Skip to main content
SpringerLink
Log in

Mental Health in Paralympic Athletes

  • Chapter
  • First Online:
Mental Health Care for Elite Athletes

  • 986 Accesses

Abstract

Paralympic athletes face the same challenges as do all other athletes in terms of their mental health. Far less is known about mental health symptoms and disorders in Paralympic athletes than in other athletes, for a range of reasons. This chapter provides an introduction to the key issues in considering mental health symptoms and disorders in this group. Questions of stigma, stereotyping, and social exclusion are important to consider, along with common histories of trauma, issues of pain, the cost and accessibility of assistive devices, and the strains associated with classification changes and developments. This is an area in urgent need of further research.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. United Nations Department of Economic and Social Affairs: Disability. Article 1-Purpose. https://www.un.org/development/desa/disabilities/convention-on-the-rights-of-persons-with-disabilities/article-1-purpose.html. Accessed 15 Feb 2022.

  2. Goodley D. Disability studies: an interdisciplinary introduction. London: Sage; 2016.

    Google Scholar 

  3. Shakespeare T. Disability rights and wrongs revisited. London: Routledge; 2013.

    Book  Google Scholar 

  4. Shakespeare T. Disability: the basics. London: Routledge; 2017.

    Book  Google Scholar 

  5. Smith B, Bundon A. Disability models: explaining and understanding disability sport in different ways. In: The Palgrave handbook of Paralympic studies. Springer; 2018. p. 15–34.

    Chapter  Google Scholar 

  6. Oliver M. The social model of disability: thirty years on. Disabil Soc. 2013;28(7):1024–6.

    Article  Google Scholar 

  7. Chisale SS. Politics of the body, fear and Ubuntu: proposing an African women’s theology of disability. HTS Teol Stud/Theol Stud. 2020;76(3).

    Google Scholar 

  8. Dirth TP, Adams GA. Decolonial theory and disability studies: on the modernity/coloniality of ability. J Soc Polit Psychol. 2019;7(1):260–89.

    Article  Google Scholar 

  9. Kavanagh C. What contemporary models of disability miss: the case for a phenomenological hermeneutic analysis. Int J Fem Approaches Bioeth. 2018;11(2):63–82.

    Article  Google Scholar 

  10. Lawson A, Beckett AE. The social and human rights models of disability: towards a complementarity thesis. Int J Hum Rights. 2021;25(2):348–79.

    Article  Google Scholar 

  11. Mitra S. The human development model of disability, health and wellbeing. In: Disability, health and human development. New York: Springer; 2018. p. 9–32.

    Chapter  Google Scholar 

  12. Mji G, Gcaza S, Swartz L, MacLachlan M, Hutton B. An African way of networking around disability. Disabil Soc. 2011;26(3) https://doi.org/10.1080/09687599.2011.560419.

  13. Ngubane-Mokiwa SA. Ubuntu considered in light of exclusion of people with disabilities. Afr J Disabil. 2018;7(1):1–7.

    Google Scholar 

  14. Cleary K. Disability studies. Fem Media Hist. 2018;4(2):61–6.

    Article  Google Scholar 

  15. Garland-Thomson R. Misfits: a feminist materialist disability concept. Hypatia. 2011;26(3):591–609.

    Article  Google Scholar 

  16. Salvador-Carulla L, Bertelli M, Martinez-Leal R. The road to 11th edition of the International Classification of Diseases: trajectories of scientific consensus and contested science in the classification of intellectual disability/intellectual developmental disorders. Curr Opin Psychiatry. 2018;31(2):79–87.

    Article  PubMed  Google Scholar 

  17. Akkermans R. Ludwig Guttmann. Lancet Neurol. 2016;15(12):1210.

    Article  Google Scholar 

  18. Silver JR. Ludwig Guttmann (1899–1980), Stoke Mandeville Hospital and the Paralympic games. J Med Biogr. 2012;20(3):101–5.

    Article  PubMed  Google Scholar 

  19. Wedgwood N. Hahn versus Guttmann: revisiting ‘sports and the political movement of disabled persons’. Disabil Soc. 2014;29(1):129–42.

