Mental Health and Cultural Barriers in Collegiate Sport: A Cross-National Mixed Methods Study of U.S. and South Korean Collegiate Athletes

Research on collegiate athlete mental health is overwhelmingly Western-centric, leaving a critical gap in understanding how cultural context shapes athletes’ experiences. This study addresses this gap through a cross-national comparison of the United States and South Korea. This convergent mixed-methods study integrated survey data from 400 athletes and in-depth interviews with 33 athletes, guided by the Social Ecological Model for Health Promotion. Quantitative results revealed that U.S. athletes reported significantly higher psychological distress (F [1, 395] = 4.99, p < .01), while social and institutional support were key predictors of mental health outcomes in both contexts (βs = –.18 to .27, ps < .001), with notable gendered variations. Integrating these findings with our qualitative analysis exposes two key phenomena: a “paradox of expression,” where higher reported distress in the U.S. likely reflects a cultural permission to disclose, and a “willingness-action gap,” where multi-level barriers prevent help-seeking. We argue these phenomena are shaped by distinct cultural ideologies: an individualistic culture of intense self-reliance and performance pressure in the U.S. and a collectivist culture of social harmony in South Korea. Ultimately, this study challenges a simplistic “better versus worse” narrative, concluding that both systems create distinct but different cultural and structural barriers to athlete mental health, demanding systemic and culturally-tailored interventions in both contexts.