This study sought to identify factors that influence whether coaches support athletes struggling with depression and anxiety. Participants were U.S. public high school coaches who completed a written survey assessing their experiences, attitudes, and behaviors related to student-athlete mental health (n = 190 coaches, 92% response rate). Around two-thirds of coaches were concerned about mental health issues among the students they coached. They were more likely to extend help to a struggling athlete if they were aware of their school’s mental health plan and had greater confidence related to helping, including feeling confident in their ability to identify symptoms of mental health disorders. Mental health professionals, including sport psychologists who work with or consult with coaches, are well positioned to help provide coaches with the education necessary to be able to support and encourage care seeking by athletes who are struggling with anxiety or depression.