Overcoming The Empathy Barrier: Mental Health in the Premier League

This article originally appeared on VICE Sports UK.

For one of the most expressive and impulsive footballers in Premier League history, Wayne Rooney has always been surprisingly reserved in press conferences. Just hours after learning that he would be on the bench for England's game against Slovenia, Rooney appeared calm and measured before the national press – aside from one telling moment. Just as the interview was about to end Rooney admitted, somewhat sheepishly, that his game was in "a difficult period."

"Lacking confidence" and "low morale" are buzzwords in every football fan's vocabulary, but there is a strange disconnect between their usage in football punditry and these concepts as side effects of an individual's poor mental health. For many of us, players are simply Panini cards; machines that only exist on a football field for 90 minutes a week. Any "difficult period" is purely football related and will, inevitably, be entirely resolved by a good performance next week. This is not always true.

Watching Rooney drift hesitantly across the pitch over the last 12 months has triggered an endless national debate over whether his form is a temporary dip in self-confidence or a sign of permanent demise and, interestingly, very few people have stopped to question whether all the talk of his declining value for club and country is not contributing even more painfully to his listless performances. Rarely do fans or the media talk about the wider psychological pressures on footballers, or how their current mental health – pertaining to career performance, non-football-related life events, or genetic predispositions – might be having an impact on their game.

Mental health issues have increasingly become a mainstream concern in British politics, but they are rarely, if ever, discussed as an aspect of the nation's most loved sport. Football has a hugely influential role in the formative years of young men (the group least likely to reach out for mental health support), and yet most of us are unaware of what is being done to tackle issues in the sport and give no thought to the impact of our own punditry.

It might come as a surprise to learn that every year around 200 players and ex-players reach out to mental health services provided by the PFA via the charity Sporting Chance. For confidentiality reasons, figures on how many players from the Premier League seek support are unavailable, but since the ever-growing network of counsellors and psychotherapists currently stands at 82 we can assume the service is a success.

Increasingly, mental health is being taken seriously by professional football. As well as giving educational seminars to clubs' academy and development squads and training a mental health ambassador at every Premier League club (fully trained in mental health first aid), the PFA and Sporting Chance gives all PFA members access to a 24-hour hotline. From here, players and ex-players are referred to counsellors or psychotherapists in their local area. During the 2016/17 season, mental health workshops will be rolled out across senior and development squads in the Premier League to teach professional footballers about mental wellbeing and strengthen their ties with the support network available to them.

Sporting Chance's Head of Operations Shellie Heather believes that this counsellor network service, which started in 2013, "is one of the best – if not the best – Employee Assistance Programme in the country". Given that the service is free and has no waiting list, she believes that the Premier League and FA are doing a remarkable job at tackling mental health issues within the sport: "I'm not sure where else in society mental health issues are so high on an industry's agenda."

Players may have access to an excellent support network, but this does not automatically excuse us – the fans – from disregarding mental health issues at the top of the game. The reasons for not caring about a footballer's emotional wellbeing are obvious enough.

"Fans have little understanding that players experience the same emotions as other young people," says Martyn Heather, Head of Welfare and Education at the Premier League. "Dealing with injuries or loss of form can be really tough and if you are susceptible to mental health issues these can easily be a trigger. It is hard for fans to understand someone playing a sport they love, and being paid a lot of money, can experience mental health issues."

Michael Bennett, Head of Player Welfare at the PFA, agrees. "The public perception is: why should these players have any problems when they are earning a large amount of money?" he said. "These are people first. They happen to play football and are getting paid a lot of money, but they are people first and they'll be people when they leave the game."

Understanding more fully the mental health issues that arise in football could help make the subject more approachable for young men generally, improving the average football fan's empathetic response to mental health problems and, potentially, bringing the subject out into the open.

One in four people in the UK experience a mental health problem each year, and despite the topic finally becoming a mainstream political concern reaching out to young men remains a difficult task. John Ashton, the president of the UK Faculty of Public Health, told The Guardian in 2014 that "the condition of adult males is of increasing concern because suicide has been going up." Suicide is, in fact, now the main cause of death for men aged 20-34.

It is not far-fetched to assume that a greater understanding of mental health issues in football could have a positive knock-on effect for society as a whole. The Premier League has a potential TV audience of 4.7 billion and according to a report by gloabelwebindex.net two thirds of Premier League watchers are male, with around 50% aged between 16 and 35. Michael Bennet believes there could be a significant correlation between the silence of young men and silence at the top of the game:

"If we can break that stigma and taboo about mental health, then hopefully more will come forward and fans will be able to understand it a bit better," he said. "Having a better understanding of the impact that it has on footballers – as people – might cause people to look at their own lives and how mental health impacts them."

As role-models to so many young people there is surely a benefit to increased awareness of mental health issues that occur amongst star players. "We have to be careful not to say this is a football issue," says Shellie Heather. "Mental health particularly amongst young men is a growing problem. Football only reflects society so inevitably we will have players who experience these issues. If football and the Premier League can help reduce the stigma then hopefully it will encourage more young people in the wider communities to seek help."

Joe Hart made headlines earlier this season after Pep Guardiola dropped him from the starting line-up and suggested he transfer elsewhere. Sympathy for England's goalkeeper was minimal, beyond a basic fascination with the entertainment aspect of the story, which seemed to reflect how our obsession with sport as a leisure activity inherently dehumanises professional athletes. Granted, Hart's wealth and fame puts him in a hugely enviable position, but how many of us considered the psychological impact of his transfer to Torino?

Under immense national scrutiny, this 29-year-old (a wizened age for a footballer, but young in almost any other industry) was told he had no value by his manager and, within three weeks of learning this, moved to a new country. By all accounts Hart has transitioned admirably, but any one of us would have found these last few months incredibly difficult.

It would be reckless to posit that either Hart or Rooney are suffering from serious psychological problems, but their stories are nevertheless intriguing examples of the media's and fans' lack of empathy with footballers – whose psychological wellbeing is as complex and important as our own.

"Rooney has played more than 400 games for club and country and now all of a sudden has been dropped. That is going to impact him in some shape or form," says Bennett. "Joe Hart going to a new club abroad; that's going to impact his mental health and wellbeing."

Understandably, mega-rich superstars who have fulfilled our collective childhood dreams rarely get our sympathy. None of them expect it. But mental health issues are prevalent in all sections of society and top-level football – with its extreme ups and downs and the ruthless analysis of form in the national press – may be a particularly high-risk profession.

Just learning about the vast network of mental health services made available to Premier League players might help individuals outside the game broach the subject, as Shellie Heather was keen to point out:

"Football is a wonderfully unifying language, and if the football industry can lead the way on this agenda somehow, I do believe it will go a long way to breaking down the stigma and 'normalising' the idea of speaking out and seeking support when you're struggling."

It is, perhaps, time to ponder the part we play as individuals when we buy into the demonisation of players and coaches. This is not just because we need to humanise the players themselves, but because there could be a significant correlation between footballers' mental health rarely being discussed and the silence amongst young men more broadly in Britain.