This study aimed to establish expert consensus on approaches to assist coaches in both identifying mental health symptoms and facilitating appropriate referral of athletes to mental health professionals. A modified Delphi approach was adopted using three rounds of expert consultation through individual and anonymous survey responses, thereby reducing potential influences or biases from group opinions. An interdisciplinary expert panel of coaches (n = 15), athletes (n = 9), psychologists (n = 16), and performance support staff (n = 26) was recruited through Australian sports networks, inclusive of sport science, medicine, and coaching to participate. Iterative surveys involved open-ended and multiple-choice questions (Survey 1), as well as statement agreement ratings (Surveys 2 and 3). The threshold for agreement was set at 80%. Fifty-three items achieved consensus across four main domains, including the coach role and responsibilities, the referral process, athlete mental health plans, and mental health training and upskilling. Consensus outcomes highlighted the nuanced and dynamic approach required to effectively support athlete mental health. The strategies and guiding principles outlined can be used to inform the development of resources that can build the confidence, skills, and knowledge of coaches in identifying, supporting, and referring athletes who require mental health assistance.
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