This document discusses how implementing a person-centered care (PCC) approach could improve dancers' mental health. PCC focuses on knowing the whole person, understanding their context and history, and engaging them as an active partner in treatment decisions. The document outlines that dancers face unique mental health risks like stress, anxiety, depression and eating disorders due to the pressures of their career and need for a supportive environment. It argues that a shift to PCC could help dancers' mental health by reaching a mutual understanding with professionals and considering dancers' priorities and wishes in their specialized care.

1. INTRODUCTION
• Healthcare has traditionally focussed on disease and its
treatment (1). Person-Centered Care (PCC) focuses on
knowing the person behind the patient, understanding their
context, history, strengths and weaknesses (2). It involves
engaging the person as an active partner in their treatment,
encouraging self-management and shared decisions.
• Respect, autonomy, empowerment, communication, dignity,
and compassion are important in PCC. It has been shown to
improve health outcomes and increase patient satisfaction
(2).
AIM
To discuss how the implementation of a PCC approach could
improve dancers' mental health
KEY EDUCATIONAL MESSAGE
A shift towards PCC could help with dancers' unique mental
health needs by reaching a mutual understanding with
professionals, taking into consideration dancers' priorities
and wishes.
CONCLUSIONS
Mental health professionals' understanding of dancers' unique
risks and needs is important. Moreover, dancers'
understanding of the benefits of PCC can lead to their
improved experience towards recovery.
An equal partnership with mental health professionals can
empower dancers to actively participate in shared decisions
and to receive specialized care designed to focus on their
needs and wishes.
Mental health problems described in dancers include stress (3-
5), anxiety (6-8), depression (4), eating disorders (9-10),
substance misuse (11) and specific personality characteristics
(12-14). Fear of being told to stop dancing and negative
perceptions of medical professionals may contribute to delays
in treatment (15-16).
Furthermore, difficulty to coordinate and integrate care
between physical and mental health services, complexity of
services, disengaged teams working in parallel, and delays in
planning or delivering care, can lead to poor outcomes of
dancers' health.
DISCUSSION
• Dancers are expected to be artists, expressing and eliciting
emotions, as well as athletes. reaching full physical potential.
Their careers involve frequent transitions and perceived or
actual losses; they might develop difficulties with their
identity, self-esteem, body image, perfectionism, self-doubt,
discipline and control.
• These can lead to "psychological injuries" such as stress,
anxiety, depression, eating disorders and substance misuse,
especially in the absence of coping mechanisms or a
supportive environment. A fragile physical state or emotions
might make dancers feel vulnerable or threatened; their whole
life might lose meaning. They might feel lost, hopeless and
helpless.
REFERENCES
1. World Health Organization (2007). People-Centred Health Care: A Policy Framework, WHO Press, Geneva.
2. Ekman, I., Swedberg, K., Taft, C., Lindseth, A., Norberg, A., Brink, E., ... & Sunnerhagen, K. S. (2011).
Person-centered care—Ready for prime time. European Journal Of Cardiovascular Nursing, 10(4), 248-251
3. Hernandez, Barbara Michiels. "Addressing occupational stress in dancers." (2012): 3-50.
4. Air ME. Psychological distress among dancers seeking outpatient treatment for musculoskeletal injury.
Journal of Dance Medicine & Science. 2013 Sep 15;17(3):115-25.
5. Grove JR, Main LC, Sharp L. Stressors, recovery processes, and manifestations of training distress in
dance. Journal of Dance Medicine & Science. 2013 Jun 15;17(2):70-8.
6. Walker IJ, Nordin-Bates SM. Performance anxiety experiences of professional ballet dancers the
importance of control. Journal of Dance Medicine & Science. 2010 Dec 15;14(4):133-45.
7. Lench HC, Levine LJ, Roe E. Trait anxiety and achievement goals as predictors of self-reported health in
dancers. Journal of Dance Medicine & Science. 2010 Dec 15;14(4):163-70.
8. Barrell GM, Terry PC. Trait anxiety and coping strategies among ballet dancers. Medical Problems of
Performing Artists. 2003 Jun 1;18(2):59-64.
9. Hincapié CA, Cassidy JD. Disordered eating, menstrual disturbances, and low bone mineral density in
dancers: a systematic review. Archives of physical medicine and rehabilitation. 2010 Nov 30;91(11):1777-89.
10. Arcelus J, Witcomb GL, Mitchell A. Prevalence of eating disorders amongst dancers: a systemic review and
meta‐analysis. European Eating Disorders Review. 2014 Mar 1;22(2):92-101.
11. Sekulic D, Peric M, Rodek J. Substance use and misuse among professional ballet dancers. Substance use
& misuse. 2010 May 1;45(9):1420-30.
12. Nordin-Bates SM, Walker IJ, Baker J, Garner J, Hardy C, Irvine S, Jola C, Laws H, Blevins P. Injury, imagery,
and self-esteem in dance healthy minds in injured bodies?. Journal of dance medicine & science. 2011 Jun
15;15(2):76-85.
13. Eusanio J, Thomson P, Jaque S. Perfectionism, shame, and self-concept in dancers: a mediation analysis.
Journal of Dance Medicine & Science. 2014 Sep 15;18(3):106-14.
14. Cumming J, Duda JL. Profiles of perfectionism, body-related concerns, and indicators of psychological
health in vocational dance students: An investigation of the 2× 2 model of perfectionism. Psychology of
Sport and Exercise. 2012 Nov 30;13(6):729-38.
15. Air M. Health care seeking behavior and perceptions of the medical profession among pre-and post-
retirement age Dutch dancers. Journal of Dance Medicine & Science. 2009 Jun 1;13(2):42-50.
16. Air ME, Grierson MJ, Davenport KL, Krabak BJ. Dissecting the doctor-dancer relationship: Health care
decision making among American collegiate dancers. PM&R. 2014 Mar 31;6(3):241-9.
Person-centered care
and dancers' mental health
Dr Nicoletta P. Lekka MD, MSc, PhD
Sheffield Health and Social Care NHS Foundation Trust, Sheffield, U.K.
Member of the Royal College of Psychiatrists’ Sport and Exercise Special Interest Group, UK
DISCLOSURES
Dr N.P. Lekka has no financial disclosures that would be a potential conflict of
interest with this presentation.
CONTACT INFORMATION
n.lekka@sheffield.ac.uk