    Article  Google Scholar 

  20. Balakrishnan A, Kulkarni K, Moirangthem S, Kumar CN, Math SB, Murthy P. The Rights of Persons with Disabilities Act 2016: mental health implications. Indian J Psychol Med. 2019;41(2):119–25.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Comas-Díaz L, Hall GN, Neville HA. Racial trauma: theory, research, and healing: introduction to the special issue. Am Psychol. 2019;74(1):1–5). . American Psychological Association. https://doi.org/10.1037/amp0000442.

    Article  PubMed  Google Scholar 

  22. Nakkeeran N, Nakkeeran B. Disability, mental health, sexual orientation and gender identity: understanding health inequity through experience and difference. Health Res Policy Syst. 2018;16(1):9–19.

    Google Scholar 

  23. Swartz L, Hunt X, Bantjes J, Hainline B, Reardon CL. Mental health symptoms and disorders in Paralympic athletes: a narrative review. Br J Sports Med. 2019;53(12):737–40. https://doi.org/10.1136/bjsports-2019-100731.

    Article  PubMed  Google Scholar 

  24. Temple JB, Kelaher M. Is disability exclusion associated with psychological distress? Australian evidence from a national cross-sectional survey. BMJ Open. 2018;8(5):e020829.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Vargas SM, Huey SJ Jr, Miranda J. A critical review of current evidence on multiple types of discrimination and mental health. Am J Orthopsychiatry. 2020;90(3):374.

    Article  PubMed  Google Scholar 

  26. Marks D. Disability: controversial debates and psychosocial perspectives. London: Routledge; 2014.

    Book  Google Scholar 

  27. Reeve D. Psycho-emotional disablism: the missing link? In: Routledge handbook of disability studies. London: Routledge; 2019. p. 102–16.

    Chapter  Google Scholar 

  28. Watermeyer B, Swartz L. Disablism, identity and self: discrimination as a traumatic assault on subjectivity. J Community Appl Soc Psychol. 2016;26(3):268–76. https://doi.org/10.1002/casp.2266.

    Article  Google Scholar 

  29. Watermeyer B. Towards a contextual psychology of disablism. Abingdon: Routledge; 2012.

    Book  Google Scholar 

  30. Filia K, Menssink J, Gao CX, Rickwood D, Hamilton M, Hetrick SE, Parker AG, Herrman H, Hickie I, Sharmin S. Social inclusion, intersectionality, and profiles of vulnerable groups of young people seeking mental health support. Soc Psychiatry Psychiatr Epidemiol. 2021;57(2):245–54.

    Article  PubMed  Google Scholar 

  31. O’Donnell P, O’Donovan D, Elmusharaf K. Measuring social exclusion in healthcare settings: a scoping review. Int J Equity Health. 2018;17(1):1–16.

    Article  Google Scholar 

  32. Scifo L, Chicau Borrego C, Monteiro D, Matosic D, Feka K, Bianco A, Alesi M. Sport intervention programs (SIPs) to improve health and social inclusion in people with intellectual disabilities: a systematic review. J Funct Morphol Kinesiol. 2019;4(3):57.

    Article  PubMed Central  Google Scholar 

  33. Tan RKJ. Social inclusion and social determinants of health. In: Liamputtong P, editor. Handbook of social inclusion: research and practices in health and social sciences. Springer; 2020. p. 1–21. https://doi.org/10.1007/978-3-030-48277-0_2-1.

    Chapter  Google Scholar 

  34. Woodgate RL, Gonzalez M, Demczuk L, Snow WM, Barriage S, Kirk S. How do peers promote social inclusion of children with disabilities? A mixed-methods systematic review. Disabil Rehabil. 2020;42(18):2553–79.

    Article  PubMed  Google Scholar 

  35. SAHRC Report. Towards a barrier-free society; 2022. http://www.sahrc.org.za/home/21/files/Reports/towards_barrier_free_society.pdf2002.pdf. Accessed 15 Feb 2022.

