Mental health is an issue that football has a difficult relationship with. Despite all the advancements that have been made in the game, whether it be physical conditioning, shoe design or injury treatment, the topic of mental health continues to draw an uncomfortable breath from players and coaches. Mental health remains an area considered taboo in football circles, although efforts are being made to end the stigma attached to it.
World Soccer Talk discussed the topic of football and mental health with Dr Vincent Gouttebarge, Chief Medical Officer of the World Players’ Union FIFpro.
Here are his thoughts:
Discussion on world football: You played professional football, then moved into sports science and health. How was this trip? What convinced you to take this path?
Dr Vincent Gouttebarge: When I was 14-15 years old and professional clubs wanted to have me in their youth academy, my parents told me that a good education was also important because the chances of becoming a professional footballer were not great and that a professional career could end. suddenly after an injury for example. Therefore, I always wanted to combine studies and professional football. During the last five years of my career, I did my thesis in the morning, from 6:15 a.m. until 12:30 p.m…. then I went to the club for afternoon training!
WST: How did you find approaching mental health when you were playing? Was it a subject that clubs, management or players knew how to approach, let alone address?
VG: During my career, mental health was not a significant issue…metal skills were important to function optimally. During my career, I saw that mental trainers were integrated into the staff in order to obtain better performances, or we had several sessions with a mental coach. Things have changed but the only important aspect for a club is performance. From my position as Chief Medical Officer of FIFPro, I am interested in the long-term mental health of players, during and after their career.
WST: The late Andreas Biermann, formerly of St. Pauli, once said: “If footballers suffer from depression, I will advise them to keep it to themselves.” It seems inconceivable that football has not made valuable progress in helping players suffering from depression or anxiety. Is this vision too naive?
VG: We know that mental health issues are somewhat taboo in professional sports like football. We need to change it and I’m sure it’s a matter of time. Some top players are starting to talk about their mental struggles and this is a way to break the barrier.
WST: Are clubs and associations better equipped to help players suffering from mental health problems? Are coaches or teammates taught to watch out for telltale signs?
VG: As long as mental health remains a taboo subject, it remains difficult to recognize the symptoms and signs. Once everyone involved in professional football is properly informed about the potential mental health issues that can arise during a football career, then it will be easier to recognize them.
WST: Likewise, do you find that players are more willing to talk about their struggles with depression and/or anxiety?
VG: Things are changing in professional sport, in football too. Some top players are starting to talk about their mental struggles and this is a way to break the barrier.
WST: As Marketing Director of FIFpro, what are the most frequently asked questions from clubs and players regarding mental health and what do you advise them to do?
VG: I always emphasize that mental health issues can arise just as much as physical health issues…and it’s important to recognize them, talk to the right person, and seek the appropriate support.
WST: In general, does the nature of professional sport, i.e. the need to win and avoid failure, discourage players or coaches from speaking out about problems they might suffer from?
VG: Professional football (like other sports) is a rather macho environment and therefore it may not be supportive to feel free to talk about it.
WST: How much do injuries play a role in a footballer’s mental health? Do you think that the more injuries a player suffers, the more vulnerable he becomes?
VG: Serious injuries lead to a long period without training or competition. These are huge stressors for players and these injured players need to deal with them properly. This is not easy, especially when other stressors in a social context can combine with an injury. Mental health problems are multifactorial: it is often the combination of stressors (football specific or non-football) that lead to mental health problems.
WST: And finances too? There are unfortunately cases where players’ salaries have been withheld by poorly managed clubs. This kind of mental strain must take its toll.
VG: Yes, it’s also considered a potential stressor for players’ mental health.
WST: How much is retirement a factor? How much do ex-footballers struggle to transition from player to ex-player?
VG: The transition out of football is not easy and remains difficult for many players. We know from scientific studies that players forced to retire (due to injury or lack of contract) are more likely to report mental health issues than those who choose to retire.
WST: Have you noticed a noticeable difference between men’s and women’s football when it comes to mental health issues?
VG: We don’t have much information on this, but it appears that both male and female gamers are likely to report mental health issues.
WST: At what level of football do you think we need to make the most progress in terms of mental health? The elite may have good infrastructure, but what about smaller clubs and organizations?
VG: At all professional levels: Money does not immunize anyone from mental health problems. Mental health issues can occur at all professional levels, but the stressors that play a role in the onset of mental health issues may differ from the elite to lower professional leagues.
WST: How did you find the approach of governing bodies, such as FIFA, to the issue of mental health? Are enough studies being carried out and solutions found?
VG: FIFPro was the first organization in 2013 to address the mental health of large groups of players. Since then, FIFA has launched a few projects in this area, which can only bring a certain positive and added value to professional football.
WST: Do you find that some nations and associations take the issue of mental health more seriously than others?
VG: In some countries, for example the United Kingdom, mental health in the community and in professional sport receives a lot of attention.
WST: Are clubs making talent aware of professional opportunities beyond football or, better yet, helping them prepare? Do such programs help provide peace of mind by showing those involved in football that there is much more, from a professional point of view, than just playing and coaching?
VG: I think clubs but also agents (not working for a players union) should emphasize more and more that education and career planning are very important to prevent long term mental health problems but also to obtain better performance.
WST: How do you find the media approach to the subject of mental health? The tragic deaths of Robert Enke and Gary Speed have rightly been widely covered, but beyond the high-profile tragedies, is the media focusing enough on mental health?
VG: The media is still the media: they want to capture sensational stories and are very eager to publish about any player’s mental struggles.
WST: FIFpro carried out its own study and found that 38% of the 826 players surveyed admitted to suffering from mental health problems. How was this study carried out? How difficult was it to organize and open up for the players and are you concerned that the percentage is a conservative number?
VG: In 2013, we first conducted a pilot study in 6 countries (Australia, New Zealand, United States, Scotland, Ireland and the Netherlands) to gain insight into the mental health issues of current and former players. , but also in order to estimate whether a larger study would be feasible. As this pilot study was well received by players’ unions and their members, we decided to launch a larger study in 11 countries on three continents. It was of course a logistical challenge, but thanks to everyone’s support, this study was very successful… for the football family but also from a scientific point of view!
WST: It is important to emphasize that mental health problems are not limited to football, other sports also have to deal with them. What have you discovered from your contemporaries in different sports?
VG: I have initiated similar studies in many other professional sports such as ice hockey, handball, cricket, rugby and even among professional football referees. Mental health issues also occur in all other professional sports.
WST: This is a very general question, but what are the main solutions that football can provide to combat mental health problems?
VG: For any health problem, we always want to work on prevention. In order to prevent mental health problems, we must first make it easier to talk about and recognize them correctly and at an early stage. Educating players and staff is an important prerequisite.
WST: Finally, for any player or coach at any level (or their friends and family) suffering from mental illness, what are the first steps they should take?
VG: Talk to someone you know and trust…it’s a big but necessary step!
You can follow Dr. Vincent Gouttebarge on Twitter