Shattering Stereotypes, Breaking Barriers: How Rugby League Is Embracing Mental Health

This article originally appeared on VICE Sports UK.

Suicide is the single biggest killer of men under the age of 45 in the United Kingdom, and according to statistics compiled by Samaritans in a 2016 report looking at data up until 2014, it's happening at a rate of up to four times higher than among women. These are figures that earlier this month Prince William described as being "an appalling stain on our society", and it's hard to find a reason to disagree with him. For young men in this country, the most likely thing to prematurely end their lives is themselves, which seems like a profoundly upsetting reality to confront.

Before confrontation, though, comes acknowledgment. We still don't talk about mental health freely in this country, despite our ignorance contributing to record numbers of deaths. Of those men who feel they have no other option than to take their own life, 75-85% were never at any stage in contact with the appropriate mental health services, missing out on the care and treatment that they so desperately needed.

This is where rugby league has started getting involved.

You know rugby league: it's the sport Sky introduces with faceless robots pummelling each other into the ground; that game only northerners down the M62 like, with that one token club in France; the sport rugby union sides go to cherry pick when they can't produce their own talent; the form of rugby played by overgrown men with more muscles than brain cells, watched by the malnourished working classes who can only derive pleasure from senseless violence with a pint in their hand. Yes, they're the people taking mental health more seriously than you are.

This juxtaposition isn't lost on them, either. There's a massive difference between what people outside the game tend to expect and project onto rugby league, and the reality of the game. If anything, rugby league lovers use it to their advantage. Founded in 2010, State Of Mind is an initiative created by experienced NHS staff, who were stirred into action by the death of former international rugby league player Terry Newton, who took his own life shortly after receiving a suspension from the game for testing positive for banned substances.

Speaking to Dr Phil Cooper, a mental health nurse consultant with the NHS and a co-founder of State Of Mind, he explained how the initiative came to be.

"Terry taking his own life in 2010 was a catalyst. I work in the NHS, and I remember reading several articles at the time suggesting that the NHS and the sport should be working together. Alongside his former teammates such as Brian Carney and Terry O'Connor, we initially started with ideas to do a conference, or offer free education sessions to players for the Rugby Football League."

Before long, though, they made the decision to expand their horizons to include fans of the sport, rather than just the players.

"Lots of blokes don't come to mental health services, so being a big rugby league fan, it was an obvious choice, really. The interesting thing about the game is that anyone that's ever played it will tell you that you're taught not to show any weakness on the pitch so your opponents can't exploit it, and that mentality can have negative knock-on effects away from the field. The RFL and Rugby League Cares have been fantastic to us. For me as a mental health professional, I've been to many sporting occasions and rugby league games over my lifetime, but there are very few where I'd have something like State Of Mind thrust in front of me."

State Of Mind didn't take long to make a difference. In their first year of existence, Dr Cooper was helping to operate a marquee for fans to visit outside a match, explaining who and what the group were about to anybody that would listen. "A lady came up to us with a gentleman," Phil remembers, "and explained to us that although she didn't know who we were, her friend had lost his son to suicide two and a half weeks previous, and he had been talking about joining him on Facebook and Twitter, and she didn't really know what to do."

Transforming into work mode on the spot, Dr Cooper gave the man the information he needed there and then, which wouldn't have happened had State Of Mind not been present at the fixture.

"I spoke to him for about half an hour at the game, showed him lots of different stuff that was available to him locally, nationally and with 24-hour services if he was struggling, and then he wandered off. It's a bit of a scary thing, because as an NHS professional you get to follow people up, but at the end of the game when we were pulling the marquee down he came back and told us that he had fully intended that to be his last game of rugby league, and that he was planning on taking his own life that night, but he wasn't going to do that now – and then he wandered off again."

