and look to see who may be there. A respected, veteran player with a gruff demeanour and hardened external shell, whom I have always had a jovial, albeit distant relationship with, is there. His massive physique fills the doorway. “Do you have minute to talk?” he asks in an atypically soft way.
I see his beyond his professional shield, calloused from decades in the league, that serves as a barrier for emotional safety into his wild blue eyes that reveal the depth of emotion in their stillness. He almost collapses in the chair and takes a few breaths before the words cascade from his heart.
The moment
“I have a good friend from home that I’m really worried about,” he releases into the space. “I don’t know if you can help, but I don’t know what to do.”
The softness in the building, plus space and time to speak, allowed us to talk until he all details on his mind released. A crumbling marriage, drinking to excess every night, the distance from family who he could lean on in this dark time, the deterioration of a career and panic that lies within thoughts of the future, and the obsessive thoughts that his life may not be worth living.
My player was deeply concerned for his hometown childhood friend who lived hours away in a different country. He wanted to help and yet did not know where to start, what to do, or what his role in this relationship should be. His empathy was palpable and I now wonder if his friend’s raw vulnerability allowed him to access fears and pain that he himself had buried deep inside himself for many years in the league.
I assured him that even if I am unable help his friend directly, I will provide him with information to pass along for his friend to consider and make the necessary steps to mend their challenges and find peace.
Creating a method
While this circumstance was different than the day-to-day mental health and wellbeing issues that came forth from players and staff in my role, it did not come as a surprise. What rang the bell of truth was the stark reality that if and when you create a space for people to come forth with their struggles, it is impossible to predict who or what real-life situation will stand in your doorway and trust you to help them find healing.
A few years prior to this moment, when I launched into the role of ‘wellbeing and performance’, it became apparent immediately that our club needed a system in place that would ensure a greater level of care, education, and knowledge of supports available. We had intentionality and energy to cultivate a new high-performance culture at the club, team-of-teams, and individual levels, yet a clearly articulated infrastructure of what, who, when, and how to respond to this newfound openness toward emotion, wellbeing, and mental health was yet to be constructed or implemented. Quite simply, if we build it and they come forth, what will we do? How can I/we create mental health and wellbeing processes that support players and staff in efficient and emotionally safe ways that make sense for the temporal, transactional, political, and employment realities of professional sports?
I knew that not all players or staff would open up to me, which in fact was both humbling and freeing. It was a beautiful thing to know that an improved workplace culture would invite stronger connections within the organization and potentially multiply the bonds amongst players and staff that could hopefully create a safer and trusting professional environment. The challenge though was similar to the player scenario above, how do I help upskill and train our player and staff to both understand themselves more fully and also know what to do if and when struggle occurs?
What I believed was needed at the maturation stage of the club to do was come up with a clear system – a simple method – that all players and staff could follow to feel more comfortable if and when another teammate and colleague opened up about their struggles. I needed to craft a manual that I have since called the Organizational Wellbeing Strategy: Creating and Sustaining a Culture of Care, Resilience, and Excellence. In the segments below, I am sharing the three sections from this manual that I believe will help any club design and implement their own wellbeing system.
Phase 1: identification
Player identifies concern for his own mental health OR someone else identifies concern for player’s mental health (e.g., team doctor, medical staff, coaches, management). Try to objectively connect what they are saying and doing to the Red Flags (see Red Flags below).
Phase 2: connection
Player is pointed via text, phone call, or in-person to club’s key point person on staff to discuss options for next steps. This person needs to be consistent and all staff should know that they are the hub of resources, education, and information. The person in this role should receive additional training to support their knowledge and skillset.
Phase 3: education of options
The club’s point person has conversation with player or staff member in crisis in-person (ideally) or over-the-phone about their options: It is also important that they player or staff member in crisis understands the limits of confidentiality within this professional setting and how each option could influence their career. While this is atypical for high performance sport, to educate a person so that they consent to whatever form of care they choose, they must know that ramifications upfront to make an informed decision. This knowledge and truth must by shared as a standard of ethics.
