Comprehensive integration of mental health screening and triage with mental performance services through a sport science hub model in collegiate sport

Abstract Collegiate sport environments often bring mental health (MH) and performance (MP) into close interaction; yet, screening, triage, referral, and MP support often remain operationally fragmented. This fragmentation may weaken follow-through after screening, limit coordination across clinical and performance services, and create uncertainty around privacy, scope boundaries, and accountability. In this Perspective, drawing on implementation science, integrated care, and systems-oriented organizational design, we suggest that a promising direction in athlete MH-MP support is not simply expanding screening availability, but building governed infrastructure that better connects identification to action. We propose a sport science hub model for coordinating two linked but distinct lanes: (1) structured MH screening, triage, and clinician-led referral workflows, and (2) MP profiling and skills-based support delivered within non-clinical scope. The model is organized around explicit guardrails, including role separation, privacy-secured and auditable access, non-punitive use protections, and emergency escalation pathways. We discuss the rationale for using structured screening and referral processes while acknowledging the limitations of current screening tools, including false-negative and false-positive concerns, and the importance of interpreting performance disruption in context rather than medicalizing normal variation. We conclude with governance principles and a forward-looking research agenda focused on implementation, trust, acceptability, screening accuracy, and prospective evaluation of integrated MH–MP systems.