Since its launch in 2012, the PFA’s Wellbeing Department has supported almost 2000 current and former players through mental health issues. The number of footballers past and present accessing the service has continued to grow year on year. While it’s encouraging that players are coming forward to seek help, men still make up 75% of all deaths by suicide in the UK, meaning more work needs to be done. The dynamic and unpredictable nature of football can be an ideal breeding ground for mental health issues due to factors such as insecure employment, a limited career span and anxiety about performance. Recently, high profile footballers such as Danny Rose and Peter Crouch have spoken candidly about their own struggles with mental health, but the reality is there are still many players who are suffering silently.
Director of Player Welfare at the PFA, Michael Bennett, believes there to be a stigma around mental health in football as talking about how you feel makes you appear weak. “Because you can’t see mental health issues, they’re not given the same gravitas as a physical injury”, he says, “I think there’s still a mindset that mental health is about schizophrenia and clinical depression. The macho nature of both fans and players of sport often means mental health issues are seen as a weakness. I feel that’s the reason why a lot of men don’t want to come forward to talk about any problems they might be having. Things are changing slowly but not as quickly as I would like”.
Hyper-masculinity in sport can also discourage men from being more open about their health, but in football, there are other impacts to consider before speaking out. Michael explains, “We have to remember that these individuals playing football have concerns about their club finding out about any mental health issues they might have, and how that might impact them trying to get into the team and securing future contracts. There is some truth in those fears because there is still a general lack of understanding about mental health issues, and players are concerned that if they come forward, the information they share might not be kept private. Staff at clubs may want to support the player the right way but maybe don’t know how. Mental health awareness is key and educating the club staff and on wellbeing protocols so they know what to do when a player does come forward is key.”.
The physical demands of a professional football career require exceptional levels of fitness, but the same training regimes are rarely applied when looking at the emotional wellbeing demands of the mind. “Players can definitely neglect their mental health”, Michael says. “When I go into clubs, my first question to the players is always, ‘how do you look after yourself physically?’ and they reel off their regimes because they know them off the bat. Then I pose the question, ‘how many of you look after your emotional wellbeing?’ and they all look at me with a confused expression like ‘what are you talking about?!’. That’s when I explain to them it doesn’t matter how physically fit you are if your emotional state is not up to scratch; it’s going to impact you. I don’t think they put the two together, so I feel that’s where the work needs to be done”.
The PFA has always supported current and former players through mental health issues. However, after the tragic death of Gary Speed that rocked the football industry in 2011, the organisation recognised more resources needed to be dedicated to looking after players emotional wellbeing, and Michael founded the Player Welfare department. Since then, his team has launched several initiatives, including running workshops for players at all 92 professional clubs and WSL 1 clubs, setting up a 24/7 counselling helpline and implementing the nationwide network of therapists supporting current/former players who may be struggling. The PFA also started an annual mental health conference called Injured in 2017, where staff at football clubs come together and start making changes to improve players’ wellbeing. Now in its third year, the impact these events are already having is undeniable.
“These conferences have been huge and the attendance numbers have started to go through the roof”, Michael says. “For the first year of the conference, we aimed to make club staff realise that a physical injury is the same as a mental health injury, and thus should be treated in the same way. In the second year, we wanted to see how they had used that information and what progress they had made 12 months on. This wasn’t to call out any clubs, but to share good practice because some clubs were doing great work and others not doing as much. We wanted them to interact and teach each other what they were doing and how they did it. This year’s conference was more about understanding the pathways of support. Clubs have a duty of care to these players, so they need to have a strategy in place to support players if they come forward and demonstrate what that would look like at their club. I feel Injured is having a considerable impact, as people have gone back to their clubs to share their knowledge with other staff members. By doing this, they have also made them aware of our services such as the helpline number, the nationwide network of counsellors and the workshops they can attend, encouraging more people to come and take part each year”.
The protection of players is a core value of the PFA and great care has been taken to develop a strategy that considers the mental health challenges a player might face. For Michael, this starts with making sure players understand what mental health issues look like in a football context. “There are several things players go through daily, which can impact their mental health. However, they may not realise or see it as a mental health issue. This could include living away from home, language barriers, suffering from a long-term injury, a new signing threatening your position in the team, amongst other things. There are issues around short-term contracts, especially in the lower divisions. Around Christmas time, I see a spike in the number of players coming forward because they’re concerned about being re-signed the following year. We're expecting these players to perform twice a week. With all these pressures going on in the background, so many of them don't know what to do or how to address it. For me, these workshops are so important, to help them recognise these issues so they aren’t caught off-guard if they come up. I also make sure they know what support is available to them, and how to access it”.
The majority of players who get in contact with Michael’s department initially were former players, but it has since changed and now it’s more current players. In addition to the 24/7 helpline and network of nationwide counsellors, the PFA also provides access to residential rehab facilities through Sporting Chance. These services are available to all professional football players, past or present. The organisation also offers a wide range of support for players leaving the game, providing access to further education, coaching and financial assistance through their benevolent fund. This focus on supporting players who have left the game is vital, and Michael agrees.
“It’s crucial to consider the mental health of players who have left the game”, he says. “We also have to remember that transitioning out of the game was traditionally retirement in a player’s early thirties. Today, there can be quite a few different transitional periods in a footballer’s career. A player who doesn’t get a Youth Training Scheme (YTS) contract or who doesn’t go on to sign a professional contract at 18, might have to transition out of the game. Failing to get into the first team at a club and having to go out on loan is a transition for players, as well as leaving the game entirely for a number of reasons. Football can be so unstable, so it’s crucial that these players are aware of the help available to them, and that we have relevant support in place for them at every stage”.
One in six people in the UK has a common mental health disorder, with anxiety and depression being the most prevalent. Rates of diagnosis for men are much lower than women, but that is usually because of underreporting, something Michael is all too familiar with. “The tendency with men is that they’ll feel something isn’t right, but they’ll just get on with it. They keep their head down, but that generally makes matters worse as issues that may be quite small to start with, can grow into something more serious. The quicker we can get men to start talking about their problems, the quicker we can start addressing them and helping to make their lives better”.
Michael is currently in the final stages of completing a Ph.D., looking at the experience of football players with mental health issues. His research has led to an interesting discovery. He says, “Most players aren’t aware of the rollercoaster of emotions they go through when playing the game. In any one match, your emotions change rapidly depending on the outcome of every pass, tackle or goal. This is also reflected in your life off the pitch. The demands from your family and friends, the club, and even yourself are constant, and in this industry, the stakes are always extremely high. I believe this continuous up and down is having a significant impact on players’ mental health and affecting their wellbeing. Any former or current player who is struggling or not feeling like themselves, I encourage you to get in touch with the PFA, your GP or speak to someone at your club. If you were to pull a hamstring, you would go straight to the doctor without a second thought, and it should be the same for your mental health. If you hold it in, the problem can escalate, so please take that first step and talk to someone”.
Current and former professional football players or their concerned relatives can find out more information about how to access wellbeing support services here.