Key Points Student-athletes experienced barriers to mental health care, such as a belief in one`s own self-reliance and a lack of confidence that mental health treatment would be effective. Regardless of sex or race, student-athletes perceived head coaches` negative attitudes toward mental health as a barrier. Overall, matching identities with their sport psychologists was not thought to be as important when student-athletes sought assistance, although they wanted their sport psychologists to talk about their similarities and differences. Context: Approximately 1 in 5 student-athletes experience some type of mental health concern. However, fewer than half of student-athletes who report mental health concerns seek mental health treatment (ie, psychotherapy or medication). Data concerning barriers to student-athletes seeking mental health care are limited but suggest that stigma is the primary reason. Further, whether having shared identities with their sport psychologists (eg, race and gender) encourages student-athletes to seek help has been minimally explored. Objectives: To determine the frequency of internal and external barriers to athletes seeking mental health care and examine the importance of athletes and sport psychologists sharing identities as a facilitator of seeking help. Design: Cross-sectional study. Setting: Collegiate athletics. Patients or Other Participants: A total of 266 student-athletes (53.8% women, 42.5% White) from a National Collegiate Athletic Association Division I university. Main Outcome Measures: Student-athletes responded to 9 binary (yes or no) prompts related to internal barriers (eg, beliefs and attitudes about mental health) and 7 reflecting external barriers (ie, different stakeholders, such as the head coach). Regarding facilitators of mental health help-seeking, student-athletes rated how important it was for them to share each of 10 identities with their sport psychologist from 1 (not at all important) to 5 (extremely important). All identified barriers and facilitators were derived from existing research. Results: Differences were found in athletes` ratings of internal and external barriers. For example, a belief in one`s own reliance and not having enough time were significant barriers, as was their head coach having a negative attitude about the importance of mental health. Female student-athletes rated sharing a gender identity with their sport psychologist as more important than did male student-athletes. Conclusions: Despite efforts by the National Collegiate Athletic Association to reduce the stigma surrounding mental health, persisting barriers within collegiate sports may keep athletes from seeking help.
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