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Mental Health

'Players forced to retire are two & a half times more likely to report mental health problems'

A new study in the European Journal of Sport Science shows professional rugby players need support especially if they’re forced to walk away from the sport.

“When it ended when I was 27, it was like somebody switching the light off overnight. I didn’t want to be burdening people afterwards, but it was a very lonely place to be, the drop-off was huge. It was like walking off a cliff.

It got to the stage where I felt I was very worthless on this planet. I had no self-esteem, I felt everything I did was wrong and it was a very dark hole that got deeper and deeper, and deeper. I was unemployed for about nine months. My girls were coming in to me in the morning seeing me just lying in bed and it was demoralising.”

THAT WAS FORMER Irish rugby international David Corkery, speaking on RTÉ Radio in February of last year about the effect premature retirement had on him.

Depression gripped him and pulled him to the edge. Struggling to come to terms with the end of his career, the ‘demons’ took over.

He told the Independent:

“Not being in that environment anymore killed off a big part of me. That surreal rugby bubble was gone and nothing could replace it. I had to adjust to a whole new way of life and I was not prepared.”

Jack McGrath, David Corkery and Niamh Briggs David Corkery (middle) at the launch of a mental fitness initiative between the IRFU and Pieta House last year. Dan Sheridan / INPHO Dan Sheridan / INPHO / INPHO

Last month, Jonny Wilkinson spoke to the Mail on Sunday about facing up to the reality of being referred to in the past tense while also admitting he had battled mental health issues throughout an injury-plagued four year period between 2003 and 2007.

I don’t feel any worth in saying I was a rugby player. I feel like I’m breaking apart in that I am going towards somewhere where my answer will be massively in the spiritual and philosophical, but it’s not there yet. It’s not the fact that I couldn’t care less. It’s just that I see it as the same now as getting up and going out for lunch. That’s what I’m feeling now as I’m breaking apart.

I’m feeling that life is going on and my appearance has been associated with my historical stuff and that’s breaking apart. That’s what I feel and that’s the confusion I see. Recognising myself is becoming more and more difficult but I see that in a positive way.”

A new study shows Corkery and Wilkinson aren’t the only ones to fear the future.

Rugby Union - Amlin Challenge Cup - Final - Biarritz Olympique Pays Basque v Toulon - Twickenham Stoop Jonny Wilkinson has admitted to 'breaking apart', having retired from rugby. Mike Egerton / EMPICS Sport Mike Egerton / EMPICS Sport / EMPICS Sport

Dr. Vincent Gouttebarge is Assistant Professor at the Academic Medical Center Amsterdam.

His latest research paper has just been published in the European Journal of Sport Science and is focused on the post-playing phase of rugby union and how prevalent common mental disorders are for retired players.

At the present time, I’m conducting research in order to get an insight into the extent of the mental health problem in professional sport disciplines involving both current and retired athletes. But this is only the first step. You want to identify the problem that crops up in a certain population. The second step is to identify the cause of the problem. So, which factors play a role in the mental health issue within professional sport? The ultimate aim is to develop and implement some support measures for the player. But before that, we need to know the extent of the problem and the potential cause.”

Players’ associations in three different countries (Ireland, France and South Africa) took part in an electronic survey in which 295 retired players with an average age of 38 answered questions.

28% reported experiencing symptoms of anxiety or depression after retirement while 24% reported adverse alcohol behaviour.

So, what do these figures tell us?

“Firstly, all the things we are reporting, they are reported by the athletes themselves and are not clinically diagnosed as a severe depression or mental disorder”, says Gouttebarge.

“It is just symptoms. It’s an indication of a problem. It’s essential that we make the difference.”

