Effect of mindfulness-based programmes on elite athlete mental health: a systematic review and meta-analysis.

OBJECTIVE: To determine the effectiveness of mindfulness-based programmes (MBPs) on the mental health of elite athletes.

DESIGN: Systematic review and meta-analysis.

DATA SOURCES: Eight online databases (Embase, PsycINFO, SPORTDiscus, MEDLINE, Scopus, Cochrane CENTRAL, ProQuest Dissertations & Theses and Google Scholar), plus forward and backward searching from included studies and previous systematic reviews.

ELIGIBILITY CRITERIA FOR SELECTING STUDIES: Studies were included if they were randomised controlled trials (RCTs) that compared an MBP against a control, in current or former elite athletes.

RESULTS: Of 2386 articles identified, 12 RCTs were included in this systematic review and meta-analysis, comprising a total of 614 elite athletes (314 MBPs and 300 controls). Overall, MBPs improved mental health, with large significant pooled effect sizes for reducing symptoms of anxiety (hedges g =-0.87, number of studies (n)=6, p=0.017, I 2 =90) and stress ( g =-0.91, n=5, p=0.012, I 2 =74) and increasing psychological well-being ( g =0.96, n=5, p=0.039., I 2 =89). Overall, the risk of bias and certainty of evidence was moderate, and all findings were subject to high estimated levels of heterogeneity.

CONCLUSION: MBPs improved several mental health outcomes. Given the moderate degree of evidence, high-quality, adequately powered trials are required in the future. These studies should emphasise intervention fidelity, teacher competence and scalability within elite sport.

PROSPERO REGISTRATION NUMBER: CRD42020176654.