Coach–Athlete Relationships and Mental Health: An Exploratory Study on Former Female NCAA Student-Athletes

Female participation in NCAA athletics has grown significantly since the passage of Title IX—the 1972 U.S. federal law that prohibits sex-based discrimination in educational programs and activities receiving federal funding—yet much of the existing research continues to focus on male athletes, leaving important gaps in our understanding of women’s experiences in collegiate sports. One underexamined area with important public health implications is the role of coach–athlete relationships in shaping female athletes’ mental health, access to resources, and overall collegiate experience. This exploratory study draws on in-depth interviews with 19 former female NCAA athletes to examine how their relationships with coaches influenced their athletic careers, mental health, and perceptions of support. Participants represented a range of sports and competitive levels, allowing for variation in experiences across contexts. Findings reveal that coach–athlete relationships are not only central to performance and motivation but also serve as key sources of emotional, social, and material support—or, in some cases, stress and disengagement. The quality and impact of these relationships were shaped by competitive pressures, team dynamics, and institutional expectations. This study underscores the importance of relational context in understanding the broader landscape of female NCAA athletes’ experiences and suggests that coach–athlete dynamics merit greater attention in both research and athletic program development. These findings underscore the relevance of coach–athlete dynamics as a public health concern, particularly in relation to mental health and emotional well-being in competitive sports environments. Supporting healthier relational cultures in collegiate athletics is essential for promoting positive health outcomes among female student-athletes.