Nine years ago, I wrote an article in the Financial Times expressing my views and concerns on the impact of mental health illness among sports people, predominantly cricketers. In the years since, mental health and its impact on sports people hasn’t disappeared, especially in this unprecedented Covid era, where its presence seems to have been amplified, and sadly cricketers seem to be among the worst affected.

Mental health awareness and attempts to tackle it are on the increase, most recently with two very high profile sportspeople; such as Simone Biles and Naomi Osaka both emphasising their difficulties and struggles around mental health.

This journey into the depths of the dark confines of the mind has been more in the open since the start of the pandemic with the numerous lockdowns around the globe, with people having to endure what is basically enforced incarceration in their own homes. While this may have prevented or prolonged further infections, the mental impact no doubt has been catastrophic for some – myself included.

Having suffered from depression and anxiety most of my adult life I thought this would be a walk in the park, a few weeks of being locked up in the house with the family. Yet it felt quite different to anything I’d previously experienced, a surreal feeling of living in a bad dream, and one from which you can’t seem to awake. I had support from my family and friends, albeit virtual most of the time.

While the world had mostly come to a halt, there were people working behind the scenes to get sport back on the road – in the safest and securest way possible. How could sport implement realistic strategies for safety and stability amidst the uncertainty?

Cricket and football in the UK were among the first to restart – though in empty lifeless stadiums. The amount of crowd interaction at cricket has thankfully increased since, due to Covid rules and a successful ongoing vaccination campaign orchestrated by the UK government.

Though for me, I still wanted to know why players were suffering and how the pandemic has affected their mental health, the most recent case that of Ben Stokes, I put my questions to Professor Nick Peirce – the Chief Medical officer for the England and Wales Cricket Board.

What is the main role of the Chief Medical Officer?

The Chief Medical Officer role entails helping support the game in running the systems and personnel to minimize the impact of injury and illness across the game. This role also oversees a specific duty of care department whose remit is to gather and deliver evidence-based proactive safety and welfare systems and well-being support.

In your time in the role, what has changed regarding mental health welfare in cricket. How would you characterize the main differences from 10-15 years ago when players like Marcus Trescothick and Michael Yardy opened up on their conditions with how Ben Stokes has sadly suffered from similar?

The main difference has been the reduction in any stigma and an openness of the culture.  You could say psychological support should just be the word for a safe environment. This has allowed the systems to be put in place with the CPA (Cricket Performance Academy) now requiring clinical psychology mentoring and the PCA (Professional Cricketers’ Association) offering a wide range of proactive programmes. The game now has many more ways to identify warning signs and a proactive rest and rotation system that has been more widely accepted.

With Covid now impacting daily life for everyone, how has this impacted players and staff involved in the setup?

It has been a uniquely challenging period where normal pressures of elite sport are added to constant low-grade societal and organisation tensions and threats. These include the jeopardy of a positive [Covid-19] test, prolonged quarantine periods, large squads, and are amplified by the removal of support provided to players and staff of some of their basic psychological needs such as family and connections with society.

What aspects do you take into consideration when preparing bio-secure environments – and assessing the risk management for players/staff, regarding their respective mental well-being?

The novelty of these bio-secure/bubble environments has long since worn off and the need to meet players’, support and operations staff’s psychological needs has to be planned in. This means getting home when possible, access to their families and significant others, the chance to have some space and autonomy, including green space and connecting with society outside the bubble. We have to build these in as well as the basics such as lower-risk activities whether it be golf, meeting friends, shopping or outdoor dining. There have to be ground rules to operate by, but with the long-term compliance and well-being aspect this is not possible with a rigid system. Instead, it must be one that allows responsible behaviour and can be flexible with risks assessed on the ground.

Having worked both in football (at Nottingham Forest) and in cricket, do you think cricketers are more adversely affected with mental health issues, and if so, what reason would you point to for that?

There is no doubt that cricket ticks many of the boxes that would provide stress and could challenge any underlying resilience or well-being issues. However, I don’t think cricketers’ mental health issues are any different or more widespread. They have been simply more widely publicised and there is greater transparency. There are plenty of well-being issues in football and often help is delayed or covert, as I know many footballers believe being tagged with a mental health issue will impact on their career and subsequent transfers.

Finally with the upcoming Ashes series – players have requested that families be allowed to accompany them. Is this something you’re trying to facilitate with the Australian government and Cricket Australia? Especially with the amount of time players are expected to be alone in bio-secure environments, and with the potential to impact their mental health, social and family interactions will be paramount for their mental well-being.

Yes, work is ongoing and the ECB at all levels is working closely with Cricket Australia and the Australian government to facilitate what we believe are the essential requirements to support their psychological well-being. This includes family, partners and significant others and is a critical part of the planning.

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