Athletes and performers share a distinct culture with unique demands, including intense physical exertion, intrusive scheduling and travel, frequent evaluation, and public criticism, that may impact their performance. High-level competition inherently necessitates a continuous need to optimize performance through cognitive and behavioral skills. At the elite level, athletic skills increasingly warrant precision, as small errors become more impactful to performance. Similarly, sensitivity to feedback also becomes more important, which may lead to stress and dampen positive perspective. These demands compete with prosocial activities outside of sport and often strain relationships. Seminal studies support these assertions: athletes evidence elevated stress, difficulty managing relationships, mental and physical fatigue, and burnout, making it difficult to fulfill major role obligations and sometimes compromising their mental wellness. Indeed, athletes tend to experience psychiatric symptoms at similar or higher severity as non-athletes. Importantly, athletes tend to underutilize traditional psychological services, perhaps due to perceived social stigma associated with the pursuit of mental health services, emphasis of mental health programs on pathology, and lack of evidence-supported mental health assessment and intervention programs adapted to sport culture. Indeed, traditional therapies may promulgate a culture of mental health service avoidance among athletes. In 2012 our research team received a substantial grant award from the National Institute on Drug Abuse in the United States to empirically develop the first sport-specific intervention to explicitly address substance use/mental health disorders in collegiate athletes. The award permitted our team to empirically develop a seamless mental wellness program for collegiate athletes that was named The Optimum Performance Program in Sports (TOPPS). TOPPS includes (a) a theoretical rationale to explain mental health and sport performance optimization; (b) standardized outreach efforts focused on developing and maintaining a campus culture that values mental health optimization as a goal-worthy initiative capable of engaging athletes into mental health services; (c) psychometrically validated mental health assessment and screening procedures; and (d) standardized methods of optimizing mental health in athletes, regardless of the presence or severity of symptomatology, which have been supported in clinical trials. In this sections, we expand on these components.
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