A person can keep winning, leading, or delivering while experiencing difficulties that deserve attention. The opposite mistake matters too: a high questionnaire score does not automatically establish a disorder. Research in elite sport makes both errors visible. The useful question is whether someone can obtain an assessment that looks beyond performance without turning every pressure into a diagnosis.
Key findings
1,121: Polish elite athletes assessed before the Paris Olympics.
72.4%: athletes crossing the initial distress-screening threshold.
51%: athletes positive on at least one subsequent screening measure.
9.5%: athletes judged after brief clinical intake interviews to have persistent concerns requiring specialist referral.
24.2%: athletes receiving psychoeducation or advice to consult a sport psychologist for less persistent difficulties.
These are assessment outputs, not a before-and-after treatment effect. The referral figure is not a gold-standard diagnostic prevalence estimate. [1]
The assessment step changed the picture
Source: Waleriańczyk and colleagues, online October 2024. The percentages must not be added together or presented as a decline in illness after treatment. [1]
A lower referral figure does not mean the other concerns were imaginary. Screening identifies possible difficulties; an interview adds context, persistence, and impact. Similar questionnaire scores can lead to different appropriate responses.
Some people may benefit from information or support without needing the same intervention as someone with persistent clinical needs. This is a question of proportionality, not a division between real and unreal distress.
The study also does not establish that a brief interview detects every future problem. It evaluated a specific procedure in one cohort. Its clinical judgments should not be exported as a universal diagnostic rule.
Achievement measures a task, not the whole person
A strong quarter, performance, or medal can coexist with difficulties outside the measured activity. It does not prove that the person is concealing a disorder. Both reassurance and suspicion can go beyond the evidence.
For executives, attendance and decision-making are relevant observations about work. They do not replace confidential assessment when someone reports concerns. A family should avoid using achievement as clinical clearance or pressure as a diagnosis.
The route to care should not require public failure first. Someone can ask for help while continuing to perform well, without the assessment presuming what the outcome must be.
Well-being and symptom severity can differ
A study of 233 UK Super League rugby players, surveyed in 2018 and 2019 and reported in 2020, found moderate or severe depressive symptoms in 2.6% and anxiety symptoms at that level in 13.7%. Separately, 35.2% scored below the study’s reference range for psychological well-being. These are different constructs and thresholds. [2]
The percentages must not be combined into one illness rate or described as current findings for every elite athlete. Source: the original rugby study. [2]
The larger well-being percentage does not reveal hidden depression in everyone outside the symptom threshold. It describes another dimension of experience. The same person can have different results on measures designed to answer different questions.
The client lesson is not a borrowed prevalence rate
Athletes, founders, performers, and executives may encounter performance expectations. That does not make their populations clinically interchangeable. These studies cannot establish how many chief executives have depression or how many affluent families need treatment.
The useful principle is to select the measure that fits the question. A performance review examines specified responsibilities. A well-being questionnaire records a dimension of experience. A clinical assessment considers explanations and appropriate care.
A tailored service can sound more precise than it is. The label high performance should not become a diagnostic shortcut or justify applying an athlete percentage to a business leader.
Three assessments have different responsibilities
| Assessment | Main question | Boundary |
|---|---|---|
| Performance evaluation | How are specified responsibilities being carried out? | Does not exclude a clinical condition |
| Screening questionnaire | Are there possible concerns to examine? | Does not independently confirm a diagnosis |
| Clinical assessment | What explains difficulties, and what response fits? | Does not guarantee future performance |
A manager or coach can notice change and help someone reach support without becoming the clinician. A clinician can assess and treat without promising that care will meet a commercial deadline.
A questionnaire needs a route to appropriate care
Before collecting sensitive answers, an organization should know who reviews them and what happens when concerns are identified. The person should understand the next step. An automated score without a meaningful pathway can create uncertainty rather than resolve it.
