Does knowledge relate to action?: The connection between mental health literacy, self-stigma, attitudes, and intentions for NCAA coaches

Coaches’ knowledge, attitudes, and beliefs about mental health—or mental health literacy (MHL)—can affect their teams’ mental health climates and thus the prevalence, detection, referral, and treatment of athletes’ mental health concerns. In the current study, we examined 1,476 National Collegiate Athletic Association (NCAA) coaches’ MHL, attitudes about help-seeking, and self-stigma about mental health and how these related to their intentions of referring their athletes for mental health care. Through PROCESS macro Model 4, with coach gender and total years coached as co-variates, we found that NCAA coach MHL was both directly, and indirectly through their attitudes about seeking professional psychological help, related to having stronger intentions to refer an athlete to psychological services. Further, coaches who had lower levels of self-stigma were more likely to have more positive attitudes about help seeking and, through that, stronger intentions of referring their athletes. Overall, MHL and lower levels of stigma explained 46% of the variance in their attitudes about help-seeking; all three variables accounted for 8% of the variance in their intentions to refer their athletes for help. Recommendations to increase coaches’ MHL and their intentions to refer athletes are offered, including topics to be covered in direct, on-going mental health education for coaches and culture building and stigma reduction in NCAA athletic departments.