Phase 4: action
The player or staff member goes forth to take action in their lives.
Phase 5: follow-up
The club’s point person should follow up as necessary to support the person and be a resource, as requested by the player or staff member in crisis.
It is very important that all players and staff in the organization are knowledgeable and educated on the most common ‘red flags’ that occur in high performance sport. This could be done via an in-person training session; however, I believe it is very important that these red flags are accessible to the players in their private moments. Thus, if your club has a team app (e.g., Kairos, Teamworks), it would be wise to have a tab for wellbeing/mental health resources.
By creating awareness, what you want to avoid the progression to the aforementioned and worsening if the player is already presenting with these symptoms. These were the Red Flags that we created with the focus of being objective, observable, and rooted in our sport cultural norms.
i) Thoughts of suicide (most serious)
ii) Changes in behaviour
iii) Changes in thinking
iv) Behaviour and thoughts on games days (on ice, in dressing room)
For the complete wellbeing program to work, players and staff need to become more comfortable knowing what options are available for them to take action if and when challenges arise within the club. It is inevitable that within a season, multiple players and staff have struggles. The greater familiarity everyone has with the club’s process, the more seamless the provision of care can be and also a sense of calm in the heightened times of chaos and emotion.
Below is an example that we generated for ‘Substance Use (Drugs and Alcohol)’.
Step 1: identification
The player either:
a) Self-identifies to the Director of Wellbeing, team medical doctor, another staff member, or a teammate
b) Is screened by player’s union and tests positive for prohibited substances
What would players say that is considered “self-identification”?
Step 2: connection
Invite the player to go speak with the key individuals in the club who are trained to corral and direct the player of his options. This is typically a player wellbeing / welfare role, team doctor, or mental health consultant.
Step 3: educate player of his options
Communicate with the player his options in a way that he receives the details and can make an informed decision that aligns with his values, wants, and career.
The options I presented to players (in this order) were:
A very important component to the ethics of this communication with the player is their understanding of the limits of confidentiality. For instance, if they work with the team doctor or psychologist, what must be shared with the GM/coach and/or on the medical technology platform file that goes with the player to every club he plays for? If he works with the union, what is the club’s relationship to that external body and how can we / not engage unless he shares information? What is the league’s TUE process and its connection to the team and medical director?
Step 4: player (hopefully) takes action
From here, the key is to support his decision fully and without veiled personal interest. Too often I have heard of staff members in elite clubs using ties to the athletes (and insider knowledge provided to them in this trusted relationship) for their own personal and professional benefit. It is fundamental and ethical to encourage to player to make informed actions that align with his values and goals, and to be there to support him, if and when asked.
Step 5: follow-up
The subsequent relationship will be contingent upon the player, his or her needs, how much he wishes to engage and the severity of need. Follow-up could look like:
Being in service of momentum
After the player left my office, I sat still in a long pause to consider the ways in which our conversation landed for him and if I was moderately helpful in his state of unknowing. What I knew for sure is that my player relaxed within himself by having a listening ear, some advice, and that he had something tangible to bring to his hometown buddy. It was a start.
A few weeks later I check in with my player to see how his friend was doing. This conversation was more succinct, a blend of the original professional guard combined with a known feeling of connection through shared experience. He told me that he reached out to his friend shortly after our call to talk. The nervousness of not knowing his role or what to say was softened by his understanding of the Red Flags. He shared these with his friend and encouraged him to speak with someone trusted as soon as possible. This gesture of support was the life preserver his friend needed, at the right time, to be of service to stop himself from drowning. His friend called his parents and asked for their support. What he was hiding from them the last few years, as he lived in a different city, tied to keep his marriage afloat and be somewhat together as a father, was no longer a silent source of shame and pain.
The healing process had begun.
This recent Leaders Virtual Roundtable gave Leaders Performance Institute members the opportunity to define mental skills and discuss their application in their environments and what we can all be doing to optimise their implementation.
