While it is common to monitor elite athletes’ training load, recovery, injuries and medical health, mental health is rarely included (Vella et al., 2021). Scholars have reported that Paralympic athletes averaged higher levels of injuries and chronic illnesses (Fagher et al., 2020; Steffen et al., 2021). It is likely that a complex life situation together with pain often experienced by Paralympic athletes may cause stress and impact their lives outside sport. Thus, it is surprising that mental health struggles have been understudied in this population. The purpose of this study will be to examine how increased attention and awareness of athletes’ mental health influences the coach-athlete relationship. Self-report data will be collected weekly with winter Paralympic athletes (started August 2021) as part of a large-scale longitudinal project that will run over five years and include training load, physical and mental health, injuries and illness. Data will be screened and evaluated each week primarily by a physiotherapist and a sport psychologist, but coaches will also receive the weekly reports. Focus group interviews will be conducted following the 2022 Paralympic Games to address coach perceptions of the following themes: mental health problems associated to performance, team-selection, stigma and help-seeking behavior. Thematic analysis will be used to analyze the data. The results will be discussed with an emphasis on how coach awareness about their athletes’ mental health influences their coach-athlete relationship and potential consequences for performance issues. Moreover, applied implications of this study will be suggested to enhance the parasport environment.