The International Olympic Committee endorses routine mental health screening and ongoing monitoring for Elite athletes, emphasizing wellbeing should be addressed across the entire sport ecosystem.

It calls for mental health education and training for coaches, support staff, and healthcare professionals, with long-term leadership and accountability from organisations to protect welfare and sustain high performance.

Sports organisations should embed mental health as a shared responsibility, foster cultures of psychological safety, reduce stigma and confidentiality concerns, implement evidence-based screening, establish clear emergency plans, and provide culturally responsive individualized care.

Recommendations should be implemented at predefined time points and after significant events, considering the full range of factors affecting training and competition.

Barriers include stigma, confidentiality concerns, and fear of deselection, which organisations must address directly to enable disclosure and effective care.

Youth-sports implications arise over who administers screenings and who holds results, given fears of deselection and potential misaligned responsibilities at clubs and academies.

Policy aims to translate top-level standards into routines at lower levels, addressing how screenings are administered, results handled, and ensuring care providers are not deciding playing time.

Treatment should be personalized, culturally sensitive, and evidence-based, potentially including psychotherapy or medication, with return-to-sport decisions guided by safety, psychological stability, functional capacity, and training demands.

Screening should occur at predefined career points and be repeated after major events, injuries, deselection, retirement, or coaching/training changes as an early warning and referral trigger, not a replacement for clinical assessment.

Clinicians and sports bodies should proactively tackle stigma, confidentiality concerns, and fear of deselection, with care plans tailored and evidence-based.

Additional guidance urges proactive addressing of low mental health literacy, safeguarding for athletes including Para and adolescents, transitions, and disability-specific stressors with culturally responsive management.

Confidentiality is essential for program effectiveness, clarifying who can access results and how they may be used to prevent data shading by athletes.