  36. Gouttebarge V, Bindra A, Blauwet C, Campriani N, Currie A, Engebretsen L, Hainline B, Kroshus E, McDuff D, Mountjoy M, Purcell R, Putukian M, Reardon CL, Rice SM, Budgett R. International Olympic Committee (IOC) Sport Mental Health Assessment Tool 1 (SMHAT-1) and Sport Mental Health Recognition Tool 1 (SMHRT-1): towards better support of athletes’ mental health. Br J Sports Med. 2021;55(1):30–7. https://doi.org/10.1136/BJSPORTS-2020-102411.

    Article  PubMed  Google Scholar 

  37. Gouttebarge V, Castaldelli-Maia JM, Gorczynski P, Hainline B, Hitchcock ME, Kerkhoffs GM, Rice SM, Reardon CL. Occurrence of mental health symptoms and disorders in current and former elite athletes: a systematic review and meta-analysis. Br J Sports Med. 2019;53(11):700–6.

    Article  PubMed  Google Scholar 

  38. Rice SM, Gwyther K, Santesteban-Echarri O, Baron D, Gorczynski P, Gouttebarge V, Reardon CL, Hitchcock ME, Hainline B, Purcell R. Determinants of anxiety in elite athletes: a systematic review and meta-analysis. Br J Sports Med. 2019;53(11):722–30.

    Article  PubMed  Google Scholar 

  39. Howe D. The cultural politics of the Paralympic movement: through an anthropological lens. London: Routledge; 2008.

    Book  Google Scholar 

  40. Howe PD. Cyborg and supercrip: the Paralympics technology and the (dis) empowerment of disabled athletes. Sociology. 2011;45(5):868–82.

    Article  Google Scholar 

  41. Pullen E, Jackson D, Silk M. (Re-) presenting the Paralympics: affective nationalism and the “able-disabled”. Commun Sport. 2020;8(6):715–37.

    Article  Google Scholar 

  42. Silva CF, Howe PD. The (in) validity of supercrip representation of Paralympian athletes. J Sport Soc Issues. 2012;36(2):174–94.

    Article  Google Scholar 

  43. Hodges CEM, Scullion R, Jackson D. From awww to awe factor: UK audience meaning-making of the 2012 Paralympics as mediated spectacle. J Pop Telev. 2015;3(2):195–212.

    Google Scholar 

  44. Pullen E, Jackson D, Silk M, Scullion R. Re-presenting the Paralympics: (contested) philosophies, production practices and the hypervisibility of disability. Media Cult Soc. 2019;41(4):465–81.

    Article  Google Scholar 

  45. Ahmed N. Paralympics 2012 legacy: accessible housing and disability equality or inequality? Disabil Soc. 2013;28(1):129–33.

    Article  Google Scholar 

  46. Postlethwaite V, Kohe GZ, Molnar G. Inspiring a generation: an examination of stakeholder relations in the context of London 2012 Olympics and Paralympics educational programmes. Manag Sport Leis. 2018;23(4–6):391–407.

    Article  Google Scholar 

  47. Shakespeare T. The Paralympics—superhumans and mere mortals. Lancet. 2016;388(10050):1137–9.

    Article  PubMed  Google Scholar 

  48. Young S. TED: ideas worth spreading. I'm not your inspiration, thank you very much. https://www.ted.com/talks/stella_young_i_m_not_your_inspiration_thank_you_very_much?language=en. Accessed 15 Feb 2022.

  49. Grue J. The problem with inspiration porn: a tentative definition and a provisional critique. Disabil Soc. 2016;31(6):838–49.

    Article  Google Scholar 

  50. Garland-Thomson R. Staring: how we look. Oxford: Oxford University Press; 2009.

    Google Scholar 

  51. Sandell R, Dodd J, Garland-Thomson R. Re-presenting disability: activism and agency in the museum. London: Routledge; 2013.

    Book  Google Scholar 

  52. Nario-Redmond MR, Kemerling AA, Silverman A. Hostile, benevolent, and ambivalent ableism: contemporary manifestations. J Soc Issues. 2019;75(3):726–56.

    Article  Google Scholar 

  53. Tyrrell B. A world turned upside down: hop-frog, freak shows, and representations of dwarfism. J Lit Cult Disabil Stud. 2020;14(2):171–86.