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Providing some additional content and provocation for the start of the roundtable, we listened to some of the thoughts and experiences of Dr Duncan Simpson who is currently serving as the Director of Personal Development at IMG Academy – Duncan is also on the Executive Board for the Association of Applied Sports Psychology in a Research & Practice position. The premise of the first section of the roundtable was to engage in some stimulus around the ’what’, ‘why’ and ‘how’ as it pertains to mental skills training.
The ‘why’ of mental skills
Simpson kicked us off by sharing this definition of mental skills training: ‘The systematic and consistent practice of psychological skills aimed at enhancing performance and personal well-being’ (Vealey 2007). There are two key components to this definition – the systematic and consistent practice and the other focusing on what is the purpose of that practice? When we think about mental skills, if you just do it without an intended outcome or purpose, it will lack any impact or substance.
Now we’ve explored a definition of mental skills and some core considerations, why is this topic of much interest and relevance to the high performance sport industry?
Recent meta analyses corroborate decades of research regarding mental skills training having a positive effect on sports performance and vital psychological factors (Brown & Fletcher, 2017; Lochbaum et al., 2022).
However, some coaches and athletic directors have not adopted mental skills training due to perceived barriers, such as lack of time, cost, and concerns over relinquishing control (Wrisberg et al., 2010; Zakrajsek et al., 2013).
To summarise this first segment of the roundtable – we know that mental skills is important because there is a significant body of research outlining the positive impacts, but we also know it’s not being implemented across all levels of sport consistently.
What? ‘Questions are the shepherds of your mind’
We have to begin thinking about the implementation of mental skills. We may want to ask ourselves some questions because these will help direct where we want to go without on programming. Below are some considerations Duncan shared when thinking about the programming of our mental skills training:
What does the athlete or team want? What are we hearing from them around what they want? Do they want to become more resilient, confident or focus – what are the areas they want? This is a really important step, in particular having the connection with the athlete to collate that feedback. Where we have seen mental skills not work is when we put the programming to the athlete and try to make them receptive to it.
What does the athlete or team need? An audit or a needs analysis, working with coaches and support staff to understand what they actually need. When we start to collate the information around what they want and need, we are much better informed around what the programming and training needs to look like.
When you think about the sport in the context in which you work, what’s the greatest return on investment? If we want to improve the resilience of the team, is that going to have the biggest impact upon performance and wellbeing? Are we strictly focused on performance or is it a combination of both? We need to evaluate what is actually going on in order to make a difference.
It’s also worth thinking about an opposing question such as ‘what’s the lowest hanging fruit?’ What’s the easiest thing, not just the greatest thing? What are the things that are no brainers?
Addition and subtraction. When we think about organisations and teams, a lot of times coaches have this idea of needing to do more; and mental skills training is another one of those things we have to do, work and focus on – it’s an addition. We can actually reframe this. Mental skills and psychological work can actually be about subtraction. Here’s an example to bring this to life – if we are to focus on team building and culture working through the lens of subtraction, an element of this might be that when we make a mistake, we don’t criticise each other. We’re not doing anything extra, we’re just stopping criticism.
Finally, and when thinking about the ‘what’ behind mental skills’, what can you provide? What are your areas of competence?
What do we mean by ‘mental skills’?
Skills, in this case mental, is an ability and capacity acquired through deliberate, systematic, and sustained effort. Below are a number of key mental skills we often seen aligned to the practice.
Mental attributes
Attributes are qualities or characteristics of a person or team. Below are some of the things you may hear from coaches or support staff around how we want our athletes to be. The below examples are the outcome, this is what we are leading towards and we’re going to practise some mental skills in the aim to reach these outcomes:
Behaviours
A behaviour is the way a person acts or reacts in response to a particular situation or stimulus. They are observable actions that express psychological attributes. What does it look like when somebody is confident, when somebody is resilient?
Collaboration and agreement between performer, coach and support staff is an important aspect here. Ultimately, it doesn’t matter whether your definition of an attribute is slightly different to another member of staff or the athlete, the collaboration and agreement is the most important.
