Mental Health

James Boyes – Flickr: Aaron Lennon in his Spurs days.

Has football scored an own goal on mental health – By football academic Duncan Stone

I know this is not quite the usual shirt and/or cycling article but nevertheless I thought it was well written and deserved a bigger audience. I hope you agree.

We hear lots of good intentions when it comes to mental health and football, but what is actually being done to help professional players and managers? And why are footballers still afraid to speak out about mental health issues? Happiful examines the culture of hyper-masculinity that persists on the pitch (and in the locker room), and uncovers some ugly truths about the beautiful game

In 2015, after re-signing Aaron Lennon on a three-year deal worth £4 million, the Everton manager at the time, Roberto Martinez, delightedly informed the press: “We know we are getting a player our fans know inside-out.” It’s a statement that proved to be tragically false in April this year, when the ex-England international was detained by police under Section 136 of the Mental Health Act.

Mental health has become an increasingly prominent topic in football in recent years following the tragic suicides of German international goalkeeper Robert Enke in 2009, and Wales manager Gary Speed in 2011. Suicide remains mercifully rare, but Lennon’s committal to hospital does represent an extreme example from within the world’s most watched football league.

Official statistics suggest as many as one in four people in the UK will suffer a mental health problem in any given year, so it would be inappropriate to make any direct association between Lennon’s illness and his job as a footballer. Undeniably, however, it was his fame as a footballer that marked Lennon out for special attention. Attention that was, in many cases, less than sympathetic.

The reporting of Lennon’s committal by certain sections of the media was malicious to say the least. The Daily Mail was widely condemned for emphasising Lennon’s wages in a tweet which read: “£55,000-a-week England footballer Aaron Lennon is detained under Mental Health Act after stand-off with police.”

Such irrelevant reporting was criticised by ex-Everton captain Phil Neville and the former Labour Party spin-doctor Alastair Campbell, who has previously battled with depression and alcoholism. And yet, the notion that millionaire footballers are somehow immune to mental health problems and ought to simply “man up” remains the default opinion of well-known media commentators and, it must be said, a wide section of the general public.

As the game appears to get inexorably richer, footballers are treated less like ordinary members of society, even if the vast majority earn a fraction of the riches bestowed upon the best Premier League players. Indeed, beyond the rarefied atmosphere of the Premiership, far more players – especially in Scotland – are employed on a part-time basis. Footballers of all standards are, nonetheless, regarded as “role models”, who are constantly expected to demonstrate unrealistic standards on and off the field.

Supporters, who often invest a great deal of their personal identity in a club, now enjoy previously unknown levels of access to players thanks to social media. Sadly, much of this access is used to criticise poor performances or behaviour. Indeed, Lennon was accused of being a “miserable bastard” for failing to smile in photographs following his transfer to Everton. Yet the public remain ignorant of the everyday realities and pressures of professional football that threaten or suppress a player’s true self.

Previously a professional with Portsmouth, Dr Martin Roderick, author of The Work of Professional Football: A labour of love?, explains that the “culture of fear” recently exposed in British cycling has a long history in football: “From a very young age, players are subject to highly precarious employment practices. Nobody, player, coach or manager, is comfortable, and voices of dissent are silenced – if they ever emerge.”

Sports governing bodies have a long history of simply paying lip-service to issues such as racism, bullying, homophobia, gambling, addiction and even corruption
In a results-driven business, a player’s true self (and their physical and mental wellbeing) is habitually sacrificed for extremely short-term goals. Managers and players are only as good as their last result, and the pressure to win encourages a culture of hyper-normative masculinity.

Physical “toughness”, which frequently requires players to play when injured, goes hand-in-hand with mental strength and an implicit image of heterosexuality. Young or old, wealthy or poor, gay or straight, fit or injured, contented or depressed, Roderick emphasises that many players, no matter how successful, wear a mask of conformity: “You have to look like you want to be there.”

