Does football care about mental health?

Two weeks ago, Darmstadt and Iceland midfielder Victor Palsson gave an emotional interview. The 29-year-old talked about grief after the death of his mother, including crying in front of his 3-year-old son and losing 8 kilos (17.6 pounds) during what he described as a dark time. 

Palsson's readiness to talk openly about topics that are rarely public knowledge in football speaks to the tools he has developed and how much more open the world is becoming about mental health. The question is: has professional football done just as much development as he has? 

"In professional sport, it is often stated that it's important to always be strong and keep going… It has to be okay and accepted to have mental struggles and to ask for help," Palsson said in his interview on Darmstadt's website. 

During the pandemic, mental health has become a more prominent topic for many areas of society.  

"With such topics, we are all the same," sports psychologist Dr. Thorsten Leber told DW. "It doesn't matter whether you are a pro footballer or a cleaner. It affects everyone the same." 

Silver lining 

With increased awareness has come an increase in understanding. Sporting Chance is a major sports mental health charity in the UK and its head of education and athlete engagement, Alex Mills, explained how the pandemic has led to a significant change in attitude towards mental health. 

"The pandemic has provided a silver lining in a horrific situation, a significant change," Mills told DW.

"Addressing your mental health doesn't have to be about extremes, because that fails to understand the link between your emotional literacy, how you would process your thoughts and feelings, use coping mechanisms, build up resilience including asking for help and support. There's an opportunity for conversations in sport to start there." 

Sadly though, while Mills says he feels more comfortable having those conversations today than six years ago, the perception that feelings get in the way of performance remains. For the general secretary of the global players' union FIFPRO, Jonas Baer-Hoffmann, there is a clear reason for this. 

Performance rather than 'holistic well-being'

"We've shifted more attention to mental health and well-being but from a performance perspective, optimizing capability to perform, rather than holistic well-being," Baer-Hoffmann told DW. 

Clearly, football finds itself in a paradox. Are high-performance environments conducive to good mental health? 

"It's a contradiction in professional sport, for sure," Leber said. "I have found there are coaches or clubs that handle this well, that are capable of protecting a player in a crisis. Often it depends on one person. For example, if the head coach thinks it is important then often the protection and understanding is also there." 

But how many players would feel comfortable speaking to their coach about potential mental health problems? 

Former England left-back Danny Rose is an example of a player who opened up about his struggles and has seen a significant drop in playing time since. He remains one of the few examples the public is aware of. 

"Of course, there are players who seek help but don't talk about it publicly," Leber said. "That should also be understood because the moment you start to carry a crisis around with you then you are also vulnerable to fans or the press. Sadly, you never know how the public will react." 

The idea behind the Super League, and the fact players were not consulted, reinforces the idea that they are increasingly being seen as commodities rather human beings. 

"I think what players have felt quite strongly in the last 10 days is how commodified they are in the governance of the game," Baer-Hoffmann said, before adding that players are concerned that the way the game is developing is overshadowing their actual identity. 

"Players are in a friction point where commercially they're asked to be blank, but personally they actually care about a lot of things and want to start expressing it and see that their platforms are meaningful. I think this friction affects your mental well-being." 

Global game 

This perspective is made worse when looking globally. Baer-Hoffmann points out that part of the reason why mental health is more of an issue in larger football economies is because players have longer-term contracts. Clubs are naturally more inclined to preserve their capacity to perform if they have a longer-standing financial commitment. For countries where that is not the case, the perspective on mental health can be drastically different. 

"I think in the majority of countries where we're working I don't think it [mental health] has been a priority for decision-makers during the pandemic. I think it comes with a certain degree of economic sophistication and capacity — if you don't have the money to pay your squad then you obviously can't pay a psychologist and that is completely legitimate. But we have countries where federations unilaterally cut salaries by 70%, in countries where people are making one to two thousand dollars a month. That in itself shows a complete disregard for mental or physical health."

The same is sadly true for many women playing football. Shorter contracts and lower incomes combined with perhaps playing in foreign countries during a pandemic make for emotionally challenging, isolating circumstances. 

Parity between physical and mental health

For Mills, who believes many UK clubs are doing good work, part of the solution lies in creating parity between physical and mental health. 

"If you go into Chelsea's academy the first thing you see is the physio's room and the club doctor's room on your right-hand side. People understand they are solutions to that problem. Talking therapy is a solution to mental health problems, developing emotional literacy is a solution, active self-care is a solution." 

Solutions will be found if clubs and organizations walk the walk. It is one thing to say mental health is a priority and another altogether to restrict it to one workshop a year. 

Premier League commitment

Recently Premier League clubs made it a requirement that club boards have a member specifically responsible for mental health and that first-team players receive mandatory mental-health education. 

"If you look at the wording of what Premier League is asking of clubs it is very much about structural change," Mills said. "If you're saying: 'no one can be discriminated against because of their mental health,' then you're saying people will be supported and they won't be treated differently." 

The past year has made the issue of physical and mental health more visible. Footballers have long been treated differently, but for all the wealth, fame and opportunity that comes with their careers, they remain people first.

If you are suffering from emotional strain or suicidal thoughts, do not hesitate to seek professional help. You can find information on where to find such help, no matter where you live in the world, at this website: https://www.befrienders.org/.