Stories like that, says Phil, are the real secret to the success of State Of Mind, and the reason why institutions like the Rugby Football League, Super League and Sky Sports have been nothing but supportive, which has led to Super League dedicating an entire round of fixtures in their name. Players will appear on screen wearing State Of Mind T-shirts, the broadcasters will acknowledge and promote the cause to over 350,000 people and the entire game will be a testament to their work, creating a league-wide dialogue that wouldn't exist otherwise.

"Most of our success has been in making ourselves accessible," Dr Cooper explains, "and maybe there's a lesson to be learnt in how best to speak to people of all backgrounds, being located somewhere that they were going to be anyway, rather than making them come to you. We've found people are far happier speaking to you because you're there with them where they want to be, and that's a really crucial difference I've noticed from how it usually works in the NHS."

The success of the group has seen their profile rise, and they've taken the opportunity to share their story and experience wherever they can, which has helped change the perception of rugby league outside of the sport's heartlands.

"We've been at conferences up and down the country now where people are starting to think about rugby league differently, because it is challenging those negative stereotypes. It's the only sport nationally that's got a full round of fixtures dedicated to mental health awareness – there are clubs that'll do things individually in other sports, but nobody else has done it across the whole sport as yet. For me, it'd be great if we could have a State Of Mind round in every sport, or something similar – an equivalent."

And why not? With the results State Of Mind have had in a relatively small sport – with a considerable lack of funding, resources and audience compared to football, say – this is an example that needs highlighting, and which ought to be used as a template for further improvement. Returning to his story about the gentleman he'd spoken to at that match back in the initiative's early days, Dr Cooper outlines just how impactful having someone to lean on was for that man, and how it had helped – and indeed saved – his life.

"He contacted us again via Facebook about four months later to let us know that he'd been accessing support and help, then the season after we were back again at the same ground and he came up to us again and gave me a big hug. I get a bit emotional talking about this – he introduced me to his other son, informing us that he was about to become a grandfather. Our only goal when we started was the hope that we could maybe save or affect one life, and we know that's happened numerous times now over the last six years. Our expansion has been down to people thinking what we're doing is quite good, I suppose."

On the back of the success of State Of Mind, the players themselves have taken matters in to their own hands in recent seasons. Stevie Ward, a forward for the Leeds Rhinos and England, suffered a near career-ending knee injury during the club's historic 2015 treble campaign. Having opened the scoring in a must-win away game at Huddersfield after touching down from a pinpoint Kevin Sinfield pass, Ward's knee later gave way underneath him, which would've been enough to end his playing days in years gone by.

Laid up staring at his inflamed knee on the physio table while one of the most famous matches in Super League history was going on outside, Ward says he'd never felt so alone. Rather than being able to complete the trophy haul with him teammates, he began a recovery period that would take him through what became one of the hardest years of his life.

"Looking back," he says, "I wasn't sure I should be acting or reacting at the time. I could tell I'd just suffered the worst injury I've ever had, but I still managed to go out and lift the League Leaders' Shield on crutches with one hand. It was my nana's funeral that day, so everything seemed to be happening at once. I questioned why it had to be me. I'd already had two long-term injuries, and I seemed to be stuck in that loop. Being stuck in that routine, you can't help but be in that same negative space in your head. That's sort of been the story of my career so far, and it's quite distressing."

Rather than keep his struggles to himself, Ward founded Mantality, a publication through which he aims to shed light on mental health within sport, using his status as a player to give a more rounded and honest view of what life can be like as an athlete, partly inspired by the inherent dishonesty of the persona people adopt while posting on social media.

"While I was injured, I thought I've got all this time on my hands, so I might as well do something positive with it. People are so scared of being or looking vulnerable that they run away from what they're actually feeling. You'll see pictures on Instagram of people looking happy when they're not, just so that they can keep up appearances. When you go on social media, it doesn't paint a picture of reality. What I've tried to create is quite a gritty publication, that's open and honest – to balance the brilliant stuff with the not-so-brilliant stuff. Hopefully what we're doing allows people to see the parts of people's lives that don't appear online, aren't usually in articles or featured on Sky Sports – we want to offer both sides of the coin. Some people can have the perception that there's folk with perfect lives, but nobody does in reality."

