ABSTRACT
Whereas the use of psychological expertise to improve performance has a long history in elite sports, sports psychiatry is a relatively young field. The International Society for Sports Psychiatry was founded in 1994, whereas the European Federation of Sport Psychology has been around since 1969. It is a common belief that high-level performance requires above the average motivation, resiliency, and dedication. Early models therefore postulated a linear approach, having health, well-being, and high-performance on one side; and illness, injury, and impaired performance on the other. Over the last years, criticism of this foundational linear model has been growing. Leading organizations have published consensus statements on mental health care for athletes, highlighting that peak performance does not equal the absence of mental disorders. On the contrary, mental health symptoms and disorders are considered common among elite athletes, who are exposed to additional risk factors, with some of these also being instrumental in their success. In this chapter, we delve deeper into the fact that good mental health is not a prerequisite for elite-level performance, and describe how it is possible to suffer from severe mental illness without significant effects on achievement potential. We conclude with a set of recommendations in order to mitigate potential harmful side effects while using mental performance training or interventions.
