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Objectives This study examined college athletes’ knowledge of mental illness and their intention to seek psychiatric treatment.Design A cross-sectional design.Setting College athletes in Japan.Participants Japanese college athletes (n=351; 255 men, 96 women; mean age=19.8 ± 0.73 years).Outcome measures The Mental Illness and Disorder Understanding Scale assessed college athletes’ mental illness knowledge. The statement ‘If I felt mental distress, I would visit a psychiatric facility’ assessed the intention to seek psychiatric treatment. First, we calculated percentage scores for knowledge and intention. Next, we examined the relationship between knowledge and intention. Finally, we categorised participants into four groups based on their knowledge and intention. The categories were ‘sufficient knowledge/active behaviour’, ‘sufficient knowledge/passive behaviour’, ‘insufficient knowledge/active behaviour’ and ‘insufficient knowledge/passive behaviour.’Results College athletes possessed a certain level of knowledge about mental illness. However, more than 60% were opposed to the intention to seek psychiatric treatment or were rated as ‘negative’. A weak positive correlation was found between knowledge and intention. Finally, approximately 50% of college athletes were knowledgeable about mental illness but were not inclined to seek support.Conclusions Mental illness knowledge does not necessarily lead to the intention to seek psychiatric treatment.