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Mental Health of Footballers. Very little is known. This needs to change

As a football fan and psychiatrist I have more than a passing interest in the Aaron Lennon story this week. Sadly newspapers like Sun and Daily Mail dramatised things appallingly . 

The reality in this story is clear . The police have powers under Section 136 of The Mental Health act to take anyone whom they deem in need of psychiatric assessment to a designated place of safety for that assessment . The legal holding lasts for 48 hours during which time it is expected the assesssment is complete. At that point other sections can be applied for with 28 days being common under Section 2 and 6 months for Section 3. Many caveats apply . In general terms Section 2 is likely to be applied if necessary where the patient is unknown previously. At this stage nothing has been reported suggesting that Section 2 has been applied. 

Any football fan will recognise certain personality types on the field with players being often impulsive and prone to anger. I have a personal theory that adult ADHD will be far more prevalent in footballers than the general population . ADHD is also strongly linked to alcohol abuse and depression. In addition one suspects that borderline personality disorder would be more common. The Telegraph reports today that Stan Collymore received that diagnosis.  

Despite the plethora of stories of depression in sportsmen and suicides, there is no precise knowledge of how common mental health disorders are in footballers. No research to my knowledge has systematically evaluated this.  All speculation is thus unproven. 

Screening for these disorders is possible through fairly simple screening tools and should detect those who need further evaluation. For example a simple questionnaire for adult ADHD if it comes out negatively means that those people are around 98% likely not to have ADHD. 

Football clubs do have a duty for mental health care. They are best placed to flag up needs for assessment . What also needs to be understood is that life stresses often tip people over into illness. Not always but often. There are forms of depression that are not obviously linked to a precipitating cause but many forms are. 

Players also would benefit from such assessments. For example impulsivity traits and emotional volatility can be recognised and to some extent the effects ameliorated. Whatever happened in Aaron Lennon’s life to make whatever happened happen, it is unlikely that there was no previous warning.  Someone in the club is likely to have seen or heard something that may have been important. 

Mental illness is common and there should be no stigma about accepting help nor diagnosis. The onus lies within the clubs to do this . Players will also benefit