Despite esports’ rapid growth as a competitive platform, the industry lacks comprehensive mental health support systems for players, coaches, and stakeholders who face unique challenges including emotional distress, online toxicity, and inadequate support structures. This study aims to develop evidence-based international mental health guidelines for the esports ecosystem using a community-based participatory research framework. The research employs a six-phase methodology: (a) stakeholder focus groups to determine preferences for guideline content and scope, (b) an e-Delphi study with international experts to gather recommendations, (c) an Expert Guideline Development Committee meeting to draft initial guidelines, (d) follow-up focus groups to assess guideline acceptability and usability, (e) a second e-Delphi study for expert feedback on revised guidelines, and (f) implementation case studies across various esports organizations. By 2026, these guidelines aim to establish a globally applicable framework that addresses the urgent need for mental health support in esports, while ensuring practical implementation across diverse organizational contexts.