THE IMPACT OF CULTURAL BARRIERS AND ATHLETIC IDENTITY ON HELP-SEEKING AMONG ELITE ATHLETES: A REVIEW
Abstract
In recent years, mental health issues among elite athletes have drawn growing academic and professional interest. Despite increased awareness, the proportion of athletes actively seeking psychological support remains low. This narrative review examines the psychological, cultural, and identity-based obstacles that impact athletes' engagement with mental health services. Drawing on a broad range of contemporary empirical research—including systematic reviews, meta-analyses, and qualitative studies—the article identifies central barriers such as stigma, fear of losing team position, concerns about confidentiality, and insufficient mental health literacy. Athletic identity is discussed as a dual-edged construct: while it can enhance motivation, it may also contribute to vulnerability when overly linked to performance and public image. Moreover, athletes from marginalized backgrounds, particularly those identifying as transgender or LGBT, often face heightened discrimination, further limiting their access to appropriate care. The review emphasizes the importance of culturally responsive and identity-aware strategies that encourage help-seeking, challenge stigma, and promote mental well-being. Practical recommendations for sports institutions, coaches, and mental health practitioners are provided.
References
Bruner, M. W., Munroe-Chandler, K. J., & Spink, K. S. (2008). Entry into Elite Sport: A Preliminary Investigation into the Transition Experiences of Rookie Athletes. Journal of Applied Sport Psychology, 20(2), 236–252. https://doi.org/10.1080/10413200701867745
Buzuvis, E. E. (2011). Transgender student-athletes and sex-segregated sport: Developing policies of inclusion for intercollegiate and interscholastic athletics. Seton Hall J. Sports & Ent. L., 21, 1.
Castaldelli-Maia, J. M., Gallinaro, J. G. de M. E., Falcão, R. S., Gouttebarge, V., Hitchcock, M. E., Hainline, B., Reardon, C. L., & Stull, T. (2019). Mental health symptoms and disorders in elite athletes: A systematic review on cultural influencers and barriers to athletes seeking treatment. British Journal of Sports Medicine, 53(11), 707–721. https://doi.org/10.1136/bjsports-2019-100710
Chan, A. S. W., Choong, A., Phang, K. C., Leung, L. M., Tang, P. M. K., & Yan, E. (2024). Societal discrimination and mental health among transgender athletes: A systematic review and Meta-analysis. BMC Psychology, 12(1). https://doi.org/10.1186/s40359-023-01493-9
Cosh, S. M., McNeil, D. G., Jeffreys, A., Clark, L., & Tully, P. J. (2024). Athlete mental health help-seeking: A systematic review and meta-analysis of rates, barriers and facilitators. Psychology of Sport and Exercise, 71, 102586. https://doi.org/10.1016/j.psychsport.2023.102586
Edison, B. R., Christino, M. A., & Rizzone, K. H. (2021). Athletic Identity in Youth Athletes: A Systematic Review of the Literature. International Journal of Environmental Research and Public Health, 18(14), 7331. https://doi.org/10.3390/ijerph18147331
Gouttebarge, V., Castaldelli-Maia, J. M., Gorczynski, P., Hainline, B., Hitchcock, M. E., Kerkhoffs, G. M., Rice, S. M., & Reardon, C. L. (2019). Occurrence of mental health symptoms and disorders in current and former elite athletes: A systematic review and meta-analysis. British Journal of Sports Medicine, 53(11), 700–706. https://doi.org/10.1136/bjsports-2019-100671
Gulliver, A., Griffiths, K. M., & Christensen, H. (2012). Barriers and facilitators to mental health help-seeking for young elite athletes: A qualitative study. BMC Psychiatry, 12, 157. https://doi.org/10.1186/1471-244X-12-157
Higa, D., Hoppe, M. J., Lindhorst, T., Mincer, S., Beadnell, B., Morrison, D. M., Wells, E. A., Todd, A., & Mountz, S. (2014). Negative and Positive Factors Associated With the Well-Being of Lesbian, Gay, Bisexual, Transgender, Queer, and Questioning (LGBTQ) Youth. Youth & Society, 46(5), 663–687. https://doi.org/10.1177/0044118x12449630
Meyer, I. H. (2003). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychological Bulletin, 129(5), 674–697. https://doi.org/10.1037/0033-2909.129.5.674
Moreland, J. J., Coxe, K. A., & Yang, J. (2018). Collegiate athletes’ mental health services utilization: A systematic review of conceptualizations, operationalizations, facilitators, and barriers. Journal of Sport and Health Science, 7(1), 58–69. https://doi.org/10.1016/j.jshs.2017.04.009
Nattiv, A., Puffer, J. C., & Green, G. A. (1997). Lifestyles and health risks of collegiate athletes: A multi-center study. Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine, 7(4), 262–272. https://doi.org/10.1097/00042752-199710000-00004
Noblet, A., Rodwell, J., & McWilliams, J. (2003). Predictors of the Strain Experienced by Professional Australian Footballers. Journal of Applied Sport Psychology, 15(2), 184–193. https://doi.org/10.1080/10413200305394
Stevens, M., Cruwys, T., Olive, L., & Rice, S. (2024). Understanding and Improving Athlete Mental Health: A Social Identity Approach. Sports Medicine (Auckland, N.Z.), 54(4), 837–853. https://doi.org/10.1007/s40279-024-01996-4
Sundgot-Borgen, J. (1994). Risk and trigger factors for the development of eating disorders in female elite athletes. Medicine and Science in Sports and Exercise, 26(4), 414–419.
Sundgot-Borgen, J., & Torstveit, M. K. (2004). Prevalence of eating disorders in elite athletes is higher than in the general population. Clinical Journal of Sport Medicine: Official Journal of the Canadian Academy of Sport Medicine, 14(1), 25–32. https://doi.org/10.1097/00042752-200401000-00005
Van Raalte, J. L., Brewer, B. W., Brewer, D. D., & Linder, D. E. (1992). NCAA Division II College Football Players’ Perceptions of an Athlete Who Consults a Sport Psychologist. Journal of Sport and Exercise Psychology, 14(3), 273–282. https://doi.org/10.1123/jsep.14.3.273
Watson, J. C. (2005). College Student-Athletes’ Attitudes Toward Help-Seeking Behavior and Expectations of Counseling Services. Journal of College Student Development, 46(4), 442–449. https://doi.org/10.1353/csd.2005.0044
Watson, J. C. (2006). Student-athletes and counseling: Factors influencing the decision to seek counseling services. College Student Journal, 40(1).
Wetherill, R. R., & Fromme, K. (2007). Alcohol Use, Sexual Activity, and Perceived Risk in High School Athletes and Non-Athletes. Journal of Adolescent Health, 41(3), 294–301. https://doi.org/10.1016/j.jadohealth.2007.04.019
Yoon, J. J., & Petrie, T. (2023). Barriers to and Facilitators of Collegiate Athletes Seeking Mental Health Services. Journal of Athletic Training, 58(9), 715–721. https://doi.org/10.4085/1062-6050-0559.22
Copyright (c) 2025 Anna Wojtkiewicz, Magda Piekarska, Oliwia Barańska
This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.
