Retired players encouraged to engage with brain health check service

While rugby continues to play concussion catch-up on the field of play by amending regulations to reduce brain injuries, the sport is equally determined to ensure that retired players can also access any help required to deal with post-career mental health issues.

The obvious headline hysteria prompted by decades of ignorance, if not neglect, in a wide variety of sports, from NFL to AFL and soccer, has been felt as keenly in rugby union, with over 200 former players from the UK and Ireland, including six women, engaged in legal action with governing bodies.

Many of these are high-profile names, such as Gavin Henson and Steve Thompson, an England World Cup winner in 2003 who can recall nothing of his finest achievement. Many others share the lingering trauma.

Former Ireland international Joe Kinnear’s death last week, after a nine-year battle with dementia, was the latest reminder of sport’s difficult historical legacy with brain injuries as it seeks to discover a future pathway into taking the best measures possible to protect participants.

“Former players read the news and hear the stories about some of their peers who are struggling,” admits World Rugby’s chief medical officer Dr Éanna Falvey. “There is no doubt these stories generate a lot of anxiety, nervousness and worry.”

The former Ireland team doctor was in Rugby Players Ireland (RPI) HQ to announce that Ireland will be the first country in the world to launch a free brain health service. The initiative will provide support for former elite players with concerns about their brain health.

Initially available to any retired player, male or female, who has played international 15s or sevens rugby, as well as any player who has played at a provincial level, it has been developed using independent and scientifically proven examination techniques.

Participants fill out an initial questionnaire before proceeding to an online consultation with a trained brain health practitioner.

Players who do not display any warning signs are supported with the most up-to-date advice on maintaining brain health. They will also be advised of RPI’s broad range of services, including mental well-being support, personal development initiatives, career guidance and community engagement opportunities.

Concerns

Any player displaying warning signs of poor brain health will be referred to a specialist for further in-person tests via their family doctor.

Concussion concerns may have triggered this initiative but other mental health issues, perhaps even some not necessarily directly linked to brain injuries, can also affect retired players.

“It encompasses general issues linked to health and mental health, smoking, drinking, lifestyle,” explains former international Marcus Horan, now a player development manager at RPI.

“That’s really important because those issues can be managed in terms of mental health. Even if there are no red flags from this service, that level of education provided can tell you how to continue managing your health. And you can keep retaking the test every two years to keep track.

“While I was playing, concussion tests came in during the latter stages of my career, and I was worried about that. But also in the position I played I was worried about my neck. Being able to walk.

“You talk to your parents asking about a history of Alzheimer’s in the family. You lose your keys and wonder is it because I’m a rugby player or is it someone else.”

At the very least, this service can re-establish links with medical services.

“I’m recently retired and come out of a situation where I have had 17 years of having a doctor always at your beck and call,” says former Leinster and Ireland lock Devin Toner.

“Since I stopped playing, I haven’t seen a doctor in two years. So to have this available is an extra peace of mind you can get every few years.”

As far as women are concerned, the issue of concussion research has lagged behind the men’s game but, with six players joining the current mammoth group action, if there are historical issues, there may be ongoing ones too.

“It’s natural there is apprehension out there,” concedes former Ireland women’s international Lynne Cantwell. “We’re going through a positive stage where there is a lot of research being done on the game to try and assist in a multi-pronged approach. But it’s natural to have that curiosity and questions.

“Education is key and the research behind it with intervention and tools, as being rolled out by RPI.”

The Irish Independent viewed the comprehensive online test that follows the initial questionnaire delivered to players. It involves a stern 30-minute series of exercises involving number manipulation, memory, verbal and visual skills.

But beyond enabling a deep dive into post-career cognitive issues, whether or not related to sporting brain injuries, there is a wider mental health brief too, attempting to re-establish links with former players who may be isolated or experiencing other social difficulties.

“Social isolation, untreated anxiety and depression, low level of exercise, are red flags,” adds Falvey, “so being actively involved in a sport in a club is a great way to deal with most of the things that are risk factors here.

“Putting people back in touch with their club, getting them helping out with coaching, that is all part of it. Rugby is part of the solution.”