College athletes continue to experience mental health crises, as depression, anxiety, high-risk behaviors, and suicide are widely reported across levels of play. The National Collegiate Athletic Association (NCAA) recently provided guidelines for colleges and universities which emphasize athletes need continued mental health support. There is evidence of support for athletes who seek help for mental health concerns, but stigma and hesitation in mental health-seeking persist. Stigma prevents many people from seeking or maintaining mental health care, even when they know they could benefit from it; college athletes are less likely to seek help due to multiple stigmas around self-determination and athletic identity. In this chapter, we focus on the college athlete experience, mental health, stigma related to seeking mental health care, and research-based recommendations for college athlete mental health support.