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Determining the role of sport coaches in promoting athlete mental health: a narrative review and Delphi approach
  1. James E. Bissett1,
  2. Emily Kroshus2,3,
  3. Stephen Hebard4,5
  1. 1Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
  2. 2Department of Pediatrics, University of Washington, Seattle, Washington, USA
  3. 3Center for Child Health, Behavior and Development, Seattle Children's Research Institute, Seattle, Washington, USA
  4. 4Institute to Promote Athlete Health and Wellness, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
  5. 5Prevention Strategies, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
  1. Correspondence to James E. Bissett; j.bissett{at}


Background Coaches have the potential to support athlete mental wellness, but many are unsure what to do and concerned they may unintentionally engage in behaviours that negatively impact their athletes. Education has the potential to help coaches engage in primary, secondary and tertiary preventive behaviours related to athlete mental health; however, there exists no empirical or consensus basis for specifying the target behaviours that should be included in such education.

Objective The aim of this research was to review extant literature about the role of sport coaches in mental health prevention and promotion, and obtain expert consensus about useful, appropriate and feasible coach behaviours.

Design Modified Delphi methodology with exploration (ie, narrative review) and evaluation phase.

Data sources Twenty-one articles from PubMed, PsycINFO and ProQuest, and grey literature published by prominent sport organisations.

Eligibility criteria for selecting studies All studies were English-language articles that focused on the role of coaches as they relate to (1) culture setting in sport, (2) addressing athlete mental health and (3) providing ongoing support to athletes with mental health concerns. No study design, publication date limits or sport characteristics were applied.

Results The coach’s role should include fostering team cultures that support athlete mental health, encouraging care-seeking and supporting athletes currently receiving mental healthcare.

Summary/Conclusion The behaviours specified herein have implications for coach education programme development. This study is the first to use a structured Delphi process to develop specific recommendations about the role coaches can play in supporting athlete mental health.

  • athlete
  • education
  • mental
  • health promotion
  • sport

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  • Contributors All authors have made substantial contribution to either the conception and design, analysis and interpretation of data, or drafting and reviewing the article. All authors have seen and given final approval for submission of the article.

  • Funding The study was funded by the Social Sciences and Humanities Research Council of Canada (SSHRC), Michael Smith Foreign Study Supplement.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval Study activities were classified as exempt by the University of Washington Institutional Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.