Soccer - npower Football League Championship - Ipswich Town v Burnley - Portman Road Gouttebarge has previously found that a quarter of professional footballers suffer from mental health issues. Clark Carlisle, left, is perhaps the most high-profile figure to speak openly about his on-going battle with the illness. PA Wire / PA Archive/PA Images PA Wire / PA Archive/PA Images / PA Archive/PA Images

“The figures are approximately the same as in other sporting disciplines, maybe a little bit lower. On one side, it’s not alarming. But on the other side, it’s not very different from the general population. Nevertheless, when you look at Europe in the last ten years, there has been a lot done regarding mental health in the general, mainly occupational population. But in contrast, in sports, mental illness is something we’re not talking about and we need to raise some self-awareness about that. We definitely need some support measure for the athletes. And the measures, in order to be effective, need to be specific.”

The most startling revelation for Gouttebarge in the course of crunching the numbers was finding the prevalence of mental health symptoms in players who had been forced to retire from the game.

We see a big difference in if a player is retiring voluntarily or not. I was at a conference in Cape Town about two weeks ago and I presented some results of this study. I performed some analysis and found that a rugby union player who involuntarily retires is more likely to experience a mental health problem than a player who voluntarily retires. Players forced to retire are two and a half times more likely to report some mental health problem.”

Gouttebarge has already studied something similar in professional football and found that one in four players suffer mental health issues while still active.

“There’s a perception that the life of a professional footballer is terrific because you earn big money and have lots of possibilities”, he told me last year when the FIFPro study was released.

There are immediate similarities with rugby. And what’s becoming clear to Gouttebarge is that regardless of the sport, regardless of the benefits, regardless of the supposed dream professional athletes live, mental health problems don’t discriminate.

“If you talk to all of the player associations across all sports disciplines, they get a lot of retired players – be they footballers or rugby players – who come to them and say ‘I’m experiencing some problem and I need to get some support’ but we don’t have a lot of things to offer at the present time.

Fortunately, there are some examples that are in place right now. In Ireland, IRUPA (the Irish players’ union) unveiled a 24-hour telephone line recently in order to provide support to a player or a family member who wants to talk about mental health. This is a good thing but we need more of it.”

Gouttebarge is knee-deep in a long-term research project. He plans on investigating similar mental health themes in professional cricket and Gaelic games but he’s not done with rugby union just yet.

Concussion is a dirty word in rugby circles. High-profile incidents have shone a light on the subject, high-profile player retirements have moved the story on.

Former England centre Shontayne Hape retired in 2013 after suffering several concussions. Last year, he wrote a searingly-honest account in the New Zealand Herald about the vicious circle and where he ended up.

“There was constant pressure from the coaches. Most coaches don’t care about what happens later on in your life. It is about the here and now. Everyone wants success. They just think ‘if we pay you this you are going to do this’. Players are just pieces of meat. When the meat gets too old and past its use-by date, the club just buys some more. You get meat that’s bruised or damaged, the club goes and buys some more.

I sat out for a week but I wasn’t right. I was back to having constant migraines. I was pretty much in a daze. Things had got so bad I couldn’t even remember my PIN number. My card got swallowed up twice. My memory was shot.

Rugby Union - RBS 6 Nations Championship 2011 - Ireland v England - Aviva Stadium Shontayne Hape in action against Ireland at the Aviva Stadium in March 2011. Julien Behal / PA Archive/PA Images Julien Behal / PA Archive/PA Images / PA Archive/PA Images

Dosing up on smelling salts, Panadol, high caffeine sports drinks and any medical drugs like that to try and stop the dizziness, fatigue and migraines was the only way I could get through trainings and matches.

I was thinking I’d rest for a year and then make come back. That’s why I never told anyone I was retired.To go with the denial, I went into depression. I was lucky I had some great support around me, from my wife, family and the players association in England but it’s still incredibly tough dealing with the fact you are washed up in your early 30s.”

Gouttebarge is intrigued by the link between concussion and mental health issues later in life and feels rugby union will only serve to complement the startling analysis already done on American football.

“In 2007, there was work done on American footballers who had retired and I think the figure in rugby will tend to confirm that the more concussions you suffer during your career, the more at risk you are to experience some mental health problem in the long-term.”

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