Special Interest Group Meeting 22nd September 2017
The most recent meeting of the Royal College of Psychiatrists Special Interest Group in Sport and Exercise Psychiatry (SEPSIG) took place on Friday September 22nd at the Institute of Sport Exercise and Health on Tottenham Court Road, W1.
The central London venue proved especially popular and this was the largest meeting to date with 25 delegates.
UK Anti-Doping (UKAD) guidance for psychiatrists
The days proceedings were opened by Prof Alan Currie. He began by reviewing the Therapeutic Use Exemption (TUE) processes in sport and how they apply to psychiatric practice. There is a proposal for stricter assessment criteria to be applied before methylphenidate exemptions will be granted for athletes with ADHD. A CPD module on TUE applications is in preparation and will shortly be available via the British Association of Psychopharmacology.
Public Health England – embedding physical activity within NHS clinical care
SEPSIG were delighted to welcome Dr. Michael Brannan who is the Deputy National Lead for Adult Health & Wellbeing. He began by describing the extent and importance of physical inactivity including the UK’s unfavourable position by comparison with other nations. He described Public Health England’s approach of using a network of influencers in key sectors (education, sports & leisure, health, social care, planning, and transport). The philosophy is to make every contact count. In the health sector this means promoting physical activity at every opportunity and especially for inactive patients. He then described a range of methods for providing health care professionals with the necessary knowledge and skills. Useful resources are available at the following links:-
Competencies of a Sports Psychiatrist
Phil Hopley & Tim Rogers from Cognacity presented a helpful framework for the psychiatrist working in sport. They showed where psychiatric skills might be put to best use and also complement the expertise of others. The ability to promote and sustain resilience in athletes, to understand and work within the culture of sport and sports specific psychopharmacology expertise were all emphasised.
Eating disorders update
Caz Nahamn gave delegates an overview of some of the eating disorders issues that are specific to sport. In particular she discussed sports specific syndromes and risk factors within sport. She then shared anonymous case studies. These were especially well received by the audience and demonstrated the outcomes that can be achieved when working in partnership with sports coaches and parents in the best interests of the athlete/patient.
Workshop and group discussion
3 anonymised cases based on real-life examples were discussed. One in each of 3 small groups of 6-8 participants. Some useful themes emerged from the discussions.
- Obstacles to accessing care. Including stigma, lack of a clear pathway, inadequate knowledge/recognition of problems.
- Collaboration between sports and the clinical team during recovery and rehabilitation. In particular this can be helpful in deciding how to grade the return to sport.
- Confidentiality and boundary issues. How much information to share? What is expected? Who needs to know? It can be helpful to agree about this from the outset. Confidentiality is for privacy not secrecy.
- Adjustment difficulties are common after a major event even if the athlete is successful. Can this be anticipated and preventative interventions offered? Consider interventions at the level of the individual, the team and the sport/organisation.
- The importance of social support in promoting resilience.
- Difficulties for student athletes – limited finances, whether to access care at home or at university.