Q&A: Dr. Lisa Post on digital mental health resources for athletes

July 17, 2018, 12:01 a.m.

Clinical psychologist Dr. Lisa Post, Ph.D., is conducting a study that introduces Stanford athletes to digital mental health, which aims to evaluate mental health by means of online assessments. At Stanford, Post is the head of sports medicine in psychiatry and the director of the Interpersonal Problems Clinic. She has also been the team clinician for the San Francisco 49’ers for the past nine years.

The Daily spoke with Post about the benefits of digital mental health resources for athletes — and, specifically, her study.


The Stanford Daily (TSD): Tell me about the logistics of the study. Who is involved, and how long will the study be?

Dr. Lisa Post (LP): The study won’t be done until the end of September, as teams come onto campus for the school year. We’ve started with the athletes who are already on campus. There are about 900 athletes. They’re all adults, and they’re all Stanford students.


TSD: What technical methodologies do you use to conduct the study?

LP: So kids come in and they get a physical. Then they’re on to the facility to fill out a variety of forms. They’re given an iPad. Psychologists are on site to help them complete the questions and discuss any problems that might arise. There’s a certain number of standardized measures we give them. Some of the measures are PHQ-9 and the GAD-7; these test for depression, anxiety, substance abuse, eating disorders, sleep, and that’s basically what [they look] at. And so [the participants] come in and they fill these out. They’re just questions, like “How many times in the last week have you felt sad?” They’re pretty basic. If it comes up having a certain number of each item being marked for positive, then the chart is flagged and we meet with the student to check in with them.

[A psychologist] will sit with the person for a few minutes, go over what they wrote down and ask whether they’d like a follow-up with us in our sport psychology department. So then we’d get contact information, and we’d meet with them. After all of that, they’re sent an email that offers them [the chance] to participate in [a] digital survey asking them if they have any suggestions for types of services they think would be helpful for them. And that’s it. It’s not long or extensive. It’s screening for mental health problems. This is just for [the students’] own health.


TSD: Why did you decide to conduct this study?

LP: Someone whom I’ve worked with in the past actually approached us with it. They were working on this study for the Australian Olympic team. And every year we’ve been improving services for athletes. We now have sports psychologists working in sports medicine practice. We also have increased pre-participation physicals, so digital mental health has really helped us use less staff. It’s economical because we can use the iPad, and students are evaluated automatically. Then we just have to send the results down to our psychologists. It really was lucky that we were offered this opportunity. But I have definitely wanted to improve help for Stanford athletes for a long time. My main thing is just helping people be healthy. Giving people access to healthcare is important thing.


TSD: Why do you think digital mental health is important? What sets it apart from visiting a regular psychiatrist face to face?

LP: Digital mental health gives [patients] another alternative to face to face meetings, and one of the reasons [why it’s important] is that it’s a lot more convenient. [Digital mental health is] time-efficient. We give out the screen and then we can immediately follow up with the folks who [demonstrate symptoms of] potential mental health problems. It also gives a lot of information about various problems we’re looking at, like anxiety disorders and eating disorders.

It also lets you potentially reach out to more people. For example, I work with the 49’ers. I once met with 64 guys in one day; that’s a lot a to do, you know.


TSD: Is digital research a relatively new thing, or has it been around for a while?

LP: I think it has been around, but it hasn’t been applied to athletes. So far there hasn’t been any alternative to meeting with athletes face to face, so it’s really great. This study lets us make people aware that it’s an option as well.


TSD: Has the conversation surrounding sports mental health ever been considered taboo?

LP: Probably, but I hope we’re working on that stigma. All mental health has had a stigma at one point, but it’s really helpful that leadership at Stanford supports folks having mental health treatment.


TSD: How do you think digital mental health can benefit student athletes in particular?

LP: There’s a lot of benefits to online prevention programs because there’s a lot of flexibility. We can really tailor that content towards whoever we’re working with. Young athletes have also been shown to have a worse attitude [than older athletes] towards seeking help, even as they deal with mental health issues like depression, anxiety, eating disorders and substance abuse due to their athletic activity.


TSD: What has your experience as the 49’ers psychologist revealed to you about mental health in sports?

LP: Overall, being able to work with both student athletes and pro athletes has shown me that athletes are a unique population with slightly different needs than the regular population. If you want to be at the top of your sport, you really need mental game to be there. If you’re bothered by depression, it can really get in your way. With the 49’ers, those guys basically give up their entire lives for months to train. There’s pressure because they don’t have job stability and one injury can take them out.


TSD: Do you think mental health issues affect certain types of athletes, genders or sports more than others? Are there any indications of this found by your study?

LP: We haven’t gathered much data yet, so I don’t know about that. But the study is more of a needs assessments. It’s asking questions. It’s asking students what they want in terms of healthcare treatments.

This transcript has been lightly edited and condensed.


Contact Shreya Hambir at shreyahambir ‘at’ gmail.com.

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