Reclaiming the Game: Challenges and Opportunities to Address Mental Health in Youth Sport

Youth sport participation is widely promoted as a protective factor for mental health. However, this relationship is likely conditional, with data to suggest that sport can either support or undermine youth mental health. Using a constructivist qualitative design, we explored the lived experiences of key stakeholders within the U.S. youth sport ecosystem to better understand how sport structures intersect with mental health. Fourteen semi-structured focus groups were conducted with 64 participants, including youth athletes, parents, coaches, organizational leaders, and individuals involved in funding, policy, and partnerships. Data were analyzed using reflexive thematic analysis. Three interconnected themes were identified: (a) The Paradox of Participation, highlighting how performance pressure, social media surveillance, and adult dysregulation erode psychological safety; (b) The Elite Industrial Complex, highlighting how pay-to-play models, early specialization, and identity foreclosure create systemic exclusion and psychological harm; and (c) Reclaiming the Game, which outlines solutions including the professionalization of adults in youth sport, creating protective policy frameworks, and the restoration of developmentally appropriate recreational pathways. Overall, the findings revealed a youth sport ecosystem in a state of crisis, marked by a misalignment between developmental needs and adult-driven, commercialized participation structures. Addressing youth mental health through sport therefore requires systemic reform that prioritizes psychological safety, equity, and human development over elite outcomes.