Featured Image: Austrian Women’s Team at FIS Alpine World Ski Championships Saalbach 2025, Ski Austria kick off.
In the fast-paced, extreme, and high-pressure world of ski racing, mental resilience can be as crucial as physical conditioning. Yet, behind bashing gates and podium finishes, many athletes silently grapple with mental health challenges that often go unnoticed or unaddressed.
While the conversation around mental health in sport is expanding, the process of referring athletes to mental health services, especially before a stressful, or even traumatic event occurs, is consistently overlooked.
Luna Ugrenović, Ph.D., EMDR-T, LAPC, CMPC, retired NCAA champion rower and coach, studied mental health referral experiences in collegiate sport. Specifically, she explored how athletes’ identities and relationships within sport affected referral experiences and outcomes, and consequently overall mental health culture, in sport.
The findings of her study emphasized how early and intentional engagement can shape athletes’ willingness to seek mental health help and their overall well-being.
Ugrenović explained, “Maintaining good health, whether it is physical or mental, is very important for high-performers, no matter if you are an athlete or not. Being exposed to mental health services early, before crises arise, helps to reduce stigma and barriers to seeking mental health assistance in times of need.”
Dr. Ugrenović’s Research Overview
Based on in-depth interviews with collegiate athletes who have been referred by those in their immediate sport environments (e.g., teammates or support staff), Ugrenović found that early, thoughtful referral conversations, long before things hit a breaking point, can make a real difference in whether athletes feel safe, supported, and ready to ask for help.
The athletes also described what they need most in these moments: a sense of choice, connection, and understanding.
When those needs were met, referrals didn’t just lead to services; they led to healing and de-stigmatization of mental health help-seeking.
“The study showed that referral conversations can be a powerful and therapeutic tool that may change an athlete’s self-perception and relationship with their mental health.”
By moving away from last-minute interventions and toward proactive, personalized support, this study offers a roadmap for meaningful and effective referral conversations, and in turn building mental wellness.
The Roadmap: Autonomy, Competence and Relatedness
In simplified terms, Basic Psychological Needs Theory (BPNT) suggests that three universal basic psychological needs (i.e., autonomy, competence, and relatedness) are essential for humans to thrive, be resilient, and fulfilled.
When all three of these needs are met, you feel more confident, motivated, and ready to handle challenges.
“I designed my qualitative study with the lens of BPNT, which is very effective in predicting positive change. I asked whether satisfying these needs allowed athletes to be more open to those referral conversations and recommendations, and what factors influenced these needs.”
A few questions she believes teams, programs, and organizations could ask to adopt a proactive approach to mental health referrals and to consider whether they are meeting these needs include:
- Do the athletes feel like they have a sense of choice?
- Do the athletes value these choices?
- Do they feel connected to the referrer?
- Do the athletes have a sense of belonging within their sport organizations?
- Do the athletes have the tools and competencies required to successfully seek services?
- What are the power differences between coaches, other staff, and the athletes that influence athletes’ openness to seek services?
By regularly reflecting on these questions, teams and organizations can hopefully create a more supportive environment that both promotes mental wellness and empowers athletes to thrive.
Importantly, Ugrenović found that many of these needs can be met by fostering a strong mental health culture within sport. This culture recognizes the importance of mental health, normalizes difficulties and seeking help for them, and prepares athletes for what to do next.
Why Should Alpine Ski Teams Care About This?
The answer is impactful. When athletes feel seen, heard, and supported in these core psychological needs, they’re more likely to seek help when needed.
Additionally, they will stay resilient through setbacks and perform at their highest potential both on and off the hill.
Finding Success in Athlete-to-Athlete Referrals
Ugrenović found that the source of referral matters.
She found that peer-to-peer referrals were more effective than those from authority figures (e.g., coaches), as they feel more relatable and less intimidating.
This information highlights a powerful opportunity for teams.
Foster a culture where athletes support each other, even in an individual sport. Encouraging open conversations and peer-led support can make a real difference to athletes’ openness to seeking mental health resources.
By normalizing mental health discussions within the group, athletes become allies in each other’s well-being, which creates a stronger, more connected team and individuals.
What If Mental Health Resources Are Limited?
When the referral process is successful and the athlete is open to seeking support, the next step can be challenging. Finding the right mental health resources becomes even harder when access or funding is limited.
Ugrenović’s study suggests that clubs, academies, and teams can start small by identifying:
- Professionals or non-profit organizations who want to come in for a seasonal workshop or one-time talks.
- Platforms such as Psychology Today to help find insurance-covered and budget-friendly mental health professionals in the area.
- Places that offer free services in cases of maltreatment (e.g., SafeSport).
- At the collegiate level, sport psychotherapists, graduate students, or early-career practitioners who can offer reduced rates or pro bono work.
- Services that are already covered by student fees (e.g., counseling centers) and other services specific to athletes (e.g., providers embedded within athletic departments)
Having a strong foundation for the referral process is a crucial first step in encouraging athletes to consider and pursue these mental health resources.
However, frequently having and encouraging those conversations, and being prepared for what to do next, can be crucial to ensuring long-term success for athletes, both on and off the hill.
Overall, a proactive approach with referral engagement is critical to building strong, high-performance athletes. “Failure is part of every sport, and a way to be able to cope with that is to have good coping resources ready to go in your toolbox. The goal is to be in as good of a headspace as possible. This will help athletes grow stronger from setbacks, which we will all encounter in life.”
About the Author: Ellie Hartman
