BJSM finds coach mental-health drivers

Joshua Frost’s new paper in the *British Journal of Sports Medicine* shifts attention from athlete mental health to the people running elite performance environments. Published online on August 26, the article sets out a research program on elite-level coaches and argues that their mental health is shaped not only by personal vulnerability, but by organizational conditions around them. The BJSM article says Frost’s PhD examined four areas among elite coaches: rates of mental ill-health, risk and protective factors, perceptions and attitudes regarding mental health, and barriers to help-seeking. Frost wrote that the work was designed to “guide early intervention” and inform future supports for coaches working in high-performance sport. ### Why are coaches, not athletes, at the center of this paper? (bjsm.bmj.com) Elite coaches have drawn less research attention than athletes, even though they work under comparable performance pressure. A 2024 systematic scoping review led by Frost said elite-level coaches face performance, organizational and personal stressors that can contribute to reduced mental health and wellbeing. A 2026 BJSM leadership article made a similar point about the wider high-performance system. (bjsm.bmj.com) That article said coaches and support staff face mental-health risks comparable to elite athletes, and that structural and cultural conditions in elite sport can inhibit help-seeking and normalize distress. ### What did Frost identify as the main drivers? Frost’s BJSM paper says the goal was to identify “risk and protective factors that shape mental health outcomes” in elite coaches. (pmc.ncbi.nlm.nih.gov) The article summary available through BJSM and PubMed does not list a full table of findings in the search excerpt, but the paper and the BJSM social post both frame organizational demands and supports as central influences on coach wellbeing. (bjsm.bmj.com) The organizational factors highlighted in the social briefing around the paper included workload, role clarity and institutional support. Those are consistent with the broader literature summarized in Frost’s earlier review, which found that elite coaches’ mental health is affected by multiple stressors tied to the structure of high-performance work rather than only individual psychology. ### Why does the paper focus on early intervention? (bjsm.bmj.com) The article’s subtitle — “to guide early intervention” — signals that Frost is arguing for action before distress becomes crisis. In the BJSM abstract page, Frost wrote that the research was intended to advance understanding of elite coach mental health so future supports can be designed earlier and more effectively. A related 2026 BJSM piece on organizational leadership in athlete mental health said high-performance systems often respond reactively, after symptoms or crises emerge, rather than proactively. (pmc.ncbi.nlm.nih.gov) That article called for leadership structures that make mental-health support part of the environment itself. ### What does “organizational support” mean in practice? Institutional support in this context refers to the conditions teams, federations and high-performance programs control: workload expectations, role definition, access to support, and the culture around disclosure and help-seeking. (bjsm.bmj.com) Frost’s paper places those system-level factors inside the mental-health discussion instead of treating coaches’ distress as an individual failing. (bjsm.bmj.com) The wider BJSM and sports-medicine literature cited in recent months points in the same direction. A 2026 article on lived-experience workforces in elite sport said reluctance to seek help can be shaped by stigma, confidentiality concerns and perceptions that mental-health professionals may not understand the demands of elite sport. ### Where does this research sit in the broader debate? (bjsm.bmj.com) The IOC’s 2026 consensus statement focused on elite athletes, but recent BJSM commentary has widened the frame to include coaches, support staff and the systems around them. Frost’s paper fits that shift by treating coach wellbeing as part of the performance ecosystem rather than a side issue. BJSM listed Frost’s article in its Online First section on August 26, and PubMed indexed it as an online-ahead-of-print paper the same week. (bjsm.bmj.com) The next step for readers is the full article itself, under DOI 10.1136/bjsports-2026-112294, where Frost’s complete findings and proposed intervention points are set out. (pubmed.ncbi.nlm.nih.gov) (bjsm.bmj.com)