Elite lean athletes at sports high schools face multiple risks for mental health concerns and are in need of psychosocial support

The combined demands on an adolescence in an elite sports high school can negativelyaffect mental health (eg, stress, burnout, depression, anxiety). Late adolescence is alsowhen elite-striving athletes typically transition from junior-to-senior level programs. In addition, adolescent elite lean sports athletes have an increased risk of suffering from abnormaleating pathology. The purpose of this study was to investigate the perceived psychosocialneeds that young, elite-striving lean sports athletes in sports high schools find essential fortheir sports careers and transition from junior-to-senior level sports. Eight Swedish elitestriving lean sports athletes (2 men and 6 women; median age 17.0 years, range: 16–18years) participated in this study and sports represented were athletics (n = 1), gymnastics (n= 3), and wrestling (n = 4). Semi-structured interviews were performed, and data was analyzed by thematic analysis. Results showed integration, both in the present situation and forthe future, as an overarching theme perceived as essential for a successful elite sportscareer over time. Three additional themes were also identified: (a) Psychosocial stress(combined performance demands, diminished social life, sports-related body weightdemands, taboo talking about eating disorders, injuries), (b) Protective psychosocial factors(social support and psychological safety, communication and coordination school andsports, self-care/health behaviors), and (c) support needs junior-to-senior transition (careeradvice and mentorship, individualized support). As a result, elite-striving, lean sports athletes attending sports high schools need additional support to excel in their academic andathletic endeavors. Sports developmental programs continue to provide inadequate supportbefore and during the junior-to-senior level transition. Similarly, despite the continued callsfor reducing the stigma of mental health, athletes in sports schools still encounter barriersfrom coaches and peers, making the subject taboo, particularly surrounding eatingpathologies