It’s also important to be sport-specific. What does that behaviour look like in your context? We are also in a position now where we can be objectively recording and capturing data based on these behaviours.
Skill learning is a relatively permanent change in behaviour as a result of practice (Magill, 2016). If we are just psycho-educating our athletes and they don’t actually change their behaviours, they probably haven’t learned it. Seeing a change in behaviour is key.
Consider this flow: one of the outcomes is that we want an athlete to take more calculated risks. When we can define what that means based on the sporting context, what do we need to allow that to happen? We need the athletes to be more confident (the attribute), what are the skills that can support that confidence (self-talk)?
Skill = Self-Talk → Attribute = Confidence → Behaviour: Take More Calculated Risks
In practice reflection
Think about reflection. Below are some questions we can ask ourselves as performance support staff and coaches.
Ultimately, when you are looking at your team, organisation and athletes:
Group reflections & insights
At the end of the call, attendees were asked to share a key reflection from the roundtable that they’d like to take forward:
What Leaders Performance Institute members said in a recent Virtual Roundtable about the current state of play around staff and coach wellbeing.
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This virtual roundtable, which is four years on from the article linked above, provided an opportunity for those on the call to reflect on the current state of play around coach and staff wellbeing. To help shape the conversations, three questions were asked of participants to help shape the discussions:
Curious to find out what the average score out of five was from the group in relation to question one? It was 3.2 out of five. It was clear that some initiatives are having a positive impact, but there remains gaps in our approaches and environments to take these scores closer to four or five.
What’s having the most impact?
Leaning on the second question above, the group explored some of the successful stories and initiatives that are currently taking place within their organisations pertaining to the topic at hand. The consensus was that it is important to maintain momentum and evolve what is working well, just as much as identifying the gaps which require more attention.
Mental health first aid training
One environment in the discussion shared that mental health first aid training has now become a foundational part of their wellbeing programme. It has created a base level education across the board and has elevated general awareness across their environment – there is more clarity on what to look out for both individually and collectively, as well as creating a safer space to have conversations that can otherwise be difficult.
Broad and bespoke support
The point above around mental health first aid training is a text book example of an initiative numerous organisations are implementing. As part of the conversations, there were convincing points shared around the need to have core, generic deliverables complemented by bespoke initiatives. Do you have clear minimum standards around your wellbeing practices (transparency, selection policies, communication, planning and child safeguarding)? We can often think about all the bells and whistles and forget about the real fundamentals so it’s important to get this right first and foremost.
Once you have the fundamentals and broad support in place, the bespoke elements are the idea of really understanding your people and the system and, in particular, the pressure points of people, and what help we can provide them based on their contexts and needs. It’s important to be agile and flexible around your wellbeing strategy due to its subjective nature.
Effective initiatives
The group also shared some specific and creative initiatives that they felt have had an impact in their environments. A ‘digital detox’ was one – two days within the season where staff and coaches get time off without having to take it as holiday with a request for no digital communication. Staff were encouraged to engage in hobbies and activities and asked to report back, which aided some quality stories and conversations internally.
There is value in providing economic levers (with a minimum required investment) that have been mandated to bolster mental health and wellbeing activity. From the specific league who brought this to the table, teams can’t spend their allocation on anything except this; they have also created communities of practice for individuals in these roles across clubs to come together to share and learn so that they are genuinely influencing coaches, staff and players.
Finally, industry or organisational shutdowns are having a positive impact. There is an appreciation that some environments are unable to do this, but for those that have implemented this, it has been the most impactful initiative. In environments where shutdowns are difficult, it’s important leadership are role-modelling the behaviours you are asking of your people, even simple things such as taking the full allocation of annual leave.
Engaging coaches
The group discussed the importance of opportunities for coaches to increase their levels of self-awareness and understanding of self. One of the teams on the call highlighted how they ask their coaches to check-in twice a year against a framework to assess their physical and mental wellbeing, while also outlining their commitments against those.
