Beyond the False Choice: Integrating Mental Health and Mental Performance Services in Sport

Athletes do not divide their psychological lives into clinical and performance compartments; yet, many organizations still deliver support as if they do. This editorial examines three broad approaches: a same-person model in which one professional addresses both domains, a separate-provider model based on specialization and referral, and a hybrid model in which distinct providers work through a coordinated system. No large sport-specific randomized trial has directly compared these approaches, and the available evidence does not justify declaring any one model universally superior. A dual-trained provider may reduce stigma, fragmentation, and disruptive handoffs, but blurred roles can create concerns about competence, scope of practice, confidentiality, and accountability. Separate providers preserve specialization and regulatory clarity, but separation without active coordination can produce referral dropout, duplicated work, and uncertain follow-up. Evidence from collaborative care outside athletics, together with emerging sport-specific literature, supports a middle position: integration at the system level without erasing professional boundaries. I argue for integrated differentiation: coordinated pathways built on explicit roles, informed consent, clear referral thresholds, consent-based communication, measurement-based follow-up, and athlete-centered confidentiality. The goal is not to collapse disciplines or build walls between them. It is to create bridges with guardrails while comparative effectiveness research determines which arrangements work best, for whom, and under what conditions.

Recommended Citation

Stamatis, Andreas (2026) “Beyond the False Choice: Integrating Mental Health and Mental Performance Services in Sport,” International Journal of Exercise Science, 19(5):5013.
DOI: https://doi.org/10.70252/IJES2026513

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