    Article  Google Scholar 

  54. Blacker CJ. What’s wrong with you? JAMA Neurol. 2021;78(3):269–70.

    Article  PubMed  Google Scholar 

  55. Deacon L, Macdonald SJ, Donaghue J. “What’s wrong with you, are you stupid?” Listening to the biographical narratives of adults with dyslexia in an age of ‘inclusive’ and ‘anti-discriminatory’ practice. Disabil Soc. 2020;37(3):406–26.

    Article  Google Scholar 

  56. Kattari SK, Olzman M, Hanna MD. “You look fine!” Ableist experiences by people with invisible disabilities. Affilia. 2018;33(4):477–92.

    Article  Google Scholar 

  57. Swartz L. Building capacity or enforcing normalcy? Engaging with disability scholarship in Africa. Qual Res Psychol. 2018;15(1):116–30. https://doi.org/10.1080/14780887.2017.1416801.

    Article  Google Scholar 

  58. Cormier DL, Ferguson LJ, Gyurcsik NC, Briere JL, Dunn JGH, Kowalski KC. Grit in sport: a scoping review. Int Rev Sport Exerc Psychol. 2021:1–38.

    Google Scholar 

  59. Codjoe L, Barber S, Ahuja S, Thornicroft G, Henderson C, Lempp H, N’Danga-Koroma J. Evidence for interventions to promote mental health and reduce stigma in Black faith communities: systematic review. Soc Psychiatry Psychiatr Epidemiol. 2021;56(6):895–911.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Henderson C, Noblett J, Parke H, Clement S, Caffrey A, Gale-Grant O, Schulze B, Druss B, Thornicroft G. Mental health-related stigma in health care and mental health-care settings. Lancet Psychiatry. 2014;1(6):467–82. https://doi.org/10.1016/S2215-0366(14)00023-6.

    Article  PubMed  Google Scholar 

  61. Mascayano F, Toso-Salman J, Ho YCS, Dev S, Tapia T, Thornicroft G, Cabassa LJ, Khenti A, Sapag J, Bobbili SJ. Including culture in programs to reduce stigma toward people with mental disorders in low-and middle-income countries. Transcult Psychiatry. 2020;57(1):140–60.

    Article  PubMed  Google Scholar 

  62. Martínez-Bello VE, Bernabé-Villodre MM, Cabrera García-Ochoa Y, Torrent-Trilles L, Vega-Perona H. The representation of athletes during Paralympic and Olympic games: a Foucauldian analysis of the construction of difference in newspapers. Disabil Soc. 2021:1–23.

    Google Scholar 

  63. Grobler L, Derman W, Blauwet CA, Chetty S, Webborn N, Pluim B. Pain management in athletes with impairment: a narrative review of management strategies. Clin J Sport Med. 2018;28(5):457–72.

    Article  PubMed  Google Scholar 

  64. Willick SE, Webborn N, Emery C, Blauwet CA, Pit-Grosheide P, Stomphorst J, Van de Vliet P, Marques NAP, Martinez-Ferrer JO, Jordaan E. The epidemiology of injuries at the London 2012 Paralympic games. Br J Sports Med. 2013;47(7):426–32. https://doi.org/10.1136/bjsports-2013-092374.

    Article  PubMed  Google Scholar 

  65. IsHak WW, Wen RY, Naghdechi L, Vanle B, Dang J, Knosp M, Dascal J, Marcia L, Gohar Y, Eskander L. Pain and depression: a systematic review. Harv Rev Psychiatry. 2018;26(6):352–63.

    Article  PubMed  Google Scholar 

  66. Kirtley OJ, Rodham K, Crane C. Understanding suicidal ideation and behaviour in individuals with chronic pain: a review of the role of novel transdiagnostic psychological factors. Lancet Psychiatry. 2020;7(3):282–90.

    Article  PubMed  Google Scholar 

  67. Badenhorst M, Runciman P, Brown JC, Swartz L, Derman WE. Promotion of Para athlete well-being in South Africa (the PROPEL studies): profiles and prevalence of psychological distress. J Sci Med Sport. 2021;24(7):616–21. https://doi.org/10.1016/J.JSAMS.2020.12.013.

