Across high-performance sport, athletes, coaches and entourage members experience mental health problems at rates comparable to or exceeding those in the general population.1 2 High-performance sport organisations, therefore, have a crucial duty of care to safeguard and promote mental health. This responsibility is complex, multifaceted and necessarily shared across multiple stakeholders, including coaches, support staff, broader entourage members, organisational leadership and athletes themselves.3 In practice, organisational policies and strategies may span the full continuum of care,4 from initiatives that raise awareness and promote well-being, to detection and early intervention and referral to clinical treatment when needed. To address this broad challenge, scholars, practitioners and policymakers have advocated for the appointment of a new dedicated role within the athlete support team, which may be referred to as a Mental Health Lead (MHL) (different labels have been used to describe this role. However, we use Mental Health Lead to reflect the broad responsibilities to oversee and coordinate a wide range of mental health initiatives), to oversee and coordinate structural organisation-wide mental health initiatives.5–7

The MHL has begun to appear in multiple high-performance sport environments. Some organisations, such as the Australian Football League, Cricket Australia and the National Basketball Association (NBA), have advocated for, or even mandated, the assignment of a designated MHL. For example, every NBA team is required to employ at least one licensed mental health professional to provide assessment, intervention and referral support. However, little remains known about how individual organisations have operationalised and resourced this role. These developments show that a formalised MHL role is becoming—or at least has the potential to become—a central feature of high-performance sport, yet its effectiveness will depend on urgently clarifying the scope and qualifications of this new role. As such, two critical questions remain: what is the primary role of the MHL and who is most qualified to fill this role?