A Hermeneutic Study of a Paraprofessional Mental Health Initiative involving Medical Teams and Male Professional Footballers

Abstract

The spotlight has only recently focussed on mental health in professional football. High-profile suicides alarmed the football community and players continue to take their own lives. Consequently, mental health disorders in professional football have become a topic of increasing interest in research, due to the serious consequences for quality of life, and the likelihood of the player’s predisposition to inflict serious self-harm. Aims Given the increased interest in and importance of mental health issues, mental health education and guidance for football medical teams is essential. The research aim was to investigate the role of the medical team in managing the mental health issues faced by male professional football players and establish whether a paraprofessional Solution Focussed Brief Therapy (SFBT) initiative could enhance that role. A total of thirty-four participants, working in Premier League and Championship level professional football, took part in this two-phased study. Nineteen were contracted players, thirteen were members of medical teams and two were PFA representatives. A Heideggerian hermeneutic approach was adopted and data was collected through fifteen in-depth interviews and four focus groups. In Phase 1, the problem of mental health disorders and mental healthcare in professional football was explored. In Phase 2, a pilot study investigated the feasibility of a SFBT intervention, delivered through a smartphone APP. Results All of the nineteen players declared mental health issues. De-selection, not injury, was the main reported issue. The majority of players and medics agreed that disclosing mental health problems could lead to de-selection from the team, for some further punishment, due to the value placed on maintaining a ‘mental toughness’. Therefore, if a sports psychologist was present at the club, the player may not seek help as it was dependent on trust in the individual. None of the players made use of the PFA counselling hotline, at any time, for mental health support. The majority of players would speak to a member of the medical team if confidentiality was guaranteed. None of the medical team members had any mental health education, and yet engaged in unofficial paraprofessional mental healthcare. All medical team members thought paraprofessional mental health education would be of benefit. The SFBT APP intervention was unanimously well received as a paraprofessional mental healthcare aid. Conclusions The SFBT intervention indicated it was clearly possible to develop a paraprofessional mental healthcare supporting role for players. Mental health issues of professional footballers could be managed more effectively if the appropriate education and SFBT intervention, from inside the medical team, was in place. This could potentially save lives. Recommendations for future strategies and further research have been detailed.