    Article  PubMed  Google Scholar 

  68. Currie A, Blauwet C, Bindra A, Budgett R, Campriani N, Hainline B, McDuff D, Mountjoy M, Purcell R, Putukian M. Athlete mental health: future directions. Br J Sports Med. 2021;55(22):1243–4. BMJ Publishing Group Ltd and British Association of Sport and Exercise Medicine.

    Article  PubMed  Google Scholar 

  69. Olive LS, Rice S, Butterworth M, Clements M, Purcell R. Do rates of mental health symptoms in currently competing elite athletes in Paralympic sports differ from non-para-athletes? Sports Med Open. 2021;7(1):1–9.

    Article  Google Scholar 

  70. McKay CD, Callaghan L, Badenhorst M, Runciman P, Derman W. Injury psychology and para athletes: same same, but different. In: The mental impact of sports injury. London: Routledge; 2022. p. 208–22.

    Google Scholar 

  71. Makuwira J. Disability-inclusive development. In: Simms K, Banks N, Engel S, Hodge P, Makuwira J, Nakamura N, Rigg J, Salamanca A, Yeophantong P, editors. The Routledge handbook of global development. London: Routledge; 2022. p. 480–92.

    Chapter  Google Scholar 

  72. Bantjes J, Swartz L. Social inclusion through parasport: a critical reflection on the current state of play. Phys Med Rehabil Clin N Am. 2018;29(2):409–16.

    Article  PubMed  Google Scholar 

  73. Aitchison B, Rushton AB, Martin P, Barr M, Soundy A, Heneghan NR. The experiences and perceived health benefits of individuals with a disability participating in sport: a systematic review and narrative synthesis. Disabil Health J. 2021;15:101164.

    Article  PubMed  Google Scholar 

  74. Patatas JM, De Bosscher V, Derom I, Winckler C. Stakeholders’ perceptions of athletic career pathways in Paralympic sport: from participation to excellence. Sport Soc. 2022;25(2):299–320.

    Article  Google Scholar 

  75. Bundon A, Ashfield A, Smith B, Goosey-Tolfrey VL. Struggling to stay and struggling to leave: the experiences of elite para-athletes at the end of their sport careers. Psychol Sport Exerc. 2018;37:296–305.

    Article  Google Scholar 

  76. Reardon CL, Hainline B, Aron CM, Baron D, Baum AL, Bindra A, Budgett R, Campriani N, Castaldelli-Maia JM, Currie A, Derevensky JL, Glick ID, Gorczynski P, Gouttebarge V, Grandner MA, Han DH, McDuff D, Mountjoy M, Polat A, et al. Mental health in elite athletes: International Olympic Committee consensus statement (2019). Br J Sports Med. 2019;53(11):667–99. https://doi.org/10.1136/BJSPORTS-2019-100715.

    Article  PubMed  Google Scholar 

  77. Swartz L, Bantjes J, Rall D, Ferreira S, Blauwet C, Derman W. “A more equitable society”: the politics of global fairness in Paralympic sport. PLoS One. 2016;11(12):e0167481. https://doi.org/10.1371/journal.pone.0167481.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  78. Javadi D, Feldhaus I, Mancuso A, Ghaffar A. Applying systems thinking to task shifting for mental health using lay providers: a review of the evidence. Glob Ment Health. 2017;4:e14.

    Article  CAS  Google Scholar 

  79. Patel V, Saxena S, Lund C, Thornicroft G, Baingana F, Bolton P, Chisholm D, Collins PY, Cooper JL, Eaton J. The Lancet Commission on global mental health and sustainable development. Lancet. 2018;392(10157):1553–98.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychology, Stellenbosch University, Stellenbosch, South Africa

    Leslie Swartz

Authors
  1. Leslie Swartz
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Leslie Swartz .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA

    Claudia L. Reardon

Rights and permissions

Reprints and permissions

Copyright information

© 2022 The Author(s), under exclusive license to Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Swartz, L. (2022). Mental Health in Paralympic Athletes. In: Reardon, C.L. (eds) Mental Health Care for Elite Athletes. Springer, Cham. https://doi.org/10.1007/978-3-031-08364-8_23

Download citation

Publish with us

Policies and ethics

Search

Navigation