My father in law, Sidney Williams, played amateur football to a good standard. He played in the Berlin Olympic Stadium in 1946-8 for the British army and was offered an opportunity to play professionally in the 1950s for Brentford but, as he was earning more elsewhere, he declined. Sidney was obsessed by football all his life. Even after retiring from playing at 38, he attended many England matches including the World Cup final in 1966.  It was clear that once he moved away from Wembley and stopped going to live matches, there was a huge hole in his life, which left him with a sadness which felt to me like unresolved grief. It was clear to anyone involved with him how much he missed the beautiful game but, like many men of his generation, he would dismiss any attempt to engage him in discussing this. 

Sid is not alone; football is hugely important for many men. Gary Lineker tweeted after England’s dramatic World Cup penalty shoot-out win over Colombia, “Football. There is nothing like it. Nothing.” While the benefits of playing football – the sheer joy of it, the physicality and exercise – are clear. I like to think about its role in male mental health. This was never discussed in Sid’s era, but today there is ever-increasing interest. 

There is some academic evidence that footballers suffer from mental health issues more than the general public. This is not surprising as there has been a long list of revelations, coming thick and fast, from ex-players detailing their problems of addiction to drugs, drinking or gambling.  Now there are the sexual abuse and coaching scandals.  On top of this we have seen many players detailing their own mental health struggles, recently Michael Carrick: “It’s not something that’s really spoken about in football. I have not spoken about it before. For the lads that I have played with that are reading this, this will be the first time that they know [about the depression]. They wouldn’t know.” This affected him so much that he wanted to come home during the 2010 World Cup. 

Marvin Sordell’s recent discussion of his own depression and the difficulties he had in acknowledging it and getting help, resulted in him calling for counsellors to be at every club.  Sordell’s request particularly interested me. I work as a psychoanalytic psychotherapist in the National Health Service (NHS), where there is a lot of concern not only about male mental health but about how to engage men in psychological services. There are many reasons why the NHS is worried: depression in men is often hidden. While women are diagnosed twice as often as men, the problem for many men is that their emotions are buried deep, cut off and often ‘depressive symptoms’ are misinterpreted as being callous or emotionless. The biggest killer of men under 45 is suicide, three times higher than for women. 

 Sidney Williams in his retirement

Sidney Williams in his retirement

When I mentioned to my cohort of football-loving male friends about this piece, they reacted positively and enthusiastically, “Football is essential for my mental health.  Interview me”. They spoke about having an outlet; some space away from family and work. This is something Sid would have recognised and understood. But in other ways there have been huge changes since Sid’s playing days. One is the modern manager who has an interest in mental health and appreciates its importance, not only for the players but also for the wider team and club staff. They put a lot of thought into the players’ environment, both on and off the pitch, with an emphasis on the importance of their players managing their emotions, channeling their feelings in a constructive way. 

The prime example was Gareth Southgate’s England World Cup campaign and his approach, that was heavily informed by psychological thinking. The Swedish manager, Janne Andersson, considers that the stress players experience in a penalty shoot-out is similar to a psychological trauma.  Southgate clearly planned for this with his psychological profiling of the players to find out who would cope best with the stress of a penalty shoot-out.  Southgate emphasises a supportive but also very business-like environment  which enabled Danny Rose to be candid about his struggles with depression, something he had been unable to do in his club set-up or even with his family. 

Another huge development today is the rise of women’s football.  During the World Cup, it was interesting to see how BBC and ITV gave a more prominent role to female presenters.  Personally, I found this challenging as football has always been for me the male domain, giving me the opportunity to be immersed in ‘a man’s world’. When I was at school in the 1970s, football was not a game for girls, they had netball! 

Hopefully, however, this has challenged the macho and sexist culture of the game, demonstrated by David Moyes, when Sunderland manager, he did not like a question from a female reporter, lashing out that she “deserved a slap.” Another recent example was the Lazio Ultras, with flyers claiming their ‘stadium was a sacred place’ where women were not welcome. 

The domestic abuse charity, Pathway Project, claimed that domestic abuse rates increase by 38% when England lose in the World Cup and up to 25% when they draw or lose.  Even when England win, abuse rates rise. Sexism is widespread in society and football is not immune to that and yet it has changed significantly – not just since Sid’s time, but for my generation too. 

I hope this love affair we are currently having with Southgate can lead to a positive change to a more open and thoughtful response around male mental health. While the environment of the current England dressing room may be a good place for mental health support, I am not sure if this is true at the moment for the majority of the amateur dressing rooms or football grounds. 

 Sid Williams during his amateur playing days

Sid Williams during his amateur playing days

It was claimed that the suicides of two high profile players, Gary Speed and Robert Enke, shocked the football community to do more on mental health. But a common thread in many ex-players accounts are the difficulties players have in discussing their mental health at the time, a sense that the club would not be interested or that showing vulnerability would jeopardise their careers.  Fears that other players or coaching staff would see them as weak and they would lose their place in the team or let down their teammates.  Players have gone through so much to get to where they are, at the top of a huge pyramid of others who have nearly made it. There is so much to lose.

I believe in a properly funded NHS mental health service, which takes the lead in the nation’s mental health. But here we have two industries, one cash-rich, the other chronically underfunded. The NHS needs a vibrant voluntary sector that can respond in an imaginative manner. Chelsea has an uncomfortable history of racism, but instead of imposing banning orders on racist fans, it now gives them the opportunity to make an educational tour of Auschwitz. This proves to me that football clubs can ‘think outside of the box’. But it is time football applied this sort of creative thinking to the psychological health of men, not only to the players who come through their doors, but to the communities they serve, and in particular the special access it gives to men of all ages.  Men are a hard to reach group for psychological treatment. But big clubs are not taking their responsibilities seriously, it is too easy to spit out youth team players from academies, and shrug their shoulders at the mental health costs to those young men, while bringing in ready-made players from other clubs. 

We know that there is a huge amount of money in football.  Gary Neville recently pointed to “the vast revenues of Premier League clubs” and the “ridiculous” sum of £211million that was paid to football agents last year. For a tiny fraction of that, surely money could be channeled back into the communities that support the teams and to potentially provide a number of mental health professionals?  But sadly, it seems to me that much as in Sid’s era, mental health is still on the subs’ bench. 

This article is dedicated to Sidney Williams (1928-2016)