The beautiful game has an ugly, dark side that lingers in the shadows. It’s called depression, and Clarke Carlisle has put it back in the spotlight.
This is not a new problem that threatens football. It’s something we’ve known about for years - and yet little from the outside looking in, little seems to have been done.
FIFPro, the international players’ union, conducted a study with current players and published their findings back in April 2014. The results were simply startling.
26% of players reported mental health problems, rising to 39% among retired players. That’s right, over one in four footballers suffer from depression, and it rises to over one in three after retirement.
"Contrary to popular belief, the life of a professional footballer has some dark sides,” Dr Vincent Gouttebarge noted at the time the study was published.
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"Former professional footballers report more mental health problems than current players, endorsing that the period just after retirement from professional football is a critical one for many players.”
Carlisle’s battle with depression dates back to his time as a young professional. In a 2013 documentary, he revealed that he had tried to take his own life with a drug overdose after suffering a knee injury. Rescued by his girlfriend, he didn’t speak about the incident again.
After losing his job as a pundit for ITV, which paid £100,000-a-year, Carlisle hit the gambling table and was charged for a drink driving offence on December 20th. Two days later, he suffered serious injuries after being hit by a lorry. After being discharged from hospital over a month later, he’s admitted it was another attempt to take his own life.
“This was my lowest point,” he said, according to BBC Sport.
The former Professional Footballers’ Association chairman is one of the lucky ones. He has survived, and has made his first steps on the road to recovery. That doesn't mean he's out of the woods though; far from it. Carlisle himself has done plenty to promote the dangers of depression and what it can do to people, and this subsequent incident shows just how tough a fight this really is.
Gary Speed's untimely passing in 2011 did the same, and whilst his death remained something of a mystery for some time afterwards, the former Newcastle United midfielder's sister finally spoke about his battle with depression two years later. The man who had overseen a renaissance in the Welsh national team was fighting a battle he couldn’t win on his own.
“He hid it from us, because people who are suffering from depression are not only fighting the illness but they are fighting the stigma that goes with it. It probably stopped him from asking for help from within his job,” sister Lesley told Carlisle in his BBC documentary titled 'Football’s Suicide Secret’.
The death of Speed, and before him Robert Enke in Germany, have helped highlight the issues of football and depression before. But is football repeating the same mistakes once again?
Enke: A life too short
Indeed, the death of goalkeeper Enke was painfully told by his close friend Robert Reng in the book, ‘A life too short’. Winner of the William Hill sports book of the year in 2011, it charted his early life, his impressive career, his family devotion and his battle with depression. The ultimate end was suicide, stepping out in front of a train. He was 32.
Both Speed and Enke feel like missed opportunities by the powers that be in football. The high-profile nature of both men meant it was a real opportunity to challenge the stigma Lesley Speed was talking about.
Instead, incidents have and will continue to occur. In Germany, former midfielder Andreas Biermann committed suicide last year. He was 33. Carlisle made his attempt two months ago. How many incidents have taken place behind closed doors - is this the tip of the iceberg?
When Speed passed away, the Professional Footballers' Association acted by sending a guidebook to players past and present, which included case studies involving Andy Cole, Paul Gascoigne and Neil Lennon. It was heralded as a ground-breaking initiative.
In the immediate aftermath of Carlisle’s suicide attempt, Gordon Taylor has since insisted that help is available to the players who want to take it.
"Mental welfare and depression is something we have been quite concerned about for a number of years now and have acted on it, along with many other sporting organisations," he told PA.
"This can be something that can affect all people in all walks of life but in sport as well. There have been a number of high-profile cases that everyone will be aware of.
Sporting chance clinic
"A booklet has gone out to all our members. We have a 24-hour helpline. We also have the Sporting Chance clinic that looks after players with such conditions and there are a number of mental health charities we support.”
However, voices have raised concerns over just how much the union are doing, with Niall Quinn questioning what sort of value a booklet really offers on such a serious issue back in 2011.
"Our union sent a book out to everybody last week. What's that about? I think they should do an awful lot more. They're a very wealthy organisation,” he said, according to the Daily Mail.
"Depression doesn't just kick in in the Premier League, it kicks in in the fourth tier, the third tier, the Championship. And it doesn't manifest itself the day somebody quits. It could be two years, three years, four years after. I think they should do an awful lot more than go on telly saying they sent books out.”
Leon McKenzie's fight
More recently, Leon McKenzie also questioned the merits of the work the PFA do to battle depression. The former Premier League striker was struggling with injuries and had gone through a divorce when he hit rock bottom at Charlton. His attempted suicide failed, and he’s now a professional boxer following in the footsteps of his father and uncle.
His second career has offered perspective on the past, and he spent time as an advisor for Elite Welfare Management - an initiative set up by Vincent Pericard to help footballers work towards ‘their second dream’.
Whilst a small few get their break in media - including Carlisle - thousands of others are out of a job in their mid-30s and considering what to do next. It can be a difficult time - sporting charity Xpro claimed in 2013 that as many as three in five Premier League footballers face bankruptcy within five years of retiring.
Then take into account the players in the lower leagues, earning a solid if unspectacular living but nothing in comparison to the glamour of the English top flight. In the eyes of McKenzie, the PFA don’t do enough to help those people.
“Once you retire from football the Professional Footballers’ Association cut you loose. That’s the sad thing," he told GiveMeSport Magazine last year.
There does appear to be a disconnect between the players’ union and the players themselves - particularly after they call time on their career. The PFA can’t be accused of doing nothing, but they can always do more. And they are not alone, as issues with England cricket players have shown in the past.
Jonathan Trott left an Ashes tour with a stress-related illness; he subsequently denied that it was depression. In 2006, Marcus Trescothick left an England tour citing personal reasons and a virus; it later emerged he was suffering from depression.
Cards on the table
Perhaps like no sportsman before him, Carlisle has put his cards on the table. He's raised his head above the parapet once again, and some have opted to take a swipe.
However, the majority have been positive as a story that's bigger than sport takes up pages of both the front and back of your national newspaper. He's pushed the subject to the masses.
It's a sad fact of life that such serious issues only ever come to the forefront of people's minds when something bad happens. Whilst it certainly isn't their lasting legacy, both Speed and Enke did the same thing with their untimely deaths.
Time for action
This time around, Carlisle's words must resonate and actions will speak louder than words. Football must do everything long-term to prevent another life being lost to this dreadful disease.