IOC urges routine screening and regular monitoring of elite athletes’ mental health

Mental health screening should become a routine part of elite sport, conducted at predefined points throughout an athlete’s career and repeated after major events, according to a new International Olympic Committee (IOC) consensus statement published in the British Journal of Sports Medicine. The guidance calls for a fundamental change in how sporting organisations understand psychological wellbeing: mental health should no longer be treated as an issue managed only when an athlete develops a diagnosable disorder or reaches a crisis.

The statement is based on a review of current scientific evidence by an international panel of 31 experts with clinical, scientific, and lived experience. It updates the IOC’s 2019 consensus statement and aims to establish a more consistent, evidence-based framework for recognising and managing mental health concerns in elite athletes. The authors describe mental health as a dynamic continuum rather than a fixed condition, ranging from positive psychological functioning to temporary distress and clinically significant disorders.

That distinction is particularly important in high-performance sport, where intense training, competition, injury, selection uncertainty, public scrutiny, and frequent travel can place athletes under sustained biological and psychological stress. An athlete may experience acute stress during a major competition, anxiety after a setback, or exhaustion during a demanding training cycle without meeting the criteria for a formal diagnosis. Nevertheless, these experiences can affect sleep, concentration, motivation, decision-making, physical recovery, and performance—and may develop into more persistent problems if they are ignored.

The IOC statement recommends that screening and monitoring be integrated into routine sports medicine rather than reserved for emergencies. Assessments could be scheduled at predictable stages of the sporting calendar and repeated after events such as serious injury, deselection, retirement, major competition, or a change in coaching and training environment. Screening tools are not intended to replace clinical assessment, the authors emphasise, but to identify warning signs early and create opportunities for confidential referral, further evaluation, and appropriate care.

The recommended response extends beyond individual treatment. Sporting organisations are urged to examine the environments in which athletes train and compete, including leadership behaviour, safeguarding procedures, communication systems, workload management, and institutional attitudes toward mental health. Stigma, concerns about confidentiality, fear of losing selection, and limited mental health literacy can all discourage athletes from seeking help. The statement therefore calls for coaches, medical teams, and support staff to receive role-specific education in early recognition, safe referral, and psychologically informed practice.

Treatment should be personalised, culturally responsive, and grounded in evidence. Depending on the athlete’s needs, care may involve psychotherapy, medication, or other appropriate interventions, with decisions shaped by clinical factors, sporting demands, personal preferences, and cultural context. The statement also stresses that return-to-sport decisions must not be based solely on competitive readiness. Safety, psychological stability, functional capacity, and the athlete’s ability to manage the demands of training and competition should guide the process.

Injury is identified as a particularly important intersection between physical performance and mental health. Pain, loss of identity, isolation from teammates, uncertainty about recovery, and pressure to return can contribute to depression, anxiety, disordered eating, or other symptoms. The authors recommend routine psychological assessment during injury rehabilitation. They also call for targeted support during major transitions, including movement between development and senior sport, changes in team or country, prolonged periods away from competition, and retirement from elite competition.

The guidance gives specific attention to groups whose needs may be overlooked by standard systems. Elite Para athletes may face disability-related stressors, accessibility barriers, classification concerns, and increased risks during transitions. Adolescent athletes require care that reflects their developmental stage, education, family relationships, and the fact that many mental health disorders first emerge during adolescence. Screening and treatment systems must therefore be adapted rather than applying a single model to every athlete.

Mental health emergencies should be addressed through formal plans that are established, rehearsed, and regularly reviewed in every elite sporting setting. These plans should define responsibilities, communication procedures, referral routes, and escalation pathways. The authors also note that psychological wellbeing is not confined to athletes. Coaches, medical professionals, and other members of the athlete entourage can experience substantial mental health burdens, making elite sport an ecosystem in which responsibility must be shared across the entire organisation.

In a linked editorial, Brian Hainline of New York University and international colleagues argue that the new consensus should prompt decisive action from international federations and national governing bodies. Mental health, they say, must be embedded in governance, safeguarding, and high-performance systems rather than treated as an optional addition to medical care or as an individual test of resilience. The consensus statement offers a roadmap, but its impact will depend on leadership, accountability, sustained investment, and the willingness of sporting institutions to make psychological safety as central as physical performance.

News Publication Date: 11-Aug-2026

Web References: https://doi.org/10.1136/bjsports-2025-111514; https://bjsm.bmj.com/content/53/11/667

References: International Olympic Committee consensus statement published in the British Journal of Sports Medicine, DOI: 10.1136/bjsports-2025-111514