Table 1

List of coach behaviours with expert consensus on utility, appropriateness and feasibility in supporting athlete mental health

Coach target behaviours
Primary prevention1.1 Coaches should verbally communicate to athletes their role in supporting athlete mental health, consistent with their sport organisation’s mental health protocol.
1.2 Coaches should verbally communicate their intention to encourage athletes to consult with a licensed practitioner with mental health service competencies when behaviours that represent mental health concerns are observed.
1.3 Coaches should verbally communicate with athletes that they believe it is important to seek help (such as, but not limited to, medical, psychological and social support) for mental health concerns.
1.4 Coaches should verbally communicate with athletes that they believe it is important to support peers in seeking help for mental health concerns.
1.5 Coaches should enlist the support of relevant stakeholders (including, but not limited to, parents, administrators and support staff) to endorse the importance of athletes seeking help for mental health concerns.
1.6 Coaches should communicate that sport-specific decision-making (eg, roster selections, playing time and so on) will not be dictated by an athlete’s mental health concerns and/or care-seeking behaviour unless the decision is endorsed by a licensed practitioner with mental health service competencies.
1.7 Coaches should share with athletes that addressing mental health concerns may improve athletic performance.
1.8 Coaches should establish bidirectional coach–athlete relationships that emphasise honesty and openness.
1.9 Coaches should engage in healthy self-care practices.
1.10 Coaches should not use language that stigmatises mental illness and mental health help-seeking.
1.11 Coaches should positively reinforce athlete behaviours that are consistent with a team culture supportive of mental health and mental health help-seeking.
1.12 Coaches should communicate to athletes that they are receptive to feedback in how to improve the team’s culture surrounding athlete mental health.
1.13 Coaches should communicate to athletes that they are receptive to feedback in how to improve their own abilities in supporting athlete mental health.
Secondary prevention2.1 Coaches should attend to changes in athlete behaviour that may indicate the emergence of a mental health concern.
2.2 If coaches are concerned that an athlete is experiencing a non-emergency mental health concern, they should ask how the athlete is feeling and listen to the athlete’s concern to initiate next steps consistent with their sport organisation’s mental health protocol.
2.3 Coaches should verbally communicate boundaries that govern what they can and cannot do when an athlete discloses mental health concerns or relevant behaviours are observed.
2.4 Coaches should provide information to athletes experiencing a potential mental health concern about local resources for accessing licensed practitioners with mental health service competencies.
2.5 In non-emergency situations, coaches should provide the athlete (or the athlete’s parent/guardian if the athlete is a minor) with information about where care can be sought from a licensed practitioner with mental health service competencies.
2.6 If coaches think an athlete may be an immediate threat to the safety of others, coaches should contact emergency services.
2.7 If coaches think an athlete may be a threat to themselves, coaches should follow their sport organisation’s emergency mental health protocol, unless there is no protocol in which case coaches should remain with the athlete until emergency services or a licensed practitioner with mental health service competencies has initiated next steps for care.
Tertiary prevention3.1 Coaches should provide positive reinforcement to athletes who are actively engaged in seeking mental healthcare.
3.2 Coaches should provide consistent ongoing support to all athletes regardless of an athlete’s relative athletic ability and skill level.
3.3 Coaches should protect the confidentiality of athletes’ mental health help-seeking, consistent with athletes’ preferences.
3.4 Coaches should respect athletes’ desired levels of coach involvement in discussing and supporting the medical and/or psychological management of mental health concerns.
3.5 Coaches should express to athletes a willingness to modify sport-related responsibilities to accommodate treatment and recovery.
3.6 Coaches should continue to offer athletes opportunities for engagement in team activities if athletes are taking a break from competition due to mental health concerns.