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Rugby and a new era of mental health vulnerability

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Scott Sloan is Director of the School of Hard Knocks, a mental health charity that provides affordable pitchside therapy to sport playing youth.

Rugby’s elite athletes are our modern gladiators, expected to be tough and tenacious under the scrutiny of often unforgiving fan bases. It’s understandable then what athletes think they may lose if they let slip the fragile edifice of infallibility — but this can come at great personal expense.

Sport is an unparalleled tool in modelling good behaviours such as dedication, fairness and comradery. These observations are so commonplace in fact there is a universal understanding of terms like ‘unsportsmanlike’ or the more colloquial ‘that’s just not cricket.’

For the average punter, getting a regular dose of sport — from bowls to basketball — is unsurprisingly associated with improvements in physical and mental wellness, no matter your ability or lack thereof (in my case).

After reading of the last-minute withdrawal of Wallabies skipper Michael Hooper this weekend, I was shocked to learn that almost one in three elite athletes experience mental health symptoms like anxiety and depression, burnout, distress, unhealthy eating patterns, insomnia, and alcohol or drug misuse.

Compared to a global prevalence of mental health disorders of 13%, it appears despite their unique sporting talents, athletes are much more susceptible to poor mental health than the general population.

What is the cause?

In terms of mental wellbeing what then separates athletes from us mere mortals? Injury and concerns about losing one’s hard-fought footing on a team, the need for validation through winning, dealing with failure, and career transition out of sport are all associated with mental health symptoms.

But another possible driver is a deeply stigmatised athlete environment that does not promote health-seeking. Studies have shown more negative attitudes towards help-seeking amongst athletes than the general population, as well as greater stigma and poorer mental health literacy. Why?

“Mental health has a stigma that is tied into weakness and is absolutely the antithesis of what athletes want to portray, ” says Dr Thelma Dye Holmes.

Studies show that men who suffer from depression have difficulties disclosing their mental health problems, reasoning that traditional masculine norms such as being strong, successful, and self-reliant inhibit help-seeking behaviour.

Results of qualitative studies support this assumption by showing that men’s decision not to seek help is accompanied by the concern that they would be making fools of themselves and expect social isolation as a consequence of not living up to masculine norms.

My own experience of rugby, and perhaps also for anyone who attended an elite rugby school, is that it’s been for too long a bastion of such debilitating and traditional masculine norms.

Rugby’s elite athletes are our modern gladiators, expected to be tough and tenacious under the scrutiny of often unforgiving fan bases. It’s understandable then what (particularly male) athletes think they may lose if they let slip the fragile edifice of infallibility. But this can come at great personal expense.

‘I was playing for the Lions and I was like, this was hell’

Earlier in 2022, the Irish entertainer Blindboy Boatclub welcomed Irish and Munster rugby standout, Keith Earls, onto his podcast alongside psychologist Dr Declan Aherne.

Ireland rugby players Keith Earls (and Peter O'Mahony

Ireland’s Keith Earls (right) and Peter O’Mahony in tears after beating the All Blacks to win the series 2-1. (Photo by Joe Allison/Getty Images)

The three men hosted a chat about mental health and sports psychology, with Earls revealing he was diagnosed with bipolar two disorder during an Irish camp in 2013.

At the height of his illustrious career at the pinnacle of elite sport, Earls was not coping: “I was just getting deeper and deeper and deeper every year. They were happening more often — my mood swings and my emptiness. It nearly became my default. The odd day of happiness and trying to hide it became exhausting.”


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With no one in the professional setup yet to turn to and “trying to be a so-called ‘macho man’ rugby player, ​​I kept it all quiet, didn’t really speak about it. I suppose the fact I didn’t know what it was, I was a small bit embarrassed, maybe.”

Earls says that intervention nine years ago has helped him hugely.

“Thankfully over the last couple of years, I have got a great hold on it. I have found my identity. Which I think was part of the problem as well. I didn’t know who I was, and I was always trying to be other people. I didn’t know when I was Keith, I didn’t know when I was Hank (the name he gives to his depressive side). And thankfully I can tell the difference now.

A new era for sports and vulnerability

Anti-stigma interventions and mental health literacy programmes that seek to increase knowledge of mental health are important in order to improve help-seeking intentions in athletes.

Ireland’s rugby players association should be highly commended for the development of their Tackle Your Feelings app, a campaign which supports proactively looking after players’ mental health and wellbeing.

In Earl’s case, it started at his lifelong club Munster creating a culture of vulnerability, mutual support and honesty in part driven by the tragic passing of Munster Head Coach Anthony Foley in 2015.

Put simply, this tragedy brought home that there was more to life than rugby, and these large lumps of men no longer needed to give off the veneer of infallibility.

“At the end of the day we’re all human as well and that’s what [Ireland Coach] Andy (Farrell) and all of us in here are all about as well: the human side of the rugby player. We’re getting to know each other on a deeper level than any squad I’ve ever been involved with,” Earls said.

Ireland rugby players Keith Earls (and Peter O'Mahony

Peter O’Mahony and Keith Earls were unafraid to show their emotions after Ireland’s famous series win over the All Blacks at Sky Stadium on July 16, 2022 in Wellington, New Zealand. (Photo: Joe Allison/Getty Images)

If one could quantify this new-found approach in a single image, there’s no greater example than Earl’s Munster and Ireland teammate Peter O’Mahony’s raw display of emotion at the end of Ireland’s recent successful tour of New Zealand.

Changing what it means to be a man

The headline for this image may read: A team that puts the human at the heart of the elite athlete provides Ireland with a historic away series win against the mighty All Blacks. What better verification for displaying our human side could be given than that?

Moreover, the Irish team’s talisman breaking down at the side of the field as the final whistle loomed provides a rallying call for all men to aspire to — the strength to bravely express one’s emotions for all to see. Now that’s really sportsmanlike. DM

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