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.
Wojtkiewicz et al. (2025) studied this question.