As the tragic case of openly gay footballer Justin Fashanu, who killed himself in 1998, or the more recent conspiracy of silence in relation to widespread child abuse implies, such an environment leaves little room for those who do not fit such a clichéd sporting identity. Thankfully, the attitudes and influence of “old school” managers such as Brian Clough or Bill Shankly, who infamously referred to “poof bandages” and called injured players “bastards”, are in decline.

Younger managers, including the ex-Inverness Caledonian Thistle manager, Richie Foran, who helped launch Scottish Football’s “Support Within Sport” campaign, worryingly reverted to the “man up” language of old when fighting a futile relegation battle last season.

The “Support Within Sport” initiative, which aims to identify and treat mental health issues among players and coaches, was launched in 2016 following research by Dr Katy Stewart, of the Hampden Sports Clinic (HSC), into the incidence of mental health issues in male players across the 42 clubs in the Scottish Professional Football League. The survey, which was funded by the UEFA Research Grant Programme, asked two simple questions:

1. “Have you, or a fellow player, experienced a mental health problem?”
2.“Who would you want to talk to about a mental health issue?”

NHS spending on mental health
The results revealed alarming levels of anxiety and depression within Scottish football, with 64% of the 600 respondents revealing that they, or a teammate, had experienced a mental health issue. A supplementary questionnaire identified 40 players suffering a significant issue at the time, and 15 of these were immediately referred for more intensive treatment available, free of charge, under the programme.

Although a number of contributory factors were identified, Dr Stewart’s research revealed how one of the key triggers of mental illness stems from the precariousness of football employment. Managers and players need to be extremely mobile in order to secure work, and frequent moves, often at short notice, to various parts of the UK or abroad, can lead to loneliness and depression.

64% of 600 Scottish football players revealed they, or a teammate, had experienced a mental health issue
Such social isolation may even be experienced within a club environment. Long-term injuries are an obvious contributory factor, but others, such as Lennon being denied a first team squad number by Tottenham manager Mauricio Pochettino, are similarly isolating and damaging to a player’s self-esteem.

Such ingrained practices will undoubtedly continue in football, but the results confirmed the urgent need for a robust system within the professional game to deal with their effects. Thus, the HSC, together with the Professional Footballers’ Association of Scotland (PFAS), established a programme of welfare specifically designed to look after the professional game.

The PFAS programme established a 24-hour helpline that provides immediate access to an experienced sports medicine doctor. And, if necessary, the player can be referred to a specialist dealing with addiction, general counselling, and experts in both sport and clinical psychology or clinical psychiatrists and psychologists within a week.

Recognising that making a phone call is still an enormous step for some players, the HSC and a group of students from Strathclyde University have also developed an app called “SUPPORT”, through which players can access self-help advice or send a message directly to a doctor.

In England, anecdotal figures have emerged. Like the PFAS, the Professional Footballers Association (PFA) also operates a 24-hour helpline. Michael Bennett, the PFA’s Head of Welfare, has disclosed that 160 players had requested help in 2016. The number of past and present players seeking help, Bennett adds, is “growing year on year”. But as more than 60% of those seeking help in 2016 were former players, the numbers suggest the prevailing culture of football still stops current players from coming forward.
While it is a truism that football, like other sports, does not exist in a social vacuum, it does seem that modern society (and modern living) increasingly reflects football rather than the other way around.

Unlike football however, where employers are legally obliged to provide (no matter how ambiguously defined) for the physical and mental care of their employees, the zero-hours contracts that define the UK’s burgeoning “gig economy” guarantee little in terms of work or wages, let alone statutory sick pay, holiday pay, pensions or health care. Undoubtedly, mental health is the societal problem of our time.

It’s here that football and society diverge.

Football has the money, but those in charge appear reticent to make the cultural changes required. Whereas government seemingly has the desire to help, yet a self-imposed age of austerity means there is insufficient money to provide the services needed. There is clearly room for improvement in both football and society.

Players who are unfortunate enough to suffer mental illness do, at least, have almost immediate access to the vital health services denied to those who rely on the NHS. We can only hope the rest of UK society can enjoy the same level of provision in the near future.

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