Ward was helped through his recovery by the faith he was shown at club level. A quirk of the contract law in rugby league states that clubs can break contract with a player who's been unable to play for over a year, but instead the Rhinos presented Stevie with the Number 13 shirt, the squad number vacated by club legend Kevin Sinfield, which many fans had called on to be retired.

"You're always respected and looked after at a club like Leeds, and I'm really fortunate to have had that. They could've been funny about my contract or lack of playing time, but for them to do the opposite and reward me with the Number 13 shirt, and put that trust in me – which they have done since I was 12 years old – that's what they've done all the way through my career, given me that support."

In the first Mantality article, setting the tone of what the publication was going to be about, Ward confessed and confronted the anxiety he's suffered, his battles with depression and what went through his mind at his lowest moments, as well as detailing the brave face he'd put on in front of others to disguise his true emotions. "Sometimes it can be hard, having mental health related things in front of me, it can bring back memories that are quite difficult to deal with," Stevie explains. "I'm not in it for myself, or to boost my ego. The response has been positive, which I think has helped – negativity might have scared people off who may have been tentative about engaging."

That positive response hasn't just been confined to social media – he's seen it in the reaction of his teammates, as well having readers write to him personally to explain how detailing his struggles has helped them in confronting their own.

"It's definitely brought more to the changing room talk. It's a strange thing, having seen that boundary crossed. It's not just laughing and joking, people are happy to actually talk about how they feel. I had an email after I released the initial article about the dark side of sport from a young lad, and he mentioned how he'd been struggling, feeling down and alone, but he said that reading what I'd had to say helped him realise that dealing with his mental health would make him a stronger person, and it wasn't a weakness. If I can present myself like that to young people, then I'll carry on doing it."

Ward isn't alone in using his time away from the rugby field to contribute to mental health awareness. On a Monday in April 2016, Halifax forward Luke Ambler lost his brother-in-law Andy to suicide. Andy had been at Ambler's house on the Saturday, but kept his problems to himself, leaving his family none the wiser as to what he was going through. Much like Ward, rather than suffer in silence, Ambler was inspired to go public with his difficulties, this with the aim of helping to prevent others from having to go through the same thing as his brother-in-law.

"The day Andy died I was devastated. He'd only been round mine two days beforehand in what we thought were high spirits, so it obviously came as a shock," Ambler told us. "I had to ring his best friend, visit his former partner and their two-year-old daughter, and essentially explain that he'd taken his own life. Knowing that he hadn't even felt he could speak to me about it, I was quite angry. I remember driving around with some music on, thinking that there has to be something available for people where they can go to talk, because this can't be happening anymore."

Allowing some breathing room between Andy's passing and acting on that impulse, Ambler says it was his mother-in-law's idea to try to appeal to as many people as possible.

"I wanted to have an Andy Roberts coffee club at first, but left it a little while to leave some space between acting and Andy passing, because we were all going through a really bad time. A couple of months later I was at a wedding, so I asked my mother-in-law for her blessing to set up the group, and she said she'd agree just as long as I didn't use his full name, because she wanted it to feel more open, rather than being just about him, which was incredibly nice of her. Since we landed on a name, everything else has kind of fallen into place."

To get the group up and running, and to spread the message as far and wide as possible, Ambler turned to social media to promote his Andy's Man Club meetings, which soon snowballed.

"Halifax put a post on social media for me, and it went viral in the local area with over 1,500 shares, and I started to get hundreds of direct messages. After we'd made a little promotion video, the first group had nine people come and the next was 14, so that night I remember having a discussion with my missus about what else we could do to spread the message."

Taking inspiration from a challenge-related meme that had begun to gain popularity, but giving it his own spin, Ambler sent a tweet that would go on to spark thousands of responses, far surpassing what even he thought was possible.

