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Elite sport coaches often rely on their discretion when assisting athletes struggling with mental health, with clear guidelines yet to be broadly adopted. This study aimed to explore how coaches perceive their role in athlete mental health and their role clarity. This study employed a descriptive qualitative approach with semi-structured interviews. 17 Australian elite level swimming coaches were interviewed, focusing on their perceived experiences with athlete mental health and any discrepancies between what their role is currently and what they perceive it should be. Thematic analysis was used to analyse results. Analysis revealed that coaches perceive their role to include open communication, actively observing their athletes' mood, and acknowledging their potential mental health knowledge deficits. They also indicated a lack of clarity for when to refer an athlete on to a medical professional. Athletes were perceived as responsible for maintaining self-awareness and help-seeking, whilst the organisational role included providing education and funding. Barriers for supporting athlete mental health included a lack of resources and poor mental health literacy. Coaches suggested a variety of recommendations to ameliorate these barriers including education and redesigning systems of support. Australian swimming coaches would greatly benefit from formal guidelines on how to identify, manage, and support athlete mental health. These guidelines should be established with input from coaches and key staff, in addition to clinical professionals and utilising evidence-based measures, including consideration of boundaries around coaches as non-mental health professionals.