A groundbreaking study recently published in BMJ Open unveils significant gaps in the understanding of mental health support-seeking behaviors among athletes, highlighting a neglected but vital area in sports psychology and mental health research. Led by a team from the University of Birmingham, the comprehensive review critically evaluates 104 studies worldwide, revealing that while athletes frequently encounter mental health challenges, the existing literature overwhelmingly concentrates on formal support systems such as psychologists and counselors, leaving semi-formal support mechanisms, especially those involving coaches and academic advisors, largely unexplored.
The study underscores that athletes face unique and sport-specific barriers when seeking mental health help. In the hyper-competitive and high-pressure environments that athletes inhabit, concerns about stigma and fear of deselection significantly hamper their willingness to access the support they need. These psychological and cultural obstacles are often compounded by structural issues such as limited access to specialized mental health professionals familiar with sports environments. The review, therefore, sought to map various dimensions of athletes’ help-seeking behaviors—namely their attitudes toward support, access challenges, and prior experiences with both formal and semi-formal sources.
Lead researcher Kirsty Brown, a PhD candidate at the University of Birmingham, commented on the implications of these findings, emphasizing the nuanced needs of athletes in mental health discourse. Brown noted, “By mapping research on athletes’ views concerning access, attitudes, and experiences, our work reveals gaps that must be addressed to develop more effective support frameworks.” She further elaborated that while there is growing academic awareness of how athletes engage with mental health services, the lack of focus on semi-formal resources like coaches represents a critical void in the literature.
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The differentiation between formal and semi-formal support mechanisms forms a central pillar of this review. Formal support includes interactions with licensed mental health professionals such as sports psychologists and counselors. In contrast, semi-formal sources encompass individuals within the athlete’s immediate social or professional network—coaches, academic advisors, and possibly even team doctors—who may provide guidance or referrals but are not mental health specialists. Notably, this study reveals that only a mere 2% of the research literature focuses specifically on athlete interactions with semi-formal support, whereas 55% analyze formal supports exclusively, and 26% consider both. This imbalance points to a significant oversight regarding the role that accessible, trusted, and frequently contacted figures may play in early mental health intervention.
Attitudes towards seeking help emerge from the study as the most researched domain, with nearly 79% of analyzed papers investigating this aspect. Athletes’ mental health attitudes—ranging from acceptance and openness to reluctance and denial—directly influence their willingness to pursue support options. However, the report emphasizes that foundational aspects such as actual access to support services are underrepresented in the research; less than one-third (32%) of studies robustly address this critical issue. Access, encompassing logistical, financial, and cultural barriers, is inherently linked to help-seeking efficacy, underscoring the need for more granular and context-specific investigations.
One of the study’s profound insights pertains to the scarcity of research on athlete help-seeking behaviors in lower-income and non-Western countries, regions where cultural norms, resource availability, and infrastructural support differ drastically from Western settings. Structural and cultural barriers—such as community stigma surrounding mental illness, lack of trained professionals, and differing perceptions of mental health—may uniquely influence athletes’ pathways to support in these contexts. The authors advocate for an expanded research focus that recognizes and respects these global variances, arguing that interventions and models must be culturally adapted to be effective.
Furthermore, the report calls for enhanced methodological rigor in future research through the consistent application of validated help-seeking measures and incorporation of established psychological theories and frameworks. The lack of standardized assessment tools and theoretical grounding in many studies limits the comparability and practical impact of findings across the field. Standardization would not only facilitate synthesis of data but also guide targeted intervention strategies and policy formulation within sports organizations and mental health services alike.
Professor Jennifer Cumming, senior lead author and a distinguished figure in sports psychology at the University of Birmingham, stresses the practical repercussions of the study. She remarked, “Our understanding of where more focus is needed is essential for developing robust, evidence-based mental health support models. Without a strong empirical foundation, efforts to assist athletes are hampered.” Her comments underscore the urgent need for multidisciplinary collaboration embracing psychology, sports science, and public health to construct comprehensive support networks that are both accessible and sensitive to athletes’ particular needs.
The investigation reveals an intriguing paradox: although coaches and academic figures are readily accessible to athletes and capable of providing critical early mental health support or referrals, the prevailing stigma and fears related to confidentiality breaches or career repercussions discourage open communication. This dynamic accentuates the importance of equipping such semi-formal supporters with adequate mental health literacy and training, fostering trust, and clarifying their roles within the athlete’s broader support ecosystem.
In sum, this review exposes a vital blind spot in athlete mental health research—namely, the underexplored potential of semi-formal sources. By illuminating varied barriers to help-seeking and pointing toward the need for inclusive, culturally aware, and theory-informed research approaches, the study lays a foundation for transformative changes in mental health support within competitive sports. It encourages stakeholders—athletic organizations, healthcare providers, researchers, and policymakers—to consider how expanding the scope of support could dramatically improve mental health outcomes for athletes worldwide.
As elite sports continue to demand exceptional physical and psychological resilience, integrating mental health support into athletes’ daily lives via accessible and trusted figures is not just desirable but imperative. The insights from this research prompt a reevaluation of current paradigms and suggest that the path forward involves a more holistic and nuanced understanding of the support landscape. Only through such integrative efforts can the sporting world hope to dismantle stigma, enhance accessibility, and foster environments where athletes’ mental wellbeing is as prioritized as their physical performance.
Subject of Research: People
Article Title: Where athletes seek mental health support – and where the literature falls short
News Publication Date: 8-Aug-2025
Keywords: Athlete mental health, help-seeking behavior, sports psychology, semi-formal support, coaches, mental health stigma, access to care, sports mental health barriers, mental health research gaps, mental health support frameworks, global mental health disparities in sport
Tags: access to mental health professionalsathlete mental health supportbarriers to seeking mental health helpdeselection concerns in sportshelp-seeking behaviors in athletesmental health support in competitive sportsrole of coaches in mental healthsemi-formal mental health support systemssports psychology research gapsstigma in athlete mental healthunique challenges for athletesUniversity of Birmingham research