The Polish process included clinical intake interviews. Its findings should not be used to promote a standalone online score stripped of that context. The evaluated procedure involved more than the instrument.
Information handling needs the same clarity. A person should understand whether responses go to clinical professionals, managers, or others. A well-being initiative should not quietly become a performance-monitoring system.
Recognize distress without medicalizing every difficulty
Setbacks, fatigue, and disappointment can occur in demanding environments. A proportionate response acknowledges them without assuming every experience is a disorder. The language of ordinary pressure should not dismiss persistent symptoms or serious impairment either.
An assessment can examine duration, context, severity, and wider circumstances. It may identify other factors requiring attention. The response should follow that evaluation rather than an organization’s preferred narrative about resilience.
For families, support need not begin with certainty about a diagnosis. It can begin with a concern and access to qualified advice. The goal is understanding the person, not proving strength or fragility.
Recovery should not mean more output
A person may improve while choosing a different workload. Another may resume performance before every symptom resolves. Those possibilities make functioning important to assess carefully rather than equate with productivity.
WHO’s workplace guidance addresses clinical support, appropriate workplace responses, and participation. It considers health and work together without making economic output the sole measure of recovery. [3]
Private programs should measure the difficulties prompting care, relevant symptoms, quality of life, and patient-defined goals. Returning to the previous calendar may be one objective, but should not be imposed as proof of success.
Follow-up should describe the life after treatment
The final appointment should not be the only observation. A report can ask whether gains persist after ordinary responsibilities resume, whether the plan remains workable, and what additional care was received.
The number reached matters. A favorable result among survey respondents differs from a result among all entrants. Missing outcomes should be visible without being assumed favorable or unfavorable.
Privacy does not prevent a provider from explaining methods and appropriately protected aggregate findings. Discretion should not become an excuse for unverifiable claims or a reason to replace evidence with a recognizable client’s story.
A practical question for teams, boards, and families
Can the person seek an independent assessment without demonstrating a collapse first? That asks about an actual route to care rather than a well-being slogan. It also distinguishes access from assumptions about what the assessment will find.
For employers, it may involve clear referral options and boundaries between clinical information and performance decisions. For families, it may mean arranging support without demanding unrestricted updates. Appropriate arrangements depend on context and the person’s autonomy.
No organization was audited here. A serious evaluation would examine how the process works in practice, not merely whether a policy or questionnaire exists.
Explain what follows a positive result
A screening program should describe the next step before someone completes it. Who will review the answers, and what kind of assessment may follow? Different findings may call for different responses. The purpose is to identify appropriate support, not to turn every threshold into the same treatment recommendation.
The person should also understand what the result cannot decide. A questionnaire alone cannot establish fitness for every professional responsibility or predict future performance. The Polish study’s interviews added context precisely because screening and clinical judgment are different parts of the process.
For a private service, this is a useful quality question. Does the assessment explain the person’s difficulties and inform a proportionate plan, or does it simply produce a score and a preselected package?
What the numbers cannot tell us
The 72.4% triage result is not diagnosed prevalence. The 9.5% referral result does not establish that everyone else was entirely well. The rugby measures cannot be added together or applied to executives. Neither study measures THE BALANCE outcomes.
The bottom line
Assess the person, not the scorecard. Achievement is information about performance; screening is information from an instrument. Neither is a complete account of health. Care should not require failure as an entry ticket or promise unlimited performance as its endpoint.
For journalists
Key comparison: 72.4% crossed initial triage, while 9.5% were referred for persistent concerns after interview in the Polish cohort.
Important caveat: the difference reflects assessment stages, not a treatment effect or proof that concerns were exaggerated.
Suggested attribution: THE BALANCE analysis of elite-sport assessment and well-being research.
Methodology and sources
The analysis uses two athlete studies and workplace guidance. Polish observations date to 2023 and 2024; rugby observations to 2018 and 2019. It does not pool different measures or calculate executive prevalence.
