Access to sports psychiatrists and specialized mental health services for NCAA Division I athletes

Abstract: Introduction: Student-athletes face unique stressors that increase their risk for mental health conditions such as anxiety, depression, disordered eating, and performance-related distress. Although the NCAA has promoted mental health support, access to specialized providers, particularly sports psychiatrists, remains extremely limited. Academic coordinators, who have frequent student contact and directly monitor academic performance, may be crucial in early identification and referral. Methods: A 19-item web-based survey was distributed nationally to NCAA Division I academic coordinators to assess perceived student-athlete mental health conditions, availability and accessibility of specialized providers, and barriers to care. Data were collected via REDCap over six weeks (Feb–Mar 2025). Results: Forty-one coordinators responded. Anxiety (100%), depression (85.4%), and family issues (75.6%) were the most common reported conditions experienced by student-athletes. All institutions reported having some mental health services, but only 22% reported access to psychiatrists. Urban institutions reported greater access than rural. Psychologists and dietitians were mostly embedded in athletic departments, psychiatrists were primarily in student health centers, and telehealth access was limited. Discussion: Access to specialized mental health care, especially sports psychiatry, is limited for NCAA Division I student-athletes. Most psychiatrists are based in general student health centers, creating barriers related to privacy, stigma, and lack of sport-specific expertise. Multidisciplinary support from sport psychologists and dietitians is growing but uneven. Conclusion: Despite NCAA guidelines, significant gaps remain in mental health services for student-athletes. Expanding telehealth, embedding providers within athletic departments, and empowering academic coordinators with training and resources are critical to improving timely, tailored support.