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Mental health and concussion protocols on IRPA agenda

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IRPA and James Mortimer     05 Dec 2012     Getty Images

At the outset IRPA representatives attended the World Federation of Player Associations summit in Nyon, Switzerland from the 13th - 17th November.

IRPA member Rugby Player Associations from around the globe then met over three days in Dublin to discuss international issues of importance to professional rugby players and the game.

The window concluded with IRPA’s attendance at the International Rugby Board (IRB) Medical Conference this last week.

All three forums were marked by meetings with the games key stakeholders. IRPA Chairman Damian Hopley commented that the conference window was always a significant time for IRPA.

“The window presents IRPA with valuable opportunities to obtain and share knowledge relating to the health of the professional player and to have representative input and dialogue into important international issues affecting professional players and the game” said Hopley.

“We were particularly encouraged by the on-going maturity and growth of the World Federation of Player Associations, and just how far our member Associations, driven by the players, have come since the 2011 Rugby World Cup.”

“We are also very encouraged by the IRB Medical Conference. It has developed significantly over recent years and now presents a fantastic platform for IRPA to be a part of raising and addressing key medical and player welfare issues within the game.”

Mental Health of the Professional Athlete – depression and feelings of
despair

One of the most significant issues within elite sport revolves round the mental health of the professional player. IRPA Executive Director Rob Nichol presented on the topic; mental health of the professional player and the hidden illness, depression, at the IRB Medical Conference.

“The game is doing so much around the physical health of the professional player, and we very much appreciate this. However it is our belief that the prevalence of depression and feelings of despair is significant amongst professional athletes and that the mental health of the professional rugby player both during and after his playing career is an area we need to put more resource and focus into.” said Nichol

“We challenged the conference to ensure that by the 2015 Rugby World Cup the game can put its hand up and say that more than any other sport we understand the issues associated with the mental health of the elite player and that we have the screening, education and support programs in place to help those who need it.”

“We felt the presentation was well received by what are a quality group of the medical practitioners and administrators operating throughout the rugby world. It is crucial we create an environment where players struggling to put their hand up, ask for help, so that professional people can help them.”

Concussion

Another significant topic in collision sports is that of concussion. IRPA has worked hard with the IRB and other stakeholders over recent years to revise the Return to Play Protocol and drive the new Pitch Side Concussion Assessment (PSCA) process.

“We are very supportive of the PSCA process.” said Nichol “For years we argued that a player who takes a knock to the head needed to be able to be removed from the field of play in order to be better assessed. It was put off on the basis that it could be used as a means of manipulating substitution rules.”

“We finally have a process under trial that provides what we believe to be a common sense approach to removing a player so that appropriate assessments can take place. So far we are impressed with how the trial is going but from a players perspective we want to emphasize three things.”

“The trial provides the opportunity to remove and replace the player for five minutes while an assessment is made. It is crucial that teams do not abuse  this right. If anyone seeks to manipulate this then they need to understand they have lost all perspective, and are potentially undermining a process designed to protect players, and potentially significant concussion and mental health complications.”

“While players undergo a PSCA during the five minutes, if at any time the player displays signs of concussion then we would ask the Doctors to act on  this.

The PSCA is not definitive, it is a screening tool that has been designed to exclude concussion. Diagnosis of concussion is made by a medical practitioner supported by other more extensive tools such as SCAT 2 and computer neuropsychological testing. We urge players to be honest and medical personnel to play it safe, play it conservative in exercising their diagnostic abilities”

“Finally we believe strongly that this process is only appropriate at the professional level of the game where appropriate medical personal are on hand. It is not suitable for the community game. The message at the community level is simple, any player suspected of concussion must be removed from the field of play and then seek medical advice – “if in doubt sit it out”

Integrity – Wagering

Another significant issue in sport is that of integrity and the threat posed by spot and match fixing, corruption and illegal wagering.

“This issue was discussed significantly at both the World Federation of Player Associations summit and the IRPA conference. Regulation is important and  the game is attempting to bring its wagering regulations up to speed. But education is the key and we are looking forward to working with the IRB
and expanding on some of the excellent education programs currently in place both within and outside of rugby.” said Nichol

Season Structure

The season structure associated with professional rugby, at both club and international level, still continues to be a concern for the players.

“We do get the sense that the professional game is too cluttered, and that over the years since professionalism the concept has been to add more to drive more value.” commented Nichol “But there comes a time when perhaps  less is more from a fan engagement and commercial perspective. We believe it is time the game provided a greater emphasis on quality as opposed to
quantity in its long term competition planning.”

“We have lobbied hard for a better alignment around the season structure, between the club and international game, between the northern and the southern hemispheres. While most are committed to competitions in their current form, the period post 2015 perhaps provides the opportunity for some fresh thinking and debate regarding this long standing issue.”

“The players need a decent period of time to rest and then undertake  pre-season conditioning between seasons. Many international players in particular struggle in this respect. We want to make sure that when they do play for either their club/province and their country they can perform to the
best of their ability. The current season structure means for most this is simply not possible. So players, coaches and teams are left to pick their moments, but even then many teams struggle” said Nichol.

“From a player welfare, spectator and commercial perspective we believe the game needs to revisit these issues, and that is something we are motivated to be a part of”

International player release

The issue of international player release, particularly for tier two and developing nations, remains one of the greatest challenges for the modern professional game.

“The current system does not work in the way that we all want it to” said Nichol “We feel for both the player, who does not want to jeopardise their career with their club but ideally wants to represent their country; the club, who simply wants to secure the best players they can and compete in what are competitive and financially demanding environments; and the country, who wants to pick the best available player , but at the same time not ruin their professional club career by creating issues that ultimately will cost the player.”

“We want international rugby to be the pinnacle of a players’ career, and to feature the best versus the best. Our view is that we need a new solution  and that the key stakeholders need to be involved in a process designed to develop that.”

“Many of the issues are commercial, and therefore will require a commercial solution. They also relate indirectly to the season structure and the dynamic  between the professional club game and the international game. Eventually we will need the IRB, National Unions, professional players and clubs at the table to solve the problem.”