A representative from a leading league shared that they had engaged in roundtables with coaches about their role design – in many instances, the role is designed so that coaches can’t switch off. The coaches have been asked to come up with the solutions. Often the narrative in sport is that to be a successful coach, there is a certain way to do things – being ‘character logical’ vs. just doing the role itself. Job design, contracts and schedule were the key things emphasised by the coaches.
Final thoughts
Where do the gaps remain?
Shifting gears from question two to question three, the group spent time reflecting on the gaps, challenges and opportunities around this topic with the idea of walking away from the call to explore in further detail with, and provoke thought across, their respective organisations.
‘Spine alignment’
We can often see misalignment within organisations. If you don’t have a really clear understanding of wellbeing and how it’s fitting into your overall strategy from your Board and CEO to High Performance Director and Head Coach, it will be very challenging. We can’t have a situation where there are different views, approaches, language and education in siloes – everybody having an understanding that wellbeing is everybody’s right and everybody’s responsibility. The more that everybody is open about those responsibilities at a system, organisation and individual level, you start to get more clarity around wellbeing and what we actually mean by wellbeing.
Understanding needs
The group were in agreement that there is always more that can be done to better understand people’s needs, even if there is some good work being done around this – needs are constantly changing and evolving, so we need to evolve with them too. Create opportunities to get into conversations and combine this with the quantitative insight you are collating through surveys and polls.
It can be quite easy from a club or organisation perspective to create a wellbeing strategy that we think is going to be useful for everybody, but often that isn’t the case. Wellbeing needs to be individualised as everyone’s contexts are so different. How can we move away from a blanket approach and be more specific, individualised and personalised?
Making wellbeing a core competency
One organisation shared that they are looking at high performance workforces needing competency or capabilities in wellbeing in the same way we’d ask for high performance in other modalities. For coaches in particular, making wellbeing one of those core competencies was essential. They are investing in the wellbeing literacy of their young athletes who are entering the programme and demanding high wellbeing literacy from coaches who in some instances are unable to meet those requirements – the athletes are outstripping the coaches in terms of knowledge and understanding. This is leading to a cultural nexus in many environments.
Group reflections and insights
At the end of the call, attendees were asked to share a key reflection from the roundtable that they’d like to take forward:
EPIC Risk Management’s Mike Huber and Ben McGregor discuss gambling harm prevention.
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It’s a startling revelation from Mike Huber, an advisor with our Partners at EPIC Risk Management, on this Gambling Harm Prevention edition of the Leaders Performance Podcast.
“Taking it a step further,” he continues, “we ask the question in our sessions ‘why do you think that is?’ And the reasons that come up from a lived experienced perspective, a research basis, are the personality traits of an athlete. The competitiveness, the ego. Sometimes it’s injuries when they have downtime.”
The reasons why athletes gamble – in the US and beyond – are manifold, as we discussed during this episode, where Mike was joined by Ben McGregor, EPIC’s Director of Sports Partnerships.
Over the course of our conversation with Mike and Ben, we covered:
For those seeking more information on gambling harm prevention, check out EPIC Risk Management’s white paper review from February 2023.
Listen above and subscribe today on iTunes, Spotify, Stitcher and Overcast, or your chosen podcast platform.
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 pathways.
The Acting Director of the Australian Institute of Sport discusses the leader’s role in modelling health-seeking behaviours.
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Her observation is all too common in such a male-dominated industry with certain roles, such as psychology, often presumed to be a more natural fit for a female practitioner than, say, a strength & conditioning role.
Matti, for her part, is a psychologist by training but has served in a series of senior managerial roles – becoming a pioneer in the process – and has shifted perceived wisdoms in the fields of people, culture and wellbeing.
As such, she was an ideal guest for the latest edition of the Elite Performance Partners (EPP) Industry Insight Series Podcast where she spoke to Dave Slemen, EPP’s Founding Partner, about her career journey and her thoughts on the evolution of psychology and wellbeing in sport.
She continues: “Over time, I got a bit more comfortable with ‘what do I bring? Why am I here? So what is the role that I’m being asked to fill and how do I utilise my strengths in that role?’”
Over the course of the conversation, Matti also spoke about:
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