Brief Description
The Sport Mental Health Assessment Tool 1 (SMHAT-1), created by the International Olympic Committee (IOC), is a standardized tool aimed at early detection of mental health symptoms and disorders in elite athletes (including professional, Olympic, Paralympic, and collegiate athletes aged 16 and older). The purpose of SMHAT-1 is to ensure timely referral and appropriate support or treatment for those in need.
The SMHAT-1 should be incorporated during the pre-competition period (a few weeks after training begins), as well as mid-season and end-season. It should also be used during significant events, such as injury, illness, surgery, unexplained performance issues, after major competitions, end of competitive cycles, suspected harassment or abuse, adverse life events, and during transitions out of sport. The SMHAT-1 includes three forms, with the second and third forms administered as needed based on positive screenings (see below).
Assessment Administration Type
Self-report
Number of questions
SMHAT-1 Athlete’s (Form 1) – 10 items
SMHAT-1 Athlete’s (Form 2) – 38 items
SMHAT-1 Athlete’s (Form 3) – 55 items
Age Range for Administration
16+
Recommended Frequency of Administration
Monthly
Summary of Scoring and Interpretations
The SMHAT-1 Athlete Measure is comprised of three distinct assessments (i.e., form 1, form 2, form 3). Scoring and interpretations will be reviewed separately for each form.
SMHAT-1 Athlete’s (Form 1): Form 1, also referred to as the APSQ, is scored on a 5-point Likert scale from 1 (“None of the time”) to 5 (“All of the time”). The total score is generated by summing all items. Total scores below 17 indicate that no further action is needed while scores of 17+ indicate that the SMHAT-1 Athlete’s Form 2 should be administered.
SMHAT-1 Athlete’s (Form 2): Form 2 consists of six screening domains with each screening being scored on a Likert scale with varying response options. Screening scores are calculated by summing the items denoted below.
Screening | Domain | Items | Clinical Threshold |
Screening 1 | Anxiety | 1-7 | 10+ |
Screening 2 | Depression | 8-15 | 10+ |
Screening 2 | Depression – Suicidality | 16 | 1+ |
Screening 3 | Sleep Disturbance | 17-21 | 8+ |
Screening 4 | Alcohol Misuse | 22-24 | Men: 4+ Women: 3+ |
Screening 5 | Drug Use | 25-29 | 2+ |
Screening 6 | Disordered Eating | 30-38 | 4+ |
Interpretations (only available for three scales)
Domain | Mild | Moderate | Moderately Severe | Severe |
Anxiety (Screening 1) | 5-9 | 10-14 | N/A | 15+ |
Depression (Screening 2) | 5-9 | 10-14 | 15-19 | 20+ |
Sleep Disturbance (Screening 3) | 5-7 | 8-10 | N/A | 11+ |
If a client endorses a 1 or more on Item 16, take immediate action to ensure safety.
If all screening scores are under threshold, no further evaluation is needed. The authors recommend referral to a brief intervention such as psychoeducation, mindfulness, meditation, mental skills training, or stress control with subsequent reevaluation using Form 1. If the client has a positive screen of 17+ when reevaluated, Form 3 should be administered.
If one or more screening scores are at or above threshold, proceed to Form 3 to gather more clinical information.
SMHAT-1 Athlete’s (Form 3): The goal of Form 3 is to conduct a comprehensive assessment to aid in identifying important problems/diagnoses and create a treatment plan. Screening scores are calculated by summing the items denoted below.
Screening | Domain | Items | Clinical Threshold |
Screening 7 | ADHD | 1-6 | 4+ |
Screening 8 | Bipolar disorder | 7-21 | If total score 7+ AND item 20 = 1 AND item 21 = 1 |
Screening 9 | PTSD | 26-30 | 3+ |
Screening 10 | Gambling | 31-39 | See below. |
Screening 11 | Psychosis | 40-55 | 6+ |
Classifications for Gambling (Screening 10)
Score | Classification |
0 | Non-problem gambling |
1-2 | Low level of problems with few or no identified negative consequences |
3-7 | Moderate level of problems leading to some negative consequences |
8+ | Problem gambling with negative consequences and a possible loss of control |
SMHAT-1 Administration Flowchart
Image source: Gouttebarge et al., 2021
Blueprint Adjustments
Blueprint has two versions of the SMHAT-1 Form 1. The SMHAT-1 Athlete’s Form 1 and the SMHAT-1 Athlete’s Form 1 Plus, which includes four additional questions: 1) academic year, 2) gender, 3) race, and 4) sport played.
Clinical Considerations
Estimated completion time: Variable based on forms administered
It is strongly recommended that clinicians review responses to Item 16 on Form 2 (if administered), which asks about thoughts of self-harm. If endorsed, clinicians should further assess for suicidality and take action accordingly to ensure client safety.
Recent research recommends administering Form 2 following Form 1 regardless of score on Form 1 given evidence of high rates of false negative screens on Form 1.Estimated completion time: 4-8 minute
Citation
Gouttebarge, V., Bindra, A., Blauwet, C., Campriani, N., Currie, A., Engebretsen, L., & Budgett, R. (2021). International Olympic Committee (IOC) sport mental health assessment tool 1 (SMHAT-1) and sport mental health recognition tool 1 (SMHRT-1): towards better support of Athlete’s’ mental health. British Journal of Sports Medicine, 55(1), 30-37.
Relevant Articles + Further Resources
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