It updates the IOC’s 2019 consensus statement and aims to establish a more consistent, evidence-based framework for recognising and managing mental health concerns in elite athletes. The IOC statement recommends that screening and monitoring be integrated into routine sports medicine rather than reserved for emergencies. Stigma, concerns about confidentiality, fear of losing selection, and limited mental health literacy can all discourage athletes from seeking help. Injury is identified as a particularly important intersection between physical performance and mental health. Mental health emergencies should be addressed through formal plans that are established, rehearsed, and regularly reviewed in every elite sporting setting.