Mental ill-health in semi-elite women’s soccer in England: a mixed-methods approach

Despite the growth in women's soccer globally, there remains sparse research in this population, especially outside of elite levels and in relation to mental health.Limited research has examined the lived experiences of mental health within sub-elite women's sport.Within this mixed-methods study, we aimed to provide insight into both the prevalence of mental ill-health and the complexities of how mental health is perceived, interpreted, and experienced in a unique and under-researched population.Footballers competing in tier three of the UK women's leagues completed a survey to assess mental ill-health symptoms.Followup semi-structured interviews were completed with six players.A total of 103 players completed the questionnaire: 49.5% (n = 51) displayed distress symptoms (Kessler-10); 44.7% (n = 46) displayed depression symptoms (CES-D); 20.4% (n = 21) displayed anxiety symptoms (GAD-7); and 22.3% (n = 23) displayed eating disorder symptoms (SCOFF).Using reflexive thematic analysis three themes were developed: "Navigating Tier 3 women's football: a balancing act", "Football: is it good for my mental health?" and "Speaking out about my mental health: the confusion and the cost".Overall, prevalence of symptoms associated with mental illhealth ranged from 20.4% to 49.5% among semi-elite female footballers, which are shaped by individual experiences.The female footballers reported athlete-specific risk factors for mental ill-health at the individual level as well as the sporting environmental level.The findings and implications for sub-elite women's soccer are discussed.