Introduction

The International Olympic Committee (IOC) has updated its 2019 consensus statement on mental health in elite athletes.1 2 The updated consensus statement2 provides an evidence-based framework for monitoring, diagnosing and managing mental health symptoms and disorders in elite athletes, including youth athletes, and discusses key stressors, environmental factors and actionable recommendations for healthcare providers, researchers and sport leaders.

Although the consensus statement provides evidence-based guidelines and a framework for addressing mental health challenges among elite youth athletes, much of the underlying evidence derives from high-income countries, creating challenges for implementation in the distinct social, economic and healthcare context of sub-Saharan Africa. In some ways, the interface between sport National Governing Bodies in sub-Saharan Africa, and International Federations or other international entities, mirrors colonial legacies and mindsets and unequal power relationships. For example, youth athletes are trafficked from former colonies with the promise of playing…