"At the time there was this press-up challenge going around, and I'd noticed people had just started posting videos of themselves without really sharing the message about PTSD that was supposed to be the point of it, so I knew we needed something simple. On the back of the few T-shirts we'd had printed was the slogan "It's okay to talk", so I thought just doing a selfie with an 'okay' hand signal would've worked. My missus didn't think it would catch on, but I just went through with it after typing up a short message in the notes app on my phone, because I had such a strong gut feeling about it."

Luke goes on: "By the following Monday, it had started to take off. I'd asked my missus to put one on [social media] and messaged a few of the lads from rugby, but there was someone from ITV and one of the Chuckle Brothers as well, which helped it gain momentum. Fast-forward to the end of that week and Ricky Gervais had joined in – it had gone into the stratosphere."

Olympians, famous sports stars, television personalities, journalists, celebrities and fellow rugby professionals from both codes began posting selfies of their own and nominating other people with huge followings, all the while sharing Luke's message promoting Andy's Man Club as an attachment, helping the group gain the type of traction and publicity it needed to reach as many people as possible. A safe space to share feelings, give support and encourage one another in whatever ongoing struggles they might have, the meetings have outgrown Halifax quite significantly, with new groups constantly popping up nationwide.

Despite running his own business and juggling a professional rugby career alongside that, Ambler remains hands-on with how Andy's Man Club operates, dedicating his spare time to the growth and expansion of a group which has risen to prominence so quickly that the government recently named it alongside State Of Mind as part of its official suicide-prevention scheme.

"I've been to every group we have at least once, and I'm still at the Halifax meeting every Monday evening. Every single place we set up I take full responsibility of, make sure it's in good hands and that they're running as smoothly as possible. When I go, I'll talk and get involved. Anyone who's facilitating the meetings has to have a real passion for it, because it's a real one-in all-in mentality."

Posting to a combined audience in the tens of thousands across a variety of social media platforms, Ambler still sets the agenda for each and every meeting that takes place under the Andy's Man Club banner, showing no sign of taking his hands off the reigns any time soon.

"How I help most is, on a Sunday night or a Monday morning, I'll send a list of questions and ideas to everyone who's involved in leading the groups, while there are also people who champion what we're doing by helping us promote, sharing group details and hanging posters, which we've had interest about from as far away as Germany, Austria and even India – it's getting bigger and bigger, which sort of shows how real and far-reaching this problem is."

Speaking to Ambler about what he does, it's clear the passion he has for wanting to help others and reduce the stigma that still surrounds mental health, echoing the sentiments of both State Of Mind and Stevie Ward in his ambition to use rugby league as an access point, but transcend the sport in the long run, and offer help to those who need it no matter how or why they discovered his work.

"At the minute I don't want this to be a job, it's not about money or anything. I know I want to keep doing it though, so it could become a lifelong commitment I suppose. It's a can of worms we've opened, I'm embracing each day and I enjoy what I'm doing. I didn't want this to be lost just inside the world of rugby, these problems obviously exist outside of the game as well. I have used it to my advantage though, given the masculinity of the sport and what it is seen to represent. This has gone to show that anyone can speak out, no matter your background."

The thing to bear in mind is that this is the work of just one corner of society, inside one minority sport, with the only fuel for progression being the desire to help improve or save the lives of those who have found themselves in a vulnerable place, unsure of where to turn for support. This isn't rugby league's problem – it's society's, but the game has made it a priority by using its platform to promote mental health awareness in a way that doesn't require applause, or any form of congratulation, but rather emulation.

Rugby league is a game that – when boiled down to the bare bones of the matter – doesn't have anything like the following, funding or influence that other sports do, so this should be seen more as a starting point than an end. If a sport that's so often defined – rightly or wrongly – by its toughness, masculinity and simplicity can grapple with a subject matter as sensitive and complex as the male mental health crisis in this country, there's no excuse for others not to pick up the mantle and not only emulate, but improve on the work of rugby league. Too many people have lost their lives, and too many more remain at risk for this to continue on in the same fashion for any longer. Enough is enough.