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There is increasing interest in the role sports coaches are expected to play in supporting the mental health of elite and sub-elite athletes. This paper presents the first single-sport, mixed-methods, study of UK athletics coaches' mental health literacy (MHL). We extend previous quantitative survey-based UK studies by incorporating the qualitative lived experiences of coaches into the analysis. We explore coaches' knowledge of mental health and illness, experience of mental health training, and willingness to support athletes with mental illness. An online survey of 184 UK athletics coaches revealed that MHL was highest among women, younger coaches, and coaches with less experience. No statistical differences were found between MHL score and disability, sexuality or region in which coaches worked. Interviews held with a sub-sample of 25 survey respondents revealed a lack of clear consensus about what constitutes mental health and mental illness, and that coaches' everyday views of these did not always correspond with formal definitions or conceptualisations. Coaches' views were instead typically characterised by dominant psychological and psychiatric understandings of mental health and illness, while the significance of social relations and inequalities were often overlooked. There was a general willingness among coaches to support athlete mental health as an aspect of their duty of care, but most lacked the relevant training and understanding to do so effectively because such training was not implemented systematically within their organisational practice. Coaches' call for mandatory athletics-specific mental health training was one strategy thought to better enhance coaches' skills, knowledge and intentions to provide and seek mental health support. Important though MHL training and other sources of support is, we conclude that this is likely insufficient on its own and that there is a parallel need for multi-level, systems-wide, approaches in sport and wider society to better support the mental health of everyone.