Coaches, Clinicians, and Public-Health Workers: Role Clarity in Sport-Based Treatment for Community Participants

Sport-based programs are increasingly used as adjuncts or low-intensity steps in community mental health, yet their safety and usefulness depend on a division of labour that is rarely written down. Coaches hold skill, load, and group climate. Clinicians hold diagnosis, risk, psychotherapy, and medication. Public-health workers hold population reach, screening pathways, and equity of access. When those licences blur, coaches begin informal therapy on the field, clinicians prescribe “join a team” without a receiving session, and public-health campaigns treat awareness posters as care. This article reports a structured concept and evidence synthesis of sport-and-mental-health research, implementation science, professional scope, safeguarding, social prescribing, and prior models of trauma-informed exercise and community-sport integration. Reviews show that physical activity and group sport can reduce depressive and anxiety symptoms and can add belonging, with small-to-moderate average effects that do not licence ungoverned clubs as clinics. Safeguarding and implementation literatures show that undefined adult power and unnamed handoffs produce harm and dropout. Synthesis yields three non-delegable clusters of work and a recurring missing role: a coordinator who owns absence, disclosure, and deterioration. The article specifies CLEAR: Clinical indication; Limits of each licence; Escalation and minimum-necessary information flow; Assessment that matches the role; and Reciprocal accountability between clinic, club, and public health. Treatment starts with fit, not with a flyer. Coaches do not process trauma or interpret symptom trajectories. Clinicians do not run drills without coaching competence and must refer to a named session. Public health must report unused reserved slots and who never arrives, not campaign reach alone. Sport-based treatment for community participants is a three-organisation intervention. Role clarity is the condition under which playing fields can carry care without pretending to be clinics.

کلیدواژه ها:

role clarity ، sport-based treatment ، coache ، clinicians ، public health.